Health Literacy Level of Patients with Diabetic Retinopathy: An Observational Descriptive Cross Sectional Study

Background: Diabetic health literacy, encompassing knowledge, motivation, and the ability to access, understand, evaluate, and apply healthcare information, is a crucial non-clinical factor in diabetes management. Objective: To evaluate the health literacy levels in diabetic patients and its impact on retinal health, including a complete epidemiological profile of the participants. Subjects and Methods: This observational descriptive cross-sectional study included 500 Egyptian diabetic patients attending the Ophthalmology outpatient clinic at Al-Azhar University Hospitals from November 2022 to September 2023. Participants underwent a comprehensive evaluation including a specially designed questionnaire based on the European Health Literacy Survey (HLS-EU), thorough medical history, complete ophthalmological examination, fundus photography, and laboratory tests as needed. Results: There was a statistically significant correlation between health literacy levels and education, BMI, treatment compliance, and the presence of retinopathy (p<0.05). Among the patients, 320 (64%) had no retinopathy. The percentage of patients with adequate health literacy (excellent and sufficient) was 44.6%, while 55.4% had inadequate health literacy (problematic and inadequate). In patients with diabetic retinopathy, only 22.8% had adequate health literacy. For those with severe diabetic retinopathy, the percentage dropped to 9.2%. Among patients without diabetic retinopathy, 57% had adequate health literacy, whereas 43% had inadequate levels. Conclusion: Health literacy is significantly associated with diabetic retinopathy, treatment compliance, BMI, and education