Association of Health Literacy and Nutritional Status Assessment with Glycemic Control in Adults with Type 2 Diabetes Mellitus

Abstract

While the role of medical and nutrition factors on glycemic control among adults with type 2 diabetes mellitus (T2DM) has been well-established, the association between health literacy (H.L.) and glycemic control is inconsistent. This study aims to determine the association of H.L. and nutritional status assessments with glycemic control in adults with type 2 diabetes mellitus. A total of 280 T2DM respondents (mean (SD) age = 49.7 (10.3) years, Glycated hemoglobin (HbA1c) = 9.9 (2.6) %, and Body Mass Index = 32.7 (15.1) kg/m2) were included in this study. A short-form Test of Functional Health Literacy in Adults (S-TOFHLA) assessed the H.L. levels. Nutritional status assessments included client history, glycemic control, anthropometric, and biochemical data. The mean (S.D.) H.L. score was 45.7 (24.6), with 56% of the respondents had inadequate H.L. Inadequate H.L. was more common among those females; housewives, low education, received oral antidiabetic therapy, and shorter diabetes duration. Respondents with inadequate H.L. were significantly older and had higher HbA1c than those with marginal and adequate H.L. Meanwhile, respondents with inadequate and marginal H.L. levels had significantly higher total cholesterol, LDL-cholesterol, and systolic blood pressure than the respondents with adequate H.L. Low H.L. scores, self-employment status, received dual antidiabetic therapy (insulin with oral agents), received insulin alone, and had higher fasting blood glucose explained about 21% of the total variation in HbA1c (adjusted R2 = 0.21; p < 0.001). Respondents with inadequate H.L. had poor glycemic control. The H.L. scores, together with nutritional status assessments, were the factors that predicted poor glycemic control among adults with T2DM.

Building a House of Skills—A Study of Functional Health Literacy and Numeracy among Patients with Type 2 Diabetes in Hungary

“…This finding is in line with the study by Papp-Zipernovszky et al (2016), which was the first research in Hungary that compared the scores of individuals with chronic illness to those of a healthy population and found that chronic patients had significantly lower FHL levels. Related studies by Agad Hashim et al (2020), Abdullah et al (2019) and Van der Heide et al (2014) also support the aforementioned result in which the presence of type 2 diabetes is in association with the individuals' FHL levels [35,58,59]. In addition, the results of the present study are consistent with the data of Cavanaugh et al (2011), in which lower FHL levels among diabetes patients were between 15 and 40%, depending on the sample.…”

The role of behavioral characteristics in disease-management of insulin-treated type 2 diabetes mellitus patients

“…This finding is in line with the study by , which was the first research in Hungary that compared the scores of individuals with chronic illness to those of a healthy population and found that chronic patients had significantly lower FHL levels. Related studies by Agad Hashim et al (2020), and also support the aforementioned result in which the presence of type 2 diabetes is in association with the individuals' FHL levels [35,58,59]. In addition, the results of the present study are consistent with the data of , in which lower FHL levels among diabetes patients were between 15 and 40%, depending on the sample.…”

Diyabetli Bireylerde Beslenme Okuryazarlığının Yaşam Kalitesi ve Metabolik Kontrol Üzerine Etkisi

“…Similarly, in a study examining the effect of health literacy and nutritional status on the glycemic values of individuals with diabetes, it was found that there was a negative correlation between glycemic values and BMI and the level of nutritional knowledge. 30 In this study, it was observed that inadequate/limited nutritional literacy negatively affected the metabolic control values and quality of life. Accordingly, a range of educational policies should be developed to increase the nutritional literacy levels of individuals with diabetes.…”