ArticleFrontiers in endocrinology2026
The mediating role of health literacy in the relationship between social support and glycemic control among rural patients with diabetes in Western China: a cross-sectional SEM study.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Social support and health literacy are important factors associated with glycemic control in patients with diabetes, but the mediating role of health literacy in rural populations remains unclear. Methods: We conducted a cross-sectional survey of 2,280 rural patients with diabetes across five regions in Guangxi using the Social Support Scale and Health Literacy Scale. Data were analyzed using Spearman correlation and structural equation modeling (SEM). A covariate-adjusted SEM was further estimated by including age, sex, education level, household income, disease duration, number of complications, BMI, and treatment type. Results: Among 2,178 valid questionnaires, the mean social support score was 26.70 ± 9.93, the mean health literacy score was 30.47 ± 9.36, and the mean HbA1c level was 8.60 ± 2.18%. Only 22.64% of participants had HbA1c levels below 7.0%, indicating generally poor glycemic control. Spearman correlation analysis showed that both social support and health literacy were significantly negatively correlated with HbA1c level ( Conclusion: Health literacy plays a significant mediating role in the relationship between social support and HbA1c level among rural patients with diabetes in western China. Strengthening social support and improving health literacy may help improve glycemic control in rural diabetes management.
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