Delay discounting associated with challenges to treatment adherence and glycemic control in young adults with type 1 diabetes

Behav Processes. 2018 Dec:157:474-477. doi: 10.1016/j.beproc.2018.06.013. Epub 2018 Jun 26.

Abstract

Introduction: Many young adults with type 1 diabetes (T1D) face challenges in adherence to self-management practices and have above-target HbA1c. Poorer decision-making skills, indicated by greater delay discounting, may be linked to these factors.

Methods: An online survey using social media ads targeted young adults aged 18-26 with T1D. Participants completed the Self-Care Inventory and the 5-trial delay discounting task and self-reported their last HbA1c value.

Results: Discounting was significantly associated with treatment adherence (r = -.14, p < .05) and HbA1c (r = .18, p < .01). Adherence was also associated with HbA1c (r = -.26, p < .01). In a hierarchical regression, adding discounting explained significant additional variance in HbA1c after controlling demographics (F(1, 257) = 3.99, p < .05); adding adherence next explained significant additional variance in HbA1c (F(1, 256) = 12.96, p < .01). In the final model, adherence significantly explained HbA1c variance (β = -.21, p < .01).

Discussion: These results expand the literature on cognitive factors and glycemic control among patients with T1D. Factors like delay discounting represent potentially modifiable risk factors targetable through interventions.

Keywords: Adherence; Delay discounting; HbA1c; Type 1 diabetes; Young adult.

MeSH terms

  • Adolescent
  • Adult
  • Blood Glucose / metabolism*
  • Delay Discounting*
  • Diabetes Mellitus, Type 1 / psychology*
  • Diabetes Mellitus, Type 1 / therapy*
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Male
  • Social Media
  • Surveys and Questionnaires
  • Treatment Adherence and Compliance / psychology*
  • Young Adult

Substances

  • Blood Glucose
  • Glycated Hemoglobin A