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Iowa Gambling Task Performance Prospectively Predicts Changes in Glycemic Control among Adolescents with Type 1 Diabetes

Published online by Cambridge University Press:  09 January 2017

Yana Suchy Open the ORCID record for Yana Suchy [Opens in a new window] ,
Tara L. Queen ,
Bryce Huntbach ,
Deborah J. Wiebe ,
Sara L. Turner ,
Jonathan Butner ,
Caitlin S. Kelly ,
Perrin C. White ,
Mary Murray  and
Michael Swinyard
...Show all authors
Yana Suchy*
Affiliation:
Department of Psychology, University of Utah, Salt Lake City, Utah
Tara L. Queen
Affiliation:
Department of Psychology, University of Utah, Salt Lake City, Utah
Bryce Huntbach
Affiliation:
Department of Psychology, University of Utah, Salt Lake City, Utah
Deborah J. Wiebe
Affiliation:
Psychological Sciences, University of California, Merced, California
Sara L. Turner
Affiliation:
Department of Psychology, University of Utah, Salt Lake City, Utah
Jonathan Butner
Affiliation:
Department of Psychology, University of Utah, Salt Lake City, Utah
Caitlin S. Kelly
Affiliation:
Department of Psychology, University of Utah, Salt Lake City, Utah
Perrin C. White
Affiliation:
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas
Mary Murray
Affiliation:
Pediatric Endocrinology, University of Utah Health Care, Salt Lake City, Utah
Michael Swinyard
Affiliation:
Pediatric Endocrinology, Intermountain Healthcare, Salt Lake City, Utah
Cynthia A. Berg
Affiliation:
Department of Psychology, University of Utah, Salt Lake City, Utah
*
Correspondence and reprint requests to: Yana Suchy, Department of Psychology, 380 S. 1530 E., Salt Lake City, UT 84112. E-mail: yana.suchy@psych.utah.edu
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Abstract

Objectives: Good glycemic control is an important goal of diabetes management. Late adolescents with type 1 diabetes (T1D) are at risk for poor glycemic control as they move into young adulthood. For a subset of these patients, this dysregulation is extreme, placing them at risk for life-threatening health complications and permanent cognitive declines. The present study examined whether deficiency in emotional decision making (as measured by the Iowa Gambling Task; IGT) among teens with T1D may represent a neurocognitive risk factor for subsequent glycemic dysregulation. Methods: As part of a larger longitudinal study, a total of 241 high-school seniors (147 females, 94 males) diagnosed with T1D underwent baseline assessment that included the IGT. Glycated hemoglobin (HbA1c), which reflects glycemic control over the course of the past 2 to 3 months, was also assessed at baseline. Of the 241,189 (127 females, 62 males, mean age=17.76, mean HbA1c=8.11) completed HbA1c measurement 1 year later. Results: Baseline IGT performance in the impaired range (per norms) was associated with greater dysregulation in glycemic control 1 year later, as evidenced by an average increase in HbA1c of 2%. Those with normal IGT scores (per norms) exhibited a more moderate increase in glycemic control, with an HbA1c increase of 0.7%. Several IGT scoring approaches were compared, showing that the total scores collapsed across all trials was most sensitive to change in glycemic control. Conclusions: IGT assessment offers promise as a tool for identifying late adolescents at increased risk for glycemic dysregulation. (JINS, 2017, 23, 204–213)

Keywords

Type 1 diabetesIowa Gambling TaskEmotional decision makingGlycemic controlCognitionAdherence.
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 23 , Issue 3 , March 2017 , pp. 204 - 213
Copyright
Copyright © The International Neuropsychological Society 2017 

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