Mean Levels and Variability in Affect, Diabetes Self-Care Behaviors, and Continuously Monitored Glucose: A Daily Study of Latinos With Type 2 Diabetes. Issue 7 (September 2017)

• Record Type: Journal Article
• Authors: Wagner, Julie; Armeli, Stephen; Tennen, Howard; Bermudez-Millan, Angela; Wolpert, Howard; Pérez-Escamilla, Rafael
• Is Part Of: Psychosomatic medicine. Volume 79:Issue 7(2017)
• Publication Date: 2017-09
• Subjects: affect -- continuous glucose monitoring -- diabetes -- Latinos -- A1c = glycosylated hemoglobin A1c -- CALMS-D = Community Health Workers Assisting Latinos Manage Stress and Diabetes -- CGM = continuous glucose monitoring -- CHW community health worker -- CI = confidence interval -- IVR = interactive voice response -- M (SD) = mean (standard deviation) -- SMBG = self-monitoring of blood glucose; Medicine, Psychosomatic -- Periodicals; 616.0805
• DOI: 10.1097/PSY.0000000000000477
• Languages: English
• ISSNs: 0033-3174

Abstract

ABSTRACT: Objective: This study investigated between- and within-person associations among mean levels and variability in affect, diabetes self-care behaviors, and continuously monitored glucose in Latinos with type 2 diabetes. Methods: Fifty participants (M [SD] age = 57.8 [11.7] years, 74% women, mean [SD] glycosylated hemoglobin A1c = 8.3% [1.5%]) wore a "blinded" continuous glucose monitor for 7 days, and they responded to twice daily automated phone surveys regarding positive affect, negative affect, and self-care behaviors. Results: Higher mean levels of NA were associated with higher mean glucose ( r = .30), greater percent hyperglycemia ( r = .34) and greater percentage of out-of-range glucose ( r = .34). Higher NA variability was also related to higher mean glucose ( r = .34), greater percent of hyperglycemia ( r = .44) and greater percentage of out-of-range glucose ( r = .43). Higher positive affect variability was related to lower percentage of hypoglycemia ( r = −.33). Higher mean levels of self-care behaviors were related to lower glucose variability ( r = −.35). Finally, higher self-care behavior variability was related to greater percentage of hyperglycemia ( r = .31) and greater percentage of out-of-range glucose ( r = −.28). In multilevel regression models, within-person increases from mean levels of self-care were associated with lower mean levels of glucose ( b = −7.4, 95% confidence interval [CI] = −12.8 to −1.9), lower percentage of hyperglycemia ( b = −0.04, 95% CI = −0.07 to −0.01), and higher percentage of hypoglycemia ( b = 0.02, 95% CI = 0.01 to 0.03) in the subsequent 10-hour period. Conclusions: Near-to-real time sampling documented associations of glucose with affect and diabetes self-care that are not detectable with traditional measures.