TY - JOUR T1 - ‘Never again will I be carefree’: a qualitative study of the impact of hypoglycemia on quality of life among adults with type 1 diabetes JF - BMJ Open Diabetes Research & Care JO - BMJ Open Diab Res Care DO - 10.1136/bmjdrc-2021-002322 VL - 9 IS - 1 SP - e002322 AU - Hannah Chatwin AU - Melanie Broadley AU - Mette Valdersdorf Jensen AU - Christel Hendrieckx AU - Jill Carlton AU - Simon Heller AU - Stephanie Amiel AU - Bastiaan de Galan AU - Norbert Hermanns AU - Katharina Finke-Groene AU - Jane Speight AU - Frans Pouwer Y1 - 2021/08/01 UR - http://drc.bmj.com/content/9/1/e002322.abstract N2 - Introduction Achieving glycemic targets and optimizing quality of life (QoL) are important goals of type 1 diabetes care. Hypoglycemia is a common barrier to achieving targets and can be associated with significant distress. However, the impact of hypoglycemia on QoL is not fully understood. The aim of this study was to explore how adults with type 1 diabetes are impacted by hypoglycemia in areas of life that are important to their overall QoL.Research design and methods Participants responded to a web-based qualitative survey involving a novel ‘Wheel of Life’ activity. Responses were analyzed using reflexive thematic analysis.Results The final sample included 219 adults with type 1 diabetes from Denmark, Germany, the Netherlands, and the UK. They had a mean±SD age of 39±13 years and diabetes duration of 20±14 years. Participants identified eight areas of life important to their overall QoL, including relationships and social life, work and studies, leisure and physical activity, everyday life, sleep, sex life, physical health, and mental health. Participants reported emotional, behavioral, cognitive, and social impacts of hypoglycemia within domains. Across domains, participants described interruptions, limited participation in activities, exhaustion, fear of hypoglycemia, compensatory strategies to prevent hypoglycemia, and reduced spontaneity.Conclusions The findings emphasize the profound impact of hypoglycemia on QoL and diabetes self-care behaviors. Diabetes services should be aware of and address the burden of hypoglycemia to provide person-centered care. Clinicians could ask individuals how hypoglycemia affects important areas of their lives to better understand the personal impact and develop tailored management plans.Data are available on reasonable request via contact with the corresponding author (https://orcid.org/0000-0001-8328-0869), provided that data are to be used for research projects related to health sciences. Data are deidentified participant data from a web-based qualitative survey. ER -