Health literacy of patients using continuous glucose monitoring

Low health literacy and numeracy are associated with poor health outcomes and lower self-efficacy. Continuous glucose monitors (CGMs) can improve diabetes management, but their benefits may be limited by health literacy levels. Our objective was to characterize health literacy levels of ambulatory care patients using CGMs to manage their diabetes in 1 urban health system. Secondary aims were to identify specific knowledge deficits related to CGM education and determine predictors of self-rated comfort with and understanding of CGM use. Participants with type 1 or type 2 diabetes using CGMs were identified using electronic medical records. Participants completed a telephone survey, including the Health Literacy Scale/Subjective Numeracy Scale (HLS/SNS) and an investigator-developed survey assessing CGM comfort and understanding. Descriptive statistics were reported for demographic information. The associations between patient characteristics and survey responses were evaluated using the chi-square test, Fisher’s exact test, or Wilcoxon rank-sum test. Eighty-two participants completed the surveys. The median HLS/SNS score for study participants was 80 (Interquartile range 71-89). Associations were found between HLS/SNS scores and education level, reported income, and private insurance coverage. Participants with higher HLS/SNS scores reported higher levels of CGM understanding and comfort. Fifty-one percent of participants (n = 42) reported no or inadequate training prior to CGM initiation. Better A1C results (