Abstract
Introduction: Low health literacy (HL) is one of the contributing factors that leads to negative diabetic outcome. Quality of life (QOL) is a state of complete physical, mental and social wellbeing. There is limited evidence on association of HL and QOL among type 2 diabetes mellitus (T2DM), therefore the objectives of this study were to identify the HL and QOL status, to determine the association between HL and QOL and factors associated with QOL among T2DM patients. Methods: This was a cross sectional study involving patients with T2DM from two public primary care clinics. HL and QOL were measured using translated and validatedHLS – Asia Q16 and DQoL-BCI questionnaires respectively among T2DM patients. Results: The mean HL score was 12.39 (3.34), 17.7 % had “inadequate HL”, 25.7% had “problematic HL” and 56.6% had “sufficient HL”. The mean DQoL-BCI score was 32.09 (6.51). Lower QOL level was negatively associated with age (b -0.140; CI: -0.190, - 0.090; p<0.001), not obese (b -1.476; CI: -2.605, - 0.347; p<0.011), and HL level (b -0.425; CI: -0.59, - 0.259; p<0.001). Lower QOL level was positively associated with uncontrolled glycaemic status (HbA1c >6.5%)(b 1.308; CI: -0.042, 2.659; p<0.058), treatment with insulin (b 4.163; CI:1.538, 6.788; p<0.002) and combination treatment of insulin and oral hypoglycaemic agents (OHA) (b 2.450; CI:1.145, 3.756; p<0.001). Conclusions: This study demonstrated that age, body mass index, HL, glycaemic control, treatment with OHA and insulin were significantly associated with QOL. This suggest the importance of identifying high risk patients with poor QOL for targeted intervention.
Highlights
Low health literacy (HL) is one of the contributing factors that leads to negative diabetic outcome
This study demonstrated that age, body mass index, HL, glycaemic control, treatment with oral hypoglycaemic agents (OHA) and insulin were significantly associated with Quality of life (QOL)
The analysis showed that older age, not obese, and higher HL scores were significantly associated with higher QOL, while having uncontrolled glycaemic status, using insulin and using combination of insulin and oral with lower QOL
Summary
Low health literacy (HL) is one of the contributing factors that leads to negative diabetic outcome. HL and QOL were measured using translated and validated HLS – Asia Q16 and DQoL-BCI questionnaires respectively among T2DM patients. Conclusions: This study demonstrated that age, body mass index, HL, glycaemic control, treatment with OHA and insulin were significantly associated with QOL. This suggest the importance of identifying high risk patients with poor QOL for targeted intervention. There are 425 million people with T2DM in 2016 [1] It is growing most rapidly in low- and middle-income countries. Eighty percent of DM patients are in low and middle income countries and out of that, more than sixty percent live in Asia including Malaysia [2]. Based on The National Health and Morbidity Survey of Malaysia (NHMS), the overall prevalence of diabetes was 17.5% in 2015 and it is expected that in 2020, the estimated prevalence is 21.6% [3]
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