ReviewThe Diabetes educator
Update on health literacy and diabetes.
Review in The Diabetes educator. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 126 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
126 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The Effect of Health Literacy Intervention on Patients with Diabetes: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2022Pooled it
- The Role of Health Literacy in Diabetes Knowledge, Self-Care, and Glycemic Control: a Meta-analysis.Journal of general internal medicine · 2019Pooled it
- Prevalence of limited health literacy among patients with type 2 diabetes mellitus: A systematic review.PloS one · 2019Pooled it
- Dietary Management Tools Improve the Dietary Skills of Patients with T2DM in Communities.Nutrients · 2022Trial
- Effects of health literacy, screening, and participant choice on action plans for reducing unhealthy snacking in Australia: A randomised controlled trial.PLoS medicine · 2020Trial
- Trial
- Randomized trial of planning tools to reduce unhealthy snacking: Implications for health literacy.PloS one · 2019Trial
- Canadian adaptation of the Newest Vital Sign©, a health literacy assessment tool.Public health nutrition · 2018Trial
- A tailored intervention to promote uptake of retinal screening among young adults with type 2 diabetes - an intervention mapping approach.BMC health services research · 2018Trial
- Health Literacy and Outcomes of a Community-Based Self-Help Intervention: A Case of Korean Americans With Type 2 Diabetes.Nursing researchTrial
- AI-generated patient information leaflets for oral anticoagulants: quality, usability, readability, and reproducibility compared with FDA-referenced materials.International journal of clinical pharmacy · 2026Article
- The Role of Health Literacy in Cardiometabolic Disease among People with Serious Mental Illness.Community mental health journal · 2026Article
- The Influence of Health Literacy on the Control of Hypothyroidism in Patients Under Levothyroxine Treatment.Clinical endocrinology · 2026Article
- The Impact of Social Determinants of Health on Chronic Diseases: A Narrative Review.Journal of community hospital internal medicine perspectives · 2026Review
- Evaluation of diabetes knowledge among people with type 2 diabetes mellitus in Portugal primary care - where is the gap.BMC primary care · 2025Article
- The mediating role of diabetes self-efficacy in the effect of health literacy on quality of life in geriatric diabetic patients in Turkey.BMC geriatrics · 2025Article
- Design and validation of the Disaster Health Literacy Questionnaire for diabetes patients in Iran: a mixed-methods study.BMJ open · 2025Article
- Factors Associated with Medication Adherence and Glycemic Control among American Indian/Alaska Native Adults with Type 2 Diabetes Within a Commercial Health Care System: A System-Wide Cross-Sectional Study.Journal of racial and ethnic health disparities · 2025Article
- Characteristics of health literacy of older adults in care prevention classes: pilot study.Journal of physical therapy science · 2025Article
- Evaluating Patient Literacy in the Health Information Space: What Does Release of Information Tell Us?Advances in health information science and practice · 2025Article
66 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
Abstract
purposeInadequate literacy is common among patients with diabetes and may lead to adverse outcomes. The authors reviewed the relationship between literacy and health outcomes in patients with diabetes and potential interventions to improve outcomes.
methodsWe reviewed 79 articles covering 3 key domains: (1) evaluation of screening tools to identify inadequate literacy and numeracy, (2) the relationships of a range of diabetes-related health outcomes with literacy and numeracy, and (3) interventions to reduce literacy-related differences in health outcomes.
resultsSeveral screening tools are available to assess patients' print literacy and numeracy skills, some specifically addressing diabetes. Literacy and numeracy are consistently associated with diabetes-related knowledge. Some studies suggest literacy and numeracy are associated with intermediate outcomes, including self-efficacy, communication, and self-care (including adherence), but the relationship between literacy and glycemic control is mixed. Few studies have assessed more distal health outcomes, including diabetes-related complications, health care utilization, safety, or quality of life, but available studies suggest low literacy may be associated with increased risk of complications, including hypoglycemia. Several interventions appear to be effective in improving diabetes-related outcomes regardless of literacy status, but it is unclear if these interventions can reduce literacy-related differences in outcomes.
conclusionsLow literacy is associated with less diabetes-related knowledge and may be related to other important health outcomes. Further studies are needed to better elucidate pathways by which literacy skills affect health outcomes. Promising interventions are available to improve diabetes outcomes for patients with low literacy; more research is needed to determine their effectiveness outside of research settings.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.