Diabetes knowledge and its association with glycemic control in childhood-onset type 1 diabetes

Type 1 diabetes (T1D) requires lifelong insulin therapy and structured diabetes education. We examined the association between diabetes knowledge and glycemic control in Korean patients with childhood-onset T1D.

This single-center retrospective study included patients (aged 9-23 years) diagnosed with T1D before the age of 18 and followed at our pediatric endocrinology clinic. Patients and caregivers completed a structured 45-item diabetes knowledge questionnaire covering 10 domains. A weighted mean knowledge score was calculated based on patient and caregiver contribution rates. Participants were categorized by hemoglobin A1c (HbA1c) into tight, optimal, and suboptimal control groups. Group differences were compared. Multinomial logistic regression analysis was used to assess associations between domain-specific knowledge and glycemic control.

Sixty-one patients were included (median age, 15.9 years; median HbA1c, 6.6%). Mean diabetes knowledge score (2.79±0.53) did not differ significantly between groups. Significant differences were limited to the insulin delivery, hypoglycemia management, and stress management domains. Higher knowledge scores for insulin delivery were independently associated with tight glycemic control (adjusted odds ratio [aOR], 4.18; 95% confidence interval [CI], 1.00-17.45). Hypoglycemia management knowledge showed a higher association with optimal glycemic control (aOR, 21.98; 95% CI, 1.68-287.72).

In patients with childhood-onset T1D, glycemic control was more closely related to knowledge domains supporting real-life application than to overall knowledge. Higher insulin delivery knowledge was associated with tight glycemic control, whereas higher hypoglycemia management knowledge was associated with optimal as compared with suboptimal control. These associations suggest a potential role for practice-oriented education in diabetes care.