Health literacy, diabetes self-care, and glycemic control in adults with type 2 diabetes. Diabetes Technol Ther 2010 Nov;12(11):913-9
Date
10/01/2010Pubmed ID
20879964Pubmed Central ID
PMC3000637DOI
10.1089/dia.2010.0058Scopus ID
2-s2.0-78649384087 (requires institutional sign-in at Scopus site) 110 CitationsAbstract
BACKGROUND: Although limited health literacy is a barrier to disease management and has been associated with poor glycemic control, the mechanisms underlying the relationships between health literacy and diabetes outcomes are unknown. We examined the relationships between health literacy, determinants of diabetes self-care, and glycemic control in adults with type 2 diabetes.
METHODS: Patients with diabetes were recruited from an outpatient primary care clinic. We collected information on demographics, health literacy, diabetes knowledge, diabetes fatalism, social support, and diabetes self-care, and hemoglobin A1c values were extracted from the medical record. Structural equation models tested the predicted pathways linking health literacy to diabetes self-care and glycemic control.
RESULTS: No direct relationship was observed between health literacy and diabetes self-care or glycemic control. Health literacy had a direct effect on social support (r = -0.20, P < 0.05) and through social support had an indirect effect on diabetes self-care (r = -0.07) and on glycemic control (r = -0.01). More diabetes knowledge (r = 0.22, P < 0.05), less fatalism (r = -0.22, P < 0.05), and more social support (r = 0.27, P < 0.01) were independent, direct predictors of diabetes self-care and through self-care were related to glycemic control (r = -0.20, P < 0.05).
CONCLUSIONS: Our findings suggest health literacy has an indirect effect on diabetes self-care and glycemic control through its association with social support. This suggests that for patients with limited health literacy, enhancing social support would facilitate diabetes self-care and improved glycemic control.
Author List
Osborn CY, Bains SS, Egede LEAuthor
Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Attitude
Blood Glucose
Diabetes Complications
Diabetes Mellitus, Type 2
Female
Health Knowledge, Attitudes, Practice
Health Literacy
Humans
Male
Middle Aged
Motivation
Self Care
Social Environment
Social Support
Young Adult
