Factors associated with change in diabetes knowledge from childhood to adolescence.

Background: A multicentric cohort of 142 children with insulin-dependent diabetes has been longitudinally studied to evaluate if their diabetes knowledge was modified by time and to assess the factors associated to this change. Methods: A knowledge scale, previously translated and validated in French (TDK), was independently completed by the children and their parents at inclusion (TO) and 4 years later (T4). Results: Mean age of the children was 10.2 years at TO. Mean knowledge score of the parents did not differ between TO and T4 but mean score of the children was significantly higher at T4 than at TO (22.2 +/- 5.7 vs 26.9 +/- 3.8, p < 0.001), Age-adjusted knowledge score of children at T4 was significantly correlated to compliance to treatment (r = 0.23, p < 0.01). The factors associated with knowledge score of the children at T4 were: age at T4 (r = 0.49, p < 0.001), knowledge score of children at T0 (r = 0.59, p < 0.001), school results of the children (r = 0.18, p = 0.04), educational level of the mother (r = 0.21, p = 0.01), family income (r = 0.19, p = 0.03), knowledge score of parents at TO (r = 0.16, p = 0,09), number of diabetes summer camp periods (r = 0.19, p = 0.03). Multivariate analysis showed that these 7 factors accounted for 59% of the variance in predicting knowledge score of the children at T4 (p < 0.001). After adjustment, age at T4, knowledge score of the children at TO and educational level of the mother stayed significantly associated with the knowledge score at T4. Conclusion: These results emphasise the importance of diabetes education programs specifically developed for children with the aim of improving diabetes knowledge at adolescence.