Delay discounting of gains and losses, glycemic control and therapeutic adherence in type 2 diabetes
Delay discounting of gains and losses, glycemic control and therapeutic adherence in type 2 diabetes
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DOI：
10.1016/j.beproc.2016.09.006
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发表时间：
2016-11-01
影响因子：
1.3
通讯作者：
Lemogne, Cedric
中科院分区：
文献类型：
--
作者：
Lebeau, Gaele;Consoli, Silla M.;Lemogne, Cedric
目标：延迟折扣是一种倾向于更喜欢较小的、较早的奖励，而不是较大的、较晚的奖励。2型糖尿病患者依从性差的部分原因可以用健康价值的折现来解释，这是延迟的函数。延迟折扣可以用以系数k为特征的双曲线模型来描述，它越高，在决策时考虑的未来后果就越少。本研究旨在确定k是否与糖化血红蛋白和2型糖尿病患者的依从性有关。方法：在两个糖尿病科室招募93名患者。延迟折扣系数用计算机化的任务来测量。记录HbA1c，并用问卷调查依从性。结果：增益延迟贴现与HbA1c呈正相关(r=0.242，P=0.023)。在调整潜在的混杂因素后，这种关联仍然显著(F=4.807，P=0.031，Eta(2)=0.058)。这种关联部分通过坚持用药来调节(β=0.048，95%CI[0.004-0.131])。结论：2型糖尿病患者血糖控制与延迟折扣有关。如果这些发现被前瞻性设计重复，它们可能会导致新的策略来改善这些患者的血糖控制。(C)2016爱思唯尔B.V.保留所有权利。
Objective: Delay discounting is the tendency to prefer smaller, sooner rewards to larger, later ones. Poor adherence in type 2 diabetes could be partially explained by a discounted value of health, as a function of delay. Delay discounting can be described with a hyperbolic model characterized by a coefficient, k. The higher It, the less future consequences are taken into account when making decisions. This study aimed to determine whether k would be correlated with glycated hemoglobin and adherence in type 2 diabetes.Methods: Ninety-three patients were recruited in two diabetology departments. Delay discounting coefficients were measured with a computerized task. HbAl c was recorded and adherence was assessed by questionnaires. Potential socio-demographic and clinical confounding factors were collected.Results: There was a positive correlation between delay discounting of gains and HbAl c (r = 0.242, P = 0.023). This association remained significant after adjusting for potential confounding factors (F=4.807, P = 0.031, eta(2) = 0.058). This association was partially mediated by adherence to medication (beta = 0.048, 95% CI[0.004-0.131]).Conclusions: Glycemic control is associated with delay discounting in patients suffering from type 2 diabetes. Should these findings be replicated with a prospective design, they could lead to new strategies to improve glycemic control among these patients. (C) 2016 Elsevier B.V. All rights reserved.