Assessment of nutritional literacy and its association with glycemic control and obesity in type 2 diabetic patients in Bahrain

Abstract

Introduction Limited evidence exists on the association between nutritional literacy, glycemic control, and obesity among patients with type 2 diabetes mellitus (T2DM) in Bahrain. This study assessed nutritional literacy and its association with glycemic control and obesity among adults with T2DM. Methods A cross-sectional study was conducted among 364 adults with T2DM recruited using consecutive sampling from public primary healthcare centers across Bahrain between July and August 2024. Data were collected through face-to-face interviews using a pilot-tested structured questionnaire administered by trained researchers (Cronbach’s α = 0.78). Glycemic control (HbA1c) and body mass index (BMI) were obtained from medical records. Data were analyzed using descriptive statistics, Pearson’s chi-square test, and multivariable logistic regression. Results Higher educational attainment was significantly associated with better glycemic control (p = 0.015), lower BMI (p = 0.019), and greater nutritional literacy (p < 0.001). Participants who used ingredient lists had better glycemic control (p = 0.040), whereas exposure to incorrect nutritional information (p = 0.003) and difficulty accessing nutritional information (p = 0.011) were associated with poorer glycemic control. Overall, 51.2% of participants were obese, 38.7% had very poor glycemic control (HbA1c > 8%), and only 5.7% correctly interpreted nutrition facts. These findings suggest that nutrition literacy-related knowledge and behaviors may play an important role in glycemic control and obesity among adults with T2DM. Conclusion Limited Nutrition literacy-related behaviors were associated with poorer diabetes-related outcomes. Targeted nutritional education may improve glycemic control and obesity management among adults with T2DM in Bahrain. Future longitudinal studies are needed to confirm these findings.