Management of type 1 diabetes (T1D) requires the ability to perform, process, and understand the clinical importance of mathematical calculations to correctly dose insulin. This degree of comprehension is the backbone of health literacy and numeracy (HLN). The Newest Vital Sign (NVS) is a valid and reliable tool to assess HLN in a clinic setting. Few studies have evaluated the NVS in youth living with T1D and its relationship to glycemic control. We hypothesized lower HLN in caretakers and patients would be associated with higher HbA1c among youth with T1D.

A cross sectional study was conducted to assess the degree of HLN in caretakers (for patient ages 6-18 years) and adolescent patients (ages 13-18 years) living with T1D. The NVS consists of 6 questions based on a fictitious nutrition label from an ice cream container. Total scores reflect probable level of HLN (0-1 likely limited; 2-3 possibly limited; 4-6 adequate literacy).

Data from 44 adult caretakers and 23 patients living with T1D was collected. Mean±SD HbA1c for youth was 8.0±1.8% (range 5.4-12.8%). Of the 44 caretakers, 42 (95.5%) scored 4-6, indicating adequate HLN, and 0 caretakers scored 0-1 points. Of 23 adolescent patients with T1D, 16 (69.5%) had adequate HLN, with 5 (21.7%) scoring 2-3, and 1 (4.3%) scoring only 1 point: high likelihood of low HLN. Youths’ HLN scores increased with age with the lowest HLN score of 1 in a patient that was 13.08 years. Mean age of those scoring 2-3 was 15.3 years and those scoring >4 was 16.5 years. HbA1c levels did not correlate with HLN scores in either caretakers or patients.

In caretakers of youth living with T1D, the NVS was unable to capture variations in HLN, possibly because this tool is based on a nutrition label which underlies all diabetes education. Given the importance of HLN in diabetes care, future work is needed to identify the best tool to assess HLN in those providing and receiving care for T1D.


L.Sancrainte: None. A.S.Shah: None. K.A.Bowers: None. A.C.Leyendecker: None. N.Yayah jones: Consultant; Medtronic.

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