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The Healthy Living Magazine

This Is a Test

By Erika Gebel, PhD ,

Numbers, numbers, numbers. Having diabetes can sometimes seem like an endless math test: there's the carb counting, the blood glucose levels, the insulin dosing…. Now, there's a real test: the Diabetes Numeracy Test, specially designed to assess diabetes math smarts. And it's not just about bragging rights; your health may be tethered to this grade. "People who did better tended to have better glucose control," says test developer Russell Rothman, MD, MPP, an assistant professor at Vanderbilt University. Rothman, funded in part by a Novo Nordisk American Diabetes Association grant, has been using the test to figure out how to turn the math weak into mathletes. Now health care providers can administer it to patients to see who might need extra help, too. Think you're an A student? Take the quiz below, and use the meter further down to see how you did.

1. If you ate the entire bag of chips, how many total grams of carbohydrate would you eat?

ANSWER ______ total grams

2. A a cup of potatoes counts as 1 carbohydrate choice. How many choices does 2 cups of potatoes count as?

ANSWER ______ choices

3. You ate 1a cups from the food labeled below. How many grams of carbohydrate did you eat?

ANSWER ______ grams

4. You have to eat 6 grams of carbohydrate for each 30 minutes you plan to walk. You are planning to walk for one hour. You have a bag with 12 crackers. Each cracker contains 10 grams of carbohydrate. How many crackers do you need to eat before your walk?

ANSWER ______ crackers

5. Your target blood sugar is between 60 and 120. Please choose the values below that are in the target range (choose all that apply):


6. You test your blood sugar 4 times a day. How many strips do you need to take with you on a 2-week vacation?

ANSWER ______ strips

7. You test your blood sugar 3 times a day. You purchase a prescription of 50 strips on March 5th. Of the dates below, by when will you need to buy new strips?

March 21st;
April 21st;
May 21st;
June 21st

8. You have a prescription for metformin extended release 500 mg tablets. The label says, "Take 1 tablet with supper each night for the first week. Then, increase by 1 tablet each week for a total of 4 tablets daily with supper." How many tablets should you take with supper each night the second week?

ANSWER ______ tablets

9. Your insulin dose is increased to 54 units and you begin using a larger syringe that holds 100 units. On the syringe below, circle the line/marking that shows you have drawn 54 units.

10. Please round down to the nearest whole number. You are given the following instructions: "Take 1 unit of insulin for every 7 grams of carbohydrate you eat." How much insulin do you take: When you eat 98 grams at supper?

ANSWER ______ units

11. You are told to follow the sliding scale shown here. The sliding scale indicates the amount of insulin you take based upon your blood sugar levels.

If Blood Sugar Is Units of Insulin
130 – 180 0
181 – 230 1
231 – 280 2
281 – 330 3
331 – 380 4

How much insulin would you take for a blood sugar of 295?

ANSWER ______ units

Insulin Dose Schedule: 1 unit of Insulin /10 grams carbohydrate at meals

If Blood Sugar Is Breakfast Lunch Supper
>120 2 2 2
>150 4 4 4
>180 6 6 6

12. Your blood sugar is 284 and you ate 40 grams of carbohydrate
at breakfast. How much total insulin do you need to take?

ANSWER ______ units

13. Your blood sugar is 380 and you will eat 60 grams of carbohydrate at supper. How much total insulin do you need to take?

ANSWER ______ units

Use the following information for questions 14 and 15. You have been asked to start taking 32 units of NPH insulin tonight at bedtime. This insulin will work during the night and will lower your blood sugar first thing in the morning. You were given the following instructions:

  • Your goal is to have the morning (fasting) blood sugar below 120.
  • Check your blood sugar every morning before breakfast.
  • Start with 32 units of NPH tonight. Increase the dose by 2 units every other day until your blood sugar is at or below 120.
  • Your fasting blood sugar must be above 120 for 2 mornings in a row in order for you to increase the insulin dose by 2 units.
  • Once your blood sugar is staying below 120, stop increasing the nighttime insulin.

You begin with 32 units of NPH insulin last night. How much NPH insulin will you take on each of the following nights?

14. Morning of day 1, your blood sugar is 164. How much insulin will you take that night?

ANSWER ______ units

15. Morning of day 2, your blood sugar is 136. How much insulin will you take that night?

ANSWER ______ units

Answer Key

1. 63 grams
2. 4 choices
3. 36 grams
4. 1 to 2 crackers
5. Circled 118 only
6. 56
7. March 21
8. 2 tablets
9. See diagram (at left)
10. 14 units
11. 3 units
12. 10 units
13. 12 units
14. 32 units
15. 34 units

Didn't get a perfect score? You're not alone. But it may be a good idea to let your health care provider know that your math is a little rusty, and that you could benefit from extra diabetes education.