Self-Compassion, Adaptive Reactions and Health Behaviours Among Adults With Prediabetes and Type 1, Type 2 and Gestational Diabetes: A Scoping Review

Biotransformation and disposition characteristics of HSK7653, a novel long-acting dipeptidyl peptidase-4 inhibitor for the treatment of type 2 diabetes

AIM

To investigate the metabolism and disposition characteristics of HSK7653 in healthy male Chinese participants.

METHODS

A single oral dose of 80 μCi (25 mg) [14C]HSK7653 capsules was administered to six healthy participants, and blood, plasma, urine and faeces were collected. Quantitative and qualitative analysis was conducted to investigate the pharmacokinetics, blood-to-plasma ratio, mass balance and metabolism of HSK7653.

RESULTS

The drug was well absorbed and reached a maximum concentration at 1.25 h. The drug-related components (HSK7653 and its metabolites) were eliminated slowly, with a half-life (t1/2) of 111 h. Unchanged HSK7653 contributed to more than 97% of the total radioactivity in all plasma samples. The blood-to-plasma ratio (0.573-0.845) indicated that HSK7653 did not tend to distribute into blood cells. At 504 h postdose, up to 95.9% of the dose was excreted, including 79.8% in urine and 16.1% in faeces. Most of the radioactivity (75.5% dose) in excreta was unchanged HSK7653. In addition, nine metabolites were detected in urine and faeces. The most abundant metabolite was M6-2, a dioxidation product of HSK7653, which accounted for 4.73% and 2.63% of the dose in urine and faeces, respectively. The main metabolic pathways of HSK7653 in vivo included oxidation, pyrrole ring opening and sulphonamide hydrolysation.

CONCLUSION

HSK7653 was well absorbed, slightly metabolized and slowly excreted in humans. The high plasma exposure and long t1/2 of HSK7653 may contribute to its long-lasting efficacy as a long-acting dipeptidyl peptidase-4 inhibitor.

Potential Correlation Between Self-Compassion and Bedtime Procrastination: The Mediating Role of Emotion Regulation

Purpose

The present research aims to investigate the potential correlations between self-compassion and bedtime procrastination, a significant behavior related to sleep. In this research, we put forward the hypothesis that a reduction in negative affect and the implementation of adaptative emotion regulation strategies can elucidate the established connections between self-compassion and a decreased tendency for bedtime procrastination.

Methods

Two cross-sectional online surveys (Survey I: n=241 and Survey II: n=546) were carried out via a convenient sampling method. Prior to their inclusion, all participants underwent a thorough assessment to confirm no evidence of clinical insomnia. The study participants in both survey investigations were asked to complete various psychometric assessments, including self-compassion, positive and negative affect, and bedtime procrastination; however, the study participants in Survey II additionally underwent the administration of a cognitive reappraisal assessment.

Results

In Survey I, a multiple mediation analysis was conducted to examine the mediating effects of self-compassion on reducing bedtime procrastination through a reduction in negative affect. The results supported the hypothesized relationships, indicating that self-compassion had the expected mediated effects by mitigating negative affective states. However, contrary to expectations, higher positive affect did not mediate the relationship between self-compassion and reduced bedtime procrastination. The findings of Survey II were confirmed through the utilization of path analysis. Moreover, this analysis provided additional evidence to suggest that the mechanism of cognitive reappraisal could account for the observed decrease in negative affect associated with self-compassion. The present study found a notable and sustained impact of self-compassion on reducing instances of delaying bedtime activities.

Conclusion

The present research contributes novel empirical evidence suggesting a negative association between self-compassion and the propensity to engage in bedtime procrastination. This relationship can be attributed partly to the implementation of an adaptative emotion regulation mechanism that effectively alleviates negative affect.

Medication Bias During the Hospital-to-Family Transition Among Young and Middle-Aged Chinese Patients with Type 2 Diabetes: A Qualitative Study

Objective

This study aimed to examine the prevalence of medication non-adherence among young and middle-aged Chinese individuals diagnosed with type 2 diabetes, and to explore the underlying causes of such deviations.

Methods

The Medication Discrepancy Tool (MDT) was used to assess medication deviations in a cohort of 100 patients who had been discharged from the hospital. Furthermore, 15 subjects were interviewed to gain a better understanding of their medication non-adherence experiences.

Results

The rate of medication deviation in the studied cohort was 79.5%, with the most frequent deviation being a reduction in the types of drugs taken. The primary cause of this deviation was found to be patient-derived, with the most common reason being symptom improvement. Iatrogenic medication deviation was most often caused by incomplete or inaccurate medication education for medical staff at discharge, resulting in patients having to guess their own medication. Internal and extrinsic motivating factors were identified as the primary causes of medication deviation behavior.

Conclusion

This study has demonstrated that medication non-adherence is a major issue among young and middle-aged Chinese individuals diagnosed with type 2 diabetes. Therefore, it is essential for nurses to be aware of the importance of medication adherence management and working.

Self-Compassion: Theory, Method, Research, and Intervention

Self-compassion refers to being supportive toward oneself when experiencing suffering or pain-be it caused by personal mistakes and inadequacies or external life challenges. This review presents my theoretical model of self-compassion as comprised of six different elements: increased self-kindness, common humanity, and mindfulness as well as reduced self-judgment, isolation, and overidentification. It discusses the methodology of self-compassion research and reviews the increasingly large number of empirical studies that indicate self-compassion is a productive way of approaching distressing thoughts and emotions that engenders mental and physical well-being. It also reviews research that dispels common myths about self-compassion (e.g., that it is weak, selfish, self-indulgent or undermines motivation). Interventions designed to increase self-compassion, such as compassion-focused therapy and mindful self-compassion, are discussed. Finally, the review considers problematic issues in the field, such as the differential effects fallacy, and considers limitations and future research directions in the field of self-compassion research.

A pilot and feasibility study of a randomized clinical trial testing a self-compassion intervention aimed to increase physical activity behaviour among people with prediabetes

BACKGROUND

Seventy-five per cent of individuals with prediabetes will eventually be diagnosed with type 2 diabetes. Physical activity is a cornerstone in reducing type 2 diabetes risk but can be a challenging behaviour to adopt for those living with prediabetes. Individuals with prediabetes experience difficult emotions associated with being at risk for a chronic disease, which can undermine self-regulation. Self-compassion enhances self-regulation because it mitigates difficult emotions and promotes adaptive coping. We performed a pilot randomized controlled trial to determine the feasibility and acceptability of a self-compassion informed intervention to increase physical activity for persons with prediabetes.

METHODS

This explanatory mixed methods study tested the feasibility and acceptability of a two-arm, randomized, single-blind, actively controlled, 6-week online intervention. Using a 1:1 allocation ratio, participants (identified as people with prediabetes, low physical activity, and low self-compassion) were randomized to a self-compassion (Mage = 60.22 years) or control condition (Mage = 56.13 years). All participants received behaviour change education (e.g. SMART goals, action-coping planning) and either other health knowledge (control condition: e.g. sleep, benefits of water) or self-compassion training (intervention condition: practising mindfulness, writing a letter to themselves offering the same support that they would offer to a friend). The primary outcome was to determine the feasibility and acceptability of the trial. To be considered feasible, our outcomes needed to meet or surpass our pre-determined criteria (e.g. time for group formation: 14-20 participants per month). Feasibility was assessed by examining the recruitment rates, retention, adherence, fidelity, and capacity. Semi-structured interviews were conducted with participants to determine trial acceptability. As a secondary purpose, we examined the means on key study variables (secondary and exploratory variables; see Table 1) at all planned time points (baseline, intervention-end, 6- and 12-week follow-up) to identify if they are suitable to include in the efficacy trial (see Additional Table 3).

RESULTS

Eighteen participants were screened and randomized to one of two conditions. Retention, instructor fidelity, safety, capacity, adherence to most of the study aspects, and acceptability by participants and facilitators all met the criteria for feasibility. Recruitment rate, process time, and adherence to home practice were below our criteria, and we offer ways to address these shortcomings for the efficacy trial.

CONCLUSION

The results from this study suggest that it should be feasible to deliver our intervention while highlighting the alterations to components that may be altered when delivering the efficacy trial. We outline our changes which should improve and enhance the feasibility and acceptability of our planned intervention. Funding for this study was from the Canadian Institutes of Health Research (CIHR).

TRIAL REGISTRATION

ClinicalTrials.gov, NCT04402710 . Registered on 09 April 2020.

A 12-month longitudinal study examining the shared and unique contributions of self-compassion and psychological inflexibility to distress and quality of life in people with Type 2 Diabetes

OBJECTIVES

Self-compassion and psychological flexibility appear to benefit wellbeing and quality of life (QoL) in the general population and in people with long-term conditions like Type 2 Diabetes (T2D). However, both variables share similarities and their unique roles in relation to distress and QoL in people with diabetes over time are not clear.

DESIGN

This was a longitudinal study with online assessments of self-compassion, psychological inflexibility, distress (depression, anxiety, diabetes-distress), and QoL at baseline (T1) and six (T2) and 12 months (T3).

METHODS

In total, 173 UK adults with T2D completed baseline questionnaires; T2 and T3 follow-ups were completed by 82 and 52 participants, respectively. Correlations were conducted to understand the relationships between variables at each time point. Hierarchical regressions were conducted to understand the unique predictive role of baseline self-compassion and psychological inflexibility in relation to distress and QoL at T2 and T3, controlling for age and baseline distress and QoL.

RESULTS

There were large significant negative correlations between self-compassion and psychological inflexibility (r > -0.50), and both had significant large correlations with distress (r > -0.50) but not QoL across time points. Regressions indicated that psychological inflexibility uniquely predicted depression (T2) and anxiety symptoms (T2 and T3) and QoL (T3). Self-compassion did not uniquely predict any of the outcomes.

CONCLUSIONS

Psychological inflexibility may play an important role in distress in T2D, but prospective studies with larger samples are needed to replicate these findings. Given the overlap between psychological inflexibility and self-compassion, treatments targeting either variable may be useful.

Compassion toward others and self-compassion predict mental and physical well-being: a 5-year longitudinal study of 1090 community-dwelling adults across the lifespan

There is growing interest in the role of compassion in promoting health and well-being, with cross-sectional data showing an inverse correlation with loneliness. This is the first longitudinal study examining both compassion toward others (CTO) and compassion toward self (CTS) as predictors of mental and physical health outcomes including loneliness, across adult lifespan. We followed 552 women and 538 men in San Diego County for up to 7.5 (mean 4.8 and SD 2.2) years, using validated rating scales for CTO, CTS, and loneliness. Linear mixed-effects models were employed to examine age- and sex-related trajectories of CTO and CTS over time. Linear regression models were used to evaluate baseline and longitudinal relationships of CTO and CTS with mental well-being, physical well-being, and loneliness. CTS and CTO were weakly intercorrelated. Women had higher baseline CTO than men. While CTO was stable over time and across the lifespan, CTS scores had an inverse U-shaped relationship with age, peaking around age 77. There were significant baseline × slope interactions of both CTO and CTS predicting improvements in physical well-being in adults <60 years old. Increases in CTO and CTS predicted improvements in mental well-being. Higher baseline CTO and CTS as well as increases in CTO and CTS scores predicted lower loneliness scores at follow-up. Thus, CTO and CTS were associated with better mental well-being and loneliness across the adult lifespan, and physical well-being in younger adults, and are promising targets for interventions to improve health outcomes.