Self-control, daily negative affect, and blood glucose control in adolescents with Type 1 diabetes.

Abstract

Objective For adolescents with type 1 diabetes, maintaining optimal daily blood glucose control is a complex self-regulatory process that likely requires self-control. This study examined whether higher self-control was associated with lower daily negative affect about diabetes and, in turn, better daily blood glucose control, i.e., lower mean daily blood glucose (MBG) and smaller standard deviations of daily blood glucose (SDBG), through two paths: 1) self-control maintaining lower mean level of negative affect and 2) self-control buffering the association of the number of daily diabetes problems with daily negative affect. Methods Adolescents (M age=12.87 years) with type 1 diabetes (n=180) completed an initial survey containing a self-report measure of self-control. Nightly electronic diaries were completed for 14 days where adolescents reported daily problems with and negative affect about diabetes, and used a study-provided blood glucose meter. Results Hypotheses were examined through multilevel modeling. Lower mean levels of daily negative affect partially mediated the relation between higher adolescent self-control and lower MBG. Adolescent self-control also buffered the association of the number of daily problems with daily negative affect, and smaller fluctuations in daily negative affect were associated with lower SDBG. Conclusions Adolescent self-control is associated with daily affect regulatory processes that may influence MBG. However, fluctuations in daily negative affect about diabetes may represent a unique within-person daily process associated with SDBG. These findings suggest that studies examining daily disease processes and interventions targeting daily affect regulation may be important to improving health in adolescents with type 1 diabetes.

Mean Levels and Variability in Affect, Diabetes Self-Care Behaviors, and Continuously Monitored Glucose: A Daily Study of Latinos With Type 2 Diabetes

“…But, to our knowledge, only one investigation studied both variability in negative affect and variability in glucose in the same study (30). Lansing et al (2016; 30) followed n=180 adolescents with type 1 diabetes for 14 days during which they completed diaries of negative affect and used a glucometer.…”

Mother, father, and adolescent self-control and adherence in adolescents with Type 1 diabetes.

“…Adolescents with better self-control capacity, i.e., the ability to modulate behavior, emotion, and cognition toward a goal (Finkenauer, Engels, & Baumeister, 2005), engage more frequently in adherence behaviors and experience better metabolic control (Berg et al, 2014; Hughes, Berg, & Wiebe, 2012; King et al, 2012; Lansing & Berg, 2014; Lansing, Berg, Butner, & Wiebe, 2016). However, there is increasing recognition that self-control is both an individual and interpersonal process.…”

“…Adolescent self-control is also associated with better metabolic control, as indexed by glycosylated hemoglobin (HbA1c) percentages, as well as averages and variability in daily blood glucose levels (Berg et al, 2014; Lansing & Berg, 2014). The importance of self-control for understanding diabetes management is highlighted by findings that self-control predicts daily negative affect toward diabetes management and, in turn, daily blood glucose levels (Lansing, Berg, Butner, & Wiebe, 2016) and that high levels of self-control may buffer against worsening metabolic control over time (King et al, 2012). …”

The Relationship Between a Balanced Time Perspective and Self-monitoring of Blood Glucose Among People With Type 1 Diabetes

“…Finally, previous research has demonstrated that having a more balanced time perspective is associated with greater self-control ability [25]. Furthermore, greater selfcontrol ability has been found to be associated with better glycaemic control in adolescents with type 1 diabetes [26]. Therefore, there may be an indirect relationship between balanced time perspective and blood glucose monitoring via self-control ability.…”

“…Trait self-control was assessed using the 13-item Brief Self-Control Scale (BSCS; [30]). Previous studies have demonstrated that the BSCS is a valid measure of self-control [e.g., 30] and it has been found to be associated with glycaemic control in individuals with type 1 diabetes [26]. Example items include: "I am good at resisting temptation" and "I often act without thinking through all the alternatives".…”