Impact of health literacy on diabetes outcomes: a cross-sectional study from Lahore, Pakistan

Saeed, Hamid; Saleem, Zikria; Naeem, Raeece; Shahzadi, Iram; Islam, Muhammad

doi:10.1016/j.puhe.2017.12.005

Cited by 60 publications

(59 citation statements)

References 24 publications

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“…These conflicting results could be related to differences in educational level, age and socioeconomic status of the patients included in the studies as well as to different criteria used to define HL. In the present study, although we did not observe a correlation between HL and HbA1c, all the patients with HbA1c < 7.0% (53 mmol/mol) were literate, similarly to the findings from Pakistan [28]. Similar to our data concerning patients with T1D, a study that evaluated HL in children with T1D and their mothers did not find a correlation between HbA1c and HL of the children, but this was found regarding mothers' HL [34].…”

Section: Discussionsupporting

confidence: 83%

“…Few studies have been conducted exclusively with T1D or their caregivers [28,30,34,38]. In our study, the prevalence of inadequate HL was 18% and it was lower than that reported in Pakistan, which was 67.2% [28] and United Kingdom (UK), which was 75% [30]. These conflicting results could be related to differences in educational level, age and socioeconomic status of the patients included in the studies as well as to different criteria used to define HL.…”

Section: Discussioncontrasting

confidence: 67%

“…In a recent review, the relationship between HL and diabetes included many aspects that are important for the management of the disease such as listening and speaking, writing and reading, and also the ability to understand and use numbers [25,26]. Although all the above mentioned skills could be indirectly related to glycemic control as well as to the evolution of diabetesrelated chronic complications, the results of some studies are still controversial because the best tool to evaluate HL, as well as the need to perform it in routine clinical care, are still undefined [26][27][28][29][30][31][32][33][34][35][36][37][38].…”

Section: Introductionmentioning

confidence: 99%

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Health literacy and glycemic control in patients with diabetes: a tertiary care center study in Brazil

Gomes

Muniz

Melo

et al. 2020

Diabetol Metab Syndr

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Background: 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. Methods: This 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. Results: Age 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. Conclusions: A 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.

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Section: Discussionsupporting

confidence: 83%

Section: Discussioncontrasting

confidence: 67%

Section: Introductionmentioning

confidence: 99%

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Health literacy and glycemic control in patients with diabetes: a tertiary care center study in Brazil

Gomes

Muniz

Melo

et al. 2020

Diabetol Metab Syndr

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“…As a result of time constraints experienced by providers, patients are often provided with written educational materials without associated interaction, explanation, and encouragement, which have limited effects. Studies have shown that inadequate health literacy can be associated with poor glycemic control, highlighting the need to go beyond written educational material [ 33 – 35 ]. A national literacy assessment in the USA in 2003 concluded that only 12% of the population had proficient health literacy and 35% had a basic or below basic level of health literacy [ 36 ].…”

Section: Patient Barriersmentioning

confidence: 99%

Addressing Clinical Inertia in Type 2 Diabetes Mellitus: A Review

Okemah¹,

Peng

Quiñones³

2018

Adv Ther

142

137

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The current epidemic of type 2 diabetes (T2D) represents a significant global and national health concern. Globally, the prevalence of diabetes has doubled between 1980 and 2014. In 2014 the World Health Organization estimated that there were 422 million adults living with diabetes worldwide. In the USA, the number of people diagnosed with T2D is estimated to increase to over 70 million by 2050, putting an immense strain on the US healthcare system. Achieving glycemic control is widely acknowledged as the key goal of treatment in T2D and is critical for reducing the onset and progression of diabetes-related complications such as cardiovascular diseases, neuropathies, retinopathies, and nephropathies. Despite the increase in the availability of antihyperglycemic medications and evidence-based treatment guidelines, the proportion of people with T2D who fail to achieve glycemic goals continues to rise. One major contributor is a delay in treatment intensification despite suboptimal glycemic control, referred to as clinical or therapeutic inertia. Clinical inertia prolongs the duration of patients’ hyperglycemia which subsequently puts them at increased risk of diabetes-associated complications and reduced life expectancy. Clinical inertia results from a complex interaction between patient, healthcare providers, and healthcare system barriers that need to be addressed together, rather than as separate entities. In this article we provide an overview of clinical inertia in the clinical management of T2D and provide suggestions for overcoming aspects that may have a negative impact on patient care.Funding: Sanofi US, Inc.

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“…Recently, it has been reported that health literacy and SOC influence the pathophysiology of chronic diseases [ 42 , 44 ]. Patients with type 2 diabetes who have poor glycemic control have been shown to have poor health literacy [ 45 ]. Since SOC is indirectly involved in the glycemic control of patients with type 2 diabetes, it is necessary to increase SOC to improve glycemic control in such patients [ 46 , 47 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of Periodontal Disease on Diabetic Retinopathy in Type 2 Diabetic Patients: A Cross-Sectional Pilot Study

Yamamoto

Morozumi

Hirata

et al. 2020

JCM

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Both periodontal disease and diabetes are common chronic inflammatory diseases. One of the major problems with type 2 diabetes is that unregulated blood glucose levels damage the vascular endothelium and cause complications. A bidirectional relationship between periodontal disease and diabetic complications has been reported previously. However, whether periodontal disease affects the presence of diabetic complications has not been clarified. Therefore, we examined the effect of the periodontal disease status on diabetic complications in patients with type 2 diabetes. Periodontal doctors examined the periodontal disease status of 104 type 2 diabetic patients who visited a private diabetes medical clinic once a month between 2016 and 2018. The subject’s diabetic status was obtained from their medical records. Bayesian network analysis showed that bleeding on probing directly influenced the presence of diabetic retinopathy in type 2 diabetes patients. In addition, bleeding on probing was higher in the diabetic retinopathy group (n = 36) than in the group without diabetic retinopathy (n = 68, p = 0.006, Welch’s t-test). Bleeding on probing represents gingival inflammation, which might affect the presence of diabetic retinopathy in type 2 diabetes patients who regularly visit diabetic clinics.

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Impact of health literacy on diabetes outcomes: a cross-sectional study from Lahore, Pakistan

Cited by 60 publications

References 24 publications

Health literacy and glycemic control in patients with diabetes: a tertiary care center study in Brazil

Health literacy and glycemic control in patients with diabetes: a tertiary care center study in Brazil

Addressing Clinical Inertia in Type 2 Diabetes Mellitus: A Review

Effect of Periodontal Disease on Diabetic Retinopathy in Type 2 Diabetic Patients: A Cross-Sectional Pilot Study

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