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09-06-2024 | Type 1 Diabetes

Differential signaling effects of blood glucose on delay discounting in individuals with and without type 1 diabetes

Authors: Zheng Liu, Noel E. Schaeffer, XiaoTian Wang

Published in: Journal of Behavioral Medicine

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Abstract

Based on the signaling hypothesis of blood glucose (BG), a rise in BG levels signals a positive energy budget for healthy individuals but cellular starvation for individuals with type 1 diabetes. We examined this novel prediction and its intervention implications in the context of delay discounting, the degree to which delayed rewards are discounted, and the regulatory effects of insulin ingestion. We recruited 44 adults with type 1 diabetes (mean age 30.8 years, diabetes duration 15.4 years) and recorded their BG levels. The delay discounting rate was measured using the intertemporal choice task, where participants were required to choose between sets of smaller-and-sooner (SS) and larger-and-later (LL) rewards. In addition, 82 age-matched healthy participants were recruited to provide a baseline comparison on delay discounting. Random forest analysis showed that among many diagnostic factors, delay discounting was most dominating in differentiating the individuals with type 1 diabetes from the control participants. A hierarchical linear mixed model revealed that participants with type 1 diabetes had a stronger preference for SS rewards (p < .001) after controlling for covariates. Participants who had insulin delivered before the last meal exhibited a stronger preference for LL rewards compared to after-meal delivery. In contrast, subjective measures (e.g., self-reported hunger) failed to predict the participants’ actual BG levels and delay discounting rates. In sum, individuals with type 1 diabetes tend to discount future rewards excessively compared to the control participants. Pre-meal insulin ingestion was associated with a higher LL preference for future rewards.
Appendix
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Footnotes
1
We also performed additional post-hoc power analysis to verify the power of our analysis (see supplementary material for more details).
 
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Metadata
Title
Differential signaling effects of blood glucose on delay discounting in individuals with and without type 1 diabetes
Authors
Zheng Liu
Noel E. Schaeffer
XiaoTian Wang
Publication date
09-06-2024
Publisher
Springer US
Published in
Journal of Behavioral Medicine
Print ISSN: 0160-7715
Electronic ISSN: 1573-3521
DOI
https://doi.org/10.1007/s10865-024-00500-7