Document Type


Publication Date



DOI: 10.17925/EE.2019.15.1.1; PMCID: PMC6587900


Purpose: The purpose of this study was to develop a measure of type 1 diabetes mellitus (T1DM) knowledge that is aimed at youth and is based on contemporary management standards. Methods: An 88-item test was derived from the American Association of Diabetes Educators 7 Self-Care Behaviors. Results: A multidisciplinary team selected the best 49 items which were piloted in a sample of 119 youths (59 males, aged 12-18, having a mean ± standard deviation glycated haemoglobin (A1C) of 9.9%±1.80 (84.7±19.7 mmol/mol). A minimum absolute point-biserial correlation coefficient of 0.250 was used to choose 49 items from the original 88 questions. Categorical principal component analysis was then used to identify the best factor analytical model that consisted of five factors composed of 19 items. These five factors explained 57% of item variances. Factors were associated with the latent variables: advanced problem-solving, hypoglycaemia prevention and management, taking insulin/medication administration, daily management and healthy active living. Conclusion: A new T1D knowledge test for youth was refined from 88 to 49 questions based on expert opinion and empirical test construction. The instrument was then refined to 19 items based on exploratory factor analysis. Future goals are to validate this factor model with another cohort and confirm concurrent validity based on youth's glycated haemoglobin and adherence behaviours. Our new T1DM knowledge measure initially appears valid and promising as a new clinical and research tool.

Journal Title

Eur Endocrinol





First Page


Last Page



Type 1 diabetes mellitus; exploratory factor analysis; paediatric


Grant support

Support: Financial support for this project was provided by The Cross Foundation and The Children’s Mercy Hospitals and Clinics Division of Endocrinology.

This article is published under the Creative Commons
Attribution Noncommercial License, which permits any non-commercial
use, distribution, adaptation and reproduction provided the original author(s)
and source are given appropriate credit.

Publisher's Online Access: