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Journal of Diabetes Research
Volume 2016, Article ID 3458969, 8 pages
Research Article

The Influence of Health Literacy and Depression on Diabetes Self-Management: A Cross-Sectional Study

1South Western Sydney Local Health District, 59a Cumberland Road, Ingleburn, NSW 2565, Australia
2School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
3Centre for Applied Nursing Research, Locked Bag 7103, Liverpool, NSW 1871, Australia
4Ingham Institute for Applied Medical Research, P.O. Box 3151, Liverpool, NSW 2170, Australia

Received 6 May 2016; Revised 15 July 2016; Accepted 19 July 2016

Academic Editor: Bernadette Bartlam

Copyright © 2016 D. Maneze et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Despite an increasing focus on health literacy in the clinical setting and in the literature, there is still ongoing debate about its influence on diabetes self-management. The aim of the study was to examine the relationships of sociodemographic, clinical, and psychological factors on health literacy and diabetes self-management. A cross-sectional survey was undertaken on 224 patients with type 2 diabetes at two diabetes centres in Sydney, Australia. Findings showed that people with low health literacy were more likely to (a) have lower educational attainment; (b) be migrants; and (c) have depressed mood. Unexpectedly, those who met threshold of good glucose control were more likely to have low health literacy. Predictors of low diabetes self-management included (a) younger age group (AOR: 2.58, 95% CI: 1.24–4.64); (b) having postsecondary education (AOR: 2.30, 95% CI: 1.05–5.01); (c) low knowledge of diabetes management (AOR: 2.29, 95% CI: 1.25–4.20); and (d) having depressed mood (AOR: 2.30, 95% CI: 1.30–4.06). The finding that depressed mood predicted both low health literacy and low diabetes self-management stresses the importance of screening for depression. Increasing people’s understanding of diabetes self-management and supporting those with depression are crucial to enhance participation in diabetes self-management.