title: Iowa Gambling Task Performance Prospectively Predicts Changes in Glycemic Control among Adolescents with Type 1 Diabetes.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  IGT assessment offers promise as a tool for identifying late adolescents at increased risk for glycemic dysregulation. (JINS, 2017, 23, 204-213).
authors.affiliation: 1Department of Psychology,University of Utah,Salt Lake City,Utah.
authors.forename: Yana
authors.identifier: 0000-0001-6513-565X
authors.initials: Y
authors.lastname: Suchy
authors.affiliation: 1Department of Psychology,University of Utah,Salt Lake City,Utah.
authors.forename: Tara L
authors.initials: TL
authors.lastname: Queen
authors.affiliation: 1Department of Psychology,University of Utah,Salt Lake City,Utah.
authors.forename: Bryce
authors.initials: B
authors.lastname: Huntbach
authors.affiliation: 2Psychological Sciences,University of California,Merced,California.
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Wiebe
authors.affiliation: 1Department of Psychology,University of Utah,Salt Lake City,Utah.
authors.forename: Sara L
authors.initials: SL
authors.lastname: Turner
authors.affiliation: 1Department of Psychology,University of Utah,Salt Lake City,Utah.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Butner
authors.affiliation: 1Department of Psychology,University of Utah,Salt Lake City,Utah.
authors.forename: Caitlin S
authors.initials: CS
authors.lastname: Kelly
authors.affiliation: 3Department of Pediatrics,University of Texas Southwestern Medical Center,Dallas,Texas.
authors.forename: Perrin C
authors.initials: PC
authors.lastname: White
authors.affiliation: 4Pediatric Endocrinology,University of Utah Health Care,Salt Lake City,Utah.
authors.forename: Mary
authors.initials: M
authors.lastname: Murray
authors.affiliation: 5Pediatric Endocrinology,Intermountain Healthcare,Salt Lake City,Utah.
authors.forename: Michael
authors.initials: M
authors.lastname: Swinyard
authors.affiliation: 1Department of Psychology,University of Utah,Salt Lake City,Utah.
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Berg
mesh_terms: D000293:Adolescent; D000339:Affect / Q000502:physiology; D001786:Blood Glucose / Q000502:physiology*; D003657:Decision Making / Q000502:physiology*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D005717:Games, Experimental; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D016014:Linear Models; D008297:Male; D025341:Principal Component Analysis; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: Adherence.; Cognition; Emotional decision making; Glycemic control; Iowa Gambling Task; Type 1 diabetes