Health literacy and blood glucose among Guyanese emergency department patients without diagnosed diabetes: a cross-sectional study

Diabetology & Metabolic Syndrome

Seth W Wright¹  Edmond K Kabagambe²  Rosalynne R Korman¹  Candace D McNaughton¹ 

[1] Vanderbilt University, 703 Oxford House, 1313 21st Avenue South, Nashville, TN, USA;Vanderbilt University, Suite 334J, 2525 West End Ave, Nashville, TN, USA

关键词: Glycated hemoglobin;    Emergency department;    Blood glucose;    Health literacy;   

Others  :  1174869
DOI  :  10.1186/s13098-015-0028-1

 received in 2014-11-29, accepted in 2015-03-26,  发布年份 2015

【 摘 要 】

Background

Low health literacy is associated with worse glycemic control among patients with diabetes; the relationship between health literacy and blood glucose among patients without diagnosed diabetes, particularly in resource-limited settings, is not known. Because emergency department patients are at risk for both low health literacy and undiagnosed diabetes, we examined their relationships among emergency department patients at the Georgetown Public Hospital Corporation in Guyana.

Methods

We conducted a cross-sectional study across random time blocks from May to August 2012 among Guyanese emergency department patients without a diagnosis of diabetes. Health literacy was assessed by the Single Item Literacy Screener (SILS, range 1-5); low health literacy was defined as SILS ≥ 3. We examined the relationships among health literacy, random blood glucose (RBG), and point-of-care glycated hemoglobin (HbA1c).

Results

Of the 228 enrolled patients, 125 (54%) were female, median age was 43 years (interquartile range 38 to 53), mean body mass index (BMI) was 25.6 kg/m² (standard deviation 6.8 kg/m²), and 103 (45.2%) had low health literacy. The receiver operating characteristic area under the curve for RBG to detect elevated HbA1c (≥48mmol/mol) was 0.94 (95% CI: 0.91-0.97). After adjustment for age, sex, BMI, ethnicity, and education, the odds of having HbA1c ≥ 48 mmol/mol, consistent with undiagnosed diabetes, rose with decreasing health literacy (OR 2.2, 95% CI 1.2-3.8, p = 0.007, per point decrease in literacy).

Conclusion

This pilot study of Guyanese emergency department patients without diagnosed diabetes found that low health literacy was common and was associated with higher HbA1c and random blood glucose.

【 授权许可】

   
2015 McNaughton et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

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