AimsTo assess the numeracy and literacy skills of individuals with Type 1 diabetes and determine if there was a relationship with achieved glycaemic control independent of socio-economic factors. Methods112 patients (mean age 43.8+/-12.5 years, 47% male, mean duration of diabetes 22.0+/-13.2 years) attending Bournemouth Diabetes and Endocrine Centre were randomly selected from the Centre's diabetes register and invited to participate in the study. The Skills for Life Initial Assessments were used to measure numeracy and literacy. These indicate skills levels up to Level 2, equivalent to the national General Certificate of Secondary Education grades A*-C. HbA 1c was also measured.Pearson's correlation was used to measure the correlation of numeracy and literacy scores with HbA 1c. T-tests were used to compare mean HbA 1c between those with or without Level 2 skills and multiple linear regression was used to investigate whether any differences were independent of demographic and socio-economic factors. ResultsLiteracy was not associated with achieved HbA 1c . In contrast, participants with numeracy skills at Level 2 or above achieved a HbA 1c lower than those with numeracy skills below Level 2 (p=0.03). Although higher socio-economic status was associated with lower mean HbA 1c , the relationship between numeracy and HbA 1c appeared to be independent of socio-economic factors.Diabetic Medicine final manuscript 2.12.10 3 ConclusionLow numeracy skills were adversely associated with diabetes control. Assessment of numeracy skills may be relevant to the structure of diabetes education programmes. Word count 228Diabetes UK Abstract reference MARD8558IN

Although the need for transplantation among African Americans is high, their donation rates are disproportionately low. This study describes the development and validation of culturally adapted psychosocial measures, including Transtheoretical Model constructs, Stages of Change, Decisional Balance, and Self-efficacy, related to deceased organ and tissue donation for an African American college population. Exploratory and confirmatory analyses for Decisional Balance and Self-efficacy measures demonstrated factor structures similar to previous studies of other behavioral applications, indicated excellent model fit and showed good internal and external validity. This study developed brief measures with good psychometric properties for an emerging behavior change domain in a new population.

Living with type 1 diabetes imposes a considerable burden on the individual to continuously self‐manage their condition. As part of an ongoing audit, the psychological outcomes of insulin pump therapy were evaluated over a three‐year period. Adult patients completed self‐report questionnaires at initiation and after 12 months of pump therapy. Diabetes emotional distress was assessed using the Problem Areas in Diabetes Scale (PAID) and cognitive and behavioural aspects of fear of hypoglycaemia using the Hypoglycaemia Fear Survey (HFS‐W, HFS‐B). HbA1c and demographic data were obtained from the clinical record. Data were collected from 190 adults, age mean (SD) years 39.6(13.9), duration of diabetes 21.0(14.1). Outcomes improved significantly from baseline to 12 months for all variables (mean [SD]): HbA1c mmol/mol 73.4(14.9), 64.6(13.1), p<0.000; PAID 23.0(14.4), 16.9(13.3), p<0.000; HFS‐W 24.1(16.3), 15.0(12.9), p<0.000; HFS‐B 19.1(9.7), 13.4(8.1), p<0.000. Paired data analysis did not indicate an association between HbA1c reduction and reduced PAID and HFS scores. It was concluded pump therapy is associated with improvements in medical and psychological variables. While a reduction in both diabetes emotional distress, and worries and behaviours related to fear of hypoglycaemia appear to be unrelated to a reduction in HbA1c, the overall burden of diabetes indicated by diabetes distress and fear of hypoglycaemia is reduced significantly 12 months after initiation of insulin pump therapy. Copyright © 2017 John Wiley & Sons.

Our retrospective analysis adds weight to evidence suggesting that referral rates for people with Type 2 diabetes are increasing rapidly and that mortality rates are reducing but that the reasons for this are multifactorial. In addition to blood pressure, smoking and gender, the HbA(1c) achieved 3 months after the initial diagnosis also appears to predict subsequent mortality. It may be appropriate to consider early and intensive intervention for individuals with new onset type 2 diabetes.

The first year following diagnosis is a critical time for those newly diagnosed with type 1 diabetes and is likely to influence long‐term glycaemic control.This paper describes a group education programme, Living with Diabetes (LwD), and reports the outcome data at one year and three years after diagnosis. HbA1c was compared with outcomes from the cohort diagnosed during the four years prior to the inception of LwD.We have demonstrated that, in terms of HbA1c, the programme achieved outcomes similar to the traditional model with similar staff resources. The LwD pathway required an additional 2.9 hours per patient but HbA1c values were consistently lower in those who attended all sessions.The data suggest the need for more concerted attention to engage patients in an ongoing care pathway during the early years following diagnosis. An evaluation of the programme suggested that patients valued the relaxed non‐hierarchical nature of the group and the opportunity to share with and ask questions of their peers. Copyright © 2013 John Wiley & Sons.