The Relationship of Worry About Hypoglycemia With Diabetes-specific and Typical Youth Behavior Among Emerging Adults With Type 1 Diabetes

Abstract

Purpose Little is known about the relationship of worry about hypoglycemia with diabetes-specific and typical-youth behaviors among emerging adults with type 1 diabetes. This study’s purpose was to examine the relationship among worry about hypoglycemia, diabetes management, and glycemic control within the context of alcohol use, hypoglycemia-related weight control behaviors, depressive symptoms, and impulse control among emerging adults with type 1 diabetes. Research Design and Methods The sample was 181 emerging adults with type 1 diabetes who were part of a larger study. Path analysis was used to test associations among worry about hypoglycemia, diabetes management, hypoglycemia-related weight control behaviors (WCB), alcohol use, impulse control, depressive symptoms and glycemic control. Results Path model fit and modification indices suggested that a feedback loop between worry about hypoglycemia and diabetes management should be incorporated into the original model. Youth with fewer depressive symptoms reported fewer hypoglycemia-related WCB and less worry about hypoglycemia; those with higher impulse control had less alcohol use and better diabetes management; those with lower alcohol use had more worry about hypoglycemia; and better glycemic control was associated with better diabetes management. Conclusions Health care professionals need to understand how multiple factors related to worry about hypoglycemia and diabetes management interact in emerging adults. In the context of depressive symptoms, impulse control, alcohol use, and hypoglycemia-related WCB, the path model results suggest several potential avenues for intervening to improve glycemic control in emerging adults.

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

“…It is possible that greater GV with equivalent peaks and nadirs results in a normal A1C for some individuals. A1C has been inconsistently associated with FOH in previous research (Hanna, Weaver, Stump, Fortenberry, & DiMeglio, 2014; Hendrieckx et al, 2014; Nixon & Pickup, 2011), suggesting that short-term measures of glycemia may better depict this phenomenon.…”

Poor sleep quality is associated with nocturnal glycaemic variability and fear of hypoglycaemia in adults with type 1 diabetes

“…It is plausible that the resulting hyperglycaemia may lead to sleep disruption due to glycosuria (Richmond, 1996). FOH may also lead to more vigilant blood glucose monitoring, which adds to sleep disturbance if individuals feel compelled to wake during the night to monitor blood glucose (Hanna, Weaver, Stump, Fortenberry, & DiMeglio, 2014).…”

Health anxiety and illness-related fears across diverse chronic illnesses: A systematic review on conceptualization, measurement, prevalence, course, and correlates

“…In this population, HA is most often conceptualized as fear of hypoglycemia (FoH) comprised of specific worries associated with insulin reaction and the different behaviours to avoid hypoglycemia (see definition above) and measured with the Hypoglycemia Fear Survey [128]. Like other manifestations of HA, it is associated with lower QOL, distress, anxiety, and depressive symptoms [7,128,196,[265][266][267][268][269][270][271]. Hypoglycemia is a common adverse event for people living with diabetes and can have very severe consequences if untreated, leading to coma and death.…”