Delay Discounting Associated with Challenges to Treatment Adherence and Glycemic Control in Young Adults with Type 1 Diabetes

Overview

Journal Behav Processes

Specialty Social Sciences

Date 2018 Jul 1

PMID 29958994

Citations 13

Authors

Maria Stoianova

Elizabeth C Tampke

Amy Hughes Lansing

Catherine Stanger

Affiliations

Soon will be listed here.

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.

Citing Articles

Delay discounting and symptoms of anxiety and depression in adolescents experiencing challenges with managing type 1 diabetes.

Anderson M, Stanger C Child Health Care. 2025; 54(1):43-58.

PMID: 39760122 PMC: 11698505. DOI: 10.1080/02739615.2023.2226393.

Relationship Between Delay Discounting and Clinical Diabetes Outcomes: A Systematic Review.

Campbell J, Linde S, Walker R, Egede L J Gen Intern Med. 2024; 39(15):3052-3063.

PMID: 39150678 PMC: 11576688. DOI: 10.1007/s11606-024-08981-7.

Association of quality of life with medication adherence and glycemic control in patients with type 1 diabetes.

Fayyaz F, Mardi P, Sobhani S, Sokoty L, Aghamahdi F, Qorbani M J Diabetes Metab Disord. 2024; 23(1):783-788.

PMID: 38932841 PMC: 11196443. DOI: 10.1007/s40200-023-01351-w.

Beyond Therapeutic Adherence: Alternative Pathways for Understanding Medical Treatment in Type 1 Diabetes Mellitus.

Cleves-Valencia J, Roncancio-Moreno M, Picione R Int J Environ Res Public Health. 2024; 21(3).

PMID: 38541320 PMC: 10970288. DOI: 10.3390/ijerph21030320.

How is Patient Adherence Possible? A Novel Mechanistic Model of Adherence Based on Humanities.

Reach G Patient Prefer Adherence. 2023; 17:1705-1720.

PMID: 37484740 PMC: 10362896. DOI: 10.2147/PPA.S419277.

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