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Study Shows Disconnect Between Diabetes Knowledge and Action

Bruce Goldfarb

It's no secret that many patients don't follow through on diabetes care recommendations. Perhaps more surprising is the large gap between knowing what actions to take and actually carrying them out.

When asked, most people with type 2 diabetes say they know about such health-promoting steps as eating a healthful diet, maintaining adequate physical activity, and losing weight. But, for most of them, that knowledge doesn't translate into healthy behaviors, according to Debbra D. Bazata, RD, LD, MA, CDE, Diabetes Center coordinator at St. Luke's South Primary Care in Overland Park, Kan.

"We knew this anecdotally," says Bazata. "Diabetes educators knew this, but I don't think it's been published."

Bazata presented the results from the Study to Help Improve Early Evaluation and Management of Risk Factors Leading to Diabetes (SHIELD) at the annual meeting of the American Association of Diabetes Educators (AADE), held August 1–4 in St. Louis.

The five-year longitudinal study surveyed diabetes-related knowledge, behaviors, and attitudes among 3,867 people with type 2 diabetes >18 years of age.

Most study participants reported being well informed about their illness and receiving appropriate recommendations from their health care providers. More than half said they were told to change their diet, and 63% were advised to get more exercise; 87% agreed that obesity contributes to the onset of chronic health problems. Only 17% said they'd rather take medication than change their lifestyle.

Most participants also reported having healthy attitudes, with 78% reporting attempts to make healthful food choices.

But when it came to translating knowledge and attitudes into action, only 26% of participants reported that they exercised regularly, and only 21% said they had performed vigorous exercise in the previous week. Thirty-three percent said they followed a prescribed eating plan. While 70% of the participants reported trying to lose weight, only 34% maintained their desired weight.

"People are being told what to do—change diet, exercise more—and they have the right attitudes," says Bazata. "But only a small percentage of people are doing it."

DIGITAL VISION/PUNCHSTOCK

Bazata says diabetes health professionals need to "teach to those barriers," working with patients to find where problems exist and helping set up treatment goals.

"It takes time and relationshipbuilding, so you can get into their life and start to solve problems," she says.

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