Why Diabetes Knowledge Is Essential

The more you understand about how diabetes, diet, nutrition, medications and technology interconnect, the better the choices you’ll make toward improving your health and wellbeing. Explore the relationship between knowledge and self-care.

Diabetes requires daily management, and the responsibility for that management typically falls to the person with the condition. Each day, people with diabetes must make choices about their diet, physical activity, and taking medications. These choices have a significant impact on long-term health outcomes.

Family and social influences, along with a person’s understanding of how their choices affect their condition, strongly influence overall health. In general, those with a deeper understanding of diabetes and strong support systems are better equipped to manage their diabetes. 

One key factor that affects someone’s ability to self-manage their diabetes is their health literacy.

What is health literacy?

According to the CDC, health literacy is the ability to find, understand, and use information to inform health-related decisions and take action. An individual’s level of health literacy often determines how they communicate with their healthcare team. Do they understand the terminology their team uses when discussing self-management behaviors? Are they asking questions to enhance their ability to make the best choices each day? Do they know how to follow-through on diabetes self-management plans they commit to with their healthcare team?

Health literacy is necessary for everyone, but especially for people with a chronic condition like diabetes. Diabetes Care and Education Specialists (DCES) and other healthcare professionals must consider health literacy when working with their patients.

In addition to health literacy, an individual’s culture, community, workplace, education, and access to care also impact their understanding of diabetes. Researchers, educators, and healthcare providers should keep these factors in mind when providing treatment and self-management education.

Researchers recently conducted a multi-year study of how health literacy affects self-management of people with type 2 diabetes. They found that people with diabetes fall into one of three levels of health literacy:

• Functional: A basic knowledge of self-management strategies such as adjusting diet and physical activity. They perform self-management tasks without a deep understanding of their impact on diabetes-related outcomes. 

• Interactive: Using cognitive and social skills to actively participate in everyday activities, take in information about diabetes from various forms of communication, and apply that information to new circumstances. 

• Critical: Using cognitive and social skills to analyze new information and exercise control over life events related to diabetes self-management.

People with diabetes can improve their health literacy over time. As people get more experience managing their condition, they might shift from simply following instructions to evaluating new information and making better-informed personal choices. 

Emily del Conte, a registered dietitian and certified diabetes outpatient educator with Evolution Nutrition (a group of registered dietitians focused on nutrition counseling), said, “With any medical condition, understanding what is happening in your body provides increased confidence to be able to participate in improved self-care.”   

With proper coaching and education, people with diabetes can improve their health literacy. By gaining a deeper understanding of health in general, they can become better able to self-manage not just their diabetes but also their overall health.

What is diabetes self-management?

According to the American Diabetes Association, the purpose of diabetes self-management education is “to give people with diabetes the knowledge, skills, and confidence to accept responsibility for their self-management.” Diabetes self-management involves making informed decisions, collaborating with healthcare providers, and problem solving to improve clinical outcomes, health status, and overall quality of life. People with diabetes need the knowledge and skills, but also the ability to apply that knowledge to manage their diabetes each day.

People who are newly diagnosed should learn about their condition and how to manage it themselves. The Diabetes Self-Management Education standards state that education should include:

• Diabetes disease process and treatment options

• Lifestyle management, including nutrition and physical activity

• Medication use 

• Instruction in how to monitor blood glucose levels as well as interpret and use the results for decision making

• Prevention, detection, and treatment of acute and chronic complications

• Development of personal strategies to address psychosocial issues, such as diabetes distress, and to promote healthy behavior and change 

Studies have shown that diabetes self-management education can help to improve health outcomes. Specifically, those who participated in a self-management education program experienced positive effects on their dietary habits, glucose management, and prevention of long-term complications. These positive effects were most pronounced within the six months after the education program. 

How does health literacy affect diabetes self-management?

People with limited health literacy have less knowledge about diabetes management, report lower health status in general, and are more likely to have higher glucose levels compared to people with higher health literacy. In contrast, people with higher health literacy have better glycemic control as measured by A1C levels. 

One recent study tested how the reading comprehension and numeracy skills of people with type 2 diabetes on insulin therapy affected their self-management and health outcomes. People with higher reading comprehension scores measured their blood glucose levels more frequently, a critical tool in daily self-management. Those who performed better on the numeracy test self-monitored their blood glucose better, injected insulin more frequently, and experienced fewer complications from diabetes. 

These findings illustrate the importance of health literacy when it comes to self-managing diabetes. Strong reading comprehension skills allow people to read, understand, and apply new information about diabetes and self-care strategies. Strong numeracy skills allow them to complete self-management tasks such as reading nutrition labels, interpreting blood glucose meter readings, and calculating insulin dosages. People with diabetes must make choices throughout the day that directly affect their health, and they can make better choices when they understand the how and why behind these decisions.

If you have diabetes and want to further your understanding of this disease, talk to your healthcare provider about local or online diabetes education courses. You can also ask for a referral to a Diabetes Care and Education Specialist. These specialists are trained to provide you with diabetes self-management education and support services such as strategies for following your treatment plan, eating healthy foods, staying active, and using your diabetes devices. These strategies can help you reduce your complications from diabetes and improve health measures like your A1C, blood pressure, and cholesterol.