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Relationships among adverse childhood experiences, delay discounting, impulsivity, and diabetes self-management
Lindsey M Shain1, Mai Nguyen1, Amy L Meadows1
1Department of Psychiatry, University of Kentucky College of Medicine.
Objective:
Adverse childhood experiences (ACEs) have been linked to risky health behaviors, as well as the development of chronic health conditions such as both type 1 and type 2 diabetes mellitus. A connection between ACEs and diabetes self-management has not yet been established. The current study aims to investigate the relationships among ACEs, delay discounting, impulsivity, and diabetes self-management.
Method:
A total of 227 adults aged 18 to 77 with type 1 diabetes, type 2 diabetes, and prediabetes were recruited to complete an online survey via Amazon's mechanical Turk. Participants completed validated measures of diabetes self-care, delay discounting, and impulsivity, as well as questions regarding diabetes history and financial strain.
Results:
In the overall sample and controlling for financial strain, increased number of ACEs was significantly associated with poorer diabetes management (r = -.15, p < .05). Higher delay discounting was associated with fewer ACEs (r = -.31, p < .05) and better diabetes care (r = .42, p < .01), as well as increased number of diabetes-related complications (r = .33, p < .01), controlling for financial strain. Participants who use insulin to manage their diabetes had significantly better diabetes self-care scores (t(225) = 8.19, p < .01), higher levels of delay discounting (t(101) = 3.15, p < .01), and fewer reported ACEs (t(224) = -2.19, p < .05).
Conclusions:
ACEs are associated with poorer diabetes self-management later in life. This may be an important consideration for clinicians treating patients with diabetes and prediabetes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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