Independent Influence of Health Literacy and Diet Predict Uncontrolled Diabetes: Study Finds

The cross-sectional study was published in the Indian Journal of Community Health in April 2025.

To address India’s escalating T2DM crisis—projected to affect 98 million individuals by 2030. Effective management is vital to prevent severe complications such as neuropathy and cardiovascular disease, yet many patients fail to achieve recommended glycemic goals. To address the cause behind it, the lead author, Rashmi Kumari of the Department of Community Medicine at Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India, and colleagues investigated the prevalence of poor glycemic control in T2D patients and its contributing socio-demographic and clinical factors in a tertiary setting.

The cross-sectional study at a tertiary Medicine Outpatient Department (OPD) evaluated 179 T2DM patients aged 40–65 on oral medications by utilizing structured random selection, excluding those on insulin or with existing complications. Clinical data from World Health Organization (WHO) STEPwise approach to Surveillance (STEPS) surveys and dietary recalls were integrated with laboratory Glycated Hemoglobin (HbA1c) testing, using SPSS version 26.0 to determine independent predictors of poor glycemic control through Chi-Square and multivariate logistic regression analyses.

Key Clinical Findings of the Study:

• Glycemic Control Prevalence: The study reveals that 35% of patients failed to achieve optimal targets, with HbA1c levels exceeding 7.5%.
• Socio-educational Risk Factors: Limited educational attainment up to the junior school level was identified as the strongest independent predictor of uncontrolled diabetes mellitus (UDM), significantly increasing risk with an adjusted odds ratio (aOR) of 7.04.
• Dietary and Metabolic Predictors: Clinical data indicates that non-vegetarian dietary habits (aOR: 2.35) and postprandial blood sugar (PPBS) levels above 140 mg/dL (aOR: 5.13) are critical independent factors contributing to poor glucose regulation.
• Obesity and Comorbidity: Trends High physical risk factors were prevalent across the cohort, with 60.33% of participants maintaining a body mass index (BMI) above 25 kg/m² and 50.79% suffering from concurrent hypertension.
• Treatment Adherence: Challenges Regarding medication compliance, the study found that 23.8% of patients with uncontrolled sugar levels frequently forgot to take their prescribed doses on time.

The results suggest that 35% of patients maintain poor glycemic control, identifying non-vegetarian diets and education only up to the junior school level as critical independent predictors of uncontrolled diabetes.

The significant rates of obesity and sub-optimal blood sugar regulation highlight a vital need for clinicians to implement tailored educational, nutritional, and weight management strategies to improve patient outcomes and reduce the incidence of diabetes-related complications

Reference

Kumari R, Singh N, Karoli R, Kandpal SD, Singh S, Ansari A, Singh C, Usmani S, Singh AK. Poor glycemic control and associated factors among Type 2 Diabetes Mellitus patients at a Tertiary Health Care facility. Indian J Comm Health. 2025;37(2):195-200. https://doi.org/10.47203/IJCH.2025.v37i02.004