Diabetes education and knowledge in patients with type 2 diabetes from the community The Fremantle Diabetes Study

Background: Diabetic patients obtain knowledge of the condition from a variety of sources. These include education programs and encounters with health-care staff such as during instruction on self-monitoring of blood glucose (SMBG). Objective: To assess whether diabetes knowledge is related to prior attendance at diabetes education programs, visits to dieticians or the current use of SMBG in a community-based cohort of subjects with type 2 diabetes. Patients: 1264 type 2 patients from the Fremantle Diabetes Study (FDS) cohort. Methods: Subjects answered 15 standard multiple-choice questions about diabetes and its management. Recall of past diabetes education, dietician consultations, and use of SMBG were recorded. Analysis of variance was used to determine whether these activities or other social and demographic factors predicted diabetes knowledge. Results: Attendance at education programs, visits to dieticians, and SMBG were independently associated with greater diabetes knowledge. Subjects who were older, whose schooling was limited, who were not fluent in English and/or who were from Southern European or indigenous Australian ethnic groups had significantly lower knowledge scores. Patients who were older, not fluent in English or from an indigenous Australian background were significantly less likely to have received diabetes education, dietetic advice or to be performing SMBG. Conclusions: Diabetes education programs, diabetes-related visits to dieticians and SMBG are associated with, and may be important sources of, improved diabetes knowledge in patients with type 2 diabetes. Our data provide evidence that barriers to access or utilization of contemporary diabetes education confront older patients, minority groups and those with language difficulties. These groups are likely to benefit from specialized programs. (C) 2003 Elsevier Science Inc. All rights reserved.