Skip Navigation
American College of Physicians Logo
  • Subscribe
  • Submit a Manuscript
  • Sign In
    Sign in below to access your subscription for full content
    INDIVIDUAL SIGN IN
    Sign In|Set Up Account
    You will be directed to acponline.org to register and create your Annals account
    INSTITUTIONAL SIGN IN
    Open Athens|Shibboleth|Log In
    Annals of Internal Medicine
    SUBSCRIBE
    Subscribe to Annals of Internal Medicine.
    You will be directed to acponline.org to complete your purchase.
Annals of Internal Medicine Logo Menu
  • Latest
  • Issues
  • Channels
  • CME/MOC
  • In the Clinic
  • Journal Club
  • Web Exclusives
  • Author Info
Advanced Search
  • ‹ PREV ARTICLE
  • This Issue
  • NEXT ARTICLE ›
Summaries for Patients |20 May 2008

Association of Numeracy and Diabetes Control Free

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
  • The summary below is from the full report titled “Association of Numeracy and Diabetes Control.” It is in the 20 May issue of Annals of Internal Medicine (volume 148, pages 737-746). The authors are K. Cavanaugh, M.M. Huizinga, K.A. Wallston, T. Gebretsadik, A. Shintani, D. Davis, R. Pratt Gregory, L. Fuchs, R. Malone, A. Cherrington, M. Pignone, D.A. DeWalt, T.A. Elasy, and R.L. Rothman.


Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.
×
  • ‹ PREV ARTICLE
  • This Issue
  • NEXT ARTICLE ›
Jump To
  • Full Article
  • FULL ARTICLE
    • What is the problem and what is known about it so far?
    • Why did the researchers do this particular study?
    • Who was studied?
    • How was the study done?
    • What did the researchers find?
    • What were the limitations of the study?
    • What are the implications of the study?
  • Figures
  • Tables
  • Supplements
  • Audio/Video
  • Summary for Patients
  • Clinical Slide Sets
  • CME / MOC
  • Comments
  • Twitter Link
  • Facebook Link
  • Email Link
More
  • LinkedIn Link
  • CiteULike Link

What is the problem and what is known about it so far?

Diabetes requires the patient to do most of the thinking. One of the most difficult tasks is working with numbers (for example, calculating the number of calories in a portion of food or deciding how much insulin to take after a high blood-sugar test result). People vary in their ability to understand numbers and solve math problems. Moreover, the average blood sugar varies widely among patients with diabetes. Therefore, improving diabetic patients' skills with numbers might improve their diabetes self-care.

Why did the researchers do this particular study?

To test diabetic patients' ability to work with numbers and to see whether skill with using numbers is associated with good control of blood sugar.

Who was studied?

Patients with diabetes from 2 primary care clinics and 2 clinics that specialized in caring for patients with diabetes. The patient population was 63% white. A total of 43% did not complete high school, and 44% had an annual income less than $20,000.

How was the study done?

The authors measured reading ability (literacy) and basic skill with numbers (numeracy) using proven tests used in many research projects. They also developed a test of skill in calculating and interpreting numbers that patients must use in the daily tasks of managing their diabetes (Diabetes Numeracy Test). For example, one question gave the desirable range of blood sugar and asked which of 3 values was in this range. The authors measured the patients' hemoglobin A1c levels, which indicate a patient's average blood sugar.

What did the researchers find?

Nearly one third of the patients had reading skills less than a 9th-grade level, and 69% had less than 9th-grade skills with numbers. One half of the patients got a score of 70% or less on the test of diabetes numeracy. One problem stated: “You have a prescription for Metformin 500-mg tablets. The label says ‘Take 1 tablet with supper each night for the first week. Then, increase by 1 tablet each week for a total of 4 tablets daily with supper.’ How many tablets should you take with supper each night the second week?” Only 65% selected the correct answer, which is 2 tablets. Patients who were older, were nonwhite, and had less formal education had lower diabetes numeracy test scores.
At every level of diabetes numeracy, the average blood sugar varied widely from patient to patient. In the entire study sample, lower numeracy was associated with slightly worse blood sugar. This relationship was stronger in certain patients: those who were younger, had worse health-related literacy, or had recently received a diabetes diagnosis.

What were the limitations of the study?

Although the patients were diverse in racial origin, income, and education, they all spoke English. The study did not report the frequency of mistakes that led to serious problems, such as dangerously low blood sugar.

What are the implications of the study?

Most of these patients were not skilled with numbers (poor diabetes numeracy) and had difficulty with problems that they would need to solve in the everyday management of their diabetes. However, at every level of diabetes-related numeracy—from good to poor—their average blood sugar varied widely. Although the patients' skill with numbers was associated with slightly better blood sugar levels, it appeared to be a small factor in managing their diabetes.

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

This feature is available only to Registered Users

Subscribe/Learn More
Submit a Comment

0 Comments

PDF
Not Available
Citations
Citation

Association of Numeracy and Diabetes Control. Ann Intern Med. 2008;148:I–53. doi: 10.7326/0003-4819-148-10-200805200-00002

Download citation file:

  • RIS (Zotero)
  • EndNote
  • BibTex
  • Medlars
  • ProCite
  • RefWorks
  • Reference Manager

© 2018

×
Permissions

Published: Ann Intern Med. 2008;148(10):I-53.

DOI: 10.7326/0003-4819-148-10-200805200-00002

©
2008 American College of Physicians
0 Citations

See Also

Association of Numeracy and Diabetes Control
View MoreView Less

Related Articles

Protocol-based nurse management of type 2 diabetes did not differ from usual GP care for HbA1c levels
Annals of Internal Medicine; 155 (6): JC3-7
Effect of Antihyperglycemic Agents Added to Metformin and a Sulfonylurea on Glycemic Control and Weight Gain in Type 2 Diabetes: A Network Meta-analysis
Annals of Internal Medicine; 154 (10): 672-679
Update in Endocrinology: Evidence Published in 2010
Annals of Internal Medicine; 154 (10): 684-689
The Effect of Adding Exenatide to a Thiazolidinedione in Suboptimally Controlled Type 2 Diabetes: A Randomized Trial
Annals of Internal Medicine; 146 (7): 477-485
View MoreView Less

Journal Club

Protocol-based nurse management of type 2 diabetes did not differ from usual GP care for HbA1c levels
Annals of Internal Medicine; 155 (6): JC3-7
View MoreView Less

Related Point of Care

Peripheral Arterial Disease
Annals of Internal Medicine; 146 (5): ITC3-1
Type 2 Diabetes
Annals of Internal Medicine; 162 (5): ITC1
Type 2 Diabetes
Annals of Internal Medicine; 152 (5): ITC3-1
View MoreView Less

Related Topics

Cardiology
Coronary Risk Factors
Diabetes
Endocrine and Metabolism

Cardiology, Coronary Risk Factors, Diabetes, Endocrine and Metabolism.

PubMed Articles

Causal Association of Overall Obesity and Abdominal Obesity with Type 2 Diabetes: A Mendelian Randomization Analysis.
Obesity (Silver Spring) 2018.
View More

Results provided by: PubMed

CME/MOC Activity Requires Users to be Registered and Logged In.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
The Comments Feature Requires Users to be Registered and Logged In.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
link to top

Content

  • Home
  • Latest
  • Issues
  • Channels
  • CME/MOC
  • In the Clinic
  • Journal Club
  • Web Exclusives

Information For

  • Author Info
  • Reviewers
  • Press
  • Readers
  • Institutions / Libraries / Agencies
  • Advertisers

Services

  • Subscribe
  • Renew
  • Alerts
  • Current Issue RSS
  • Online First RSS
  • In the Clinic RSS
  • Reprints & Permissions
  • Contact Us
  • Help
  • About Annals
  • About Mobile
  • Patient Information
  • Teaching Tools
  • Annals in the News
  • Share Your Feedback

Awards

  • Personae Photography Prize
  • Junior Investigator Awards
  • Poetry Prize

Other Resources

  • ACP Online
  • Career Connection
  • ACP Advocate Blog
  • ACP Journal Wise

Follow Annals On

  • Twitter Link
  • Facebook Link
acp link acp
silverchair link silverchair

Copyright © 2018 American College of Physicians. All Rights Reserved.

Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Privacy Policy

|

Conditions of Use

×

You need a subscription to this content to use this feature.

×
PDF Downloads Require Access to the Full Article.
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
INSTITUTIONAL SIGN IN
Open Athens|Shibboleth|Log In
Annals of Internal Medicine
PURCHASE OPTIONS
Buy This Article|Subscribe
You will be redirected to acponline.org to sign-in to Annals to complete your purchase.
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
Access to this Free Content Requires Users to be Registered and Logged In. Please Choose One of the Following Options
Sign in below to access your subscription for full content
INDIVIDUAL SIGN IN
Sign In|Set Up Account
You will be directed to acponline.org to register and create your Annals account
Annals of Internal Medicine
CREATE YOUR FREE ACCOUNT
Create Your Free Account|Why?
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×