Level of Health Literacy Among Type 2 Diabetic Persons and its Relation to Glycemic Control

Health literacy is the degree to which an individual can obtain, process, understand and communicate about health related information to make informed health decisions. Our aim was to study the influence of Diabetic health literacy in affecting the glycemic control in Diabetic patients.

This is a Cross sectional Analytical study in 200 diabetic patients. Diabetic Knowledge Test developed by Michigan Diabetic Research and Training Center was modified after appropriate permission and was used to measure health literacy. HbA1C was used as a measure of glycemic control.

In the study population, Median HbA1C was 9 gm% with Interquartile Range (IQR) of 6.10-11.80 in low health literacy group, 7.80 with an IQR of 5.95-9.32 in marginal health literacy group and 6.20 with an IQR of 5.38-7.90 in adequate health literacy group (P Value <0.001). After adjusting for socio demographic characteristics, Linear regression analysis showed that HbA1C decreased by 0.385 for every one point increase in Questionnaire score [Std.error 0.60, 95% C.I. "-0.502 to -0.267, P Value <0.001]. The Odds of achieving adequate glycemic control was 0.309 in marginal health literacy group and 0.205 in low health literacy group. (95% C.I=0.092-0.455). On applying Pearson's correlation between answer score and HbA1C,we got correlation coefficient "r"=-0.417 indicating a strong negative correlation. We also found that patients with low health literacy had higher chances of developing hospitalizations (P=0.027), Neuropathy (P =0.001) and retinopathy (P=0.049).

This study shows that inadequate health literacy is an independent predictor of glycemic control and complications. Development of strategies to communicate more effectively with patients who have poor health literacy are needed at the patient clinician level and the patient system level and should be based on a deeper understanding of the needs and competencies of patients with poor health literacy.