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Type of Medical Care Received Can Improve Patients’ Diabetes Numeracy

Glycemic control unaffected by improved ability to understand numbers…

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Managing diabetes requires patients to rely heavily on self-care in monitoring their blood glucose levels, adjusting their diet accordingly and taking their medications. Having the ability to use and understand numbers is vital to patients with diabetes, yet a literature review shows that many patients are not well-versed in using numbers to manage their diabetes. About 25% of patients could not identify a normal blood glucose value, 56% were unable to correctly count carbohydrates using a food label and 59% could not adjust their insulin dose based on a blood glucose reading. A previous study showed that those with low diabetes numeracy scores had lower self-efficacy perception and poorer glycemic control. This previous study did not explore the association between numeracy and whether the patient receives diabetes care from a specialist or a primary care physician.

Researchers for this study compared diabetes numeracy and glycemic control depending on the diabetes care the patient received. Patients either saw an endocrinologist in a diabetes-focused center or a primary care physician. The study also compared how type 1 diabetes patients’ management compared to type 2 diabetes patients’.

To calculate diabetes numeracy, the Diabetes Numeracy Test-15 (DNT-15) was used. It has been validated to effectively assess a patient’s diabetes numeracy using 15 questions. A total of 194 subjects took part in this study. The DNT-15 scores were used to measure the primary outcome.

A statistically significant difference was observed in DNT-15 scores depending on type of care the patients received. Those seeing an endocrinologist had higher average scores when compared to those seeing their primary care physician (12.905 vs 9.384, P=0.002). A significant difference in glycemic control was not observed depending on type of care (average HbA1c 7.886 vs 7.647, P>0.05). A significant difference was also not observed in DNT-15 scores when comparing type 1 and type 2 diabetes patients (11.95 vs 11.43, P>0.05).

The results of this study showed that diabetes patients seeing an endocrinologist or a diabetologist had higher average numeracy scores than those patients seeing a primary care physician. These increased scores, however, did not lead to improved glycemic control. While the results of this study were unable to demonstrate the importance of numeracy in diabetes patients, physicians should still be aware that low numeracy skills could be a potential detriment to optimal glycemic control.

Practice Pearls:

  • High numeracy skills are considered important for diabetes patients to adequately use self-care on daily basis
  • This study examined whether the type of care a patient receives (diabetes-focused center vs primary care center) leads to higher numeracy scores and better glycemic control
  • Patients seeing an endocrinologist were likely to have higher diabetes numeracy scores, but this did not translate to having improved glycemic control

Zuagg SD, Dogbey G, Collins K, Reynolds S, Batista C et al. Diabetes Numeracy and Blood Glucose Control: Association With Type of Diabetes and Source of Care. Clinical Diabetes. 2014.