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.

摘要

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 A16, group B 12-16 and group C12 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%, p0.05 and vs. group B: 7.8+/-1.6%, p0.05), higher BMI (group C: 23.9+/-3.2 vs. group A: 21.8+/-3.1 kg/m(2), p0.05) and lower HDL-cholesterol level (group C: 1.8+/-0.5 vs. group A: 2.0+/-0.3 mmol/l, p0.05). 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, p0.05; and 12.6+/-2.9 vs. 14.1+/-3.5 scores, p0.05). 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.