Abstract
The purpose of this study is to explore functional health literacy (FHL) and numeracy skills in an insulin-treated, type 2 diabetes mellitus (T2DM) patient population, and their impact on diabetes self-care activities. A non-experimental, cross-sectional quantitative design was used for this study. The sample consisted of 102 T2DM patients on insulin therapy, including 42 males and 60 females, with a mean age of 64.75 years (SD = 9.180) and an average diabetes duration of 10.76 years (SD = 6.702). Independent variables were sociodemographic variables (e.g., age, educational level, etc.) and diabetes and health-related factors (e.g., duration of diabetes (years), the frequency of blood glucose testing/day, etc.). For this study, the participants completed the reading comprehension exercise from the Short Test of Functional Health Literacy (S-TOFHLA) and the Shortened Version of the Diabetes Numeracy Test (DNT-15), which specifically evaluates the numeracy skills of patients living with diabetes. The associations between the variables were examined with Spearman’s rank correlation. Multivariate regression analysis was performed to examine whether measured FHL skills impact diabetes self-care activities. We found that DNT-15 test (β = 0.174, t(96) = 2.412, p < 0.018) had significant effect on the frequency of blood glucose testing/day. Moreover, the problem areas for patients with T2DM mostly included multi-step calculations according to food label interpretations, and adequate insulin dosage based on current blood glucose levels and carbohydrate intake. The results of regression analyses and Spearman’s rank correlation indicated that limited FHL and diabetes numeracy skills not only influenced the participants’ behaviors related to self-management, but they also affected their health outcomes. Thus, besides the personalization of insulin treatment, it is indispensable to provide more precise information on different types of insulin administration and more refined educational materials based on medical nutrition therapy.
Highlights
According to the International Diabetes Federation (IDF), the number of people diagnosed with diabetes mellitus (DM) has more than tripled over the past 20 years
In Europe, it is estimated that among adults aged 20 to 79, there are 59.3 million people who are diagnosed with DM, with the majority affected by type 2 diabetes mellitus (T2DM) [2]
The purpose of this study is to explore functional health literacy (FHL) levels and numeracy skills in an insulintreated T2DM patient population are related to diabetes, and they impact on diabetes therapy
Summary
According to the International Diabetes Federation (IDF), the number of people diagnosed with diabetes mellitus (DM) has more than tripled over the past 20 years. In Europe, it is estimated that among adults aged 20 to 79, there are 59.3 million people who are diagnosed with DM, with the majority affected by type 2 diabetes mellitus (T2DM) [2]. T2DM negatively affects patients’ quality of life and life expectancy [3], and it often places serious economic burdens on society and its healthcare systems [4]. It is well-known that patients with T2DM are required to perform daily self-care tasks such as monitoring glucose levels, following a diet plan, remembering to take antidiabetic medications and insulin at the right time, preparing the correct dosage, and performing.
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