Health Literacy on Type 2 Diabetes Mellitus Among Patients at Primary Health Care: A Cross-Sectional Study
DOI:
https://doi.org/10.22437/e-sehad.v6i1.42762Keywords:
Type 2 Diabetes Mellitus, Health Literacy, Primary Health Care, Cross-Sectional StudyAbstract
ABSTRACTBackground: Health literacy plays a pivotal role in the effective management of Type 2 Diabetes Mellitus (T2DM), influencing patients' ability to understand health information, adhere to treatment, and adopt healthy lifestyles. Limited health literacy has been associated with poor glycemic control, increased risk of complications, and higher healthcare utilization. This study aimed to assess health literacy among patients with T2DM and identify sociodemographic factors associated with health literacy in a primary health care setting in Jambi, Indonesia.
Method: A cross-sectional study was conducted among 170 patients with T2DM attending Puskesmas Putri Ayu, Jambi, Indonesia, between January and March 2025. Participants were recruited using consecutive sampling. Data were collected through interviewer-administered structured questionnaires assessing sociodemographic characteristics and diabetes-related health literacy. Health literacy was categorized as poor, moderate, or good based on the total questionnaire score. Descriptive statistics, Chi-square tests, and multivariable logistic regression were used to analyze the data..
Result: Among the 170 participants, 61.8% were female and 35.3% were aged 51–60 years. Most respondents had completed secondary education (58.8%). Poor health literacy was identified in 57.6% of participants, while 30.6% demonstrated moderate health literacy and only 11.8% had good health literacy. Educational attainment, age, employment status, and family history of diabetes were significantly associated with health literacy (p < 0.05). Higher educational attainment was the strongest predictor of adequate health literacy..
Conclusion: Most patients with T2DM attending primary health care demonstrated inadequate health literacy. Strengthening patient-centered educational interventions tailored to patients' educational backgrounds and individual needs is essential to improve diabetes self-management and support better health outcomes.
References
1. Chen P, Callisaya ML, Wills K, Greenaway TM, Winzenberg T. Cognition, Educational Attainment and Diabetes Distress Predict Poor Health Literacy in Diabetes: A Cross-Sectional Analysis of the SHELLED Study. PLoS One. 2022;17(4):e0267265. https://doi.org/10.1371/journal.pone.0267265
2. American Diabetes Association ADA. Summary of revisions: Standards of Care in Diabetes—2024. Diabetes Care. 2024;47(Supplement_1):S5–10. https://doi.org/https://doi.org/10.2337/dc24-SREV
3. Dalela S, Ahmed M. Systematic Review of Invention Education Research Landscape: State of the Discipline and Future Directions. Front Educ (Lausanne). 2024;9. https://doi.org/10.3389/feduc.2024.1284442
4. Lešinskis K, Mavļutova I, Spilbergs A, Hermanis J. Digital Transformation in Entrepreneurship Education: The Use of a Digital Tool KABADA and Entrepreneurial Intention of Generation Z. Sustainability. 2023;15(13):10135. https://doi.org/10.3390/su151310135
5. Hou Z, He N. Governance and Management of Public Health Programmes. 2021;391–408. https://doi.org/10.1093/med/9780198816805.003.0051
6. D’Souza N, Scahill S. The Need to Integrate in Primary Healthcare: Nurse Identity Constructions of Pharmacists as Entrepreneurs. J Health Organ Manag. 2020; https://doi.org/10.1108/jhom-01-2020-0009
7. Zechariah S, Ansa BE, Johnson S, Gates AM, Leo GD. Interprofessional Education and Collaboration in Healthcare: An Exploratory Study of the Perspectives of Medical Students in the United States. Healthcare. 2019; https://doi.org/10.3390/healthcare7040117
8. Kirchhoff S, Dadaczynski K, Pelikan JM, Zelinka-Roitner I, Dietscher C, Bittlingmayer UH, et al. Organizational Health Literacy in Schools: Concept Development for Health-Literate Schools. Int J Environ Res Public Health. 2022;19(14):8795. https://doi.org/10.3390/ijerph19148795
9. Mogessie HM, Gebeyehu MA, Kenbaw MG, Assefa T. Diabetic Health Literacy and Associated Factors Among Diabetes Mellitus Patients on Follow Up at Public Hospitals, Bale Zone, South East Ethiopia, 2021. PLoS One. 2022;17(7):e0270161. https://doi.org/10.1371/journal.pone.0270161
10. Taguba CLD. Effectiveness of Project-Based Learning and Design Thinking Model in Entrepreneruship Education Among Teacher Education Students. 2025; https://doi.org/10.21203/rs.3.rs-7919514/v1
11. Usman FO, Kess-Momoh AJ, Ibeh C V, Elufioye AE, Ilojianya VI, Oyeyemi OP. Entrepreneurial Innovations and Trends: A Global Review: Examining Emerging Trends, Challenges, and Opportunities in the Field of Entrepreneurship, With a Focus on How Technology and Globalization Are Shaping New Business Ventures. International Journal of Science and Research Archive. 2024;11(1):552–69. https://doi.org/10.30574/ijsra.2024.11.1.0079
12. Widyaningsih N, Ahsani DN. Correlation of Age, Duration of Diabetes Mellitus, HbA1c Levels, and Erectile Dysfunctions in Type II Diabetes Mellitus. 2021; https://doi.org/10.2991/ahsr.k.210115.031
13. AlShorman O, Masadeh M, Alshorman B. Mobile Health Monitoring Based Studies for Diabetes Mellitus: A Review. Bulletin of Electrical Engineering and Informatics. 2021; https://doi.org/10.11591/eei.v10i3.3019
14. Kaewmungkoon S, Reangsungnern G. Financial Technology Creation and Multidimensional Entrepreneurial Opportunity Evaluation Among Startup Entrepreneurs in Thailand. 2026; https://doi.org/10.21203/rs.3.rs-9445204/v1
15. Selen F, Polat Ü. The Effect of Web Based Type 2 Diabetes Education on Diabetes Self Management. Digit Health. 2023;9. https://doi.org/10.1177/20552076231205739
16. Chen J, Jing X, Liu X, Volkmann A-M, Chen Y, Liu Y, et al. Assessment of Factors Affecting Diabetes Management in the City Changing Diabetes (CCD) Study in Tianjin. PLoS One. 2019;14(2):e0209222. https://doi.org/10.1371/journal.pone.0209222
17. Mugume IB, Wafula ST, Kadengye DT, Olmen J v. Performance of a Finnish Diabetes Risk Score in Detecting Undiagnosed Diabetes Among Kenyans Aged 18–69 Years. PLoS One. 2023;18(4):e0276858. https://doi.org/10.1371/journal.pone.0276858
18. Hennis A, Caixeta R, Ondarsuhu D, Chávez C, Guallar JA. Panorama of Diabetes in the Americas. 2022; https://doi.org/10.37774/9789275126332
19. Rachmawati U, Sahar J, Wati DNK. The Association of Diabetes Literacy With Self-Management Among Older People With Type 2 Diabetes Mellitus: A Cross-Sectional Study. BMC Nurs. 2019;18(S1). https://doi.org/10.1186/s12912-019-0354-y
20. Panyasaisophon T, Visuttranukul A, Thamrongworakun P, Buapian T, Tudpor K, Thanaphonganan N. Effects of Educational Health Literacy Development Program on Health Literacy, Health Behaviors, and Clinical Outcomes in Type 2 Diabetes Mellitus Patients in Thailand: A Mixed-Method Study. JPTCP. 2023;30(5). https://doi.org/10.47750/jptcp.2023.30.05.059
21. Kim SH, Utz S. Effectiveness of a Social Media–Based, Health Literacy–Sensitive Diabetes Self‐Management Intervention: A Randomized Controlled Trial. Journal of Nursing Scholarship. 2019;51(6):661–9. https://doi.org/10.1111/jnu.12521
22. Carvalho AC d., Treptow ILG, Latorraca C de OC, Pacheco RL, Valsecchi VA dos S, Riera R, et al. Health Literacy in Patients With Type 2 Diabetes Mellitus: A Systematic Review. Clinics. 2025;80:100774. https://doi.org/10.1016/j.clinsp.2025.100774
23. Oktora SI, Butar DB. Determinants of Diabetes Mellitus Prevalence in Indonesia. Jurnal Kesehatan Masyarakat. 2022; https://doi.org/10.15294/kemas.v18i2.31880
24. Fralick M, Jenkins AJ, Khunti K, Mbanya JC, Mohan V, Schmidt MI. Global Accessibility of Therapeutics for Diabetes Mellitus. Nat Rev Endocrinol. 2022;18(4):199–204. https://doi.org/10.1038/s41574-021-00621-y
25. Butayeva J, Ratan ZA, Downie S, Hosseinzadeh H. The Impact of Health Literacy Interventions on Glycemic Control and Self‐management Outcomes Among Type 2 Diabetes Mellitus: A Systematic Review. J Diabetes. 2023;15(9):724–35. https://doi.org/10.1111/1753-0407.13436
26. Kusumaningrum AR, Ricardo R. Effect of Socio-Economic Status on the Prevalence of Diabetes Mellitus in Indonesia. International Journal of Public Health Science (Ijphs). 2022;11(1):281. https://doi.org/10.11591/ijphs.v11i1.21080
27. Baek C-O, Kim KH, Song SK, Kim JH. An Unusual Case of Bilateral Peripheral Edema in a Male With Undiagnosed Type 2 Diabetes Mellitus. Journal of Korean Diabetes. 2019;20(1):57. https://doi.org/10.4093/jkd.2019.20.1.57
28. Asmelash D, Asmelash Y. The Burden of Undiagnosed Diabetes Mellitus in Adult African Population: A Systematic Review and Meta-Analysis. J Diabetes Res. 2019;2019:1–8. https://doi.org/10.1155/2019/4134937
29. Nabila L, Ejaz S, Madury SA. Drug-Related Problems (DRPs) in Geriatric Patients With Type 2 Diabetes Mellitus (T2DM): A Review. Indonesian Journal of Pharmacology and Therapy. 2022; https://doi.org/10.22146/ijpther.2695
30. Nugraha DP, Asni E, Sembiring LP. Antihiperglicemic Therapy Compliance With Hba1c Levels In Type 2 Diabetes Mellitus Patients Among Pekanbaru Prolanis Participants. Buletin Farmatera. 2020; https://doi.org/10.30596/bf.v5i1.4203
31. Amadi AN, Amoke OC, Agbai PO. Prevalence: Knowledge, Attitude and Management Practices of Diabetes Mellitus and Hypertension in Amaoba Ikwuano Abia State Nigeria. Journal of Applied Sciences and Environmental Management. 2019; https://doi.org/10.4314/jasem.v22i12.17
