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Fear of hypoglycemia and its association with well-being, metabolic outcomes, and psychological health: A cross-sectional study in Danish adolescents with type 1 diabetes

Year: 2025

Type: article

Abstract: INTRODUCTION: Fear of hypoglycemia (FoH) among adolescents with type 1 diabetes (T1D) may hinder optimal diabetes treatment. This study aimed to investigate the association between FoH and metabolic outcome and psychological health. MATERIALS AND METHODS: Adolescents aged 11-18 with T1D and their parents were recruited from a diabetes clinic in Copenhagen from 2016-2017. Data were collected from 142 adolescents and 123 parents using Children's Hypoglycemia Index (CHI), the World Health Organization-Five Well-Being Index, the Adherence in Diabetes Questionnaire, and DISABKIDS (health-related quality of life). Associations between CHI scores and clinical, demographic, and psychological data were analyzed. Rasch modeling was used for psychometric validation of Danish version of CHI. RESULTS: Higher CHI scores were observed in females (p = 0.01). Adolescent and parental CHI scores were significantly correlated across CHI subscales (r = 0.20-0.33). With increasing CHI scores, we observed a decrease in well-being (p = 0.004), and health-related quality of life (p=<0.0001-0.007). No associations were found with HbA1c, treatment methods, blood glucose monitoring, diabetes duration, or adherence (p = 0.06). The Danish version of the CHI proved valid and useful for detecting FoH. We found an acceptable fit to the Rasch model across all three subscales. CONCLUSION: Though not related directly to treatment outcome FoH might be an important indicator of psychological health in adolescents with T1D.

Source: PLoS ONE

DOI: 10.1371/journal.pone.0334243