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Fear of hypoglycemia: relationship to hypoglycemic risk and psychological factors
Stockholm Univ, Dept Psychol, S-10691 Stockholm, Sweden.
Univ Virginia, Dept Psychiat & Neurobehav Sci, Charlottesville, VA USA.
Karolinska Inst, Karolinska Univ Hosp, Dept Med, Huddinge, Sweden.
Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Div Med, Stockholm, Sweden.
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2015 (English)In: Acta Diabetologica, ISSN 0940-5429, E-ISSN 1432-5233, Vol. 52, no 3, 581-589 p.Article in journal (Refereed) Published
Abstract [en]

The major aims of this study were to examine (1) the association between fear of hypoglycemia (FOH) in adults with type 1 diabetes with demographic, psychological (anxiety and depression), and disease-specific clinical factors (hypoglycemia history and unawareness, A(1c)), including severe hypoglycemia (SH), and (2) differences in patient subgroups categorized by level of FOH and risk of SH. Questionnaires were mailed to 764 patients with type 1 diabetes including the Swedish translation of the Hypoglycemia Fear Survey (HFS) and other psychological measures including the Perceived Stress Scale, Hospital Anxiety and Depression Scale, Anxiety Sensitivity Index, Social Phobia Scale, and Fear of Complications Scale. A questionnaire to assess hypoglycemia history was also included and A(1c) measures were obtained from medical records. Statistical analyses included univariate approaches, multiple stepwise linear regressions, Chi-square t tests, and ANOVAs. Regressions showed that several clinical factors (SH history, frequency of nocturnal hypoglycemia, self-monitoring) were significantly associated with FOH but R (2) increased from 16.25 to 39.2 % when anxiety measures were added to the model. When patients were categorized by level of FOH (low, high) and SH risk (low, high), subgroups showed significant differences in non-diabetes-related anxiety, hypoglycemia history, self-monitoring, and glycemic control. There is a strong link between FOH and non-diabetes-related anxiety, as well as hypoglycemia history. Comparison of patient subgroups categorized according to level of FOH and SH risk demonstrated the complexity of FOH and identified important differences in psychological and clinical variables, which have implications for clinical interventions.

Place, publisher, year, edition, pages
2015. Vol. 52, no 3, 581-589 p.
Keyword [en]
Type 1 diabetes, Hypoglycemia, Fear of hypoglycemia, Severe hypoglycemia, Psychological factors
National Category
Public Health, Global Health, Social Medicine and Epidemiology Endocrinology and Diabetes Psychology
Identifiers
URN: urn:nbn:se:miun:diva-25642DOI: 10.1007/s00592-014-0694-8ISI: 000355233500018PubMedID: 25528005Scopus ID: 2-s2.0-84930084883OAI: oai:DiVA.org:miun-25642DiVA: diva2:849449
Available from: 2015-08-28 Created: 2015-08-18 Last updated: 2016-12-21Bibliographically approved

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