453-P: Diabetes Knowledge Test Score Predicts HbA1c Levels after Discharge in Inpatients with Type 2 Diabetes
Authors: OKUBO KAZUYA , MINAMI TAICHI , KAMEDA AKIKO , YAMADA TAKU , HIIRAGI HIROKO , YOSHIDA FUMINA , TAKAHASHI MAYUKO , SUZUKI YOICHI , TERAUCHI YASUO 
Published: June 2021

Introduction: Many cross-sectional studies have reported that higher diabetes knowledge test (DKT) scores were associated with better glycemic controls in outpatients with type 2 diabetes. We investigated whether inpatients with high DKT scores could achieve better glycemic control after discharge.
Method: This multicenter longitudinal study included 37 inpatients with type 2 diabetes, who had poor glycemic control from October 2018 to November 2019 in Japan. The exclusion criteria were history of stroke, dementia, and psychiatric conditions. The baseline characteristics were HbA1c level, 10.5%±2.5%; median age, 70 y (58-76); median (first to third quartile); diabetes duration, 6 y (1-20); and fasting plasma C-peptide level, 1.4 ng/ml (0.9-2.0 ng/ml). The patients underwent the original DKT at discharge, consisting of 14 items (full score, 14 points). The Cronbach’s α was 0.71. The questions included Q6 “When is a good time to improve the postprandial blood glucose level if you exercise?”, Q11 “How many calories are in 100 g steamed white rice?”, and Q12 “Which beverage is inappropriate during hyperglycemia?” We investigated whether DKT score and baseline characteristics correlated with the HbA1c level at 48 weeks after discharge.
Result: The HbA1c level at 48 weeks after discharge was 7.2% (6.3%-7.6%); ΔHbA1c, −2.6 (−4.6 to −1.2); and total DKT score, 10 (6-11). The total DKT score was negatively associated with the HbA1c level at 48 weeks after discharge (Spearman r: −0.26) and ΔHbA1c (r: −0.30). The subjects with shorter diabetes durations and higher ΔCPR showed improved HbA1c levels. The patients who correctly answered Q6, Q11, and Q12 dependently got better HbA1c levels at 48 weeks after discharge compared with those with incorrect answers(p&lt;0.05).
Conclusion: The better total DKT score improved HbA1c levels in patients with type 2 diabetes at 48 weeks after discharge. Knowledge of calorie intake and best exercise timing may contribute to better glycemic control.

Disclosure
K. Okubo: None. T. Minami: None. A. Kameda: None. T. Yamada: None. H. Hiiragi: None. F. Yoshida: None. M. Takahashi: None. Y. Suzuki: None. Y. Terauchi: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo, Eli Lilly Japan K. K., Novo Nordisk, Sanofi, Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo, Eli Lilly Japan K. K., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novartis Pharmaceuticals Corporation, Novo Nordisk, Ono Pharmaceutical Co., Ltd., Sanofi, Sumitomo Dainippon Pharma Co., Ltd., Takeda Pharmaceutical Company Limited, Speaker’s Bureau; Self; Abbott, Astellas Pharma Inc., AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo, Eli Lilly Japan K. K., Merck Sharp & Dohme Corp., Mitsubishi Tanabe Pharma Corporation, Novartis Pharmaceuticals Corporation, Novo Nordisk, Ono Pharmaceutical Co., Ltd., Sanofi, Sanwa Kagaku Kenkyusho, Sumitomo Dainippon Pharma Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited.