Patients With T2D Often Lack Knowledge That Could Help Manage Disease


The implementation of targeted educational interventions might improve knowledge gaps, which pose great risk to patients, in type 2 diabetes (T2D) management.

Many patients with type 2 diabetes (T2D) lack knowledge about the management of their condition, according to findings published in Frontiers in Public Health.1

Patient with T2D self-monitoring glucose levels / AntonioDiaz -

Patient with T2D self-monitoring glucose levels / AntonioDiaz -

Maintaining adequate knowledge about T2D can be crucial for preventing complications associated with the disease, whereas a lack of awareness and misconceptions can act as barriers to its management. This is especially important considering the potential severity of these complications, such as lower limb amputation, cardiovascular diseases, and neuropathies, as well as the prevalence of T2D. The condition, which is largely self-managed, accounts for more than 90% of all diabetes cases.1

Key Takeaways

  • A lack of awareness and misconceptions about T2D can create roadblocks to managing the disease, but staying informed can reduce the risk of complications.
  • Three items showed concerningly low scores, with less than 15% of participants answering correctly. Notably, only 4.4% could identify signs of ketoacidosis, a serious complication of T2D.
  • In a patient-centered approach, health care professionals can work together with individuals to design personalized management plans that reflect their specific needs and knowledge about their condition.

In assessing the diabetes knowledge of a cohort of patients with T2D, investigators sought to identify major knowledge gaps among the population to prevent complications and improve patients’ quality of life. To account for the potential influence of sociodemographic characteristics, investigators also assessed how knowledge changed among patients based on sex, age, education, and living arrangements.

“Our main motivation was to contribute to the reduction of the existing disparity in the knowledge that diabetic patients have regarding their disease,” said Professor Pedro Lopes Ferreira, lead study author and director of the Center for Health Studies and Research of the University of Coimbra in a news release.2 “With this study we evidenced the need to improve the disease knowledge of type 2 diabetic patients.”

In their cross-sectional, observational study, investigators in Portugal recruited 1200 patients with T2D. Eligible participants were at least 18 years old, had a time diagnosis of at least 1 year, attended ambulatory visits from 1 of 5 chosen health settings, and committed to attending multidisciplinary visits for at least 3 months.

Nearly 40% (479) of participants were insulin-treated, while the rest (721) were non-insulin treated, on a special diet with/without oral antidiabetics. The mean age of participants was 65.6±11.4 years and almost half of participants were female.

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Participants used the self-administered Diabetes Knowledge Test to measure their own knowledge about diabetes. The test presented six dimensions, including food; ways to assess diabetes; effect of external variables on diabetes control; signs and symptoms; control over medication; and causes of glycemic deregulation.

Investigators found that higher knowledge was consistently observed among patients who were younger (P < .001), had higher education (P < .001), did not live alone (P < .001), or followed a diet, even if not constantly. The percentage of correct answers for insulin-treated versus non-insulin treated patients was 58.7% and 51.8%, respectively, demonstrating a small advantage to insulin-treated patients when it comes to diabetes knowledge (P < .05).

Although study results demonstrated that the majority of participants were knowledgeable about food-related questions, how to measure blood sugar levels, and the positive impact of physical activity,2 their knowledge fell short on other items.

Three items received a percentage of correct answers lower than 15%, including a question about identifying signs of ketoacidosis, a potentially life-threatening T2D complication, with only 4.4% of correct answers. On another item, less than 12% of participants answered correctly as to which food should not be used to treat low blood glucose, with 56.9% of participants incorrectly choosing skim milk as the answer. Further, only 13.3% of participants correctly identified among a list of choices (any unsweetened food; any diabetic food; any food that says “sugar free” on the label; any food that has less than 20 calories per serving) which 1 was considered a “free food” (any food that has less than 20 calories per serving).

The investigators proposed that a lack of targeted educational interventions might explain some of the knowledge gaps observed in the current study.

“One of the main reasons for this disparity in knowledge is probably the behavior of health professionals and the areas that are prioritized when informing patients,” said Lopes Ferreira.2

For better diabetes knowledge, health care professionals should prioritize patient education based on what patients identify as knowledge gaps rather than rely on preconceived notions of what’s important. By working alongside patients, health care professionals can design individualized plans that address each patient’s specific needs and understanding of their condition.

READ MORE: Diabetes Resource Center

1. Ferreira PL, Morais C, Pimenta R, et al. Knowledge about type 2 diabetes: its impact for future management. Front. Public Health. Published March 7, 2024.
2. Many type 2 diabetes patients lack potentially life-saving knowledge about their disease. News release. EurekAlert. March 8, 2024. Accessed March 12, 2024.
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