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

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

Pamela Martyn-Nemeth  1 , Laurie Quinn  2 , Sue Penckofer  3 , Chang Park  2 , Vanessa Hofer  4 , Larisa Burke  2
Affiliations

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

Pamela Martyn-Nemeth et al. J Diabetes Complications. 2017 Apr.

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.

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Figures

Figure 1
Figure 1
3-Day CGM recordings on two subjects. Each line represents a different day. Note that, despite similar A1C levels, the GlucSDs differ.
See this image and copyright information in PMC

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