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Numeracy Skills and Glycemic Control in an Observational, Multicenter, Cross-Sectional, and International Study of
Ioanna Kosteria1, Przemyslawa Jarosz-Chobot2, Carine de Beaufort3,4
1Department of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, National and Kapodistrian University of Athens, Athens, Greece.
Insights
Numeracy skills, measured by the Wordless Mathematical Test (WMT), predict glycemic control (HbA1c) in children with type 1 diabetes. This suggests personalized therapy adjustments may improve outcomes.
Area of Science:
- Pediatric Endocrinology
- Diabetes Management
- Health Psychology
Background:
- Glycemic control in type 1 diabetes (T1D) is crucial for preventing long-term complications.
- Numeracy skills, the ability to understand and use numerical information, may influence self-management of T1D.
- Previous research has not fully elucidated the relationship between general numeracy and T1D outcomes in adolescents.
Purpose of the Study:
- To investigate the association between numeracy skills and glycemic outcomes (HbA1c) in children and adolescents with T1D.
- To evaluate the predictive utility of general numeracy (Wordless Mathematical Test, WMT) versus diabetes-specific numeracy (Diabetes Numeracy Test, DNT-5) for HbA1c levels.
- To explore the potential of numeracy assessment in tailoring diabetes care.
Main Methods:
- Cross-sectional study involving 306 adolescents (aged 12-18) with T1D from 7 centers.
- Centralized HbA1c measurement.
- Assessment of numeracy using the WMT and DNT-5.
- Multivariate generalized linear modeling to predict HbA1c, with model selection via adjusted R-squared.
- Pearson's correlation to assess observed vs. predicted HbA1c in training and testing datasets.
Main Results:
- Numeracy skills, as assessed by the WMT, significantly predicted HbA1c levels after adjusting for sociodemographic and clinical factors.
- The DNT-5 did not show a significant association with HbA1c.
- The WMT-based predictive model demonstrated a significantly higher effect size compared to single-parameter models (p < 0.05).
- Observed and predicted HbA1c correlations were consistent across training (0.34) and testing (0.37) datasets.
Conclusions:
- General numeracy skills, measured by the WMT, are a significant predictor of glycemic control in pediatric T1D.
- The WMT is a potentially valuable and efficient tool for personalized diabetes care in clinical practice.
- Consideration of patients' numeracy skills in therapy planning and potential numeracy training may improve diabetes management.
Aims:
This study examined the possible association between numeracy skills and glycemic outcomes in children with type 1 diabetes.
Methods:
The study used a cross-sectional design and collected data from 7 centers of the Hvidoere Study Group. HbA1c was measured centrally. Numeracy was assessed using the specific 5-item Diabetes Numeracy Test (DNT-5) and the international, general Wordless Mathematical Test (WMT). The HbA1c predictive multivariate generalized linear model was constructed using the adjusted R-squared index for model selection. Pearson's correlation coefficient was calculated between observed and predicted HbA1c levels in the training and testing datasets.
Results:
Overall,306 adolescents aged 12-18 (mean age 14.96 ± 1.68) years and diabetes duration of 6.57 (±3.75) participated in this study. Numeracy skills, as assessed by the WMT but not DNT-5, predicted the HbA1c levels after adjustment for sociodemographic and clinical factors. The correlation between observed and predicted HbA1c levels was consistent in both datasets and was 0.34 (N = 155) and 0.37 (N = 61) for the training and test datasets, respectively (p = 0.412). The effect size for the WMT-based predictive model of HbA1c adjusted for clinical and socioeconomic factors was significantly higher (p < 0.05) than the single-parameter-based model.
Conclusions:
Numeracy, as assessed by an international general math test, is a good predictor of HbA1c in children and adolescents with type 1 diabetes. The basic and short WMT is a potentially effective tool in personalized clinical pediatric diabetes practice. Therapy planning should consider adjusting therapy to compensate for lower numeracy skills and/or training to improve the patient's numerical proficiency.
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