Spouse Involvement in Everyday Type 2 Diabetes Care: Effects of Social Control on Continuously Measured Glucose

University Of Delaware, Newark DE

Investigators

Linked publications, trials & patents

Abstract

7. PROJECT SUMMARY/ABSTRACT Type 2 diabetes (T2D) self-management, which includes diet, exercise, and medication adherence, is critical to prevent potentially fatal complications. Spouses often attempt to influence T2D patients? health behavior?termed social control?which has been shown to both facilitate and impede self-management. A critical barrier to developing effective T2D interventions that include spouses is the current lack of knowledge of precisely how and under what conditions spouses facilitate or impede T2D management. The proposed research aims to identify the conditions that lead social control to impede T2D glycemic control, which was objectively measured using continuous glucose monitoring (CGM). A key advantage of CGM over traditional glycemic indices (e.g., HbA1c) is its ability not only to summarize average glycemic control, but also glucose variability, which has been independently linked to T2D complications. Social control is hypothesized to associate with greater glucose variability under conditions of patient distress and poor relationship quality. This proposal involves secondary analysis of a longitudinal study of partnered T2D patients: After baseline surveys, patients wore CGMs and completed 5 surveys per day for a 7-day period. These data will be used to accomplish the following aims: Aim 1. To examine the between-person interactions among baseline social control, distress, and relationship quality as predictors of model-implied glucose variability over the subsequent 7 days. Aim 2. To examine the within-person interactions among momentary social control, distress, and relationship quality as dynamic predictors of within-person model-implied glucose variability. Results of the proposed research will inform when and for whom social control is detrimental and the development of targeted couples T2D self-management interventions. The proposed Fellowship will provide the Applicant with the training needed to launch a productive, rigorous, independent program of research in pursuit of her overarching career goal?to advance understanding of mechanisms that underlie the association between close relationships and physical health. The proposed research and training will address the Applicant?s lack of prior research experience in physical health outcomes, provide her with powerful methodological skills tailor-made for her interests, fill gaps in her discipline-specific conceptual knowledge in health psychology, and enhance her dissemination and professional skills. The proposed Fellowship Mentors and training sites (University of Delaware, Christiana Care Health System, and New York Regional Center for Diabetes Translation Research) are ideally suited for the proposed research and training activities. The integrated research and training plan described in this proposal will satisfy critical training needs and enhance the Applicant?s potential for an independent research career.