Abstract
BackgroundThe primary objective of our study was to determine which factors influence health literacy (HL) in patients with type 1 diabetes (T1D) and type 2 diabetes (T2D), and the secondary one was to evaluate the influence of HL on glycemic control.MethodsThis was an observational, cross-sectional study with 347 patients (144 with T1D and 203 with T2D), conducted between December 2014/December 2017. Data were obtained from medical records and/or questionnaire. The short test of Functional Health Literacy (S-TOFHLA) was used to evaluate HL.ResultsAge and years of school attendance were the most important variables associated with better performance in S-TOFHLA mainly in patients with T1D. A correlation between age and years of school attendance with S-TOFHLA score was observed in both groups of patients. After an unadjusted analysis, more patients with T1D presented adequate HL [119 (82.6%) vs 87 (44.8%, p < 0.001)]. Patients with T1D had higher scores than patients with T2D (84.4 ± 21.4 vs 61.6 ± 26.8 points, p < 0.001), respectively. This difference did not persist after adjustment for age and years of school attendance (73.04 ± 2.14 ± vs 70.04 ± 1.76 points) respectively, p = 0.348). No difference was found in HbA1c levels according to S-TOFHLA. All patients with T1D and HbA1c levels < 7.0% (53 mmol/mol) had adequate HL.ConclusionsA considerable number of patients with either T1D or T2D did not have adequate HL. Overall, age and years of school attendance were the most important variables associated with better performance of S-TOFHLA. Although no difference was found in HbA1c levels according to S-TOFHLA, patients with T1D who self-reported as White, with more years of school attendance, and higher HL score reached more frequently a good glycemic control. Finally, in addition to therapeutic regimens, approaches on diabetes management should also include patients’ HL evaluation along with psychological and social aspects.
Highlights
The primary objective of our study was to determine which factors influence health literacy (HL) in patients with type 1 diabetes (T1D) and type 2 diabetes (T2D), and the secondary one was to evaluate the influence of HL on glycemic control
Ever since the results of the UKPDS [6] and the Diabetes Control and Complications Trial (DCCT) and Epidemiology of Diabetes Interventions and Complications (EDIC) studies were brought up to light, showing that good glycemic control reduces the risk of diabetesrelated chronic complications [7], different intensive therapies were proposed for both groups of patients [8, 9]
5 (3.7%) and 4 (2.0%) patients with T1D and T2D, presented capillary glycemia (CG) < 100 mg/dl, respectively, but no one presented symptoms of hypoglycemia. These patients were re-tested for CG, and when the results were over 100 mg/dl, they were evaluated
Summary
The primary objective of our study was to determine which factors influence health literacy (HL) in patients with type 1 diabetes (T1D) and type 2 diabetes (T2D), and the secondary one was to evaluate the influence of HL on glycemic control. Ever since the results of the UKPDS [6] and the Diabetes Control and Complications Trial (DCCT) and Epidemiology of Diabetes Interventions and Complications (EDIC) studies were brought up to light, showing that good glycemic control reduces the risk of diabetesrelated chronic complications [7], different intensive therapies were proposed for both groups of patients [8, 9]. Considering patients with T2D, the Discover study, an observational worldwide survey, showed that the majority of the patients were out of good glycemic control targets [13]. In previous Brazilian studies, only 13.2% of patients with T1D [14] and less than 50% of patients with T2D presented HbA1c at goal [15]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
