The Association of Health Literacy with the Management of Type 2 Diabetes

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2017-12-01

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Kumar, Samita

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Introduction: Type 2 Diabetes (T2D) is a chronic metabolic disease characterized by high blood glucose levels in the blood. It is associated with microvascular and macrovascular complications which can lead to potential threats such as to amputations and even death. The irony of the disease is that these complications are preventable with appropriate treatment and self-management. The Emergency Medicine Department (ED) at University of Southwestern Medical center conducted this study to assess health literacy Parkland Memorial Hospital patients with T2D. The objective for the research study was to assess the for association of health literacy with management of T2D. Methods: This was a prospective study with collection of personal health information (PHI) and 30 day-follow up for ED recidivism. Eligibility was assessed by pre-screening via EPIC (Electronic Medical Record System for Parkland). The tool for measuring health literacy was the Short Assessment of Health Literacy (SAHL) and data was collected. Results: The total number of subjects enrolled was 23 with ages 18 or above male and females both with Spanish or English speaking only with T2D. Mean age of the subjects was ~50 years with standard deviation of 10 years, males were over half than women. About 74% were white hispanic males. According to the data collected, 30% of the patients demonstrated inadequate health literacy based on SAHL score survey. Since the study could not reach adequate power due to low enrollment, no significant associations could be made from this small sample size. Total number of subjects required to have adequate power was 400. Conclusions: Due to low enrollment period at this time the recommendation would be to continue collecting data to have a larger sample size to afford the observation of statistically relevant associations. If any, statistically significant associations are found, then future studies will focus on improving diabetes outcomes through the development of educational tools at the individual patient’s appropriate literacy level. There are many reasons to improve diabetes care and explore all possible factors that contribute to poor outcomes. Millions of people are living with uncontrolled diabetes and the burden is not only on the patient but also on the community as a whole. Quality care should aim for improved benchmarks for patients with diabetes and their knowledge about the disease, such as 1) obtaining HbA1c levels below 8%, 2) blood pressure in the normal range, 3) having regular foot exams to keep a check on any developing signs of pressure sores and 4) most importantly having dilated eye exam on a regular basis.

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