Diabetes + Poor Math Skills = Higher A1c

Having diabetes involves a lot of  pretty complex arithmetic. You’ve got to calculate carbs from nutrition labels, total the calories and carbohydrates in a meal, calculate insulin dosage based on insulin-to-carbohydrate intake, and on and on. These tasks aren’t simple: They require an understanding of measurement, estimation, time, logic, and multi-step operations, and the knowledge of which math skills to apply to each problem.

But what if you’re challenged when it comes to understanding and using numbers and math skills in daily life, otherwise known as having poor numeracy (the math equivalent of literacy)? According to a recent study, poor numeracy can explain the association between African American ethnicity and poor glycemic control (high A1c) in patients with type 2 diabetes.

The study, led by Dr. Chandra Y. Osborn and colleagues at Vanderbilt University in Nashville, Tennessee, tested 383 adults with type 2 diabetes on their ability to perform common diabetes-related numerical tasks. The subjects were asked to perform calculations such as this one, from the Diabetes Numeracy Test created by Vanderbilt University: “You have to eat six grams of carbohydrate for each 30 minutes you plan to walk. You are planning to walk for one hour. You have a bag with 12 crackers. Each cracker contains 10 grams of carbohydrate. How many crackers do you need to eat before your walk?”

Overall, the researchers found, patients with the highest test scores had lower A1c’s, reflecting better average blood sugar levels over the previous few months. They also concluded that diabetes numeracy can explain the ethnic disparities seen in diabetes. African Americans with diabetes tend to have poorer blood sugar control than whites, as well as higher rates of diabetes complications. But this study found that low diabetes-related numeracy, not ethnicity, was the factor significantly related to poor glycemic control.

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Diabetes Care, September 2009


The Diabetes Numeracy Test, Vanderbilt University

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