Fear of hypoglycemia: Influence on glycemic variability and self-management behavior in young adults with type 1 diabetes

J Diabetes Complications. 2017 Apr;31(4):735-741. doi: 10.1016/j.jdiacomp.2016.12.015. Epub 2017 Jan 20.

Abstract

Purpose: The purpose of this study was to examine how fear of hypoglycemia (FOH) is associated with glycemic variability (GV) and self-management behavior in young adults (aged 18-35) with type 1 diabetes (T1DM).

Procedures: Using a prospective repeated-measures design, in 35 young adults, within- and between-person and temporal associations of FOH, specific self-management behaviors, and GV were measured. The data were collected using questionnaires and real-time measures using daily diaries, insulin pump downloads, actigraphy, and continuous glucose monitoring.

Findings: FOH was associated with greater glycemic variability. Significant temporal associations emerged. Concurrent day (glucose SD, p=.011) and previous-evening fear levels were associated with GV (glucose SD, p=.007). FOH was also associated with greater calorie intake (r=.492, p=.003) and less physical activity (light activity, r=-.341, p=.045).

Conclusions: The significant associations of FOH with GV, dietary patterns, and physical activity provide evidence for FOH as an important psychological factor associated with diabetes care.

Keywords: Behavior; Fear of hypoglycemia; Glycemic variability; Self-management; Type 1 diabetes.

MeSH terms

  • Adolescent
  • Adult
  • Anxiety / complications
  • Anxiety / etiology
  • Blood Glucose / analysis
  • Chicago
  • Combined Modality Therapy / adverse effects
  • Combined Modality Therapy / psychology
  • Cost of Illness*
  • Diabetes Complications / prevention & control
  • Diabetes Complications / psychology
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / psychology
  • Diabetes Mellitus, Type 1 / therapy*
  • Diet, Diabetic / adverse effects
  • Diet, Diabetic / psychology
  • Exercise / psychology
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Hyperglycemia / prevention & control*
  • Hypoglycemia / prevention & control*
  • Insulin Infusion Systems / adverse effects
  • Male
  • Monitoring, Ambulatory / adverse effects
  • Monitoring, Ambulatory / psychology
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Self-Management* / psychology
  • Stress, Psychological / complications
  • Stress, Psychological / etiology*
  • Young Adult

Substances

  • Blood Glucose