What is the clinical evidence from this study?

Study design: Cohort. Population: Type 2 diabetes (n=123). Intervention: Positive affect. Primary outcome: HbA1c at 5 years (β -0.36, 95% CI -0.61, -0.16).

What does this research mean for the field?

Baseline positive affect prospectively predicts lower HbA1c five years later among adults with type 2 diabetes, and this protective effect is strongest for those experiencing high stress. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

April 18, 2023Open Access

Links of positive affect and stress to HbA1c: a prospective longitudinal study

Key Result

Baseline positive affect prospectively predicted lower HbA1c five years later (β -0.36) among adults with type 2 diabetes, and this protective effect was strongest for those experiencing high stress.

Study Design

Type

Cohort (n=123)

Multicenter

Structured PICO

Does positive affect prospectively predict lower HbA1c levels over time in adults recently diagnosed with type 2 diabetes?

Population

123 adults recently diagnosed with type 2 diabetes (within 5 years), married or cohabitating with a romantic partner who did not have diabetes. Mean age 53.3, 44.7% female, 60.2% White, 39.8% Black. Recruited in southwestern Pennsylvania, USA.

Intervention

Higher positive affect (PA) measured via 14-day daily diary at baseline

Outcome

HbA1c levels at baseline (T1), 6 months (T2), and 5 years (T3)surrogate

Positive affect prospectively predicts lower HbA1c over 5 years in adults with type 2 diabetes, particularly buffering those experiencing high levels of stress.

Main Result

Effect estimate: β -0.36 (95% CI -0.61, -0.16)

Limitations

Relatively high attrition, with only 123 of the original 207 participants included
Differential attrition (higher for those with higher HbA1c, lower income, and Black participants) may reduce generalizability
Baseline HbA1c was measured just prior to the daily diary period during which affect was assessed
Used only a single positive affect scale capturing happiness or well-being
No assessments of HbA1c between 6 months and 5 years
Collection of the five-year follow-up data was interrupted by the onset of the COVID-19 pandemic

Abstract

While affect is linked to a number of diabetes outcomes, the specific role of positive affect (PA) in HbA1c remains unclear. The present study examined whether PA prospectively predicted lower HbA1c among adults with type 2 diabetes and whether this relation was moderated by stress. Participants were 123 adults (44.7% female; 60.2% White, 39.8% Black) recently diagnosed with type 2 diabetes. Perceived stress, diabetes-specific distress, and PA were assessed at baseline; HbA1c was assessed at baseline (T1), six months (T2), and five years (T3). PA was cross-sectionally associated with lower HbA1c at T1 and prospectively predicted lower HbA1c at T3. PA interacted with both measures of T1 stress to predict T1 HbA1c, and PA interacted with T3 perceived stress to predict T3 HbA1c. Interactions were consistent with stress buffering. Sensitivity analyses attentuated findings, but robust evidence remained for PA as a protective factor for blood glucose five years later and for a stress-buffering effect of PA on diabetes-specific distress. Findings suggest PA may be a clinically useful indicator among adults with type 2 diabetes and may be particularly important for those experiencing the greatest stress from their disease.

Ask AI

Helpful

Bookmark

View Full Paper