Deterioration of diabetic patients' knowledge and management skills as determined during outpatient visits.

A checklist of 22 items that diabetic persons need to perform correctly in order to carry out adequate home management was analyzed for 30 patients in an outpatient clinic. Both a recording of correct performance (baseline assessment) and a reassessment 3--17 mo later were obtained for each item included in the study. An 8 1/2% error rate occurred on reassessment. Approximately one-third of the patients had an error rate of 10% or more. No significant relationship was found between the percentage of error and age, interval between assessments, years of diabetes, or past performance on the checklist. Nor did a majority of the errors occur on items that showed an error immediately before the correct baseline assessment. This error rate is less than in reports not including a correct baseline performance. However, it is high enough to indicate that reassessment is needed more frequently than is generally done.