دانلود رایگان مقاله کنترل قند خون و پایبندی درمانی در دیابت نوع 2

Abstract

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 k, 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 coef- ficients were measured with a computerized task. HbA1c 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 HbA1c (r = 0.242, P = 0.023). This association remained significant after adjusting for potential confounding factors (F = 4.807, P = 0.031, 2 = 0.058). This association was partially mediated by adherence to medication ( = 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.

4. Conclusions

The main objective of this study was to examine the association between delay discounting of gains and losses and HbA1c in patients with type 2 diabetes. In accordance with our primary hypothesis, we found a positive, statistically significant, correlation between the delay discounting coefficientfor gains and HbA1c. Despite the small proportion of explained variance,the relationship between the delay discounting coefficient for gains and HbA1c was a robust one. This association remained significant after adjustment for potential confounding variables in a general linear model. In contrast, we did not find a correlation between the delay discounting coefficient for losses and HbA1c. Concerning our secondary hypothesis, there was evidence for a partial mediation by medication adherence, confirmed by the attenuation of the association between the delay discounting coefficient and HbA1c when including the adherence variable in the general linear model.