156-OR: Fear of Hypoglycemia in People with Type 1 Diabetes and Problematic Hypoglycaemia: A Mismatch between Worry and Behaviour?
| Autor: | Simon Heller, Dulmini Kariyawasam, Elena Toschi, Rory H. Maclean, Stephanie A. Amiel, Peter Jacob, Pratik Choudhary, Therese C. Anderbro, Sean Haywood |
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| Rok vydání: | 2020 |
| Předmět: |
Type 1 diabetes
Pediatrics medicine.medical_specialty business.industry Endocrinology Diabetes and Metabolism Insulin medicine.medical_treatment media_common.quotation_subject Psychological intervention Hypoglycemia medicine.disease Diabetes mellitus Cohort Internal Medicine medicine media_common.cataloged_instance European union Worry business media_common |
| Zdroj: | Diabetes. 69 |
| ISSN: | 1939-327X 0012-1797 |
| DOI: | 10.2337/db20-156-or |
| Popis: | Problematic hypoglycemia complicates insulin therapy in >25% of adults with type 1 diabetes (T1D). Previous work has identified relationships between cognitive barriers to hypoglycemia avoidance and impaired awareness of hypoglycemia (IAH) with recurrent severe episodes (SH). We investigated fear of hypoglycemia in people with IAH and SH enrolling in a trial of interventions to restore hypoglycemia awareness (“HARPdoc” ClinicalTrials.gov NCT02940873) and compared their data with T1D clinic attenders not enriched for problematic hypoglycemia. Method: Adults with T1D (HARPdoc cohort; n=98, age 54±13 yr, 56% female, T1D duration 40±15 yr) and problematic hypoglycemia (Clarke score 5.5±1.0) completed the Hypoglycemia Fear Survey II (HFS), Hyperglycemia Avoidance Scale (HAS) and anonymous 12 month SH recall forms. The T1D clinic comparator group was n=467, age 46±14 yr, 50% female, T1D duration 30±13 yr. Results: In preliminary analyses, the HARPdoc cohort (n=88) reported higher scores on total HFS (p=0.018) and its worry subscale (p12 SH per yr). Worry scores increased with higher SH rates (p=0.004). Behavior scores increased (p=0.041) but not above the comparator 75th centile. In the ’maintaining high glucose’ subset of HFS behavior items, scores increased between the high SH rate groups (p=0.042) but not the lower rate groups. Conclusion: The majority of people with significant hypoglycemia problems show appropriately increased worry but not corresponding increases in behavior scores. A subgroup show inappropriately low worry. Inability to change behaviors, and worry about hyperglycemia, may be barriers to avoiding SH. Disclosure R.H. Maclean: None. P. Jacob: None. S. Haywood: None. P. Choudhary: Advisory Panel; Self; Abbott, Eli Lilly and Company, Insulet Corporation, Medtronic. Research Support; Self; European Union, JDRF. Speaker’s Bureau; Self; Dexcom, Inc., Novartis AG, Novo Nordisk A/S, Sanofi-Aventis. S.R. Heller: Advisory Panel; Self; Eli Lilly and Company, Novo Nordisk A/S, Zealand Pharma A/S. Speaker’s Bureau; Self; AstraZeneca, Novo Nordisk A/S. Other Relationship; Self; MannKind Corporation. E. Toschi: None. D. Kariyawasam: None. T.C. Anderbro: None. S.A. Amiel: Advisory Panel; Self; Medtronic, Novo Nordisk A/S, Roche Pharma. Other Relationship; Self; Diabetes UK. Funding JDRF (4-SRA-2017-266-M-N) |
| Databáze: | OpenAIRE |
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