Relationships Among Adverse Childhood Experiences, Delay Discounting, Impulsivity, and Diabetes Self-Management

Objective: Adverse childhood experiences (ACEs) have been linked to risky health behaviors, as well as the development of chronic health conditions such as both type 1 and type 2 diabetes mellitus. A connection between ACEs and diabetes self-management has not yet been established. The current study aims to investigate the relationships among ACEs, delay discounting, impulsivity, and diabetes self-management. Method: A total of 227 adults aged 18 to 77 with type 1 diabetes, type 2 diabetes, and prediabetes were recruited to complete an online survey via Amazon’s mechanical Turk. Participants completed validated measures of diabetes self-care, delay discounting, and impulsivity, as well as questions regarding diabetes history and financial strain. Results: In the overall sample and controlling for financial strain, increased number of ACEs was significantly associated with poorer diabetes management (r = -.15, p <.05). Higher delay discounting was associated with fewer ACEs (r = -.31, p <.05) and better diabetes care (r =.42, p <.01), as well as increased number of diabetes-related complications (r =.33, p <.01), controlling for financial strain. Participants who use insulin to manage their diabetes had significantly better diabetes self-care scores (t(225) = 8.19, p <.01), higher levels of delay discounting (t(101) = 3.15, p <.01), and fewer reported ACEs (t(224) = -2.19, p,.05). Conclusions: ACEs are associated with poorer diabetes self-management later in life.