Background: This study was designed to investigate the status of diabetes-related health literacy among the elderly in rural China and to explore the influencing factors. Methods: The "Chinese Public Diabetes Prevention and Control Literacy Questionnaire" and a general socio-demographic questionnaire were completed by the participants selected by the multistage cluster random sampling method. The collected data were used to analyse the factors affecting diabetes-related health literacy of the rural elderly. Results: A total of 867 elderly aged 60 years and over participated in this study. The average score for diabetes-related health literacy was 18.64±8.68; among the study population, 2 individuals, 408 individuals, and 457 individuals were in the high, medium, and low levels of health literacy, respectively. The results of a statistical analysis showed that sex (OR=1.511, 95% CI:1.052 - 2.172), marital status (OR= 0.571, 95% CI: 0.384 - 0.849), personal annual income (OR=1.575, 95% CI:1.009 - 2.457), history of hyperglycaemia (OR=0.363, 95% CI: 0.184 - 0.717), and pre-diabetes (OR=23.406, 95% CI: 15.661 - 34.981) were the main influencing factors of diabetes-related health literacy among the elderly in Yiyang City, Hunan Province. Conclusion: The level of diabetes-related health literacy was very low among the elderly in China's rural areas. This indicates that diabetes health education for the rural elderly population should be strengthened through multiple channels in the future, and more attention should be paid to older male adults with unstable marriage, poor economic conditions, prediabetes, and no history of hyperglycaemia.
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