Patients’ impatience is an independent determinant of poor diabetes control

Abstract Aims Some individuals have a preference for the present rather than for the future. We investigated the impact of this impatient relationship to temporality on adherence to medication and HbA1c level in type 2 diabetic patients. Methods An observational, cross-sectional monocenter study in 90 patients consulting for a health check-up at a Center for Preventive Medicine. We used questionnaires assessing adherence to medication, impatience in a fictive monetary choice (preferring a smaller amount now to a higher amount later) and in daily life situations, foresight, locus of control, and social deprivation. Results Impatience in the monetary choice was associated with non-adherence to medication ( P = 0.005). In a multivariate logistic regression model, the risk of observing HbA1c ≥ 7% was associated with a long duration of diabetes (OR 5.2, CI 1.7–15.7, P = 0.003), monetary impatience (OR = 5.1, CI 1.7–15.4, P = 0.004), a high “chance and other people” score of the locus of control (OR = 5.1, CI 1.7–15.7, P = 0.004), a suboptimal foresight (OR 3.9, CI 1.2-12.0, P = 0.02). A decision-tree analysis (CHAID algorithm) showed that in this cohort of 90 patients, the 11 people who were adherent to medication, patient in the monetary scenario, had optimal foresight, and gave importance neither to chance nor to other people, had all HbA1c below 7%. Conclusion An impatient relationship to temporality was found associated with non-adherence to medication and uncontrolled HbA1c in type 2 diabetic patients. Treatment strategies for chronic diseases should be tailored according to this novel dimension of psychology.