Moderating effect of health literacy on the relationship between diabetes self-management education and self-care monitoring activities among individuals with type 2 diabetes mellitus

Abstract Background Type 2 diabetes mellitus (T2DM) is a chronic condition requiring effective self-management for optimal health outcomes. Diabetes self-management education (DSME) is pivotal in T2DM care, with its efficacy potentially affected by patients’ health literacy levels. This study explor...

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Main Authors: Hanyi Lee, Hyeon Sik Chu
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-23765-2
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author Hanyi Lee
Hyeon Sik Chu
author_facet Hanyi Lee
Hyeon Sik Chu
author_sort Hanyi Lee
collection DOAJ
description Abstract Background Type 2 diabetes mellitus (T2DM) is a chronic condition requiring effective self-management for optimal health outcomes. Diabetes self-management education (DSME) is pivotal in T2DM care, with its efficacy potentially affected by patients’ health literacy levels. This study explores the moderating impact of health literacy on the correlation between DSME and DM self-care activities among individuals with T2DM in Korea, addressing the literature gap on health literacy’s influence on diabetes self-management. Methods This descriptive correlational study utilized data from the 2021 Korean Community Health Survey conducted by the Korea Disease Control and Prevention Agency, comprising 26,172 participants diagnosed with T2DM undergoing pharmacotherapy. The study assessed participants’ engagement in DSME, self-care monitoring activities (including HbA1c testing, retinal examinations, and microalbuminuria tests), and verbal and health text literacy levels. Statistical analyses, encompassing correlation and moderation analyses, were conducted using SPSS and SPSS Process Macro software. Results It was found that 29.5% of the participants engaged in appropriate self-care monitoring activities, whereas 70.5% did not. Higher levels of verbal and health text literacy were significantly linked with enhanced self-care monitoring. Furthermore, both forms of health literacy significantly moderated the correlation between DSME and self-care monitoring activities, suggesting that health literacy levels can impact the efficacy of DSME in enhancing diabetes self-management. Conclusion These findings underscore the critical role of health literacy in diabetes self-management. Healthcare professionals should account for patients’ health literacy levels when devising and implementing DSME programs, utilizing literacy-appropriate methods to ensure universal program benefits. This study emphasizes integrating health literacy considerations into DSME programs to enhance diabetes self-care. Subsequent research should examine the effects of various health literacy aspects on diabetes self-management and develop tailored educational strategies to improve health literacy among T2DM patients.
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spelling doaj-art-c0d9805698ca412d80159a31508084b32025-08-20T04:03:11ZengBMCBMC Public Health1471-24582025-07-0125111010.1186/s12889-025-23765-2Moderating effect of health literacy on the relationship between diabetes self-management education and self-care monitoring activities among individuals with type 2 diabetes mellitusHanyi Lee0Hyeon Sik Chu1College of Nursing, Hanyang UniversityCollege of Nursing, Dankook UniversityAbstract Background Type 2 diabetes mellitus (T2DM) is a chronic condition requiring effective self-management for optimal health outcomes. Diabetes self-management education (DSME) is pivotal in T2DM care, with its efficacy potentially affected by patients’ health literacy levels. This study explores the moderating impact of health literacy on the correlation between DSME and DM self-care activities among individuals with T2DM in Korea, addressing the literature gap on health literacy’s influence on diabetes self-management. Methods This descriptive correlational study utilized data from the 2021 Korean Community Health Survey conducted by the Korea Disease Control and Prevention Agency, comprising 26,172 participants diagnosed with T2DM undergoing pharmacotherapy. The study assessed participants’ engagement in DSME, self-care monitoring activities (including HbA1c testing, retinal examinations, and microalbuminuria tests), and verbal and health text literacy levels. Statistical analyses, encompassing correlation and moderation analyses, were conducted using SPSS and SPSS Process Macro software. Results It was found that 29.5% of the participants engaged in appropriate self-care monitoring activities, whereas 70.5% did not. Higher levels of verbal and health text literacy were significantly linked with enhanced self-care monitoring. Furthermore, both forms of health literacy significantly moderated the correlation between DSME and self-care monitoring activities, suggesting that health literacy levels can impact the efficacy of DSME in enhancing diabetes self-management. Conclusion These findings underscore the critical role of health literacy in diabetes self-management. Healthcare professionals should account for patients’ health literacy levels when devising and implementing DSME programs, utilizing literacy-appropriate methods to ensure universal program benefits. This study emphasizes integrating health literacy considerations into DSME programs to enhance diabetes self-care. Subsequent research should examine the effects of various health literacy aspects on diabetes self-management and develop tailored educational strategies to improve health literacy among T2DM patients.https://doi.org/10.1186/s12889-025-23765-2Diabetes mellitusHealth literacyDiabetes self-management educationSelf-care monitoring
spellingShingle Hanyi Lee
Hyeon Sik Chu
Moderating effect of health literacy on the relationship between diabetes self-management education and self-care monitoring activities among individuals with type 2 diabetes mellitus
BMC Public Health
Diabetes mellitus
Health literacy
Diabetes self-management education
Self-care monitoring
title Moderating effect of health literacy on the relationship between diabetes self-management education and self-care monitoring activities among individuals with type 2 diabetes mellitus
title_full Moderating effect of health literacy on the relationship between diabetes self-management education and self-care monitoring activities among individuals with type 2 diabetes mellitus
title_fullStr Moderating effect of health literacy on the relationship between diabetes self-management education and self-care monitoring activities among individuals with type 2 diabetes mellitus
title_full_unstemmed Moderating effect of health literacy on the relationship between diabetes self-management education and self-care monitoring activities among individuals with type 2 diabetes mellitus
title_short Moderating effect of health literacy on the relationship between diabetes self-management education and self-care monitoring activities among individuals with type 2 diabetes mellitus
title_sort moderating effect of health literacy on the relationship between diabetes self management education and self care monitoring activities among individuals with type 2 diabetes mellitus
topic Diabetes mellitus
Health literacy
Diabetes self-management education
Self-care monitoring
url https://doi.org/10.1186/s12889-025-23765-2
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