Psychosocial predictors of short-term glucose among people with diabetes: A narrative review

Type 1 and type 2 diabetes are metabolic disorders that require one to manage one's blood glucose levels on a daily basis through a series of behaviorally complex tasks. Research shows that psychosocial factors, including mood, stress, and social relationships, have a significant influence on one's ability to maintain these disease management routines and achieve healthy blood glucose levels. However, researchers have typically approached these questions from a between-person perspective. Here, we argue for greater consideration of short-term, within-person links of psychosocial factors-including mood, stress, and social interactions-to glucose outcomes. Drawing from existing social and health psychology theories, we put forth an organizing theoretical framework describing how psychosocial experiences may operate on glucose outcomes over subsequent hours. We then review the small but burgeoning literature of intensive longitudinal studies that have examined the short-term effects of negative affect, positive affect, stress, and social interactions on glucose outcomes. Findings showed somewhat stronger links for negative affect and stress compared to positive affect and social interactions, but studies varied greatly in their methodologies, making direct comparisons challenging. A number of findings, particularly in the social interaction literature, depended on dispositional or contextual factors, further complicating interpretation. There was little investigation of the mechanistic pathways that may connect psychosocial factors to glucose outcomes, and few studies conducted lagged analyses to probe the directionality of these links. We conclude by proposing best practices for future research that will address the key weaknesses in the extant literature.