1887
Volume 2025, Issue 4
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Type 2 diabetes mellitus (T2DM) requires significant patient involvement, with health literacy playing a crucial role in patients’ ability to navigate their care. Qatar has one of the highest T2DM prevalence rates globally, yet research on health literacy in this population remains limited. The purpose of this study was to evaluate health literacy levels and predictors among Type 2 diabetes patients in Qatar.

An analytical cross-sectional study was conducted, targeting patients diagnosed with type 2 diabetes. A total of 450 patients were randomly sampled, and data were collected through structured interviews using the European Health Literacy Survey Questionnaire - short version (HLS-EU-Q16) to measure health literacy. In addition to determining the prevalence of different health literacy levels, associations between health literacy and patient characteristics were examined using bivariate analysis. A regression model was employed to identify independent predictors of health literacy.

Of the 450 participants, 57.8% were male with a mean age of 51.6 years. 62.4 % demonstrated sufficient health literacy, 31.8 % problematic, and 5.8 % inadequate levels. Health literacy was significantly associated with participants’ age, education, occupation, income, living situation, diabetes duration, treatment, and complications ( < 0.05). Multivariable analysis showed that primary (adjusted odds ratio (AOR), 0.080; < 0.001), no formal (AOR, 0.162; = 0.008) and secondary education (AOR, 0.266; = 0.001) each reduced the odds of higher literacy versus university education, while living with family (AOR, 2.843; = 0.030) and being managed with oral medications alone (AOR, 3.230; = 0.004) or no medication (AOR, 11.196; = 0.038) increased the odds.

Although a high proportion of patients had sufficient health literacy, many still struggled with problematic or inadequate levels, especially those with lower education or complex insulin regimens. Routine health literacy assessment and targeted, culturally appropriate education for high-risk groups should be embedded in diabetes services and national strategies.

© 2025 Alchawa, Alasaad, Maaloul, Zirie, Bougmiza, licensee HBKU Press.
Loading

Article metrics loading...

/content/journals/10.5339/qmj.2025.104
2025-12-04
2025-12-05

Metrics

Loading full text...

Full text loading...

/deliver/fulltext/qmj/2025/4/qmj.2025.104.html?itemId=/content/journals/10.5339/qmj.2025.104&mimeType=html&fmt=ahah

References

  1. World Health Organization . Diabetes Fact Sheet. 2021. Available from: https://www.who.int/news-room/fact-sheets/detail/diabetes. Accessed August 24, 2021.
     [Google Scholar]
  2. World Health Organization . Urgent action needed as global diabetes cases increase four-fold over past decades. Available from: https://www.who.int/news/item/13-11-2024-urgent-action-needed-as-global-diabetes-cases-increase-four-fold-over-past-decades. Accessed May 10, 2025.
     [Google Scholar]
  3. Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, et al. IDF Diabetes Atlas: global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018 Apr; 138:271–81. https://doi.org/10.1016/j.diabres.2018.02.023
     [Google Scholar]
  4. International Diabetes Federation . IDF Diabetes Atlas 2025 | Global Diabetes Data & Insights. 2025. Available from: https://diabetesatlas.org/resources/idf-diabetes-atlas-2025/. Accessed May 10, 2025.
     [Google Scholar]
  5. Awad SF, O’Flaherty M, Critchley J, Abu-Raddad LJ. Forecasting the burden of type 2 diabetes mellitus in Qatar to 2050: a novel modeling approach. Diabetes Res Clin Pract. 2018 Mar; 137:100–8. https://doi.org/10.1016/j.diabres.2017.11.015
     [Google Scholar]
  6. Al-Thani MH, Al-Mutawa KA, Alyafei SA, Ijaz MA, Khalifa SAH, Kokku SB, et al. Characterizing epidemiology of prediabetes, diabetes, and hypertension in Qataris: a cross-sectional study. PLoS One. 2021 Oct; 16:(10):e0259152. https://doi.org/10.1371/journal.pone.0259152
     [Google Scholar]
  7. Nutbeam D, Kickbusch I. Health promotion glossary. Health Promot Int. 1998 Dec 26; 13:(4):349–64. https://doi.org/10.1093/heapro/13.4.349
     [Google Scholar]
  8. Nugent TL, Galea AM, Sammut R. Health literacy, self-management and glycaemic control in persons living with type 2 diabetes mellitus: a cross-sectional study. Pract Diab. 2023 Jul; 40:(4):28–34. https://doi.org/10.1002/pdi.2467
     [Google Scholar]
  9. 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 Sep; 15:(9):724–35. https://doi.org/10.1111/1753-0407.13436
     [Google Scholar]
  10. Bains S, Egede L. Associations between health literacy, diabetes knowledge, self-care behaviors, and glycemic control in a low income population with type 2 diabetes. Diabetes Technol Ther. 2011 Mar; 13:(3):335–41. https://doi.org/10.1089/dia.2010.0160
     [Google Scholar]
  11. Parmar J, Masri A El, MacMillan F, McCaffery K, Arora A. Health literacy and medication adherence in adults from ethnic minority backgrounds with Type 2 Diabetes Mellitus: a systematic review. BMC Public Health. 2025 Jan; 25:(1):222. https://doi.org/10.1186/s12889-024-20734-z
     [Google Scholar]
  12. Dahal PK, Hosseinzadeh H. Association of health literacy and diabetes self-management: a systematic review. Aust J Prim Health. 2019 Jan; 25:(6):526–33. https://doi.org/10.1071/PY19007
     [Google Scholar]
  13. al Sayah F, Majumdar S, Egede L, Johnson JA. Associations between health literacy and health outcomes in a predominantly low-income African American population with type 2 diabetes. J Health Commun. 2015; 20:(5):581–8. https://doi.org/10.1080/10810730.2015.1012235
     [Google Scholar]
  14. Zhao N, Luo X, Zhang H, Dai R, Pan W, Hambly BD, et al. Cross-sectional study on health literacy and internet accessibility among patients with DM in Gansu, China. Front Public Health. 2021 Oct; 9:692089. https://doi.org/10.3389/fpubh.2021.692089
     [Google Scholar]
  15. Al Sayah F, Williams B, Johnson JA. Measuring health literacy in individuals with diabetes: a systematic review and evaluation of available measures. Health Educ Behav. 2012 Apr; 40:(1):42–55. https://doi.org/10.1177/1090198111436341
     [Google Scholar]
  16. Caruso R, Magon A, Baroni I, Dellafiore F, Arrigoni C, Pittella F, et al. Health literacy in type 2 diabetes patients: a systematic review of systematic reviews. Acta Diabetol. 2018 Jan; 55:(1):1–12. https://doi.org/10.1007/s00592-017-1071-1
     [Google Scholar]
  17. Ahmed S, Kehyayan V, Abdou M, Bougmiza I. Prevalence and determinants of health literacy among the adult population of Qatar. Front Public Health. 2023 Nov; 11:1278614. https://doi.org/10.3389/fpubh.2023.1278614
     [Google Scholar]
  18. Planning and Statistics Authority . Monthly figures on total population; 2023. Available from: https://www.psa.gov.qa/en/statistics/Statistical%20Releases/General/QMS/QMS_PSA_109_Feb_2023.pdf. Accessed March 27, 2023.
     [Google Scholar]
  19. World Health Organization . ICD-10 : international statistical classification of diseases and related health problems : tenth revision. Geneva: World Health Organization; 2004.
     [Google Scholar]
  20. Dean A, Sullivan K, Soe M. OpenEpi: open source epidemiologic statistics for public health; 2013. Version 2.3.1. Available from: https://www.openepi.com/SampleSize/SSPropor.htm. Accssed November 3, 2021.
     [Google Scholar]
  21. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behav Res Methods. 2009 Nov; 41:(4):1149–60. https://doi.org/10.3758/BRM.41.4.1149
     [Google Scholar]
  22. Ji M, Ren D, Dunbar-Jacob J, Gary-Webb TL, Erlen JA. Self-management behaviors, glycemic control, and metabolic syndrome in type 2 diabetes. Nurs Res. 2020 Mar/Apr; 69:(2):E9–17. https://doi.org/10.1097/NNR.0000000000000401
     [Google Scholar]
  23. United Nations Educational, Scientific, and Cultural Organization (UNESCO) International Bureau of Education . World Data on Education Qatar. 2011. Available from: http://www.ibe.unesco.org/. Accessed January 17, 2022.
     [Google Scholar]
  24. World Health Organization . Obesity and overweight. 2021. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. Accessed February 15, 2022.
     [Google Scholar]
  25. Pelikan JM, Röthlin F, Ganahl K. Measuring comprehensive health literacy in general populations: validation of instrument, indices and scales of the HLS-EU study Vienna Austria 6th Annual Health Literacy Research Conference Summary & Conclusions. Proceedings of the 6th Annual Health Literacy Research Conference. 2014;3–4. Available from: www.lbihpr.lbg.ac.at. Accessed February 1, 2022.
     [Google Scholar]
  26. Sørensen K, Van den Broucke S, Pelikan JM, Fullam J, Doyle G, Slonska Z, et al. Measuring health literacy in populations: illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q). BMC Public Health. 2013 Oct; 13:948. https://doi.org/10.1186/1471-2458-13-948
     [Google Scholar]
  27. Pelikan JM, Ganahl K, Van den Broucke S, Sørensen K. Measuring health literacy in Europe: Introducing the European Health Literacy Survey Questionnaire (HLS-EU-Q). In: Okan O, Bauer U, Levin-Zamir D, Pinheiro P, Sørensen K, eds. International Handbook of Health Literacy. Bristol: Policy Press; 2019. p.115–38.
     [Google Scholar]
  28. Wångdahl J, Lytsy P, Mårtensson L, Westerling R. Health literacy among refugees in Sweden - a cross-sectional study. BMC Public Health. 2014 Oct; 14:1030. https://doi.org/10.1186/1471-2458-14-1030
     [Google Scholar]
  29. Bas-Sarmiento P, Poza-Méndez M, Fernández-Gutiérrez M, González-Caballero JL, Falcón Romero M. Psychometric assessment of the European Health Literacy Survey Questionnaire (HLS-EU-Q16) for Arabic/French-speaking migrants in Southern Europe. Int J Environ Res Public Health. 2020 Nov; 17:(21):8181. https://doi.org/10.3390/ijerph17218181
     [Google Scholar]
  30. Ginter E, Simko V. Type 2 diabetes mellitus, pandemic in 21st century. In: Ahmad SI, ed. Diabetes: An Old Disease, a New Insight. New York, NY: Springer New York; 2013. p.42–50. https://doi.org/10.1007/978-1-4614-5441-0_6
     [Google Scholar]
  31. Abdullah A, Liew SM, Salim H, Ng CJ, Chinna K. Prevalence of limited health literacy among patients with type 2 diabetes mellitus: a systematic review. PLoS One. 2019 May; 14:(5):e0216402. https://doi.org/10.1371/journal.pone.0216402
     [Google Scholar]
  32. Abdullah A, Liew SM, Salim H, Ng CJ, Chinna K. Correction: Prevalence of limited health literacy among patients with type 2 diabetes mellitus: a systematic review. PLoS One. 2022 Jan; 17:(1):e0261430. https://doi.org/10.1371/journal.pone.0261430
     [Google Scholar]
  33. Schillinger D, Grumbach K, Piette J, Wang F, Osmond D, Daher C, et al. Association of health literacy with diabetes outcomes. JAMA. 2002 Jul; 288:(4):475–82. https://doi.org/10.1001/jama.288.4.475
     [Google Scholar]
  34. Mohammadi Z, Tehrani Banihashemi A, Asgharifard H, Bahramian M, Baradaran HR, Khamseh ME. Health literacy and its influencing factors in Iranian diabetic patients. Med J Islam Repub Iran. 2015 Jul; 29:230. Available from: https://pubmed.ncbi.nlm.nih.gov/26478888
     [Google Scholar]
  35. Mashi AH, Aleid D, Almutairi S, Khattab F, AlMuqawed AN, Khan SZ, et al. The association of health literacy with glycemic control in Saudi patients with type 2 diabetes. Saudi Med J. 2019 Jul; 40:(7):675–80. https://doi.org/10.15537/smj.2019.7.24277
     [Google Scholar]
  36. ALSharit BA, Alhalal EA. Effects of health literacy on type 2 diabetic patients’ glycemic control, self-management, and quality of life. Saudi Med J. 2022 May; 43:(5):465. https://doi.org/10.15537/smj.2022.43.5.20210917
     [Google Scholar]
  37. Pavão ALB, Werneck GL, Saboga-Nunes L, Sousa RA de. Avaliação da literacia para a saúde de pacientes portadores de diabetes acompanhados em um ambulatório público. Cad Saude Publica. 2021; 37:2021. https://doi.org/10.1590/0102-311X00084819
     [Google Scholar]
  38. Mogessie HM, Gebeyehu MA, Kenbaw MG, Tadesse TA. 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 Jul; 17:(7):e0270161. https://doi.org/10.1371/journal.pone.0270161
     [Google Scholar]
  39. Alareeki A, Awad SF, Critchley JA, El-Nahas KG, Al-Hamaq AO, Alyafei SA, et al. Epidemiological impact of public health interventions against diabetes in Qatar: mathematical modeling analyses. Front Public Health. 2023 Jun; 11:1167807. https://doi.org/10.3389/fpubh.2023.1167807
     [Google Scholar]
  40. Qatar News Agency . MOPH launches a groundbreaking national action plan to tackle obesity, diabetes, and ASCVD risks; 2024. Available from: https://qna.org.qa/en/news/news-details?id=0067-moph-launches-a-groundbreaking-national-action-plan-to-tackle-obesity,-diabetes,-and-ascvd-risks&date=14/11/2024. Accessed May 24, 2025.
     [Google Scholar]
/content/journals/10.5339/qmj.2025.104
Loading
Health literacy levels and predictors among type 2 diabetes patients in Qatar: An analytical cross-sectional study
Qatar Medical Journal 2025, 104 (2025); https://doi.org/10.5339/qmj.2025.104
/content/journals/10.5339/qmj.2025.104
/content/journals/10.5339/qmj.2025.104
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): health literacy, HLS-EU-Q16, Qatar and type 2 diabetes

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error