Endocrine Abstracts

Aim: NICE guidelines states that every diabetes patient should have sufficient knowledge of HbA1c to allow them to be actively involved in their diabetes management. Our study aimed to investigate this in an outpatient setting in a multi-ethnic UK hospital clinic.

Method: We interviewed 97 patients using an out-patient questionnaire and also gathered demographic information and latest HbA1c values from electronic data and medical records.

Results: Only 38% (95% CI=28.6–48.6) of our study population sample (n=97) reported familiarity with HbA1c (47 females and 29% males, P=0.072).Those with type 1 diabetes were more likely than type 2 to recognise the term HbA1c (77% compared to 32%, P=0.002). Those with higher educational attainment (P=0.002), and from more skilled occupations (NS-SEC), P=0.004, were significantly more likely to have heard of HbA1c. Patients self-reporting Asian ethnicity were the least likely to have heard of HbA1c (19% Asians compared to 49% Caucasian, 42% Afro-Caribbean and, 67% ‘Others’ P=0.037).

There was no significant relationship between the patients’ most recent HbA1c value across a range of recorded variables: age (P=0.0114), gender (P=0.159), diabetes type(P=0.725), ethnicity (P=0.292), employment classification (P=0.564), time since diagnosis (P=0.201), and education level (P=0.232). HbA1c value did not differ significantly according to knowledge of HbA1c (P=0.092) either.

Conclusion: Basic knowledge of HbA1c amongst our clinic population is significantly limited. Unlike other studies (USA and Scandinavia), our results do not show that greater patient knowledge of HbA1c necessarily translates into improved glycaemic control. Better understanding of their own HbA1c and thereby long-term diabetes control, is fundamental to self empowerment of diabetes patients. We need to emphasise more on practical aspects of patient education including use of materials and resources in a variety of languages if we are to alter long term outcomes in our diabetes population.