The impact of health literacy on self-monitoring of blood glucose in patients with diabetes receiving care in an inner-city hospital

J Natl Med Assoc. 2010 Jan;102(1):5-9. doi: 10.1016/s0027-9684(15)30469-7.


Background: Self-monitoring of blood glucose (SMBG) is considered to be 1 of the cornerstones of diabetes self-management. It is unclear whether inadequate health literacy affects SMBG.

Objective: The objective of this study was to examine the relationship between health literacy and SMBG.

Methods: This was a cross-sectional survey of 189 patients with diabetes, aged 18 to 65 years, receiving care in a large urban, public health care setting. We measured health literacy using the shortened version of the Test of Functional Health Literacy in Adults. The diabetes care profile was used to determine the use of self-monitoring of blood glucose.

Results: Most (60.9%) of the survey participants were assessed as functionally health literate. The majority (90.9%) of the study participants reported testing their blood sugar at least once daily. Although adequate health literacy was associated with recording of blood sugar testing (p = .049), we found no statistically significant relationship between health literacy and the frequency of SMBG. Persons self-reporting having diabetes for more than 10 years were less likely to self-monitor blood glucose (odds ratio, 0.33; 95% CI, 0.11-0.99).

Conclusions: SMBG frequency is not independently associated with health literacy, but SMBG result recording is noted among patients with inadequate literacy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood Glucose Self-Monitoring* / standards
  • Blood Glucose Self-Monitoring* / statistics & numerical data
  • Confidence Intervals
  • Cross-Sectional Studies
  • Data Collection
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 2 / blood*
  • Female
  • Health Behavior
  • Health Literacy / statistics & numerical data*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Patient Education as Topic / statistics & numerical data
  • Poverty
  • Surveys and Questionnaires
  • Urban Population / statistics & numerical data*
  • Young Adult