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Shim EJ, Park SJ, Im GH, Hackett RA, Zaninotto P, Steptoe A. Trajectories of depressive symptoms in Korean adults with diabetes: Individual differences and associations with life satisfaction and mortality. Br J Health Psychol 2024. [PMID: 39048530 DOI: 10.1111/bjhp.12742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 07/09/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE We examined trajectories of depressive symptoms and their predictors in adults with diabetes. We assessed whether these trajectories were related to life satisfaction and mortality. DESIGN Longitudinal, prospective observational study. METHODS We analysed data from 1217 adults with diabetes (aged ≥45 years) in the Korean Longitudinal Study of Aging (2006-2018). RESULTS Three trajectories of depressive symptomology were identified in growth mixture models: low/stable (i.e., low and stable levels of symptoms; 85.56%), high/decreasing (i.e., high levels of symptoms with a decreasing trajectory; 7.47%), and moderate/increasing (i.e., moderate levels of symptoms with an increasing trajectory; 6.98%). Participants with poor perceived health status at baseline were more likely to be in the moderate/increasing or high/decreasing classes than in the low/stable class. The moderate/increasing class had the lowest satisfaction with quality of life, followed by the high/decreasing and low/stable classes. The moderate/increasing and the high/decreasing classes had lower satisfaction with relationships with spouse and children than the low/stable class. The high/decreasing class had a higher mortality risk than the low/stable class. CONCLUSIONS Long-term monitoring of depressive symptoms in adults with diabetes is warranted given their potential adverse impact on life satisfaction and mortality.
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Affiliation(s)
- Eun-Jung Shim
- Department of Psychology, Pusan National University, Busan, Korea
| | - Sang Jin Park
- Department of Psychology, Pusan National University, Busan, Korea
| | - Gyu Hyeong Im
- Department of Psychology, Pusan National University, Busan, Korea
| | - Ruth A Hackett
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paola Zaninotto
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
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Dimou K, Dragioti E, Tsitsas G, Mantzoukas S, Gouva M. Association of Personality Traits and Self-Care Behaviors in People With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e50714. [PMID: 38234931 PMCID: PMC10792707 DOI: 10.7759/cureus.50714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2023] [Indexed: 01/19/2024] Open
Abstract
Diabetes self-care is critical for individuals with type 2 diabetes mellitus (T2DM), and exploring the impact of personality traits on this domain remains pivotal. This study aimed to investigate the association between personality traits and various dimensions of self-care in people with T2DM. A Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA)-guided systematic review with meta-analysis was conducted. Two reviewers independently screened articles, extracted data, and assessed the risk of bias. Estimates were pooled using random-effects meta-analysis. Twenty-three studies, that met our inclusion criteria, revealed distinct associations between certain personality traits and various aspects of self-care. Notably, traits such as openness, conscientiousness, and agreeableness showed associations with improved foot care compliance (odds ratio (OR) = 2.53, 95% CI = 1.49-4.28; OR = 1.84, 95% CI = 1.10-3.08; and OR = 2.07, 95% CI = 1.23-3.48, respectively). Openness was also linked to better overall self-care behaviors (OR = 2.00, 95% CI = 1.17-3.41), while conscientiousness correlated with reduced smoking (OR = 0.96, 95% CI = 0.93-0.99), and agreeableness was associated with improved medication adherence (OR = 1.68, 95% CI = 1.34-2.31). Conversely, traits like extraversion and neuroticism showed associations with decreased medication adherence (OR = 0.77, 95% CI = 0.61-0.96 and OR = 0.51, 95% CI = 0.40-0.65, respectively), with neuroticism additionally linked to lower overall self-care behaviors (OR = 0.67, 95% CI: 0.55-0.81). This study emphasizes the intricate role of personality traits in shaping self-care practices in individuals with T2DM, underscoring the significance of factoring these traits into tailoring and improving diabetes self-care strategies. Nevertheless, establishing definitive causal relationships mandates further in-depth longitudinal investigations and broader meta-analyses to achieve a more conclusive understanding.
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Affiliation(s)
- Konstantina Dimou
- Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, GRC
| | - Elena Dragioti
- Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, GRC
| | - Georgios Tsitsas
- Department of Economy and Sustainable Development, Harokopio University, Athens, GRC
| | - Stefanos Mantzoukas
- Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, GRC
| | - Mary Gouva
- Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, GRC
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Reach G. How is Patient Adherence Possible? A Novel Mechanistic Model of Adherence Based on Humanities. Patient Prefer Adherence 2023; 17:1705-1720. [PMID: 37484740 PMCID: PMC10362896 DOI: 10.2147/ppa.s419277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 06/19/2023] [Indexed: 07/25/2023] Open
Abstract
Patient non-adherence is a major contemporary medical issue because of its consequences in terms of frequency, morbidity and mortality, and health care costs. This article aims to propose a mechanistic model of adherence based on the tenet that non-adherence is the default option, as long-term adherence in chronic diseases requires sustained effort. The real question becomes, how is patient adherence possible? By focusing on adherent patients, the paper explains the mental mechanisms of adherence using concepts largely drawn from humanities, philosophy of mind, and behavioral economics and presents the findings of empirical studies supporting these hypotheses. The analysis first demonstrates the relationship between patient adherence and temporality and the influence of character traits. Further, it points out the importance of habit, which allows adherence to become non-intentional, thereby sparing patients' cognitive efforts. Finally, it points out the importance of the quality of the interaction between the person with a chronic disease and the health professional. These features explain why adherence is a syndrome (the healthy adherer phenotype), separating people into those who are safe and those who are at risk of non-adherence, non-control of diabetes, and complications. The concepts presented in this article summarize 20 years of personal clinical and philosophical reflection on patient adherence. They are mainly illustrated by examples from diabetes care but can be applied to all chronic diseases. This novel model of adherence has major practical and ethical implications, explaining the importance of patient education and shared medical decision-making in chronic disease management.
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Affiliation(s)
- Gérard Reach
- Education and Health Promotion Laboratory, Sorbonne Paris Nord University, Bobigny, Île-de-France, 93000, France
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4
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Kosmalski M, Frankowski R, Różycka-Kosmalska M, Sipowicz K, Pietras T, Mokros Ł. The Association between Personality Factors and Metabolic Parameters among Patients with Non-Alcoholic-Fatty Liver Disease and Type 2 Diabetes Mellitus-A Cross-Sectional Study. J Clin Med 2023; 12:4468. [PMID: 37445503 DOI: 10.3390/jcm12134468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/27/2023] [Accepted: 07/01/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND The increasing prevalence of type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) states a serious problem for public health. The introduction of effective methods of treatment and prevention is crucial to avoid complications of these diseases. Among them, we can specify psychological factors that affect everyday life and determine the patient's attitude towards therapy, and what follows, their compliance in treatment. The literature indicates these connections in various ways; in our study, we extend this view to include a broader perspective of human personality. OBJECTIVE We decided to investigate the associations between personality factors and metabolic parameters in patients with NAFLD and T2DM in order to better understand the patient's approach to the treatment of a chronic disease, such as those mentioned, and to establish the basis for further research implementing psychological interventions in the treatment of NAFLD and T2DM. METHODS One hundred participants with NAFLD and T2DM underwent blood tests and anthropometric measures. Each of them was asked to complete five questionnaires evaluating their personality properties. RESULTS We revealed that a rise in body mass index is related to a fall in the emotional intelligence factor of utilizing emotions, and a rise in emotional perception. The decrease in task-oriented coping style and a rise in emotion-oriented coping style are associated with a waist-hip ratio increase. The increase in fasting plasma glucose is predicted by a decrease in task-oriented coping style score. A fall in social diversion coping style score is associated with a high-density lipoprotein increase; in turn, a triglycerides increase is connected with a decline in rhythmicity score. CONCLUSIONS The personality factors are in relationship in the management of NAFLD and T2DM. They affect a patient's approach to treatment, which is very important, because we know lifestyle and dietary interventions are an important part of the treatment of these diseases. The compliance manifests by lifestyle modifications, taking medications regularly, measuring blood glucose, and inspection visits in outpatients' clinics are a large part of a diabetic's life. Future studies introducing psychological intervention to improve, e.g., coping styles or rhythmicity are needed to implement new methods of patient management.
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Affiliation(s)
- Marcin Kosmalski
- Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
| | - Rafał Frankowski
- Students' Research Club, Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
| | | | - Kasper Sipowicz
- Department of Interdisciplinary Disability Studies, The Maria Grzegorzewska University in Warsaw, 02-353 Warsaw, Poland
| | - Tadeusz Pietras
- Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
- Second Department of Psychiatry, Institute of Psychiatry and Neurology, Sobieskiego 9, 02-957 Warsaw, Poland
| | - Łukasz Mokros
- Second Department of Psychiatry, Institute of Psychiatry and Neurology, Sobieskiego 9, 02-957 Warsaw, Poland
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Novak JR, August KJ, Kavookjian J, Whitley H, Burnett D. Exploring typologies of appraisals, involvement, and distress in type 2 diabetes family members. J Health Psychol 2023; 28:133-148. [PMID: 35924837 DOI: 10.1177/13591053221115326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The present study conducted a latent profile analysis from a US national sample of 446 family members to identify and predict unique clusters of family members' PWD illness appraisals, involvement, and psychological distress. Time since diagnosis, diabetes adherence, the relationship with the PWD, age, gender, race/ethnicity, income, and economic pressure were included as predictors. Class membership was used to predict the family members' own health behaviors (sleep quality, days of physical activity, and diet quality). Results revealed four distinct classes: Moderately Concerned, Involved, and Distressed (32.51%), Least Concerned, Distressed, and Involved (27.13%), Less Concerned and Distressed, Moderately Involved (23.77%), and Most Concerned, Involved, and Distressed (16.82%). The significant predictors and outcomes of class membership revealed interesting patterns in associations with class membership. Consequently, in addition to involving family members, health promotion and intervention efforts must consider the psychological health and illness appraisals of family members rather than a one-size-fits-all approach.
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Affiliation(s)
- Josh R Novak
- Department of Human Development and Family Science, Auburn University, Auburn, AL, USA.,Boshell Diabetes and Metabolic Diseases Research Program, Auburn University, Auburn, AL, USA
| | - Kristin J August
- Department of Psychology and Health Sciences Center, Rutgers University, Camden, NJ, USA
| | - Jan Kavookjian
- Boshell Diabetes and Metabolic Diseases Research Program, Auburn University, Auburn, AL, USA.,Harrison School of Pharmacy, Auburn University, Auburn, AL, USA
| | - Heather Whitley
- Boshell Diabetes and Metabolic Diseases Research Program, Auburn University, Auburn, AL, USA.,Harrison School of Pharmacy, Auburn University, Auburn, AL, USA
| | - Donna Burnett
- Boshell Diabetes and Metabolic Diseases Research Program, Auburn University, Auburn, AL, USA.,Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL, USA
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Ruiz-Adame M, Ibañez A, Mollayeva T, Trépel D. Association Between Neuroticism and Dementia on Healthcare Use: A Multi-Level Analysis Across 27 Countries from The Survey of Health, Ageing and Retirement in Europe (SHARE). J Alzheimers Dis 2023; 95:181-193. [PMID: 37482998 PMCID: PMC11194739 DOI: 10.3233/jad-230265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
BACKGROUND People with high levels of neuroticism are greater users of health services. Similarly, people with dementia have a higher risk of hospitalization and medical visits. As a result, dementia and a high level of neuroticism increase healthcare use (HCU). However, how these joint factors impact the HCU at the population level is unknown. Similarly, no previous study has assessed the degree of generalization of such impacts, considering relevant variables including age, gender, socioeconomic, and country-level variability. OBJECTIVE To examine how neuroticism and dementia interact in the HCU. METHODS A cross-sectional study was performed on a sample of 76,561 people (2.4% with dementia) from 27 European countries and Israel. Data were analyzed with six steps multilevel non-binomial regression modeling, a statistical method that accounts for correlation in the data taken within the same participant. RESULTS Both dementia (Incidence Rate Ratio (IRR): 1.537; α= 0.000) and neuroticism (IRR: 1.122; α= 0.000) increased the HCU. The effect of having dementia and the level of neuroticism increased the HCU: around 53.67% for the case of having dementia, and 12.05% for each increment in the level of neuroticism. Conversely, high levels of neuroticism in dementia decreased HCU (IRR: 0.962; α= 0.073). These results remained robust when controlling for age, gender, socioeconomic, and country-levels effects. CONCLUSION Contrary to previous findings, neuroticism trait in people with dementia decreases the HCU across sociodemographic, socioeconomic, and country heterogeneity. These results, which take into account this personality trait among people with dementia, are relevant for the planning of health and social services.
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Affiliation(s)
- Manuel Ruiz-Adame
- Applied Economic Department, University of Granada, Campus of Melilla, Melilla, Spain
- Trépel Laboratory, Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Agustín Ibañez
- Latin American Brain Health Institute, Universidad Adolfo Ibanez, Santiago, Chile
- Cognitive Neuroscience Center & CONICET, Universidad de San Andres, Buenos Aires, Argentina
- Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA
- Predictive Brain Health Modelling, Trinity College Dublin, Dublin, Ireland
| | - Tatyana Mollayeva
- Dalla Lana School of Public Health, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- KITE Research Institute, Toronto Rehab, University Health Network, Toronto, Canada
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
| | - Dominic Trépel
- Trépel Laboratory, Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- Trinity College Dublin, Dublin, Ireland
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7
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Geerling R, Kothe EJ, Anglim J, Emerson C, Holmes-Truscott E, Speight J. Personality and weight management in adults with type 2 diabetes: A systematic review. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:1044005. [PMID: 36992758 PMCID: PMC10012143 DOI: 10.3389/fcdhc.2022.1044005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/20/2022] [Indexed: 11/13/2022]
Abstract
AimsManaging weight in the context of type 2 diabetes presents unique hormonal, medicinal, behavioural and psychological challenges. The relationship between weight management and personality has previously been reviewed for general and cardiovascular disease populations but is less well understood in diabetes. This systematic review investigated the relationship between personality constructs and weight management outcomes and behaviours among adults with type 2 diabetes.MethodsMedline, PubMed, Embase, PsycINFO and SPORTDiscus databases were searched to July 2021. Eligibility: empirical quantitative studies; English language; adults with type 2 diabetes; investigation of personality-weight management association. Search terms included variants of: diabetes, physical activity, diet, body mass index (BMI), adiposity, personality constructs and validated scales. A narrative synthesis, with quality assessment, was conducted.ResultsSeventeen studies were identified: nine cross-sectional, six cohort and two randomised controlled trials (N=6,672 participants, range: 30-1,553). Three studies had a low risk of bias. Personality measurement varied. The Big Five and Type D personality constructs were the most common measures. Higher emotional instability (neuroticism, negative affect, anxiety, unmitigated communion and external locus of control) was negatively associated with healthy diet and physical activity, and positively associated with BMI. Conscientiousness had positive associations with healthy diet and physical activity and negative associations with BMI and anthropometric indices.ConclusionsAmong adults with type 2 diabetes, evidence exists of a relationship between weight management and personality, specifically, negative emotionality and conscientiousness. Consideration of personality may be important for optimising weight management and further research is warranted.Systematic review registrationwww.crd.york.ac.uk/prospero/, identifier CRD42019111002.
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Affiliation(s)
- Ralph Geerling
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
- *Correspondence: Ralph Geerling,
| | - Emily J. Kothe
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Jeromy Anglim
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | | | - Elizabeth Holmes-Truscott
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | - Jane Speight
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
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Vandraas KF, Reinertsen KV, Kiserud CE, Bøhn SK, Lie HC. Health literacy among long-term survivors of breast cancer; exploring associated factors in a nationwide sample. Support Care Cancer 2022; 30:7587-7596. [PMID: 35674792 PMCID: PMC9385742 DOI: 10.1007/s00520-022-07183-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/21/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Poor health literacy may hamper health management and long-term outcomes in breast cancer survivorship. Knowledge of factors associated with poor health literacy is needed to identify survivors in need of additional support and to improve the quality of health care, but is currently scant. Here, we explore health literacy and associated factors in a nationwide sample of long-term survivors of breast cancer. MATERIAL AND METHODS All survivors aged 20-65 years when diagnosed with stage I-III breast cancer in 2011 or 2012 were identified through the Norwegian Cancer Registry, and invited to participate in the Survivorship, Work and Sexual Health (SWEET) study. Health literacy was measured using The European Health Literacy Survey Questionnaire-12 (HLS-EU-Q12) and analyzed as a continuous and categorical variable. Associations between health literacy and socioeconomic, physical, and mental health variables, including the most common late effects after cancer treatment, were explored in uni- and multivariable linear regression models. RESULTS The final sample consisted of 1355 survivors (48%) with a mean age of 60 years at survey (SD 8.7). Eight years had passed since diagnosis (SD.0.7), and the majority of survivors had high socioeconomic status. Advanced judgment calls concerning treatment and health risks were reported to be the most difficult for survivors to handle. Mean health literacy sum score was 36.2 (range 12-48, SD 5.4). Thirty-nine percent had intermediate, while 19.3% reported marginal or inadequate health literacy. Education, income, age at diagnosis, the personality trait neuroticism, and fear of cancer recurrence were significantly associated with health literacy in the multivariate model, explaining 12% of the variance in health literacy scores. CONCLUSION Low levels of health literacy were prevalent in this population-based sample of long-term survivors of breast cancer, despite high socioeconomic status. Communicating and interpreting risks seem to be especially challenging. Attention to health literacy at a societal and individual level is necessary in order to provide survivorship care of high quality.
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Affiliation(s)
- Kathrine F Vandraas
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radium Hospital, Oslo, Norway.
| | - Kristin V Reinertsen
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Cecilie E Kiserud
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Synne K Bøhn
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radium Hospital, Oslo, Norway
| | - Hanne C Lie
- National Advisory Unit for Late Effects After Cancer Treatment, Department of Oncology, Oslo University Hospital, Radium Hospital, Oslo, Norway
- Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
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Reach G, Benarbia L, Benhamou PY, Delemer B, Dubois S, Gouet D, Guerci B, Jeandidier N, Lachgar K, Le Pape G, Leroy R, Masgnaux JH, Raclet P, Reznik Y, Riveline JP, Schaepelynck P, Vambergue A, Vergès B. An Unsafe/Safe Typology in People with Type 2 Diabetes: Bridging Patients' Expectations, Personality Traits, Medication Adherence, and Clinical Outcomes. Patient Prefer Adherence 2022; 16:1333-1350. [PMID: 35642243 PMCID: PMC9148599 DOI: 10.2147/ppa.s365398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/05/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Support programs are provided to people with diabetes to help them manage their disease. However, adherence to and persistence in support programs are often low, making it difficult to demonstrate their effectiveness. AIM To identify the determinants of patients' perceived interest in diabetes support programs because it may be a powerful determinant of effective participation in such programs. PATIENTS AND METHODS An online study conducted in April 2021 in metropolitan France on 600 people with diabetes recruited from a consumer panel. A 64-item psychosocial questionnaire including a question asking to evaluate the helpfulness of a support program was used. Univariate, multivariate, and multiple correspondence analyses were performed. RESULTS The existence of a typology, known as Unsafe/Safe, was discovered, in which patients with type 2 diabetes respond in two distinct ways. Type U (unsafe) patients, who believe that a support program would be helpful, are more likely to be nonadherent to their treatment, have high hemoglobin A1c levels, have at least one diabetic complication, lack information regarding their disease and treatment, rate the burden of their disease and impairment of their quality of life as high, worry about their future, and are pessimistic. Type S (safe) patients have the opposite characteristics. Type U patients can be dichotomized into two broad classes: one in which they lack information regarding disease and treatment and the other in which alterations in the quality of life and burden of the disease predominate. Insulin-treated patients give more importance to the lack of information, whereas noninsulin-treated patients complain primarily about the burden of the disease and impairment of quality of life. CONCLUSION This study describes this new U/S typology, proposes a simple method based on a nine-item questionnaire to identify type U patients by calculating a Program Helpfulness Score described herein, and clarifies the nature of the intervention to be provided to them. This novel approach could be applied to other chronic diseases.
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Affiliation(s)
- Gérard Reach
- Health Education and Promotion Laboratory (LEPS EA 3412), Sorbonne Paris Nord University, Bobigny, France
- Correspondence: Gérard Reach, Health Education and Promotion Laboratory (LEPS EA 3412), Sorbonne Paris Nord University, 74 Rue Marcel Cachin, Bobigny Cedex, 93017, France, Tel + 33 (0)6 60 84 53 25, Email
| | | | - Pierre-Yves Benhamou
- Department of Endocrinology, Grenoble University Hospital; Grenoble Alpes University, INSERM U1055, LBFA, Grenoble, France
| | - Brigitte Delemer
- Service d’Endocrinologie – Diabète – Nutrition, CHU de Reims - Hôpital Robert Debré, and Université de Reims Champagne Ardenne, UFR Sciences Exactes Et Naturelles, Reims, France
| | - Séverine Dubois
- Department of Diabetology and Endocrinology, CHU Angers, Angers, France
| | - Didier Gouet
- Department of Diabetology and Endocrinology, Saint Louis Hospital, La Rochelle, France
| | - Bruno Guerci
- Department of Endocrinology, Diabetology and Nutrition, CHRU of Nancy, Brabois Hospital, and ILCV Lorraine University, Vandoeuvre-les-Nancy, France
| | - Nathalie Jeandidier
- Department of Endocrinology, Diabetes and Nutrition, Hôpitaux Universitaires de Strasbourg, and Université de Strasbourg, Strasbourg, France
| | - Karim Lachgar
- Department of Diabetology and Endocrinology, Centre Hospitalier Simone Veil, Eaubonne, France
| | | | - Rémy Leroy
- Private Medical Practice, Endocrinology and Diabetology, Lille, France
| | | | - Philippe Raclet
- Association Française des Diabétiques de Bourgogne Franche-Comté, Dijon, France
| | - Yves Reznik
- Department oEndocrinology and Diabetology, CHU Côte de Nacre, Caen, and University of Caen Basse-Normandie, Medical School, Caen, France
| | - Jean-Pierre Riveline
- Department of Diabetology and Endocrinology, Lariboisière Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
- Unité INSERM U1138 Immunity and Metabolism in Diabetes, ImMeDiab Team, Centre de Recherches des Cordeliers, and Université de Paris, Paris, France
| | - Pauline Schaepelynck
- Department of Nutrition-Endocrinology-Metabolic Diseases, Pôle ENDO, APHM-Hôpital la Conception, Marseille, France
| | - Anne Vambergue
- Department of Diabetology, Endocrinology, Metabolism and Nutrition, CHU Lille, and University Hospital European Genomic Institute for Diabetes, Lille, France
| | - Bruno Vergès
- Department of Endocrinology-Diabetology,CHU Dijon, and University of Burgundy, INSERM LNC UMR1231, Dijon, France
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10
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Wang H, Sun X, Yue H, Yang Y, Feng D. The dyadic effects of personality traits on depression in advanced lung cancer patients and caregivers: The mediating role of acceptance of illness. Eur J Cancer Care (Engl) 2021; 31:e13538. [PMID: 34791725 DOI: 10.1111/ecc.13538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/18/2021] [Accepted: 10/13/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This study aimed to explore the intrapersonal and interpersonal effects of three personality traits-neuroticism, extraversion and conscientiousness-on depression and examine whether acceptance of illness mediates the actor and partner effects in advanced lung cancer patients and caregivers using the Actor-Partner Interdependence Mediation Model (APIMeM). METHODS A total of 304 dyads of advanced lung cancer patients and caregivers were studied. Personality traits, acceptance of illness and depression were measured using 44-item Big Five Inventory, the Acceptance of Illness (AIS) scale and the Patient Health Questionnaire (PHQ-9). RESULTS The APIMeMs suggested that there were significant actor-actor effects of the three personality traits on depression through their own acceptance of illness. Additionally, significant actor-partner effects of neuroticism and extraversion on depression were also found. Specifically, patients' neuroticism was negatively related to their own acceptance of illness, which increased caregivers' depression, and caregivers' higher extraversion was related to their own higher acceptance of illness, which reduced patients' depression. Furthermore, a significant partner-actor effect was only found in the neuroticism model. Patients' neuroticism was negatively related to caregivers' acceptance of illness, which increased caregivers' depression. CONCLUSION The three personality traits had both interpersonal and intrapersonal effects on depression in advanced lung cancer patient-caregiver dyads, and acceptance of illness played an important mediating role in these relationships.
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Affiliation(s)
- Hui Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xiangjie Sun
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Haorun Yue
- Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Yaoyao Yang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Danjun Feng
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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Lee SF, Li CP. Personality as a predictor of HbA1c level in patients with type 2 diabetes mellitus. Medicine (Baltimore) 2021; 100:e26590. [PMID: 34232208 PMCID: PMC8270580 DOI: 10.1097/md.0000000000026590] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 06/17/2021] [Indexed: 01/04/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is the most common type of diabetes, accounting for around 90% of all cases worldwide. One means to strengthen the prevention and treatment of diabetes is via changes in self-management and lifestyle behaviors. However, lifestyle and personal health behaviors are strongly influenced by personality traits, and thus personality may play a significant role in such aspects as medication compliance, exercise habits, blood glucose monitoring, diet control, and maintenance of an ideal body weight.In this study, we examined whether certain personality traits of patients with T2DM are correlated with higher glycohemoglobin (HbA1c) levels.A total of 214 participants with T2DM were recruited from an outpatient setting. χ2 test and logistic regression analyses with 5 models were employed.The OR for the "neuroticism" trait was 3.199 (95% CI = 1.228-8.331, P = .017), and those with this trait were 3.199 times more likely to have higher HbA1c levels than those with the "openness-extraversion" personality trait. This strong relationship between neuroticism and a higher HbA1c level was also evident in models 2, 3, 4, and 5. One-way ANOVA also indicated that the group with the neuroticism personality trait had significantly different mean fasting glucose, HbA1c, triglyceride, and high-density lipoprotein cholesterol levels.We found that a personality characterized by neuroticism is an independent predictor of higher HbA1c level in this study. We also found that people in the pre-contemplation and contemplation stages of exercise have higher HbA1c levels.
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Affiliation(s)
- Shu-Fen Lee
- Department of Nursing, Cardinal Tien College of Healthcare and Management, New Taipei
| | - Chih-Ping Li
- Department of Health Industry Management, Kainan University, Taoyuan, Taiwan
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Li QF, Ma QW, Zhu CH, Chen JB, Liang SW, Cai CC, Zhao JB. Neuroticism and patients’ depressive symptoms: a moderated mediation model of illness perception and patient-physician trust. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01918-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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陈 平, 黎 泽, 郭 怡, 孙 昕, Edwin BFISHER. [To explore medication adherence of patients with type 2 diabetes mellitus using the latent profile analysis based on the Big Five personality theory]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2021; 53:530-535. [PMID: 34145856 PMCID: PMC8220047 DOI: 10.19723/j.issn.1671-167x.2021.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore the personality portraits of patients with type 2 diabetes mellitus (T2DM), its relationship with medication adherence and the influencing factors of medication adherence. METHODS T2DM patients from 22 community health service stations of 4 community health service centers in Tongzhou district and Shunyi district in Beijing were selected as the research objects. A self-designed questionnaire was used to collect demographic information. The short version of Big Five personality scale was used to collect personality information, and latent profile analysis was used to explore their personality portraits. The medication adherence was evaluated by medication adherence scale, and the difference of medication adherence among the different personality portraits was explored by analysis of variance. The influencing factors of medication adherence were explored by the ordinal Logistic regression model. RESULTS In the study, 751 T2DM patients were included. Latent profile analysis showed that the T2DM patients in this study could be divided into four types of personality portraits, including introverted and stable type (42.7%), negative type (12.7%), anxiety type (15.3%) and active and responsible type (29.3%). Among them, 75 patients said that they did not use medicine or insulin, 5 patients were lack of data, and finally 671 patients with T2DM were included in the analysis about medication adherence. The analysis of variance showed that there was no significant difference in medication adherence between anxiety type (5.55±1.65) and negative type (5.94±1.53, P=0.089), but the medication adherence score of anxiety type was significantly lower than that of introverted and stable type (6.17±1.46, P=0.001) and active and responsible type (6.09±1.65, P=0.004). Anxiety type and negative type were seen as a whole in the ordinal Logistic regression model named anxiety and negative type. The results showed that compared with anxiety and negative type, the active and responsible type or introverted and stable type was the protective factor for good medication adherence (OR=1.567, 95%CI: 1.096-2.237; OR=1.774, 95%CI: 1.214-2.591), and the education level also affected the medication adherence. CONCLUSION T2DM can be classified into four types of personality portraits based on Big Five personality theory. The anxiety and negative type after the combination of anxiety type and negative type is the independent risk factor for poor medication adherence. In addition, education level is also the influencing factor of medication compliance.
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Affiliation(s)
- 平 陈
- 北京大学公共卫生学院社会医学与健康教育系,北京 100191Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China
| | - 泽明 黎
- 北京大学公共卫生学院社会医学与健康教育系,北京 100191Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China
| | - 怡 郭
- 北京大学公共卫生学院社会医学与健康教育系,北京 100191Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China
| | - 昕霙 孙
- 北京大学公共卫生学院社会医学与健康教育系,北京 100191Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China
| | - B. FISHER Edwin
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina-Chapel Hill,North Carolina 27599-7440,USADepartment of Health Behavior, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, North Carolina 27599-7440, USA
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陈 平, 黎 泽, 郭 怡, 孙 昕, Edwin BFISHER. [To explore medication adherence of patients with type 2 diabetes mellitus using the latent profile analysis based on the Big Five personality theory]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2021; 53:530-535. [PMID: 34145856 PMCID: PMC8220047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Indexed: 09/21/2023]
Abstract
OBJECTIVE To explore the personality portraits of patients with type 2 diabetes mellitus (T2DM), its relationship with medication adherence and the influencing factors of medication adherence. METHODS T2DM patients from 22 community health service stations of 4 community health service centers in Tongzhou district and Shunyi district in Beijing were selected as the research objects. A self-designed questionnaire was used to collect demographic information. The short version of Big Five personality scale was used to collect personality information, and latent profile analysis was used to explore their personality portraits. The medication adherence was evaluated by medication adherence scale, and the difference of medication adherence among the different personality portraits was explored by analysis of variance. The influencing factors of medication adherence were explored by the ordinal Logistic regression model. RESULTS In the study, 751 T2DM patients were included. Latent profile analysis showed that the T2DM patients in this study could be divided into four types of personality portraits, including introverted and stable type (42.7%), negative type (12.7%), anxiety type (15.3%) and active and responsible type (29.3%). Among them, 75 patients said that they did not use medicine or insulin, 5 patients were lack of data, and finally 671 patients with T2DM were included in the analysis about medication adherence. The analysis of variance showed that there was no significant difference in medication adherence between anxiety type (5.55±1.65) and negative type (5.94±1.53, P=0.089), but the medication adherence score of anxiety type was significantly lower than that of introverted and stable type (6.17±1.46, P=0.001) and active and responsible type (6.09±1.65, P=0.004). Anxiety type and negative type were seen as a whole in the ordinal Logistic regression model named anxiety and negative type. The results showed that compared with anxiety and negative type, the active and responsible type or introverted and stable type was the protective factor for good medication adherence (OR=1.567, 95%CI: 1.096-2.237; OR=1.774, 95%CI: 1.214-2.591), and the education level also affected the medication adherence. CONCLUSION T2DM can be classified into four types of personality portraits based on Big Five personality theory. The anxiety and negative type after the combination of anxiety type and negative type is the independent risk factor for poor medication adherence. In addition, education level is also the influencing factor of medication compliance.
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Affiliation(s)
- 平 陈
- 北京大学公共卫生学院社会医学与健康教育系,北京 100191Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China
| | - 泽明 黎
- 北京大学公共卫生学院社会医学与健康教育系,北京 100191Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China
| | - 怡 郭
- 北京大学公共卫生学院社会医学与健康教育系,北京 100191Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China
| | - 昕霙 孙
- 北京大学公共卫生学院社会医学与健康教育系,北京 100191Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing 100191, China
| | - B. FISHER Edwin
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina-Chapel Hill,North Carolina 27599-7440,USADepartment of Health Behavior, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, North Carolina 27599-7440, USA
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Soriano EC, Lenhard JM, Gonzalez JS, Tennen H, Chow SM, Otto AK, Perndorfer C, Shen BJ, Siegel SD, Laurenceau JP. Spousal Influence on Diabetes Self-care: Moderating Effects of Distress and Relationship Quality on Glycemic Control. Ann Behav Med 2021; 55:123-132. [PMID: 32491154 DOI: 10.1093/abm/kaaa038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Spouses often attempt to influence patients' diabetes self-care. Spousal influence has been linked to beneficial health outcomes in some studies, but to negative outcomes in others. PURPOSE We aimed to clarify the conditions under which spousal influence impedes glycemic control in patients with type 2 diabetes. Spousal influence was hypothesized to associate with poorer glycemic control among patients with high diabetes distress and low relationship quality. METHODS Patients with type 2 diabetes and their spouses (N = 63 couples) completed self-report measures before patients initiated a 7-day period of continuous glucose monitoring. Mean glucose level and coefficient of variation (CV) were regressed on spousal influence, diabetes distress, relationship quality, and their two- and three-way interactions. RESULTS The three-way interaction significantly predicted glucose variability, but not mean level. Results revealed a cross-over interaction between spousal influence and diabetes distress at high (but not low) levels of relationship quality, such that spousal influence was associated with less variability among patients with low distress, but more among those with high distress. Among patients with high distress and low relationship quality, a 1 SD increase in spousal influence predicted a difference roughly equivalent to the difference between the sample mean CV and a CV in the unstable glycemia range. CONCLUSIONS This was the first study to examine moderators of the link between spousal influence and glycemic control in diabetes. A large effect was found for glucose variability, but not mean levels. These novel results highlight the importance of intimate relationships in diabetes management.
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Affiliation(s)
- Emily C Soriano
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA
| | - James M Lenhard
- Section of Endocrinology and Metabolism, Christiana Care Health System, Wilmington, DE, USA
| | - Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University; Departments of Medicine and Epidemiology & Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | - Howard Tennen
- Department of Community Medicine and Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Sy-Miin Chow
- Department of Human Development and Family Studies, Pennsylvania State University, State College, PA, USA
| | - Amy K Otto
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA
| | - Christine Perndorfer
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA
| | - Biing-Jiun Shen
- Division of Psychology, School of Humanities and Social Sciences, Nanyang Technological University, Singapore
| | - Scott D Siegel
- Value Institute, Christiana Care Health System, Wilmington, DE, USA
| | - Jean-Philippe Laurenceau
- Department of Psychological & Brain Sciences, University of Delaware, Newark, DE, USA.,Helen F. Graham Cancer Center, Christiana Care Health System, Wilmington, DE, USA
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Heid AR, Pruchno R, Wilson-Genderson M, Cartwright FP. The Prospective Association of Personality Traits and Successful Aging. Int J Aging Hum Dev 2021; 94:193-214. [PMID: 33616413 DOI: 10.1177/0091415021989460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We used data (N = 928) from ORANJ BOWL, a six-wave panel of adults (aged 50-74 at baseline) to address the association between personality and successful aging at two points in time, 8 years apart. Regressions examined the associations between Wave 2 neuroticism, extraversion, openness, agreeableness, and conscientiousness and Wave 3 subjective success, functional ability, pain, and chronic conditions. Models tested personality traits independently and then simultaneously, with interactions. Confirmatory analyses used Waves 5/6 data. All traits but openness were individually associated with successful aging at both time points. When testing traits simultaneously, only neuroticism and extraversion were consistently associated with subjective success, with an interaction at Waves 2/3. Neuroticism (Waves 2/3) and conscientiousness (Waves 5/6) were associated with functional ability. Neuroticism was associated with pain (Waves 2/3). Personality was not associated with chronic conditions. These analyses set up future work examining relationships between change in personality and change in successful aging.
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Affiliation(s)
| | - Rachel Pruchno
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | | | - Francine P Cartwright
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
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Niemiec A, Juruć A, Molęda P, Safranow K, Majkowska L. Personality Traits, Metabolic Control and the Use of Insulin Pump Functions in Adults With Type 1 Diabetes: An Observational Single-Visit Study. Diabetes Ther 2021; 12:419-430. [PMID: 33325007 PMCID: PMC7843737 DOI: 10.1007/s13300-020-00974-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 11/19/2020] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION While a few studies have assessed the association between personality and metabolic outcomes in children and adolescents with type 1 diabetes (T1DM), there have been none in adults or in subjects treated with insulin pumps, and hypoglycaemic episodes have not been considered in these studies. The aim of this observational single-visit study was to assess the association between personality traits and metabolic control, hypoglycaemic episodes and insulin pump use in adult T1DM patients. METHODS Data were obtained from 52 adults with T1DM treated in a tertiary care centre (no complications or comorbidities; aged 27 ± 8 years; diabetes duration of 12.8 ± 6.8 years; treated with insulin pumps for 6.3 ± 0.4 years). "Big Five" personality traits (neuroticism, extraversion, openness, agreeableness and conscientiousness) were assessed using the NEO-Five Factor Inventory questionnaire. Data on HbA1c, blood glucose levels, frequency of glucose testing, the number of hypoglycaemic episodes (< 3.9 mmol/l), basal and prandial insulin doses, and the number and types of boluses in the last 14 days were obtained from the insulin pumps and glucometers. RESULTS The mean levels of the assessed parameters were: HbA1c 7.2 ± 1.2% (55.0 ± 13.1 mmol/mol), episodes of hypoglycaemia 7.0 (3.00-9.75) and glucose tests per day 7.3 ± 3.9. All personality traits showed average intensity. None of the traits were associated with HbA1c, glycaemia, number of glucose tests, or number or kind of insulin boluses. Conscientiousness was the only factor associated with the incidence of hypoglycaemia in both univariate (r = + 0.46, p < 0.001) and multivariate (β = + 0.41, p < 0.001) analyses. CONCLUSIONS Despite results reported for children and adolescents, personality traits of adult patients with T1DM were not essential for metabolic control assessed by HbA1c or for the use of insulin pump functions; however, higher conscientiousness may be related to more frequent hypoglycaemic episodes. Extrinsic factors should be searched as more relevant for metabolic control and proper use of very expensive insulin pump therapy.
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Affiliation(s)
- Agnieszka Niemiec
- Department of Diabetology and Internal Diseases, Pomeranian Medical University in Szczecin, Siedlecka 2, 72-010, Police, Poland
- Department of Internal Medicine, Independent Public Specialist Health Care Center "Zdroje", Mączna 4, 70-780, Szczecin, Poland
| | - Agata Juruć
- State University of Applied Sciences, Przyjaźni 1, 62-510, Konin, Poland
| | - Piotr Molęda
- Department of Diabetology and Internal Diseases, Pomeranian Medical University in Szczecin, Siedlecka 2, 72-010, Police, Poland.
| | - Krzysztof Safranow
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
| | - Lilianna Majkowska
- Department of Diabetology and Internal Diseases, Pomeranian Medical University in Szczecin, Siedlecka 2, 72-010, Police, Poland
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Toelle BG, Marks GB, Dunn SM. Psychological and Medical Characteristics Associated with Non-Adherence to Prescribed Daily Inhaled Corticosteroid. J Pers Med 2020; 10:E126. [PMID: 32937794 PMCID: PMC7565720 DOI: 10.3390/jpm10030126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/31/2020] [Accepted: 09/10/2020] [Indexed: 12/28/2022] Open
Abstract
Medication non-adherence is associated with sub-optimal asthma control. Identification of medical and psychological characteristics associated with non-adherence is important to enable a targeted and personalized approach when working with patients and for the development of interventions to improve patient outcomes by improving medication adherence. We enrolled adults who had diagnosed asthma and who were prescribed daily inhaled corticosteroid medication. We used published and validated instruments to measure medical characteristics including asthma features, practical asthma knowledge and perceived involvement in care and psychological characteristics including anxiety, depression, optimism, and personality traits, to assess the relationship with medication non-adherence. A total of 126 participants provided data, with 64 (50.8%) of the participants identified as non-adherent. Multivariate analyses showed that younger age, high neuroticism scores and a previous asthma hospital admission were associated with non-adherence. Interestingly, depression was associated with a lower risk of non-adherence. This study showed that a personalized medicine approach would include interventions targeting those who are younger, who have been in hospital for asthma and who rate high on the neuroticism personality trait. Given the availability of effective medications for asthma, better understanding of the characteristics associated with non-adherence is important to enhance optimal self-management.
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Affiliation(s)
- Brett G. Toelle
- Woolcock Institute of Medical Research, The University of Sydney, Sydney 2006, Australia;
- Sydney Local Health District, Sydney 2050, Australia
| | - Guy B. Marks
- Woolcock Institute of Medical Research, The University of Sydney, Sydney 2006, Australia;
- South Western Sydney Clinical School, University of New South Wales, Sydney 2170, Australia
- Ingham Institute of Applied Medical Research, Sydney 2170, Australia
| | - Stewart M. Dunn
- Department of Psychological Medicine, The University of Sydney, Sydney 2006, Australia;
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Hazrati-Meimaneh Z, Amini-Tehrani M, Pourabbasi A, Gharlipour Z, Rahimi F, Ranjbar-Shams P, Nasli-Esfahani E, Zamanian H. The impact of personality traits on medication adherence and self-care in patients with type 2 diabetes mellitus: The moderating role of gender and age. J Psychosom Res 2020; 136:110178. [PMID: 32623192 DOI: 10.1016/j.jpsychores.2020.110178] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 06/16/2020] [Accepted: 06/19/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This study aimed to investigate the role of the five-factor model of personality (FFM) and the moderating role of gender and age in predicting medication adherence (MA) and self-care behaviors (SCB) among Iranian patients with type 2 diabetes mellitus (T2DM). METHODS This study was conducted on 495 patients with T2DM (73.5% female; n = 364) from two major cities of Iran (Tehran and Qom) in 2019. Pearson's correlation coefficient, multiple regression analysis, and conditional process analysis were performed. P < .05 and P < .10 were considered significant for the relationships and moderation analysis, respectively. RESULTS Neuroticism indicated a negative association with MA and SCB. Positive associations were found between MA and personality traits, including extraversion, agreeableness, and conscientiousness, whereas extraversion showed a weak correlation with SCB. According to the covariate-adjusted regression model, neuroticism had a negative effect on MA and SCB. Agreeableness had a positive effect on MA and a negative effect on SCB. However, extraversion exerted a negative effect on MA and a positive effect on SCB. Also, the negative effect of neuroticism on MA was highlighted in women, indicating marginally significant moderation effect. The positive effects of extraversion and conscientiousness on MA were moderated by age. The effect of conscientiousness on SCB was positive in young patients and negative in old patients. No interaction effect was observed between age and gender. CONCLUSION This study indicated that neuroticism, extraversion, and agreeableness significantly contributed to MA, but not to SCB. However, the effects were conditioned by age for extraversion and conscientiousness to some extent.
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Affiliation(s)
- Zahra Hazrati-Meimaneh
- Department of Health Education and Promotion, School of Health, Qom University of Medical Sciences, Qom, Iran; South Tehran Heath Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammadali Amini-Tehrani
- Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran; Health Psychology and Behavior Medicine Research Group, Student Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ata Pourabbasi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Zabihollah Gharlipour
- Department of Health Education and Promotion, School of Health, Qom University of Medical Sciences, Qom, Iran.
| | - Fatemeh Rahimi
- South Tehran Heath Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran..
| | | | - Ensieh Nasli-Esfahani
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran..
| | - Hadi Zamanian
- Department of Health Education and Promotion, School of Health, Qom University of Medical Sciences, Qom, Iran; Health Psychology and Behavior Medicine Research Group, Student Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Abdullah MFILB, Sidi H, Ravindran A, Gosse PJ, Kaunismaa ES, Mainland RL, Mustafa N, Hatta NH, Arnawati P, Zulkifli AY, Woon LSC. How Much Do We Know about the Biopsychosocial Predictors of Glycaemic Control? Age and Clinical Factors Predict Glycaemic Control, but Psychological Factors Do Not. J Diabetes Res 2020; 2020:2654208. [PMID: 32455131 PMCID: PMC7222480 DOI: 10.1155/2020/2654208] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 04/22/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Diabetes mellitus is one of the most common noncommunicable diseases in Malaysia. It is associated with significant complications and a high cost of treatment, especially when glycaemic control is poor. Despite its negative impact on health, data is still lacking on the possible biopsychosocial predictors of poor glycaemic control among the diabetic population. This study is aimed at determining the prevalence of poor glycaemic control as well as its association with biopsychosocial factors such as personality traits, psychiatric factors, and quality of life (QOL) among Malaysian patients with diabetes. METHODS A cross-sectional study was conducted at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) using outpatient population diabetic patients. Demographic data on social and clinical characteristics were collected from participants. Several questionnaires were administered, including the Beck Depression Inventory-II (BDI-II) to measure depressive symptoms, the Generalized Anxiety Disorder-7 (GAD-7) to assess anxiety symptoms, the Big Five Inventory (BFI) to evaluate personality traits, and the WHO Quality of Life-BREF (WHOQOL-BREF) to assess QOL. Multivariate binary logistic regression was performed to determine the predictors of poor glycaemic control. RESULTS 300 patients with diabetes mellitus were recruited, with the majority (90%) having type 2 diabetes. In this population, the prevalence of poor glycaemic control (HbA1C ≥ 7.0%) was 69%, with a median HbA1C of 7.6% (IQR = 2.7). Longer duration of diabetes mellitus and a greater number of days of missed medications predicted poor glycaemic control, while older age and overall self-perception of QOL protected against poor glycaemic control. No psychological factors were associated with poor glycaemic control. CONCLUSION This study emphasizes the importance of considering the various factors that contribute to poor glycaemic control, such as duration of diabetes, medication adherence, age, and QOL. These findings should be used by clinicians, particularly when planning a multidisciplinary approach to the management of diabetes.
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Affiliation(s)
| | - Hatta Sidi
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Malaysia
| | - Arun Ravindran
- Centre for Addiction and Mental Health, University of Toronto, Canada
| | | | | | | | - Norlaila Mustafa
- Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Malaysia
| | | | | | | | - Luke Sy-Cherng Woon
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, Malaysia
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Weinstein G, Elran Barak R, Schnaider Beeri M, Ravona-Springer R. Personality traits and cognitive function in old-adults with type-2 diabetes. Aging Ment Health 2019; 23:1317-1325. [PMID: 30406666 DOI: 10.1080/13607863.2018.1493720] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objectives: Personality may constitute an important domain of influence on cognitive function in old-adults. We assessed the relationship of personality traits and cognitive performance in individuals with Type-2 Diabetes (T2D), and explored possible mediators. Method: The sample includes 377 dementia-free subjects with T2D participating in the Israel Diabetes and Cognitive Decline study who underwent assessment of cognition and personality (mean age 72 ± 4y; 42% females). We assessed the relationships of personality traits with episodic memory, semantic categorization, attention/working memory, executive function and overall cognition using linear regression models adjusting for age, education, sex, BMI, T2D duration, Hemoglobin A1C (HbA1C), hypertension, c-reactive protein, total- to HDL-cholesterol ratio and ApoEɛ4 genotype. A post-hoc mediation analysis was conducted with HbA1C, proportion of days covered (PDC) by T2D prescription claims and depressive symptoms. Results: After adjustment for multiple covariates, high neuroticism levels were associated with poorer performance overall (β= -0.16 ± 0.05; p = 0.001) and with poorer episodic memory, attention/working memory, and semantic categorization (β= -0.14 ± 0.05; p = 0.007, β= -0.12 ± 0.05; p = 0.017 and β= -0.12 ± 0.05; p = 0.018, respectively). High scores on openness to experience were associated with better global cognition (β = 0.11 ± 0.05; p = 0.026), executive functions (β = 0.13 ± 0.05; p = 0.013) and semantic categorization (β = 0.17 ± 0.05; p = 0.001, respectively). Depressive symptoms mediated the association of neuroticism with executive function, and the association of openness with executive function and overall cognition. Conclusion: Personality may play an important role in cognitive health among elderly subjects with T2D. Future studies should address the mechanisms underlying these relationships and specifically the potential role of depressive symptoms which may be in the causal pathway between personality traits and cognitive outcomes.
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Affiliation(s)
- Galit Weinstein
- a School of Public Health, University of Haifa , Haifa , Israel
| | | | - Michal Schnaider Beeri
- b Department of Psychiatry, The Icahn School of Medicine at Mount Sinai , New York , NY , USA.,c The Joseph Sagol Neuroscience Center, Sheba Medical Center , Tel-Hashomer , Israel
| | - Ramit Ravona-Springer
- d Department of Psychiatry, Sheba Medical Center , Ramat-Gan , Israel.,e Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel
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22
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Sanatkar S, Baldwin P, Clarke J, Fletcher S, Gunn J, Wilhelm K, Campbell L, Zwar N, Harris M, Lapsley H, Hadzi-Pavlovic D, Christensen H, Proudfoot J. The influence of personality on trajectories of distress, health and functioning in mild-to-moderately depressed adults with type 2 diabetes. PSYCHOL HEALTH MED 2019; 25:296-308. [PMID: 31537118 DOI: 10.1080/13548506.2019.1668567] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Identification of mental health risk is important for optimising diabetes care in type 2 diabetes mellitus (T2DM). Personality is linked to diabetes health and may assist detection of individuals with T2DM most at risk of chronic mental health difficulties. This study examined the moderator effect of personality factors on changes in psychological distress and functioning in adults with T2DM and mild-to-moderate depressive symptoms across a 12-month period. Data were obtained from participants in a randomised controlled trial of adults with T2DM. Participants completed measures of depression (Patient Health Questionnaire-9), anxiety (General Anxiety Disorder-7), general functioning (Work and Social Adjustment Scale), diabetes distress (Diabetes Distress Scale), and diabetes self-management (Self-Management Profile for Type 2 Diabetes) at baseline, 3-, 6- and 12-months. Glycaemic control (HbA1c) was measured at baseline, 6- and 12-months. Two hundred trial completers agreed to complete a personality inventory (Big Five Inventory). Low neuroticism was linked with reduced depression, anxiety, functional impairment and diabetes distress over the year. High extraversion was associated with decreased anxiety and functional impairment. High conscientiousness was linked to increased healthy eating. No personality trait moderated HbA1c levels. Personality screening may help identify mental health risk and guide medical carer approach in T2DM patients.
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Affiliation(s)
- Samineh Sanatkar
- Black Dog Institute, Sydney, Australia.,School of Psychiatry, UNSW Sydney, Sydney, Australia
| | - Peter Baldwin
- Black Dog Institute, Sydney, Australia.,School of Psychiatry, UNSW Sydney, Sydney, Australia
| | - Janine Clarke
- Black Dog Institute, Sydney, Australia.,School of Psychiatry, UNSW Sydney, Sydney, Australia
| | - Susan Fletcher
- Department of General Practice, University of Melbourne, Victoria, Australia
| | - Jane Gunn
- Department of General Practice, University of Melbourne, Victoria, Australia
| | - Kay Wilhelm
- School of Psychiatry, UNSW Sydney, Sydney, Australia
| | - Lesley Campbell
- Diabetes and Metabolism Division, Garvan Institute of Medical Research, Sydney, Australia
| | - Nick Zwar
- School of Medicine, University of Wollongong, Wollongong, Australia
| | - Mark Harris
- Centre for Primary Health Care and Equity, UNSW Sydney, Sydney, Australia
| | - Helen Lapsley
- School of Psychiatry, UNSW Sydney, Sydney, Australia
| | | | - Helen Christensen
- Black Dog Institute, Sydney, Australia.,School of Psychiatry, UNSW Sydney, Sydney, Australia
| | - Judith Proudfoot
- Black Dog Institute, Sydney, Australia.,School of Psychiatry, UNSW Sydney, Sydney, Australia
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23
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Novak JR, Gast J, Peak T, Johnson R, Morrey R, Smith M, Souders M. A Case Study of Health-Related Support Processes in 2 Happy, Gay Couples. Am J Lifestyle Med 2019; 12:462-471. [PMID: 30783399 DOI: 10.1177/1559827618788854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/31/2018] [Accepted: 06/25/2018] [Indexed: 11/16/2022] Open
Abstract
The purpose of this case study was to explore 2, early-relationship, same-sex couples on the strategies used to support their partner's engagement in health promoting behaviors. A semistructured interview protocol was used to conduct 120-minute interviews with each couple and analyzed using grounded theory methods. Five organizing categories emerged during the analysis, resulting in a conceptual process model of health-related support in same-sex relationships. These categories, provided a snapshot of how processes interact with each other; they were context, relationship dynamics, health support processes, couple adaptation, and balancing physical/relational health. Couples described the balancing of relational and physical health as an ongoing, important theme in the success of health support. Implications for both health prevention and intervention are discussed.
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Affiliation(s)
- Josh R Novak
- Department of Human Development and Family Studies (JRN, RJ), Utah State University, Logan, Utah.,Department of Kinesiology and Health Sciences (JG, RM, M Smith, M Souders), Utah State University, Logan, Utah.,Sociology, Social Work, and Anthropology Department (TP), Utah State University, Logan, Utah
| | - Julie Gast
- Department of Human Development and Family Studies (JRN, RJ), Utah State University, Logan, Utah.,Department of Kinesiology and Health Sciences (JG, RM, M Smith, M Souders), Utah State University, Logan, Utah.,Sociology, Social Work, and Anthropology Department (TP), Utah State University, Logan, Utah
| | - Terry Peak
- Department of Human Development and Family Studies (JRN, RJ), Utah State University, Logan, Utah.,Department of Kinesiology and Health Sciences (JG, RM, M Smith, M Souders), Utah State University, Logan, Utah.,Sociology, Social Work, and Anthropology Department (TP), Utah State University, Logan, Utah
| | - Rhees Johnson
- Department of Human Development and Family Studies (JRN, RJ), Utah State University, Logan, Utah.,Department of Kinesiology and Health Sciences (JG, RM, M Smith, M Souders), Utah State University, Logan, Utah.,Sociology, Social Work, and Anthropology Department (TP), Utah State University, Logan, Utah
| | - Rachel Morrey
- Department of Human Development and Family Studies (JRN, RJ), Utah State University, Logan, Utah.,Department of Kinesiology and Health Sciences (JG, RM, M Smith, M Souders), Utah State University, Logan, Utah.,Sociology, Social Work, and Anthropology Department (TP), Utah State University, Logan, Utah
| | - Madeline Smith
- Department of Human Development and Family Studies (JRN, RJ), Utah State University, Logan, Utah.,Department of Kinesiology and Health Sciences (JG, RM, M Smith, M Souders), Utah State University, Logan, Utah.,Sociology, Social Work, and Anthropology Department (TP), Utah State University, Logan, Utah
| | - Marissa Souders
- Department of Human Development and Family Studies (JRN, RJ), Utah State University, Logan, Utah.,Department of Kinesiology and Health Sciences (JG, RM, M Smith, M Souders), Utah State University, Logan, Utah.,Sociology, Social Work, and Anthropology Department (TP), Utah State University, Logan, Utah
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24
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Oster E. Diabetes and Diet: Purchasing Behavior Change in Response to Health Information. AMERICAN ECONOMIC JOURNAL. APPLIED ECONOMICS 2018; 10:308-348. [PMID: 31853330 PMCID: PMC6919656 DOI: 10.1257/app.20160232] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Individuals with obesity and related conditions are often reluctant to change their diet. Evaluating the details of this reluctance is hampered by limited data. I use household scanner data to estimate food purchase response to a diagnosis of diabetes. I use a machine learning approach to infer diagnosis from purchases of diabetes-related products. On average, households show significant, but relatively small, calorie reductions. These reductions are concentrated in unhealthy foods, suggesting they reflect real efforts to improve diet. There is some heterogeneity in calorie changes across households, although this heterogeneity is not well predicted by demographics or baseline diet, despite large correlations between these factors and diagnosis. I suggest a theory of behavior change which may explain the limited overall change and the fact that heterogeneity is not predictable.
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