Educational Report

Health Numeracy and Literacy of Glycosylated Hemoglobin Test (HbA1c) in a Diabetic Population in a Metropolitan Tertiary-care Hospital Outpatient Podiatry Practice

10/11/2018

BACKGROUND: The glycosylated hemoglobin test (HbA_1c) is used as a measurement of diabetes control over a 3-month period. Elevated HbA_1c is indicative of poorer control of blood glucose levels and has been associated with cardiovascular disease, nephropathy, neuropathy, and retinopathy. A reduction in HbA_1c by less than 1% can decrease 5-year mortality rates by 50%. However, HbA_1c is less intuitive than fingerstick point-of-care glucose measurements, and patients may not have an understanding of its relevance.

OBJECTIVE: This study aims to determine the level of awareness patients with diabetes have about HbA_1c%.

MATERIALS AND METHODS: At a New York City tertiary care hospital-based outpatient podiatry practice, incoming patients with diabetes were surveyed about their HbA_1c knowledge over a 3-month period.

RESULTS: Of the 217 patients identified, 175 were complete observations. The HbA_1c knowledge was categorized into 3 groups: (1) knows HbA_1c value (n = 106); (2) knows about HbA_1c but does not know value (n = 27); and (3) does not know what HbA_1c is (n = 32). The mean HbA_1c level between the 3 groups was not statistically significant (Kruskal-Wallace, P = .06); however, the difference in the mean for patients who knew their most recent HbA_1c% (mean, 6.68%) versus patients who did not know (mean, 7.46%) was significant (Wilcox, P = .01).

CONCLUSIONS: These data suggest there is a benefit in measured HbA_1c% for patients who know their value as compared with those who do not, but not in those patients who understand HbA_1c values in general. In addition, the data point to a gap in health literacy and opportunity for intervention, as only 64.6% of patients with diabetes knew their most recent HbA_1c%. Health numeracy and health literacy are issues faced in all areas of health care, and the prevalence of diabetes in the general population makes knowledge of HbA_1c test a national concern with vast public health implications.

CITATION
Mond S, Neville K, Fridman R. Health numeracy and literacy of glycosylated hemoglobin test (HbA_1c) in a diabetic population in a metropolitan tertiary-care hospital outpatient podiatry practice. Poster presented at: Symposium on Advanced Wound Care Fall; November 2-4, 2018; Las Vegas, NV.

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This abstract was not subject to the WOUNDS peer-review process.

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