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  • Higher health literacy is associated with better glycemic control in adults with type 1 diabetes: a cohort study among 1399 Danes

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Clinical Care/Education/Nutrition
Higher health literacy is associated with better glycemic control in adults with type 1 diabetes: a cohort study among 1399 Danes
  1. Kasper Olesen1,
  2. Anne Louise F Reynheim1,2,
  3. Lene Joensen1,
  4. Martin Ridderstråle1,3,
  5. Lars Kayser2,
  6. Helle T Maindal1,4,
  7. Richard H Osborne2,5,
  8. Timothy Skinner1,6,
  9. Ingrid Willaing1
  1. 1 Steno Diabetes Center Copenhagen, Gentofte, Denmark
  2. 2 Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  3. 3 Novo Nordisk A/S, Søborg, Denmark
  4. 4 Department of Public Health, Section for Health Promotion and Health Services, Aarhus University, Aarhus, Denmark
  5. 5 Health Systems Improvement Unit, Deakin University Centre for Population Health Research, Geelong, Australia
  6. 6 Charles Darwin University, School of Psychological and Clinical Sciences, Darwin, Australia
  1. Correspondence to Kasper Olesen, Steno Diabetes Center Copenhagen, Niels Steensens Vej 6, 2820, Gentofte, Denmark ; kasper.olesen{at}regionh.dk

Abstract

Aim Self-management of diabetes is influenced by a range of factors including the ability to access, understand, appraise, and use of health information in everyday life, which can collectively be called health literacy. We investigated associations between nine domains of health literacy and HbA1c level in people with type 1 diabetes.

Methods A cross-sectional study was conducted with 1399 people with type 1 diabetes attending a Danish specialist diabetes clinic. Health literacy was assessed using the nine-domain Health Literacy Questionnaire. The association between health literacy and HbA1c was analyzed using linear regression with adjustment for age, sex, educational attainment and diabetes duration.

Results Of the 1399 participants, 50% were women, mean age was 54 years, and mean HbA1c was 61 mmol/mol (7.8%). Higher health literacy scores were associated with lower HbA1c levels across eight of nine health literacy domains. This association remained significant after adjusting for educational attainment. Among the domains, ‘Actively managing my health’ had the strongest impact on HbA1c. This was in turn predicted by ‘Appraising health information’, ‘Having sufficient information to manage health’, and ‘Social support for health’.

Conclusions Higher health literacy levels are associated with lower HbA1c regardless of educational background. This study highlights the importance of healthcare provision to respond to the health literacy levels of people with diabetes and to the possible need to provide program designed to enhance health literacy.

  • Hba1c
  • Health Literacy
  • Glycemic Control

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjdrc-2017-000437

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    Footnotes

    • Contributors Supervised by LJ and IW; ALFR prepared data and carried out preanalysis. All authors contributed to the design of the study. KO completed the analyses and drafted the manuscript. All authors contributed to the final version of the manuscript.

    • Competing interests None declared.

    • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

    • Ethics approval The Danish Data Protection Agency.

    • Provenance and peer review Not commissioned; externally peer reviewed.