Numeracy skills are vital for a child with diabetes as they need to be able to manage their diabetes effectively, in order to protect one from the complications that come with diabetes. There have been numerous studies that illustrate the poor numeracy skills in children with diabetes. A numeracy intervention specifically related to diabetes was put into place to illustrate whether or not such an intervention is effective in improving a child’s diabetic numeracy ability, which will lead to the improvement of diabetes self-management in the future. A Quantitative quasi-experimental pre-test - post-test non equivalent control group design was conducted to explore the efficacy of an applied numeracy intervention in a South Africa type 1 diabetic child population. The study group comprised of 58 children with type 1 diabetes, each group consisted of 29 participants, and each participant in the experimental group was closely matched according to their level of formal education, grade, age and sex to a research participant in the control group. Both groups were measured before and after the intervention. The children were between the ages of 8 and 13. All participants were in formal education between Grades 3 and Grade 8. Results revealed that participants in both groups had lower ‘functional’ grades as compared to their ‘actual grade’ level which suggests that they performed below their expected grade level. Participants performed better in areas assessing basic mathematical skills than areas which assessed applied diabetes mathematical skills. The intervention was shown to be effective as analyses revealed that there was a highly significant difference (p<0.001) between the Pre and Post Test (applied mathematical sections) of the experimental group which took part in the intervention. This research is only the starting point for the assessment of the effectiveness of a numeracy component in diabetes related education in South Africa, and through this one would hope that more research in South Africa will be done in this area.

Type I diabetes has the ability to promote change in the family. In truth, although the child with diabetes is the diagnosed patient, the whole family has diabetes. While the challenges that families have to face are many, families seem to have the ability to “bounce back” (i.e., they have resilience). Research on the construct of resilience, and more specifically, family resilience has surged in recent times. However, South African research on family resilience is limited. This study aimed to explore and describe the factors that facilitate adjustment and adaptation in families that include a child living with Type I diabetes. The Resiliency Model of Stress, Adjustment and Adaptation, developed by McCubbin and McCubbin (2001) served as a framework to conceptualise the families’ adjustment and adaptation process. Non-probability purposive and snowball sampling techniques were employed. Sixteen families participated in this study, providing a total of 31 participants. Participants consisted of the caregivers of a family living with a child between the ages of four and 12 with Type I diabetes. The study was triangular in nature, with an exploratory, descriptive approach. A biographical questionnaire with an open-ended question was used in conjunction with seven other questionnaires to gather data. These questionnaires were: The Family Hardiness Index (FHI), the Family Time and Routine Index (FTRI), the Social Support Index (SSI), the Family Problem-Solving Communication (FPSC) Index, the Family Crises-Oriented Personal Evaluation Scales (F-COPES), the Relative and Friend Support Index, and the Family Attachment and Changeability Index 8 (FACI8). Descriptive statistics were used to describe the biographical information. Quantitative data were analysed by means of correlation and regression analysis, and a content analysis was conducted to analyse the qualitative data. The results of the quantitative analysis indicated three significant positive correlations with the FACI8. These variables were family hardiness (measured by the FHI), family problem-solving communication (measured by the FPSC), and family time and routines (measured by the FTRI). The results of the qualitative analysis revealed that social support, the caregivers’ acceptance of the condition, and spirituality and religion were the most important strength factors that contributed to the families’ adjustment and adaptation. Although the study had a small sample and many limitations, the study could be used as a stepping-stone for future research on resilience in families living with chronic medical conditions and will contribute to family resilience research in the South African context.

The aim of this study was to assess the dietary intake, diet-related knowledge and metabolic control in children with Type 1 Diabetes Mellitus between the ages of 6-10 years attending the Paediatric Diabetic Clinics at Grey’s Hospital, Pietermaritzburg and Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu-Natal. This was a cross sectional observational study that was carried out in a total of 30 subjects out of a possible 35 subjects that qualified for inclusion in the study from both the Grey’s Hospital clinic (n=8) and IALCH clinic (n=22). The dietary intake was assessed in a total of 25 subjects using a three day dietary record (n=20) and a 24 hour recall of the third day of the record (n=16). Diet-related knowledge was assessed using a multiple choice questionnaire. Metabolic control was assessed using the most recent HbA1c and the mean HbA1c results over the previous 12 months from the date of data collection. Height and weight measurements were also carried out. Information on socioeconomic status and education status of the caregivers was obtained from 22 caregivers through follow-up phone calls. All measurements except for dietary intake were obtained from all subjects participating in the study. The mean percentage contribution of macronutrients to total energy was very similar to the International Society for Pediatric and Adolescent Diabetes (ISPAD) Consensus Guidelines (2002). The mean percentage contribution of macronutrients to total energy from the 3 day dietary records and the 24 hour recalls were as follows: carbohydrate (52% and 49%); sucrose (2% and 2%); protein (16% and 17%); fat (32% and 34%). Micronutrient intake was adequate for all micronutrients except for calcium and vitamin D which showed low intakes. The mean diet-related knowledge score for the sample was 67% with significantly higher scores in children older than 8 years of age. The latest HbA1c for the sample was 9.7% and the mean HbA1c over the previous 12 months from the date of data collection was 9.6%. There was a significant positive correlation between age of the participant and the latest HbA1c (r = 0.473; p=0.008) and a significant negative correlation between the education level of the caregivers and the latest HbA1c (r = - 0.578; p=0.005) and the mean HbA1c over 12 months (r = - 0.496; p=0.019). Significant differences were found between African and Indian children respectively for HbA1c, with higher values in African children. There was no correlation between BMI for age and latest HbA1c (r = 0.203, p=0.282) or mean HbA1c over 12 months (r = 0.101, p=0.594). Z score for BMI for age was also not correlated with latest HbA1c (r = 0.045, p=0.814) or mean HbA1c over 12 months (r = - 0.012, p=0.951). Children from the Grey’s Hospital Clinic were found to have higher HbA1c values (p=0.001) and lower diet-related knowledge scores as compared to the children from the IALCH Clinic (p=0.038). It should be noted that the ethnic and racial composition of the children attending these two clinics differed. In conclusion the macronutrient intake in this sample was found to be similar to the ISPAD Consensus Guidelines (2002) while calcium and vitamin D intakes were low. Overall this sample displayed good diet-related knowledge while metabolic control was found to be poor. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2007.