title: Glycemic control in pediatric type 1 diabetes: role of caregiver literacy.
abstract: OBJECTIVE
  Poorly controlled diabetes may occur because caregivers of children with type 1 diabetes fail to comprehend provided diabetes education. We hypothesized that poorly controlled diabetes is associated with lower literacy/numerical skills of caregivers of children with type 1 diabetes.
  
  
  METHODS
  Primary caregivers were evaluated by using Newest Vital Sign (NVS) and a sociodemographic questionnaire. The NVS identifies individuals who are at risk for low health literacy by measuring general literacy/numeracy skills and yields an overall estimate of health literacy. The NVS scores are interpreted to suggest inadequate, limited, or adequate literacy.
  
  
  RESULTS
  Two hundred caregivers of children who had type 1 diabetes with mean hemoglobin A1c (HbA1c) of 8.8 +/- 1.9%, age of 11.8 +/- 3.7 years, duration of disease of 4.8 +/- 3.3 years, and BMI of 20.8 +/- 4.4 kg/m(2) participated. HbA1c in those of inadequate literacy (10.4 +/- 2.2%) was significantly higher than in those of adequate literacy (8.6 +/- 1.7%; P < .001). HbA1c in those whose caregivers had limited literacy (9.5 +/- 2.2%) did not differ significantly from the other 2 groups. On adjusting for independent covariates, we found that children whose caregivers had at least 50% correct math answers had better glycemic control (8.5 +/- 1.7%) than those who failed (9.8 +/- 2.1%; P < .0005).
  
  
  CONCLUSIONS
  Literacy and numerical skills of caregivers significantly influence glycemic control of their children with type 1 diabetes. Assessing literacy/numeracy skills of caregivers and addressing these deficiencies may be crucial in optimizing glycemic control.
authors.affiliation: Department of Pediatric Endocrinology, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Krishnavathana
authors.initials: K
authors.lastname: Hassan
authors.forename: Rubina A
authors.initials: RA
authors.lastname: Heptulla
mesh_terms: D015992:Body Mass Index; D017028:Caregivers / Q000193:education* / Q000523:psychology; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000453:epidemiology / Q000523:psychology; D003927:Diet, Diabetic; D004522:Educational Status; D005515:Food Labeling; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008403:Mass Screening; D008433:Mathematics; D015999:Multivariate Analysis; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013781:Texas
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human