Fear of Hypoglycemia in Parents of Children with Type 1 Diabetes Associated with Poor Control

The association between a higher level of hypoglycemic-related fear and parental emotional distress and poorer glycemic control in the child emphasizes the need for programs to support and guide parents.…

To analyze, in a population-based study, the association between parental fear of hypoglycemia and (i) the prevalence of hypoglycemia and diabetes treatment factors in children with Type 1 diabetes and (ii) emotional distress in mothers and fathers.

Mothers (n = 103) and fathers (n = 97) of 115 children with Type 1 diabetes (1–15 years old) participated in the study. In addition to demographic and disease-specific data, the participants completed the Hypoglycemia Fear Survey — Parent version (HFS-P) (worry and behavior subscales) and the Hopkins Symptom Checklist — 25 items (HSCL-25) to measure emotional distress.

The results showed a higher HFS-P worry score was associated with higher glycated hemoglobin (HbA_1c), a higher frequency (≥ 7) of what parents experienced as problematic hypoglycemic events during the past year and co-morbid disease in the child. A higher HFS-P behavior score was associated with children receiving insulin injections compared with using an insulin pump and a higher frequency (≥ 7 per day) of blood glucose measurements. The mothers had higher scores than the fathers in both the worry and behavior subscales. The mothers’ and the fathers’ HFS-P worry scores correlated significantly with their HSCL-25 scores.

From the results it was concluded that the association between a higher level of hypoglycemic-related fear and parental emotional distress and poorer glycemic control in the child emphasizes the need for programs to support and guide parents. The results suggest that future interventions should target both the parents’ fear and appropriate ways to prevent hypoglycemia in children with Type 1 diabetes.

J Clin Psychol Med Settings. 2008 Sep;15(3):252-9.