Factors determining the self‐management skills of diabetic patients

Competence in various aspects of diabetes self-care was assessed in 125 patients attending the diabetic clinic at Royal Prince Alfred Hospital, Camperdown, Australia. Fifty patients were referred for review because poor management skills were suspected. Their performance was compared with that of 75 patients randomly selected for assessment. Whilst there was no difference in performance between these 2 groups, a significant determinant of competence in diabetes self-care was fluency in English. Non-English speaking patients scored significantly less in all aspects tested, except management of hypoglycaemia. Prior attendance at a diabetes education programme predicted better performance, but this was largely accounted for by better fluency in English. Re-testing of deficit areas at 6 months showed significant improvements in performance. We conclude that all patients would benefit from the routine testing of diabetes management skills and such routine testing is needed to identify and rectify problem areas. Particular groups such as migrants require intensive efforts, so that their inadequate knowledge and skills can be identified.