Delay-related behaviors tied to self-care in type 2 diabetes
medwireNews: Placing more value on immediate than delayed rewards is associated with poor self-care among people with type 2 diabetes, a study suggests.
The researchers describe the strength of these relationships as “modest,” but stress that the findings are clinically relevant.
“Specifically, understanding the central role of patient value for future health and the emotional response to delay may be an important factor to consider when establishing care plans, setting goals, and providing informational resources for patients when it comes to self-managing type 2 diabetes, namely for diet and foot care,” they write in Diabetes Care.
Leonard Egede and team at the Medical College of Wisconsin in Milwaukee, USA, used the Quick Delay Questionnaire to measure delay-related behavior, which they explain is the process of deciding between immediate rewards and delayed but more meaningful outcomes.
Delay discounting reflects people placing more value on immediate than delayed rewards even when the delayed rewards are greater. In their study cohort, of 356 adults with type 2 diabetes, this behavior was significantly associated with having less education, as was delay aversion, which indicates that people avoid delay because of a negative emotional response to it. Delay aversion was also linked to poorer health status.
The study participants were aged an average of 62 years, and 70% were men. A majority of the cohort was Black (54.5%), followed by White (41.8%), with just 3.7% being of Hispanic or other ethnicity.
Both delay-related behaviors were associated with poorer self-care behaviors, assessed using the Summary of Diabetes Self-Care Activities scale, with the associations persisting after adjustment for baseline variables. Specifically, higher delay discounting and aversion were significantly associated with a less healthy diet, both generally and with regard to intake of fruit and vegetables and high-fat foods, and they also correlated with poorer foot care.
In addition, delay aversion was associated with poorer mental quality of life as assessed with the 12-Item Short-Form Survey.
“These results suggest that individuals who place less value on the future and those who experience a negative emotional response when delays are present have lower engagement in self-care behaviors for diet and foot care,” the researchers summarize.
They add: “Moreover, because both delay discounting and delay aversion are considered modifiable factors, developing interventions to target delay discounting and delay aversion may improve engagement in self-care behaviors.”
But the team cautions that evidence for the role of these factors “remains scarce,” and highlights the need for further research, particularly intervention studies.
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