title: [The degree of health knowledge in children with type 1 diabetes affects the metabolic control only in patients with an optimum or suboptimum level of HbA1c].
abstract: BACKGROUND
  The aim of care in type 1 diabetes (T1D) is to achieve a good metabolic control decreasing the risk of acute and chronic complications. An important element of therapy is health education.
  
  
  OBJECTIVE
  The aim of the study was to analyze the influence of the level of health knowledge on metabolic control and occurrence of acute complications in T1D children.
  
  
  METHODS
  The study involved 100 T1D patients aged 12-18 years. The own test was used to check the level of diabetes knowledge and skills of patients were evaluated on the basis of practical tasks. Metabolic control assessment was based on HbA1c, frequency of acute complications and the incidence and causes of hospitalization in the year preceding the study.
  
  
  RESULTS
  Patients responded correctly to 66% of the questions. The mean level of HbA1c was 8.13-1.75%. Severe hypoglycemia occurred in 12 children, diabetic ketoacidosis in 7, 30 patients were hospitalized. There was no significant relationship between the level of patients´ knowledge and HbA1c (p = 0.625). After excluding patients with poorly controlled diabetes (HbA1c -9.0%), the relationship between level of health knowledge and HbA1c was found (r= -0.26, p=0.022). There was no difference in level of knowledge in patients with and without acute complications, and among patients who were and were not hospitalized. Among patients with HbA1c <9.0 the better level of knowledge was observed in not hospitalized patients compared with those requiring hospitalization (23.3-4.9 vs. 20.0-4.2, p=0.038).
  
  
  CONCLUSIONS
  The level of health knowledge had an influence on metabolic control only in children with good or satisfactory HbA1c. Additional operation should be targeted to patients with unsatisfactory metabolic control.
authors.forename: Beata
authors.initials: B
authors.lastname: Brosowska
authors.forename: Milena
authors.initials: M
authors.lastname: Brzozowska
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Szadkowska
mesh_terms: D000293:Adolescent; D015190:Blood Glucose Self-Monitoring; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D008297:Male; D010353:Patient Education as Topic / Q000379:methods*
chemical_list: D007004:Hypoglycemic Agents