Poor numeracy skills are associated with glycaemic control in Type 1 diabetes


Sarah Marden, Diabetes Dietitian, Bournemouth Diabetes and Endocrine Centre, Royal Bournemouth Hospital NHS Foundation Trust, Bournemouth, BH7 7DW, UK. E-mail: sarah.marden@nhs.net


Diabet. Med. 29, 662–669 (2012)


Aims  To assess the numeracy and literacy skills of individuals with Type 1 diabetes and determine if there is a relationship with achieved glycaemic control independent of their duration of diabetes, diabetes education, demographic and socio-economic factors.

Methods  One hundred and twelve patients completed the study (mean current age 43.8 ± 12.5 years, 47% male, mean duration of diabetes 22.0 ± 13.2 years) out of 650 randomly selected patients from the Bournemouth Diabetes and Endocrine Centre’s diabetes register. The Skills for Life Initial Assessments were used to measure numeracy and literacy. These indicate skills levels up to level 2, equivalent to the national General Certificate of Secondary Education grades A*–C. HbA1c was also measured. Pearson’s correlation was used to measure the correlation of numeracy and literacy scores with HbA1c. To compare mean HbA1c between those with or without level 2 skills, t-tests were used, and multiple linear regression was used to investigate whether any differences were independent of duration of diabetes, diabetes education, demographic and socio-economic factors.

Results  Literacy was not associated with achieved HbA1c. In contrast, participants with numeracy skills at level 2 or above achieved an HbA1c lower than those with numeracy skills below level 2 (P = 0.027). Although higher socio-economic status was associated with lower mean HbA1c, the relationship between numeracy and HbA1c appeared to be independent of socio-economic factors.

Conclusions  Low numeracy skills were adversely associated with diabetes control. Assessment of numeracy skills may be relevant to the structure of diabetes education programmes.