Association between caregiver health literacy and patient characteristics in pediatric new onset diabetes mellitus.

OBJECTIVES

This study aimed to describe the health literacy of caregivers of patients with new onset diabetes mellitus (NODM) presenting to a large, pediatric medical center and to describe the association between caregiver health literacy and patient characteristics.

STUDY

DESIGN

This was a retrospective, cohort study. Caregiver health literacy was assessed using the Newest Vital Sign (NVS). NVS is scored 0-6: adequate literacy (AL) (4-6); possibility of limited literacy (PLL) (2-3); and high likelihood of limited literacy (HLLL) (0-1).

METHODS

Bivariate and multivariable analyses were performed with caregiver health literacy as the predictor. P < 0.05 was considered significant.

RESULTS

Between January 1, 2016 and December 31, 2023, there were 1832 NODM patients [mean age 10.2 (4.8) years, 46 % female]; 1701 (92.8 %) caregivers completed NVS: 92.3 % AL, 5.2 % PLL, and 2.5 % HLLL. Among 1091 diagnosed before January 1, 2023, 561 (51.4 %) and 136 (12.5 %) utilized a continuous glucose monitor (CGM) and insulin pump, respectively, within 12 months. Lower health literacy was associated with higher odds of interpreter use (PLL p < 0.001; HLLL p < 0.001), of tailored diabetes education (PLL p < 0.001; HLLL p < 0.001), and longer length of stay (PLL p < 0.001; HLLL p < 0.001). HLLL (adjusted odds ratio [aOR] 0.25, 95 % confidence interval [CI] 0.06, 0.94) but not PLL (aOR 1.06, 95% CI 0.44, 2.57) was associated with lower odds of CGM use within 12 months.

CONCLUSIONS

Patients with NODM whose caregivers have lower health literacy represent a high-risk population associated with increased resource utilization, longer hospitalization, and risk for decreased uptake of diabetes technology. A health-literacy informed approach to initial education may offer opportunities to support the individual needs of caregivers.