Health literacy level has no impact on frequency of blood-glucose monitoring for inner-city patients with diabetes
Research Activities, August 2010, No. 360
Self-monitoring of blood-glucose levels is critical for diabetics to control their disease effectively. Individuals who have high health literacy levels often do better when it comes to managing their diabetes. But, what about those with low levels of health literacy? Can they be expected to successfully monitor their blood-glucose levels? According to findings from a recent study, the answer is yes.
Researchers enrolled 189 patients with diabetes who were between the ages of 18 and 65. All were receiving care from a large, hospital-based diabetes subspecialty clinic. Each participant received a 1-hour in-person interview during which they were asked questions about rating their overall health, chronic conditions, use of health care services, and health behaviors. They were also given a short version of the Test of Functional Health Literacy in Adults. Most participants were black, female, with low incomes and a high-school education or less. The researchers found no significant differences in blood-sugar monitoring rates according to health literacy level. More than 90 percent of those studied reported testing their blood sugar at least once a day; 75.6 percent did this twice a day or more. Overall, 22.9 percent of those studied had inadequate health literacy (unable to read and interpret health texts); another 16.2 percent had marginal literacy (difficulty reading and interpreting health texts).
Interestingly, patients with inadequate health literacy will monitor their blood sugar as often as literate patients, but are less likely to record the results in their diary. Factors associated with inadequate health literacy levels included being older, having less education, not having insurance, and dealing with diabetes for a long time. In fact, patients who had diabetes for 10 years or longer were significantly less likely to perform self-monitoring of blood-glucose levels. The study was supported in part by the Agency for Healthcare Research and Quality (HS10875 and HS11617).
See "The impact of health literacy on self-monitoring of blood glucose in patients with diabetes receiving care in an inner-city hospital," by Nkechi Mbaezue, M.D., M.S., Robert Mayberry, M.P.H., Ph.D., Julie Gazmararian, Ph.D., and others in the January 2010 Journal of the National Medical Association 102(1), pp. 5-9.