Abstract
Aim: Our aim was to assess the independent association between blood glucose level and health literacy (HL) adjusting for many socio-demographic characteristics and body mass index (BMI) in an adult population in Albania, a transitional country in the South Eastern Europe.Methods: A cross-sectional study was carried out in Tirana in 2012–2014 including a population-based sample of 1,154 individuals aged ≥18 years (57% women; mean age: 45.5 ± 16.4 years; response rate: 88.6%). HL was assessed by use of HLS-EU-Q instrument. Blood glucose level was measured in a fasting state by use of rapid finger stick method. Information on socio-demographic characteristics was collected, and BMI was calculated based on measurement of height and weight in all participants. General Linear Model (GLM) and binary logistic regression were used to assess the independent association of blood glucose level and HL adjusting for all socio-demographic factors and BMI.Results: One-third of participants had pre-diabetes (100–125.9 mg/dl) and further 11% had diabetes (≥126 mg/dl) based on the measured blood glucose level. In fully-adjusted GLM, mean blood glucose level was significantly lower among individuals with excellent HL compared with their counterparts with inadequate HL (99.3 vs. 106.0, respectively). Furthermore, the odds for the presence of diabetes in the group of study participants whose HL was “inadequate” were 2.6 times higher (95% CI = 1.3–5.4) compared to those whose HL was “excellent.”Conclusion: We obtained evidence of a strong and significant inverse relationship between measured blood glucose level and HL, independent of many socio-demographic characteristics and measured BMI in a population-based study in a country of the Western Balkans.
Highlights
Health status is largely influenced by health behavior through complex processes involving multichannel multi-layer interactions between individual socio-demographic factors and numerous external factors, influenced and modeled by cognitive skills and internal motivation and attitude toward certain behaviors [1, 2]
Continuous professional and/or regular selfmonitoring of glucose levels is critical for successful diabetes management [9, 10] and it is becoming increasingly relevant for the monitoring and prevention of diabetes among healthy and asymptomatic prediabetic population as well, based on recent developments predicting the expansion of use of glucose monitors across all population groups [11]
In fully-adjusted models controlling for all socio-demographic factors and body mass index (BMI), the difference between the two Health literacy (HL) groups persisted, with mean glucose levels being significantly lower among participants with excellent HL levels compared with those with inadequate HL levels (99 vs. 106 mg/dl)
Summary
Health status is largely influenced by health behavior through complex processes involving multichannel multi-layer interactions between individual socio-demographic factors and numerous external factors, influenced and modeled by cognitive skills and internal motivation and attitude toward certain behaviors [1, 2]. Health literacy (HL), the ability to access, understand, appraise and Health Literacy and Glucose Level apply health information in order to make appropriate health decisions [3], is often considered as a mediator in the processes leading to specific health behaviors and to health status [2, 4]. Maintaining the levels of blood glucose within normal range is important to health. As the levels of blood glucose fluctuate greatly during everyday life activities [5], health behavior becomes sensibly relevant for the prevention of diabetes in the general population [6] and especially important in the management of diabetes in terms of diet, physical activity, monitoring blood glucose levels, medication taking, promptly spotting the signs and symptoms of hypoglycemia and hyperglycemia and reducing glucose imbalance risks in general [7, 8]. The agestandardized burden of NCDs (DALYs per 100,000 population) in Albania in 2017 was lower than in most of the former Yugoslavian Republics, excluding Slovenia [14]
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