Examining the Relationship Between Delay Discounting, Delay Aversion, Diabetes Self-care Behaviors, and Diabetes Outcomes in U.S. Adults With Type 2 Diabetes. Diabetes Care 2021 Apr;44(4):893-900
Date
02/12/2021Pubmed ID
33568402Pubmed Central ID
PMC7985422DOI
10.2337/dc20-2620Scopus ID
2-s2.0-85103305615 (requires institutional sign-in at Scopus site) 2 CitationsAbstract
OBJECTIVE: Delay discounting and delay aversion are emerging areas for understanding diabetes management; however, few data exist on their relationship with multiple diabetes self-care behaviors and diabetes outcomes.
RESEARCH DESIGN AND METHODS: This cross-sectional study included 356 adults with type 2 diabetes across three racial/ethnic groups receiving care from two primary care clinics. The primary predictors were delay discounting and delay aversion. Outcomes included self-care behaviors, quality of life (QOL; mental health component score [MCS], physical component score), and A1C. Multiple linear regression models were run to examine the association between predictors and the outcomes, A1C, QOL, and each self-care behavior.
RESULTS: Higher delay discounting was associated with lower engagement in self-care behaviors for general diet (B = -0.06; 95% CI -0.12; -0.01), specific diet (B = -0.07; 95% CI -0.12; -0.03), and foot care (B = -0.10; 95% CI -0.17; -0.02). Higher delay aversion was associated with lower engagement in self-care behaviors for general diet (B = -0.06; 95% CI -0.10; -0.01), specific diet (B = -0.03; 95% CI -0.07; -0.01), foot care (B = -0.11; 95% CI -0.17; -0.05), and lower MCS (B = -0.38; 95% CI -0.71; -0.06).
CONCLUSIONS: In a diverse sample of adults with type 2 diabetes, higher delay discounting and higher delay aversion were significantly related to lower engagement in self-care behaviors. High delay aversion was specifically related to lower QOL. These findings offer new knowledge by highlighting the role that delay-related behaviors may have in the performance of self-care behaviors and the impact on QOL. Work is needed to further elucidate these relationships. Specifically, these results highlight the importance of targeting value and decision-making for diabetes self-management.
Author List
Campbell JA, Williams JS, Egede LEAuthors
Jennifer Annette Campbell PhD, MPH Assistant Professor in the Medicine department at Medical College of WisconsinLeonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of Wisconsin
Joni Williams MD, MPH Associate Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultCross-Sectional Studies
Delay Discounting
Diabetes Mellitus, Type 2
Humans
Quality of Life
Self Care
