Knowledge after five-day teaching program in intensive insulin therapy performed at the onset of type 1 diabetes influence the development of late diabetic complications

Abstract 

We evaluated the influence of baseline diabetic knowledge on clinical course of type 1 diabetes treated with intensive functional insulin therapy (IFIT) from the onset of the disease. 86 subjects with newly diagnosed type 1 diabetes, aged 23.4±5.1 attended a five-day structured training program in IFIT at baseline, followed by a test consisting of 20 questions. Patients were divided into subgroups according to test results: group A>16, group B 12–16 and group C<12 scores. At follow-up (7.1±1.5 years) metabolic control and development of microangiopathy were assessed. Patients with low knowledge at baseline had higher HbA1c levels than subjects with higher knowledge (group C: 9.2±1.9 vs. group A: 7.7±1.5%, p<0.05 and vs. group B: 7.8±1.6%, p<0.05), higher BMI (group C: 23.9±3.2 vs. group A: 21.8±3.1kg/m², p<0.05) and lower HDL-cholesterol level (group C: 1.8±0.5 vs. group A: 2.0±0.3mmol/l, p<0.05). Patients with retinopathy and albuminuria at follow-up had lower level of diabetic knowledge at baseline (respectively: 12.5±3.6 vs. 14.2±3.3 scores, p<0.05; and 12.6±2.9 vs. 14.1±3.5 scores, p<0.05). The development of microangiopathy was associated with lower diabetic knowledge (RR=3.71; 95%CI: 1.15–12.01, p=0.02 for retinopathy and RR=4.33; 95%CI: 0.98–19.10, p=0.04 for microalbuminuria). The higher diabetic knowledge at baseline the better metabolic control and lower risk of microangiopathy in the future.

Keywords: Intensive functional insulin therapy, Education, Type 1 diabetes, Retinopathy, Albuminuria