The ADKnowl: identifying knowledge deficits in diabetes care

Diabet Med. 2001 Aug;18(8):626-33. doi: 10.1046/j.1464-5491.2001.00537.x.


Aims: To present the ADKnowl measure of diabetes-related knowledge and evaluate its use in identifying the nature and extent of patient and health professional knowledge deficits.

Method: The ADKnowl was used in a large-scale study of 789 patients (451 treated with insulin and 338 treated with tablets and/or diet) attending for annual review at one of two hospital out-patient diabetes clinics

Results: Knowledge deficits were apparent in the patients. For example, 57% did not recognize the inaccuracy of the statement 'fresh fruit can be eaten freely with little effect on blood glucose levels'. Seventy-five percent of patients did not know that it is advisable to trim toenails to the shape of the toe. Knowledge deficits were identified for many other areas of diabetes management, e.g. prevention of hypoglycaemia, avoidance of ketoacidosis. Sixteen health professionals at the clinics answered the same items. Contrary to recommendations, 25% of health professionals thought that fresh fruit could be eaten freely. Seventy-five percent of health professionals did not know the current recommendations for trimming toenails. As expected, HbA1c did correlate with scores from two specific items, while HbA1c did not correlate with summed ADKnowl score.

Conclusions: Patient knowledge deficits were identified. Some specific knowledge deficits among health professionals may be the cause of some patient knowledge deficits. The ADKnowl is a useful tool in assessing both patient and health professional knowledge deficits and is available for use in a context of continuing evaluation.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Mass Index
  • Diabetes Mellitus / rehabilitation*
  • Diabetes Mellitus, Type 1 / rehabilitation
  • Diabetes Mellitus, Type 2 / rehabilitation
  • Educational Measurement
  • Educational Status
  • Ethnicity
  • Female
  • Glycated Hemoglobin A / analysis
  • Health Knowledge, Attitudes, Practice*
  • Hospitals, General
  • Hospitals, Teaching
  • Humans
  • Male
  • Patient Education as Topic* / standards*
  • Surveys and Questionnaires


  • Glycated Hemoglobin A