Association between Health Literacy and Glycemic Control of Patients with Type 2 Diabetes Mellitus

Abstract

The present study aimed to investigate the association between health literacy and glycemic control. This study used a cross-sectional analytical study design, and consisted of a questionnaire that was administered to 544 patients with type 2 diabetes mellitus (T2DM) who were followed at three public hospitals under the Ministry of Public Health, Phetchabun province. Information about patients’ glycemic control was collected via medical records.  Stratified two-stage cluster sampling was employed in this study. Multiple binary logistic regression was used to investigate the association between health literacy and glycemic control. The majority of participants were female (72.6%), and the mean age was 55.6 years. More than 60% of participants had primary school level education and were married (75.6%). The majority of participants (87.7%) were covered by universal health insurance schemes, and the mean duration of diabetes was 7.5 years. The majority of participants (66.9%) had a high level of health literacy, and glycemic control (Hemoglobin A1c [HbA1c] <7%) was present in 27.0%. After adjusting for duration of diabetes, hypertension, and type of medication, we found that a high level of health literacy (adjusted odds ratio [AOR] = 1.6; 95% confidence interval [CI] = 1.1–2.6; p=.042), duration of diabetes ≥5 years (AOR = 0.5; 95% CI = 0.3–0.8) and duration of diabetes ≥10 years (AOR = 0.5; 95% CI = 0.3–0.8) were also strongly associated with glycemic control. This study demonstrates that a high level of health literacy and duration of diabetes are associated with glycemic control. Therefore, healthcare personnel should be evaluated to screen patients with low levels of health literacy. Channels for accessing health information and various programs for patients with diabetes (≥5 years) who have low levels of health literacy are needed, to improve their health literacy levels.