How time and risk preferences affect glucose control in type 2 diabetes patients

Abstract The attitude to self-care of individuals with type 2 diabetes (T2D) is commonly influenced by their time preferences (i.e., long-run discounting and time-consistency), and/or risk preference (i.e., risk tolerance). Tailored preference-based self-care management may improve clinical and cost...

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Main Authors: Suparee W. Boonmanunt, Oraluck Pattanaprateep, Hataikarn Nimitphong, Unyaporn Suthutvoravut, Panu Looareesuwan, Taya Kitiyakara, Boonsong Ongphiphadhanakul, Gareth McKay, John Attia, Ammarin Thakkinstian
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-16791-y
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author Suparee W. Boonmanunt
Oraluck Pattanaprateep
Hataikarn Nimitphong
Unyaporn Suthutvoravut
Panu Looareesuwan
Taya Kitiyakara
Boonsong Ongphiphadhanakul
Gareth McKay
John Attia
Ammarin Thakkinstian
author_facet Suparee W. Boonmanunt
Oraluck Pattanaprateep
Hataikarn Nimitphong
Unyaporn Suthutvoravut
Panu Looareesuwan
Taya Kitiyakara
Boonsong Ongphiphadhanakul
Gareth McKay
John Attia
Ammarin Thakkinstian
author_sort Suparee W. Boonmanunt
collection DOAJ
description Abstract The attitude to self-care of individuals with type 2 diabetes (T2D) is commonly influenced by their time preferences (i.e., long-run discounting and time-consistency), and/or risk preference (i.e., risk tolerance). Tailored preference-based self-care management may improve clinical and cost-effectiveness. This study investigates associations between elicited time and risk preferences with diabetes-related outcomes, i.e., Hemoglobin A1c (HbA1c) and blood glucose level. Time and risk preferences of 396 T2D patients were measured by incentivized tasks. Clinical data was retrieved from hospital information systems for diabetes outcomes (HbA1c and blood glucose levels) and clinical factors. We assessed patient diabetes-associated self-care behaviors and other epidemiological factors by questionnaire. Multivariate linear regressions with stepwise model selection were used to evaluate potential associations with T2D outcomes. We found that participants who favored immediate gratification over greater long-term benefits (time-inconsistent towards present or present-biased) had significantly higher HbA1c levels than time-consistent participants, with a coefficient (95% CI) of 0.41 (0.02,0.80). Neither time nor risk preferences were significantly associated with blood glucose levels. These findings suggest the use of tailored diabetes interventions to help present-biased patients overcome self-control problems. This targeted approach may be more cost-effective but requires formal testing.
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spelling doaj-art-34eb38e04e724e21b246c33e6ff1d8522025-08-24T11:27:39ZengNature PortfolioScientific Reports2045-23222025-08-0115111210.1038/s41598-025-16791-yHow time and risk preferences affect glucose control in type 2 diabetes patientsSuparee W. Boonmanunt0Oraluck Pattanaprateep1Hataikarn Nimitphong2Unyaporn Suthutvoravut3Panu Looareesuwan4Taya Kitiyakara5Boonsong Ongphiphadhanakul6Gareth McKay7John Attia8Ammarin Thakkinstian9Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDivision of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDepartment of Family Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDivision of Gastroenterology and Hepatology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityDivision of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityCentre for Public Health, Queen’s University of BelfastSchool of Medicine and Public Health, Centre for Clinical Epidemiology and Biostatistics, University of NewcastleDepartment of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityAbstract The attitude to self-care of individuals with type 2 diabetes (T2D) is commonly influenced by their time preferences (i.e., long-run discounting and time-consistency), and/or risk preference (i.e., risk tolerance). Tailored preference-based self-care management may improve clinical and cost-effectiveness. This study investigates associations between elicited time and risk preferences with diabetes-related outcomes, i.e., Hemoglobin A1c (HbA1c) and blood glucose level. Time and risk preferences of 396 T2D patients were measured by incentivized tasks. Clinical data was retrieved from hospital information systems for diabetes outcomes (HbA1c and blood glucose levels) and clinical factors. We assessed patient diabetes-associated self-care behaviors and other epidemiological factors by questionnaire. Multivariate linear regressions with stepwise model selection were used to evaluate potential associations with T2D outcomes. We found that participants who favored immediate gratification over greater long-term benefits (time-inconsistent towards present or present-biased) had significantly higher HbA1c levels than time-consistent participants, with a coefficient (95% CI) of 0.41 (0.02,0.80). Neither time nor risk preferences were significantly associated with blood glucose levels. These findings suggest the use of tailored diabetes interventions to help present-biased patients overcome self-control problems. This targeted approach may be more cost-effective but requires formal testing.https://doi.org/10.1038/s41598-025-16791-yHbA1cPresent biasRisk preferenceTime consistencyTime preferenceType 2 diabetes
spellingShingle Suparee W. Boonmanunt
Oraluck Pattanaprateep
Hataikarn Nimitphong
Unyaporn Suthutvoravut
Panu Looareesuwan
Taya Kitiyakara
Boonsong Ongphiphadhanakul
Gareth McKay
John Attia
Ammarin Thakkinstian
How time and risk preferences affect glucose control in type 2 diabetes patients
Scientific Reports
HbA1c
Present bias
Risk preference
Time consistency
Time preference
Type 2 diabetes
title How time and risk preferences affect glucose control in type 2 diabetes patients
title_full How time and risk preferences affect glucose control in type 2 diabetes patients
title_fullStr How time and risk preferences affect glucose control in type 2 diabetes patients
title_full_unstemmed How time and risk preferences affect glucose control in type 2 diabetes patients
title_short How time and risk preferences affect glucose control in type 2 diabetes patients
title_sort how time and risk preferences affect glucose control in type 2 diabetes patients
topic HbA1c
Present bias
Risk preference
Time consistency
Time preference
Type 2 diabetes
url https://doi.org/10.1038/s41598-025-16791-y
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