Epstein to Study How Self-Control Can Help Prediabetes Patients

Epstein studies decision-making with an emphasis on health behavior, and project researchers will translate approaches they have developed to study how patients on the brink of developing Type 2 diabetes can be taught to be less impulsive.

Prediabetes represents an elevation of fasting blood glucose or glycated hemoglobin that will transition to Type 2 diabetes unless behavior changes are made, such as losing weight, improving dietary quality or exercising more.

Many people with a diagnosis of prediabetes will also have elevated blood pressure or blood lipids.

“While you would think that everyone who is told they are at risk for diabetes would immediately initiate multiple behavior changes, it is hard to change behavior, with one of the main challenges being the fact that many people with prediabetes discount the future,” says Epstein, who is also chief of the Division of Behavioral Medicine.

Epstein says patients can improve their dietary decisions and medical compliance by employing future-oriented thinking.

“Our recent research has demonstrated that many people have difficulty resisting the impulse for immediate gratification,” he says. “They do something called delay discounting, in which they discount future rewards in favor of smaller, immediate rewards.

But Epstein says researchers have also found that people can be taught to postpone immediate gratification by visualizing a future event through a method called episodic future thinking, which can be described as a projection of the self into the future to pre-experience an event.

“The overarching goal of this grant is to translate our research on delay discounting and episodic future thinking into powerful interventions that can prevent people with prediabetes from becoming diabetic,” Epstein says.

The grant was awarded as part of the Science of Behavior Change Initiative funded by the NIH and by the National Institute of Diabetes and Digestive Kidney Diseases.

Warren Bickel, a professor and director of the Virginia Tech Carilion Research Institute’s Addiction Recovery Research Center, is a co-principal investigator on the grant.