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

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 A > 16, group B 12-16 and group C < 12 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%, p < 0.05 and vs. group B: 7.8 ± 1.6%, p < 0.05), higher BMI (group C: 23.9 ± 3.2 vs. group A: 21.8 ± 3.1 kg/m2, p < 0.05) and lower HDL-cholesterol level (group C: 1.8 ± 0.5 vs. group A: 2.0 ± 0.3 mmol/l, p < 0.05). 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, p < 0.05; and 12.6 ± 2.9 vs. 14.1 ± 3.5 scores, p < 0.05). 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.