[Health Literacy and Metabolic Control in Individuals Diagnosed with Type 2 Diabetes Mellitus: A Cluster Randomized Clinical Trial]

Abstract

People with type 2 diabetes mellitus (DM2) experience difficulties in self-management. One of the variables involved is the low level of health literacy (HL) which corresponds to the degree to which people access, understand, evaluate and use information to engage with health demands in different contexts, in order to promote and maintain good health.

Hypothesis: People diagnosed with diabetes mellitus who participate in an intervention to increase their level of health literacy improve their metabolic compensation measured in HBA1c.

Aim: To evaluate the effect of an HL intervention program on metabolic control and self-efficacy of people with DM2, who are treated in primary care centers (CESFAM) in a commune in Santiago, Chile.

Methods: A randomized controlled clinical trial in a cluster, in 4 CESFAM, 2 intervention group (IG) and 2 control group (CG). In addition to the usual intervention, the CESFAM-GI received face-to-face and telephone follow-up counseling, group sessions, and audiovisual support material for a period of 6 months. Pre- and post-intervention measurements were taken.

Results: No differences were observed in the HbA1C values of the GI between baseline and final measurements; however, in the CG it increased by 1 point between both measurements, showing a deterioration compared to the IG. Attendance at the workshops in the IG is positively associated with the achievement of LS level. The results indicate that the intervention was more effective -than the usual intervention- in preventing the deterioration of HbA1C.

Conclusions: An intervention that considers LS adapted to the Latin American sociocultural context with a combination of group and individual strategies can generate a difference in HBA1c.