Fear of hypoglycaemia and self-management in type 1 diabetes

• Of the 798 participants, 437 (55%) reported fear of hypoglycaemia (FoH)
• FoH was associated with higher frequency of blood glucose monitoring in men and women
• In women, FoH was associated with higher energy intake
• In men, FoH was associated with higher mean serial HbA1c and carbohydrate intake
• The level of physical activity and insulin use were not associated with FoH

AimsWe studied the association between fear of hypoglycaemia (FoH) and various diabetes self-management practices.MethodsData from 798 individuals with type 1 diabetes participating in the FinnDiane Study were included. Self-reported questionnaires were used to assess FoH and self-management practices (e.g. dietary intake, insulin administration, physical activity). For glycaemic control, we used both the latest HbA1c measurements and the serial HbA1c measurements from the medical files. Factor analysis was used to reveal underlying constructs within the food frequency section of the diet questionnaire.ResultsIn all, 44% and 63% of men and women reported FoH, respectively. In men, FoH was associated with higher mean serial HbA1c levels, higher number of reported self-monitoring of blood glucose (SMBG), higher carbohydrate intake, and lower scores in the “high-fat” factor. In women, FoH was associated with a higher number of reported SMBGs and higher energy intake. No difference was observed in physical activity and insulin administration.ConclusionsFoH has various implications for the self-management of diabetes. More studies are however needed to assess on one hand the association between FoH and diabetes self-management, and on the other hand, FoH and its long term consequences, such as the emergence of diabetic complications and mortality.