From the public health perspective, health literacy may represent an important variable explaining the prevalence of poor health outcomes among patients with type 2 diabetes,15 as well as some of the socioeconomic, racial, and ethnic disparities in diabetes outcomes in the United States.17,34 A considerable proportion of patients with type 2 diabetes is likely to have poor health literacy. In the United States, nearly 80% of patients with type 2 diabetes have completed only high school or less compared with 40% of the general population.16 In our sample, 66% of patients with a high school education or less had inadequate or marginal health literacy. Because of its higher prevalence in racial and ethnic minorities,1 poor health literacy may represent an important variable contributing to high rates of diabetes complications, such as diabetic retinopathy and blindness, end-stage renal disease, and lower extremity amputations among racial and ethnic minorities.35- 40