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The Relationship Between Parent Fear of Hypoglycemia and Youth Glycemic Control Across the Recent-Onset Period in Families of Youth with Type 1 Diabetes

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Abstract

Background

This study aims to examine the relationship between parents’ fear of hypoglycemia (FH) over a 1-year period and child glucose metrics in 126 families of youth recently diagnosed with type 1 diabetes (T1D).

Methods

Parents completed the Hypoglycemia Fear Survey for Parents (HFS-P) and uploaded 14 days of glucose data at a baseline, 6-month, and 12-month assessment.

Results

Parents’ HFS-P total and worry scores increased to a clinically meaningful degree from baseline to 6-month assessment, while multilevel models revealed within- and between-person variability in parents’ HFS-P worry and behavior scores over time associated with child glycemia. Specifically, a significant negative relationship for within-person worry scores suggested that when parents reported higher than their average worry scores, their children recorded fewer glucose values in the target range, while within-person behavior scores suggested that when parents reported lower than their average behavior scores, their children recorded more values above the target range. There was also a negative relationship for between-person behavior scores with child glycated hemoglobin and a positive relationship for between-person behavior scores with child glucose values in the target range.

Conclusions

In the recent-onset period of T1D, parental FH worry and behavior associated with child glycemia possibly due to changes in parents’ perceptions of their child’s hypoglycemia risk. The clinically meaningful increases in parent FH in the recent-onset period and the negative association for between-person behavior scores with child glycated hemoglobin suggest that clinics should consider screening parents for FH, especially among parents of children with lower glycemic levels.

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Acknowledgements

The authors thank the families who participated in the TACKLE-T1D Study.

Funding

This research was supported by a grant R01-DK100779 from the National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases.

Author information

Authors and Affiliations

  1. Center for Healthcare Delivery Science, Nemours Children’s Health, Orlando, FL, USA

    Alexandra D. Monzon

  2. Division of Endocrinology, Children’s National Hospital, Washington, DC, USA

    Shideh Majidi

  3. Division of Endocrinology, Children’s Mercy Hospital, Kansas City, MO, USA

    Mark A. Clements

  4. Center for Healthcare Delivery Science, Nemours Children’s Health, Jacksonville, FL, USA

    Susana R. Patton

Authors
  1. Alexandra D. Monzon
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  2. Shideh Majidi
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  4. Susana R. Patton
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Contributions

SRP and MAC secured funding for the present study and designed the initial study concept. SRP, MAC, and SM oversaw data collection. ADM conducted the statistical analyses. ADM and SRP wrote the initial manuscript draft. All authors edited and approved final manuscript.

Corresponding author

Correspondence to Susana R. Patton.

Ethics declarations

Ethics Approval

The Institutional Review Boards at participating hospitals approved all study procedures prior to recruitment. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent to Participate

All families provided written informed consent and assent prior to study procedures.

Conflict of Interest

No competing financial interests exist for authors ADM, SM, and SRP. MAC is the chief medical officer for Glooko, has consulted with Medtronic Diabetes, Eli Lilly, and receives research support from Abbott Diabetes.

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Monzon, A.D., Majidi, S., Clements, M.A. et al. The Relationship Between Parent Fear of Hypoglycemia and Youth Glycemic Control Across the Recent-Onset Period in Families of Youth with Type 1 Diabetes. Int.J. Behav. Med. 31, 64–74 (2024). https://doi.org/10.1007/s12529-023-10159-0

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