Researchers in Portugal asked 365 people with type 2 diabetes what they knew about managing their condition. They found that most people had only average knowledge about their disease, with major gaps in understanding diet, blood sugar numbers, recognizing symptoms, and taking insulin correctly. The study showed that younger people and those with more education tended to know more about diabetes. Surprisingly, people who had diabetes for many years weren’t necessarily better informed than newer patients. These findings suggest doctors and nurses need to teach patients more about specific topics like nutrition and medication to help them manage their diabetes better and avoid serious health problems.

The Quick Take

  • What they studied: How much people with type 2 diabetes understand about their disease and what factors help or hurt their knowledge
  • Who participated: 365 adults with type 2 diabetes visiting primary care clinics in Portugal between September 2022 and March 2023
  • Key finding: People not taking insulin scored an average of 7.29 out of a possible score, while those taking insulin scored 11.98. Both groups struggled most with understanding diet, reading blood sugar test results, recognizing low blood sugar symptoms, and using insulin correctly.
  • What it means for you: If you have type 2 diabetes, you may benefit from asking your doctor or nurse for more detailed education about diet, blood sugar numbers, and how your medications work. Younger people and those with higher education levels tend to understand diabetes better, suggesting that extra teaching support may help others catch up.

The Research Details

Researchers conducted a snapshot study between September 2022 and March 2023 in Portugal. They asked 365 people with type 2 diabetes to take a test called the Diabetes Knowledge Test (DKT), which measures how much someone understands about their disease. The test covered topics like diet, blood sugar control, recognizing symptoms, and taking medications. The researchers also collected information about each person’s age, education level, how long they’d had diabetes, and their current blood sugar control measured by a test called HbA1c.

This type of study is called a cross-sectional study, which means researchers looked at everyone at one point in time rather than following them over months or years. They used a convenience sample, meaning they enrolled people who were available at the clinics during the study period, rather than randomly selecting from all diabetes patients in Portugal.

Understanding what people with diabetes actually know about their disease is crucial for doctors and nurses to provide better education. By identifying specific areas where knowledge is weak—like diet and medication use—healthcare providers can create targeted teaching programs. This approach helps patients take better care of themselves, keep their blood sugar more stable, and avoid serious complications like heart disease and kidney damage.

This study provides useful real-world information from actual patients in primary care settings. However, because it used a convenience sample rather than randomly selecting participants, the results may not represent all Portuguese diabetes patients. The study was conducted at one point in time, so it shows what people knew then but doesn’t tell us whether their knowledge improved or got worse over time. The large sample size of 365 people makes the findings fairly reliable for the clinics studied.

What the Results Show

The study found that people with type 2 diabetes had only average knowledge about their disease. Those not taking insulin scored 7.29 points on the knowledge test, while those taking insulin scored 11.98 points. Both groups struggled significantly with the same topics: understanding what foods to eat, interpreting blood sugar test results (HbA1c values), recognizing symptoms of low blood sugar, and using insulin correctly.

The researchers discovered that certain groups of people tended to know more about diabetes. Younger people scored better than older people. People with higher education levels understood their disease better than those with less education. Interestingly, people whose blood sugar was better controlled (lower HbA1c levels) also tended to have better knowledge of diabetes.

One surprising finding was that simply having diabetes for many years didn’t mean someone understood it better. Some people who had lived with diabetes for a long time still had only average knowledge, while some newer patients knew more. This suggests that time alone doesn’t teach people about their disease—they need actual education from healthcare providers.

The study highlighted that diet and nutrition education was particularly weak across all groups. People struggled to understand which foods were healthy choices and how different foods affected their blood sugar. Another major gap was understanding HbA1c values—the blood test that shows average blood sugar control over three months. Many patients couldn’t explain what this number meant or why it mattered. Symptom recognition was also problematic, meaning people didn’t always know when their blood sugar was dangerously low or high. For those taking insulin, understanding how to use it correctly and when to adjust doses was a significant knowledge gap.

This research aligns with other studies showing that diabetes patients often lack sufficient knowledge about their disease. Previous research has also found that education level and age affect how well people understand and manage diabetes. The finding that better blood sugar control connects with better knowledge supports the idea that education helps people manage their disease more effectively. However, this study provides new insight by showing that simply living with diabetes for years doesn’t automatically improve knowledge, suggesting that passive experience isn’t enough—active education is necessary.

The study only looked at people in Portugal’s primary care system, so results may not apply to other countries with different healthcare systems or education approaches. The researchers used a convenience sample, meaning they enrolled people who happened to be at clinics during the study period rather than randomly selecting from all diabetes patients. This could mean the results don’t represent all Portuguese diabetes patients. The study was a snapshot in time, so we don’t know if people’s knowledge improved or got worse afterward. The study didn’t explore why people had gaps in knowledge or what teaching methods might work best to fill those gaps.

The Bottom Line

If you have type 2 diabetes, ask your healthcare team for detailed education about: (1) healthy eating and how different foods affect your blood sugar, (2) what your HbA1c number means and why it matters, (3) how to recognize symptoms of low blood sugar and what to do about it, and (4) if you take insulin, exactly how to use it and when to adjust your dose. These recommendations are supported by this research showing these are the areas where most patients lack knowledge. Confidence level: Moderate—this study identifies knowledge gaps, but more research is needed to test which teaching methods work best.

Anyone with type 2 diabetes should pay attention to this research, especially older adults and those with less formal education, since the study found these groups tend to have lower diabetes knowledge. Healthcare providers, nurses, and diabetes educators should use these findings to create better teaching programs focused on diet, blood sugar numbers, symptom recognition, and medication use. People newly diagnosed with diabetes should not assume they’ll naturally learn what they need to know over time—they should actively seek education from the start.

Improving your diabetes knowledge can start immediately by asking your doctor or nurse questions. You may notice better blood sugar control within weeks to months as you apply what you learn about diet and medication. However, developing strong diabetes management habits typically takes several months of consistent practice and learning.

Want to Apply This Research?

  • Track your diabetes knowledge by recording weekly: (1) one new thing you learned about diet and blood sugar, (2) your HbA1c target and current level, (3) symptoms of low blood sugar you can recognize, and (4) your insulin dose or medication schedule if applicable. Rate your confidence in each area on a scale of 1-10.
  • Use the app to set weekly learning goals: Monday—learn about one healthy food choice, Wednesday—understand one aspect of your blood sugar numbers, Friday—practice recognizing one symptom of low blood sugar. Schedule reminders to review these topics and discuss them with your healthcare provider at your next visit.
  • Every month, retake a simple diabetes knowledge quiz in the app covering diet, blood sugar numbers, symptoms, and medications. Track your scores over time to see improvement. Share your progress with your doctor to identify remaining knowledge gaps that need more education.

This research describes what knowledge gaps exist among people with type 2 diabetes but does not provide medical advice. If you have type 2 diabetes, consult with your doctor, nurse, or certified diabetes educator before making any changes to your diet, medications, or diabetes management plan. The findings apply to the Portuguese primary care setting and may not apply to all healthcare systems or populations. This study is observational and cannot prove that better knowledge directly causes better blood sugar control—only that they are associated. Always work with your healthcare team to develop a personalized diabetes management plan based on your individual health needs.