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

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.

Copyright © 2017 Elsevier Inc. All rights reserved.

Figures

Figure 1

3-Day CGM recordings on two subjects. Each line represents a different day. Note that, despite similar A1C levels, the GlucSDs differ.