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Hypoglycemia fear damages quality of life for young adults with type 1 diabetes

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December 7, 2018

Young adults with type 1 diabetes who report fear of hypoglycemia and other complications and low self-efficacy also report reduced quality of life, according to findings published in The Diabetes Educator.

Denise A. Kent

“More than half of type 1 diabetes cases are diagnosed before the age of 21 years,” Denise A. Kent, PhD, RN, APN, a clinical instructor in the department of biobehavioral health science at the University of Illinois College of Nursing in Chicago, told Endocrine Today. “Identifying keys to quality of life during an early and stressful stage of life may help people with diabetes have and keep better quality of life in later stages. Findings highlight the need for support for patients with type 1 diabetes to find the best management program while decreasing their worry.”

Kent and colleagues conducted a cross-sectional, exploratory study of 180 adults aged 18 to 35 years with type 1 diabetes duration of more than 1 year (82.8% women, mean age, 27.35 years). Participants were recruited online with the help of diabetes groups, such as the American Diabetes Association, and completed surveys that assessed factors related to diabetes, including quality of life, fear of hypoglycemia, fear of complications, diabetes behavior, self-management and knowledge.

The researchers observed negative correlations between quality of life and fear of hypoglycemia and fear of other complications and a positive correlation between quality of life and self-efficacy (P < .001 for all). All three were confirmed as the most significant factors in quality of life based on multiple linear regression analysis.

“For many young adults with [type 1 diabetes], the unpleasant and unpredictable negative consequences of hypoglycemia result in a fear of hypoglycemia,” the researchers wrote. “Fear of hypoglycemia motivates some individuals to overreact to avoid hypoglycemia, resulting in actions that compromise metabolic control.”

The researchers also examined the difference in quality of life measurements based on pump use. Participants who used an insulin pump (n = 129) had higher scores in self-reported self-efficacy, quality of life and self-management (P < .001) vs. those who did not use a pump (n = 51).

“Care of young adults with type 1 diabetes should include minimizing their worries about diabetes. The goal of diabetes management is not only to maintain a normal blood sugar level, but also to achieve a high quality of life,” Kent said. “Young adults are engaging in developmental tasks and new relationships. Minimizing their worries about diabetes will help them focus on the important new roles they are taking on personally and societally. It may also help people with diabetes have and maintain better quality of life in later stages.” – by Phil Neuffer

Disclosures: The authors report no relevant financial disclosures.