Researchers Identify Possible Risk Factors for Fear of Hypoglycemia

-Craig Idlebrook

It’s commonly known that high blood sugar levels can lead to short-term and long-term complications for people with type 1 diabetes, and that the best way to reduce the risk of these complications is to keep blood sugar levels in an optimal range.

Despite this, many people with type 1 diabetes purposely keep their blood sugar levels higher than recommended. That’s because the risk of hypoglycemia in the short term can outweigh the benefits of staying in range in the minds of many with type 1 diabetes. If someone with type 1 diabetes chronically keeps blood sugar levels higher than optimal out of fear of going low, that can have major implications on their long-term health.

A new research effort led by T1D Exchange and Eli Lilly and Company has attempted to uncover which people with type 1 diabetes might be more at risk of fear of hypoglycemia, a clinical term to characterize a strong anxiety of going low which may cause a significant change in blood sugar management. What the researchers found is that those with type 1 diabetes who already had mental health challenges associated with anxiety and depression were more likely to report fear of hypoglycemia.

The study’s findings were shared at the 79th American Diabetes Association Scientific Sessions in San Francisco this month.

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For the study, the researchers contacted 494 participants of T1D Exchange Glu, an online forum and news site for people with type 1 diabetes. They then had the participants complete a survey that included several questions from the Hypoglycemia Fear Scale (HFS-II) short form and the Hypoglycemia Attitudes and Behavior Scale (HABS), to gauge their fear of hypoglycemia.

After analyzing the data from these questionnaires, the researchers found that those participants who had anxiety, depression, or diabetes distress (the emotional state in which people experience feelings such as stress, guilt, or denial that arise from living with diabetes and the burden of self-management) were more likely to also report a higher level of fear of hypoglycemia. The researchers also found that those who had had type 1 diabetes for longer tended to have less fear of hypoglycemia, which might suggest that the fear of hypoglycemia can lessen over time with experience.

T1D Exchange data analyst Jingwen Liu, PhD, said such findings can help clinicians determine whether to screen for fear of hypoglycemia in patients who already have been identified as having anxiety, depression, or diabetes distress.

“Our findings are largely in line with the growing literature on fear of hypoglycemia, which shows a great deal of comorbidity across a wide range of mental health issues, such as anxiety, depression, and fear of hypoglycemia. Such evidence adds to the calls for a better mental health screening process in clinics serving people with diabetes,” said Dr. Liu.

You can read more about T1D Exchange-related research at the ADA 79th Scientific Sessions here. 


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