Introduction:
In Victoria, 2,300 adults use insulin pump therapy (IPT) to manage their type 1 diabetes (T1D). Carbohydrate counting (CC) is integral to IPT and for achieving optimal HbA1c. However low numeracy skills may reduce CC confidence and accuracy. Self-efficacy strongly predicts behaviour change, therefore CC confidence may increase IPT self-efficacy and hence improve T1D self-management.
Aim:
To determine whether a CC skills workshop increases CC confidence among adults with T1D using or planning to use IPT.
Methods:
Fifty participants attended a 4-hour workshop that included theoretical and mathematical components and hands-on activities. Participants completed a 13-item study-specific questionnaire before, immediately after and three months post-workshop. Items rated confidence in CC and using a calculator for CC, on a 4-point scale 0 (“not at all confident”) to 3 (“extremely confident”). Self-efficacy for CC-related numeracy was rated on a 5-point scale (0-4; “very difficult” to “very easy”).
Results:
Most participants (n=43; 86%) were using IPT (mean 3.4 years; 34% were male; mean age 51.5 years, range 24-74; mean diabetes duration 23.4 years, range 1-58). Before the workshop 50% of participants (n=25) were “not at all confident” or “a little confident” in CC. Immediately after the workshop, participants had increased CC confidence (+0.75, 95% CI 0.44-1.05; p<0.001), confidence to use a calculator for CC (+0.67, 95% CI 0.23-1.10; p=0.002), and self-efficacy for CC-related numeracy (+0.77, 95% CI 0.28-1.26; p=0.001).
At 3-month follow-up (n=29; 58%) participants’ increased confidence was maintained. There was no correlation between CC confidence and age, gender, length of T1D diagnosis or duration of IPT use.
Conclusion:
Despite long-standing T1D and using IPT for several years, many adults are not confident with CC. Attending a CC workshop increased self-efficacy in adults using IPT, which may improve their uptake and accuracy of CC.