Diabetes Knowledge and Its Relationship With Achieving Treatment Recommendations in a National Sample of People With Type 2 Diabetes
- Sarah Stark Casagrande, PHD1⇓,
- Nilka Ríos Burrows, MPH2,
- Linda S. Geiss, MA2,
- Kathleen E. Bainbridge, PHD3,
- Judith E. Fradkin, MD4 and
- Catherine C. Cowie, PHD4
- 1Social and Scientific Systems, Silver Spring, Maryland
- 2Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
- 3Division of Scientific Programs, National Institute on Deafness and Other Communication Disorders, Bethesda, Maryland
- 4Division of Diabetes, Endocrinology and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland
- Corresponding author: Sarah Stark Casagrande, .
OBJECTIVE We examined the prevalence of knowledge of A1C, blood pressure, and LDL cholesterol (ABC) levels and goals among people with diabetes, its variation by patient characteristics, and whether knowledge was associated with achieving levels of ABC control recommended for the general diabetic population.
RESEARCH DESIGN AND METHODS Data came from 1,233 adults who self-reported diabetes in the 2005–2008 National Health and Nutrition Examination Survey. Participants reported their last ABC level and goals specified by their physician (not validated by medical record data). Analysis included descriptive statistics and logistic regression.
RESULTS Among participants tested in the past year, 48% stated their last A1C level. Overall, 63% stated their last blood pressure level and 22% stated their last LDL cholesterol level. Knowledge of ABC levels was greatest in non-Hispanic whites, lowest in Mexican Americans, and higher with more education and income (all P ≤ 0.02). Demographic associations were similar for those reporting physician-specified ABC goals at the American Diabetes Association–recommended levels (A1C <7%, blood pressure <130/80 mmHg, and LDL cholesterol <100 mg/dL). Nineteen percent of participants stated that their provider did not specify an A1C goal compared with 47% and 41% for blood pressure and LDL cholesterol goals, respectively. For people who self-reported A1C <7.0%, 83% had an actual A1C <7.0%. Otherwise, participant knowledge was not significantly associated with risk factor control, except for in those who knew their last LDL cholesterol level (P = 0.046 for A1C <7.0%). Results from logistic regression corroborated these findings.
CONCLUSIONS Ample opportunity exists to improve ABC knowledge. Diabetes education should include behavior change components in addition to information on ABC clinical measures.
- Received October 10, 2011.
- Accepted February 22, 2012.
- © 2012 by the American Diabetes Association.
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.