Does knowledge on diabetes management influence glycemic control? A nationwide study in patients with type 1 diabetes in Brazil

Abstract

ObjectiveThe purpose of this study is to establish demographic and clinical data associated with the knowledge on diabetes management and its influence on glycemic control in patients with type 1 diabetes.MethodsThis was a retrospective, observational, multicenter study conducted with 1,760 patients between August 2011 and August 2014 in 10 cities of Brazil.ResultsOverall, 1,190 (67.6%) patients knew what glycated hemoglobin (HbA1c) means. These patients were older, had longer disease duration, longer follow-up in each center, reported lower frequency of self-reported hypoglycemia, and were more frequently Caucasians and at glycemic goal. Multivariate analysis showed that knowledge on what HbA1c means was related to more years of school attendance, self-reported ethnicity (Caucasians), severe hypoglycemia, economic status, follow-up time in each center, and participation on diabetes educational programs. Good glycemic control was related to older age, more years of school attendance, higher frequency of daily self-monitoring of blood glucose, higher adherence to diet, and knowledge on what HbA1c means.ConclusionPatients with a knowledge on what HbA1c means had a better chance of reaching an adequate glycemic control that was not found in the majority of our patients. Diabetes care teams should rethink the approaches to patients and change them to more proactive schedules, reinforcing education, patients’ skills, and empowerment to have positive attitudes toward reaching and maintaining a better glycemic control. Finally, the glucocentric approach to diabetes management should be changed to actions that include patients’ psychosocial aspects aiming to reduce the stress of living with diabetes, improving glycemic control, and avoiding adverse outcomes.

The Role of Health Literacy in Diabetes Knowledge, Self-Care, and Glycemic Control: a Meta-analysis

“…This is an important finding as research has previously shown that diabetes knowledge is related with successful self-management and health outcomes. 91,92 On the contrary, we found that health literacy had a positive impact on self-care activities only for studies that assessed literacy with perception-based measures. The same result was found in subgroup analyses for two specific self-care activities: exercise and food care, but not for diet and blood monitoring.…”

Self-Care Practices of Preparatory School Students with Type 1 Diabetes Mellitus in ELBehira Governorate

“…Identical findings were portrayed by two novel studies. First, Gomes M et al (2018) [37] revealed that self-management of T1DM among young people was associated with higher age, more years of school attendance, lower reported rates of hypoglycemia and better glycemic control. Second, Ryan M (2014) [38] found that age was significantly correlated with diabetes self-care practices score.…”

“…Concurred findings were shown by four recent studies. First, Gomes M et al (2018) [37] portrayed that DM related knowledge was associated with lower rates of severe hypoglycemia, more years of school attendance and economic status. Second, Moskovitz A et al (2018) [45] revealed that better knowledge score of the studied diabetic adolescents was significantly associated with longer duration of contracting the disease.…”

Costs of Continuous Subcutaneous Insulin Infusion and Multiple-Dose Insulin Therapies for Type 1 Diabetes Mellitus: A Review of Health Economics Studies

“…The most frequent degenerative complications are acute myocardial infarction, peripheral arteriopathy, stroke, and microangiopathy (AMÉRICO and ROCHA, 2020;CORTEZ et al, 2015). However, it is well established that these complications of T1DM can be avoided when glycemic control is adequate (GOMES et al 2018).…”