title: Baseline diabetic knowledge after 5-day teaching program is an independent predictor of subclinical macroangiopathy in patients with type 1 diabetes (Poznan Prospective Study).
abstract: OBJECTIVE
  The cardiovascular diseases (CVD) are the leading cause of mortality in type 1 diabetes (DM1). Carotid intima-media thickness (IMT) has been approved as a marker of subclinical atherosclerosis. The aim of this prospective study was to evaluate the relationship between baseline diabetic knowledge after five-day teaching program and IMT in patients with (DM1) treated with intensive functional insulin therapy (IFIT) from the onset of the disease.
  
  
  METHODS
  The analysis included 79 subjects aged 23.4 ± 5.1 years with newly diagnosed DM1, participating in Poznan Prospective Study (PoProStu). The patients attended a five-day structured training program in IFIT at diagnosis, followed by a test consisting of 20 questions. After follow-up period of 11 years we evaluated the presence of microangiopathy and subclinical macroangiopathy. IMT of the right common carotid artery was determined using high resolution ultrasonography and calculated automatically with the Carotid Analyzer for Research program.
  
  
  RESULTS
  After 11-year follow-up median intima-media thickness was 560 (IQR: 520-630) μm. We found a negative correlation between diabetes knowledge at baseline and IMT at the end of follow-up (r=-0.27, p=0.017). In multivariate linear regression model baseline diabetic knowledge test result was associated with IMT at follow-up, independently from sex, age, smoking status, presence of hypertension and diabetic kidney disease (all at follow-up) and from mean follow-up LDL-cholesterol concentrations and HbA1c results (β=-8, 95% CI -16, -1, p=0.037).
  
  
  CONCLUSIONS
  Baseline diabetic knowledge after 5-day teaching program is an independent predictor of subclinical macroangiopathy in patients with DM1.
authors.affiliation: Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland. Electronic address: olaaraszkiewicz@interia.pl.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Araszkiewicz
authors.affiliation: Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Zozulinska-Ziolkiewicz
authors.affiliation: Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Stanislaw
authors.initials: S
authors.lastname: Pilacinski
authors.affiliation: Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Naskret
authors.affiliation: Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Uruska
authors.affiliation: Department of Internal Medicine and Diabetology, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Bogna
authors.initials: B
authors.lastname: Wierusz-Wysocka
mesh_terms: D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000188:drug therapy* / Q000628:therapy; D003925:Diabetic Angiopathies / Q000503:physiopathology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D010353:Patient Education as Topic; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000503:physiopathology / Q000517:prevention & control*; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Education; Intensive functional insulin therapy; Intima-media thickness; Macroangiopathy; Type 1 diabetes