Patient Perceptions of Current Disease Control in Poorly Controlled Diabetes

Abstract

Background: Studies suggest that patients do not understand the hemoglobin A1c value (A1c). However, clinicians may communicate information about glycemic control in other ways. Given this, this study evaluates patients’ understanding of current diabetes control, independent of the A1c, and the factors affecting this understanding. Method: Cross-sectional survey of patients with poorly controlled diabetes seen in urban clinics in fall of 2010. Results: 177 people completed the survey. 73.5% were women, 83.0% were African-American and the average age was 56.5 years. 80.2% of respondents reported having had diabetes for at least five years. 39% reported past participation in a diabetes education course. Average A1c was 9.9(S.D. 1.7)%; no differences were noted based on income, education, disease duration, or complication history. 23.7% described their disease control as “good” or “excellent” in spite of an average A1c of 9.5% (1.2). Notably, most of this group reported diabetes for over five years and did not differ in history of diabetes-related complications or educational attainment compared to those with more accurate perceptions of control. Conclusion: The high proportion of participants who reported “good” or “excellent” control in spite of mean A1c greater than 9.5% raises serious questions about the effectiveness of current communication methods for patients with poorly controlled diabetes.