Metabolism is the set of life-sustaining chemical
transformations within the cells of living organisms. These
enzyme-catalyzed reactions allow organisms to grow and reproduce,
maintain their structures, and respond to their environments. The knowledge of metabolism has helped medicine develop the fight against diabetes. Evaluation of diabetes education programs (DEPs) has provided minimal
empirical support for a relationship between improved knowledge and
better metabolic control. We hypothesized that improved knowledge in
specific areas is predictive of changes in specific measures of diabetes
control. Patients (n = 558) attending one of five DEPs completed a
diabetes knowledge questionnaire at baseline and post-DEP. Glycosylated
hemoglobin (GHb) was measured at baseline and at 3 months follow-up.
Total diabetes knowledge (DKN) scores increased significantly by 18%,
but improvement was uncorrelated with changes in GHb (r = 0.03).
Improvement in nine specific content areas failed to predict changes in
GHb (all P greater than 0.05) and improvement in knowledge of the causes
of hypoglycemia did not predict changes in frequency of hypoglycemia
(chi 2 = 1.54; P greater than 0.05). We conclude that neither global nor
specific knowledge improvement predicts metabolic control in diabetes
and suggest that evaluation of diabetes education should focus more
intensively on behavioral and attitudinal outcomes.
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