Examining the association between delay discounting, delay aversion and physical activity in Chinese adults with type-2 diabetes mellitus

ARTICLE HIGHLIGHTS

Research background

Physical inactivity is the fourth leading cause of mortality worldwide and is a modifiable risk factor. Physical activity not only proves effective in managing blood glucose levels and reducing risk factors for cardiovascular disease in individuals with type 2 diabetes mellitus (T2DM) but also serves as a preventive measure against or delay in the onset of diabetes-related complications. In China, 22.3% of adults do not meet the minimum level of physical activity recommended by the World Health Organization.

Research motivation

Research has indicated that individuals' inability to engage in and maintain regular physical activity is partly attributable to a psychological inclination favoring immediate rewards over delayed, more substantial ones.

Research objectives

To investigate the relationship between delay discounting, delay aversion, glycated hemoglobin (HbA1c), and various levels of physical activity in Chinese adults diagnosed with T2DM.

Research methods

In 2023, 400 adults with T2DM were recruited from the People's Hospital of Linxia Hui Autonomous Prefecture of Gansu Province. A face-to-face questionnaire was used to gather demographic data and details on physical activity, delay discounting, and delay aversion. In addition, HbA1c levels were measured in all 400 participants. Multiple linear regression models were utilized to assess the relationship between delay discounting, delay aversion, and HbA1c levels, along with the intensity of different physical activities measured in met-hours per week.

Research results

After controlling for sample characteristics, delay discounting was negatively associated with moderate physical activity (β = -2.386, 95%CI: -4.370 to -0.401). Similarly, delay aversion was negatively associated with the level of moderate physical activity (β = -3.527, 95%CI:-5.578 to -1.476) in the multiple linear regression model, with statistically significant differences.

Research conclusions

Elevated delay discounting and increased delay aversion correlated with reduced levels of moderate physical activity. Result suggests that delay discounting and aversion may influence engagement in moderate physical activity. This study recommends that health administration and government consider delay discounting and delay aversion when formulating behavioral intervention strategies and treatment guidelines involving physical activity for patients with T2DM, which may increase participation in physical activity.

Research perspectives

It is worth highlighting that both delay discounting and delay aversion are modifiable factors, developing interventions to address these factors may bolster participation in physical activity. One approach with a proven track record for reducing delay discounting is episodic future thinking, which involves vividly envisioning positive future events. This method will be utilized in future studies to diminish delay in discounting and enhance engagement in physical activities.