Low health literacy is associated with higher risk of type 2 diabetes: a cross-sectional study in Germany

Background!#!Low health literacy is believed to be associated with behaviours that increase the risk of type 2 diabetes. But there is limited knowledge on the relation between health literacy (HL) and diabetes risk, and whether improving HL could be a potential prevention strategy. Therefore, the main purpose of this study was to examine the link between HL and diabetes risk among non-diabetic adults.!##!Methods!#!We used data from the Hamburg Diabetes Prevention Survey, a population-based cross-sectional study in Germany. One thousand, two hundred and fifty-five non-diabetic subjects aged 18-60 years were eligible. The German Diabetes Risk Score (GDRS, ranging 0 to 123 points) was used to determine the individual risk of type 2 diabetes. The short version of the European Health Literacy Questionnaire (HLS-EU-Q16, ranging 0 to 16 points) was applied to assess the individual self-reported HL. Subjects were asked to self-estimate their diabetes risk, which was then compared with the calculated GDRS. Descriptive statistics were calculated to investigate group differences in the GDRS and self-estimated diabetes risk. Linear as well as logistic regression models were performed to analyse potential influencing variables of the GDRS as well as incorrect self-estimated diabetes risk. In three nested statistical models for each outcome, these analyses were adjusted for age, gender, educational level and the presence of chronic conditions.!##!Results!#!According to the criteria of the GDRS, 996 (79.4%) subjects showed 'low risk', 176 (14.0%) 'still low risk', 53 (4.2%) 'elevated risk', and 30 (2.4%) 'high to very high risk' to develop type 2 diabetes within the next 5 years. In the statistical models including all control variables, subjects with 'inadequate HL' scored 2.38 points higher on the GDRS (95% CI 0.378 to 4.336; P = 0.020) and had a 2.04 greater chance to estimate their diabetes risk incorrectly (OR 2.04; 95% CI 1.33 to 3.14; P = 0.001) compared to those with 'sufficient HL'.!##!Conclusion!#!The risk of type 2 diabetes is increased in people with inadequate self-reported HL. People with high diabetes risk and inadequate HL might be provided with educational programs to improve diabetes knowledge and reduce behavioural risk factors

Regionalization of federal health reporting using the example of diabetes surveillance

Unzureichend behandelt kann die Stoffwechselerkrankung Diabetes mellitus zu schwerwiegenden Folgeerkrankungen führen. Nationale und internationale Analysen zeigen einen kontinuierlichen Anstieg der Diabetesprävalenz über die letzten Jahre. Am Robert Koch-Institut (RKI) wird derzeit eine Nationale Diabetes-Surveillance aufgebaut, die das Diabetesgeschehen indikatorenbasiert unter Nutzung von Primär- und Sekundärdaten kontinuierlich abbilden soll. Ziel des Bund-Länder-Gesprächs war es, die Bundesländer frühzeitig in die Konzeption der Diabetes-Surveillance einzubinden und die Bedarfe der Gesundheitsberichterstattung (GBE) der Länder zu berücksichtigen. Das RKI lud alle Vertreter der Länder-GBE zu einem Gespräch nach Berlin ein. Dies war bereits das zweite Bund-Länder-Gespräch im Rahmen der Diabetes-Surveillance. Ein kontinuierlicher Austausch in Form regelmäßiger Bund-Länder-Gespräche wird angestrebt.Insufficiently treated diabetes mellitus can lead to severe comorbidities. National and international analyses show a continuous increase in diabetes prevalence over the last decades. Currently, an indicator-based national diabetes surveillance system is implemented at the Robert Koch Institute (RKI) to monitor and report on diabetes development on the basis of available primary and secondary data. The aim of the meeting was to go into deeper discussions and to integrate expectations and expertise of the federal states into the design of the national surveillance system. A close collaboration between the RKI and the federal states is intended.Peer Reviewe