Diabetes as an expert field

I've seen several posts about how the math behind diabetes should be perfect, or that it is difficult to manage even though we know so much about it as patients.  I came across an article recently that, although the participants were all type 2 diabetics, might generalize to type 1's.  Researchers measured lots of demographic information (age, gender, occupation, etc.), and found no relationship between any of these variables to adherence (doing what you are supposed to) or glycemic control (your blood sugar levels).  They also found that even when participants could give facts about diabetes (eating sugar raises blood sugar), they could not necessarily transfer that knowledge to an application (you just did X, Y, and Z, how do you control your sugar?).  Interestingly, while some things were related to increased adherence, the only variable related to improved blood sugars was the ability to detect problems (using more ways to identify irregular blood sugars). 

This adds support to the common belief that some people have an easier time managing their diabetes even if they do not apply themselves as rigorously.  It also suggests focusing on detecting irregular bg might be the best way to improve control.  Perhaps most interesting (because this is relevant to my field), the method used by researchers was similar to methods used with field experts such as air traffic controllers, nuclear power plant operators, software experts, or fighter pilots, suggesting that treating/training diabetics in a similar manner may improve control.  If anyone can access the article, check it out:

Lippa, K. D., Klein, H. A., & Shalin, V. L. (2008). Everyday expertise: Cognitive demands in diabetes self-management. Human Factors, 50(1), 112-120.

I will check it out. I love having a database as part of my job. Do you know where I can read the health care reform? All 1000 plus pages? I'd like to delve into that. I can be pretty obsessive about reading such things. It's helpful in my line of work.

I didn't want to pay the $20 or so to access the PDF of the article you cited.  However, I imagine statistical psychologists could have (and probably have already had) a field day with studies correlating HbA1c's with intelligence scores (IQ's) and personality profiles.  It would be fun for us as a group to speculate on these two questions:

1. Do you think that Type 1's with higher IQ scores have better A1c's than those with lower scores?
2. Do you think that that certain "personality types" are better at managing T1 Diabetes than others?
       We could experiment with this by each of us taking a "Big 5" Personality Profile Test
       Here's the link to an online one:  Big 5 Test


Sorry for not posting the article Paul, my understanding of the "fair use" portion of copyright law is that posting an article where 5,000+ people could download it would be frowned upon.  One thing I forgot to mention about the article is that they did not use A1C results as the measure for glycemic control...they had people report their highest bg in the past week.  I will be the first to admit, this is not the best way to go about things, but given the increased difficulty using live blood would have created, I think it was a good first step. 

1. I would not expect I.Q. to correlate with A1C results (at least not strongly).  I.Q. says nothing about motivation, which explains why some highly intelligent people have no drive.  Even at the other end of the spectrum, someone with an I.Q. around 60 may receive care from a specialist, counteracting the influence of I.Q.

2. It has been awhile since I worked with OCEAN, the only element I would expect to impact care would be Openness to new experiences, when someone is first diagnosed (unless there is an emotional intelligence component somewhere).  I do think OCEAN could help predict how well someone copes.

There are studies on these topics out there, but I'm not familiar with them.  Neat ideas, can't wait to hear the rest of the opinions that trickle in!

This is ME according to the online test.  How about YOU?



Openness to Experience/Intellect

         High scorers tend to be original, creative, curious, complex; Low scorers tend to be conventional, down to earth, narrow interests, uncreative.
         You enjoy having novel experiences and seeing things in new ways.     (Your percentile: 93)
         High scorers tend to be reliable, well-organized, self-disciplined, careful; Low scorers tend to be disorganized, undependable, negligent.
         You are well-organized, and are reliable.     (Your percentile: 64)
         High scorers tend to be sociable, friendly, fun loving, talkative; Low scorers tend to be introverted, reserved, inhibited, quiet.
         You tend to shy away from social situations.     (Your percentile: 37)
         High scorers tend to be good natured, sympathetic, forgiving, courteous; Low scorers tend to be critical, rude, harsh, callous.
         You tend to consider the feelings of others.     (Your percentile: 79)
         High scorers tend to be nervous, high-strung, insecure, worrying; Low scorers tend to be calm, relaxed, secure, hardy.
         You are a generally anxious person and tend to worry about things.     (Your percentile: 93)

I tend to think that neither emotional nor any other kind of intelligence is necessarily a friend to a person with a chronic illness. I think it can be, if you know how to filter out the bull jive that you notice. I also think that more than any other factor, original environment plays a great part in how T1's look at themselves and the world later on. I say this because according to that (in my opinion culturally biased) test that measures IQ, my number was high. I have had relatively decent A1C's but not always.

You didn't ask me, but I took it. <a href="http://www.outofservice.com/bigfive/results/?oR=0.95&amp;cR=0.556&amp;eR=0.312&amp;aR=0.694&amp;nR=0.719">I'm a O93-C41-E12-A57-N80 Big Five!!</a>

I agree, emotional intelligence might not be the best candidate, but since part of the definition I know includes being able to recognize and control your emotions, I felt it might make a decent candidate.  Lippa et al., 2008 suggests interpretting somatic signals is important, perhaps the more general categories of "self-awareness" or "self-regulation" would be better ("skill in biofeedback" maybe?)?

[quote user="Crochet Nut"]

You didn't ask me, but I took it. <a href="http://www.outofservice.com/bigfive/results/?oR=0.95&amp;cR=0.556&amp;eR=0.312&amp;aR=0.694&amp;nR=0.719">I'm a O93-C41-E12-A57-N80 Big Five!!</a>


It's interesting how similar our profiles are.

                                      YOU               ME

Openness                        93                 93
Conscientiousness          41                 64
Extroversion                    12                 37
Agreeableness                 57                79
Neuroticism                      80                93

The curve is the same and we are equal in Openness.  In all the other traits, for better or for worse, I am a little more conscientious, a little more extroverted, a little more agreeable and a little more neurotic.


I wonder if this will change. It's self reported...maybe if I do more conscientious things, it'll register higher.

I'm not very agreeable. I can type, but when it comes to social interaction other than teaching (where the exact opposite occurs), I am almost nonfunctional...large crowds, the noise of many people talking all at once, is overwhelming.

It's an interesting test...thank you for posting it.

                                    Crochet nut               Paul                Gina

Openness                             93                      93                   70
Conscientiousness                 41                      64                   83
Extroversion                         12                      37                   59
Agreeableness                      57                      79                   74
Neuroticism                         80                       93                   60

Just something to think about, scores on the traits change over time, and the test examines the traits you have instead of labeling you as a good or bad person.  There is no optimum score.  So interestingly, if a major correlation was found for glycemic control, the question would then become, should people change their lifestyle or should we identify different strategies for different responses (this happens with medication adherence and locus of control).  As it was brought up already, in addition to self-reporting, you might want to consider self-selection bias here, or the validity and reliability of this particular scale.

not sure about IQ (I dn't know enough about IQ to even guess...people I think are brilliant have horible IQ's ans visa versa...)...but definately personality type!!  I'd love to see some data on...Shall we get our scoures on the Big5 and then report back?

super interesting.  going to save and reread this later when I have more time.  Thanks!

I didn't take the test you recommended, Paul, but another great personality test that I've taken is the DISC test. I'd be interested to see what other's results are compared to mine. My result is that I'm a 'C' (conscientious), and the description is very accurate! I would recommend anyone to take it. I'm not sure if there is a cost, because I took it for a spiritual gifts workshop, so I was just given a code to take it. Now that I remember, though, I think I did have to pay about $8 for the workshop, so that may be the price of the test. But, I think that is fairly cheap for the detailed results they give you. After taking the test, you are given your results as a PDF. It includes two different detailed results based on your answers: "This is expected of me" and "This is me".

Seriously, if you don't mind paying the small price, the results really are scarily accurate. I think there is a DISC test that you can take for free, but the results wouldn't be as extensive. You should all try it out.



A little off base, but has anyone ever taken the Myers Briggs? There is a free version which is not, of course, the exact replication of the Myers Briggs, but it is interesting. I came up as an INFP. Anyone else ever taken this one? I'll look up a version that is pretty thorough, etc.

I would say we're on the right track with the direction of this thread, as I truly believe that there are personality characteristics which would be beneficial to good diabetes management and there are some which might be detrimental. To me, it only makes sense.  It is, of course, important to restate and re-emphasize that no "value judgements" should be attached to the presence or absence of any of these personality traits.  Likewise, as intelligent and motivated human beings, fortunately we are in the position to change ourselves and modify our behavior..., that is, if we are able to, and make the effort to, identify the "problems."  And, that's exactly what all these personality tests were designed to accomplish.

it's a very well respected test.  Where did you find the facimile of this test.  It would be interesting to take it

Here's the link to the test.  You can copy paste the results if you want.
Just click on it.  (You don't have to answer the optional questions at the end.)

Big 5 Test


Crochet Nut-

I've taken the Myers-Briggs test, also. According to that one, I'm an INTJ. I will now go take the one Paul recommended to see how it compares. (=