Living with hypoglycemia
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OBJECTIVE: To increase understanding of the everyday experiences of hypoglycemia for patients with type 1 diabetes through the use of a narrative research approach.
SETTING: Center for diabetes treatment and research.
DESIGN: Cross-sectional assessment using a narrative research approach.
PATIENTS/PARTICIPANTS: Twenty outpatients (aged 21–30 years) diagnosed with type 1 diabetes for at least 10 years.
MEASUREMENTS AND MAIN RESULTS: Experiences of hypoglycemia were investigated during in-depth, semistructured interviews that were tape-recorded, transcribed, and analyzed to identify common themes, Self-report measures of depression (Revised Hamilton Rating Scale for Depression) and anxiety (State-Trait Anxiety Inventory) also were administered. Subjects reported the following common themes: interpersonal conflict including fears of dependency and loss of control and problems addressing concerns about hypoglycemia with significant others; difficulty making sense of their hypoglycemic behaviors in relation to their usual ways of functioning; and perceived lack of understanding by others, including physicians, about the emotional experiences of hypoglycemia. Subjects were neither clinically depressed nor anxious.
CONCLUSIONS: These findings suggest that type 1 diabetes patients’ experiences of hypoglycemia negatively affect their interpersonal relationships and views of themselves. Hypoglycemia also was described as an extremely private experience that was rarely discussed with others. Patient education and professional support in the treatment of hypoglycemia are recommended to enhance treatment decision making for patients with type 1 diabetes.
- The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–86. CrossRef
- Cryer PE. Iatrogenic hypoglycemia in IDDM: consequences, risk factors, and prevention. In: Marshall SM, Home PD, Alberti KGMM, Krall LP, eds. Diabetes Annual. Amsterdam, The Netherlands: Elsevier; 1993;7:317–31.
- Gold AE, Deary IJ, Frier BM. Hypoglycaemia and non-cognitive aspects of psychological function in insulin-dependent (Type 1) Diabetes Mellitus. Diabetic Med. 1997;14:111–8. CrossRef
- Langen SJ, Deary IJ, Hepburn DA, Frier BM. Cumulative cognitive impairment following recurrent severe hypoglycaemia in adult patients with insulin-treated diabetes mellitus. Diabetologia. 1991;34:337–44. CrossRef
- Wredling R, Levander S, Adamson U, Lins PE. Permanent neuropsychological impairment after recurrent episodes of severe hypoglycaemia in man. Diabetologia. 1990;33:152–7. CrossRef
- McCrimmon RI, Deary IJ, Huntly BJP, MacLeod KJ, Frier BJ. Visual information processing during controlled hypoglycaemia in humans. Brain. 1996;119:1277–87. CrossRef
- Reich JN, Kaspar C, Puczynski MS, et al. Effect of a hypoglycemic episode on neuropsychological functioning in diabetic children. J Clin Exp Neuropsychol. 1990;12:613–26.
- Gonder-Frederick LA, Cox DJ, Bobbitt SA, Pennebaker JW. Mood changes associated with blood glucose fluctuations in insulin dependent diabetes mellitus. Health Psychol. 1989;8:45–59. CrossRef
- Polonsky WH, Davis CL, Jacobson AM, Anderson BJ. Correlates of hypoglycemic fear in type I and type II diabetes mellitus. Health Psychol. 1992;11:199–202. CrossRef
- Wredling RAM, Theorell PGT, Roll HM, Lins PES, Adamson UKC. Psychosocial state of patients with IDDM prone to recurrent episodes of severe hypoglycemia. Diabetes Care. 1992;15:518–20. CrossRef
- Pramming S, Thorsteinsson B, Bendtson I, Binder C. Symptomatic hypoglycaemia in 411 type I diabetic patients. Diabetic Med. 1991;8:217–22. CrossRef
- Stewart M, Brown JB, Weston WW, McWhinney IR, McWilliam CL, Freeman TR. Patient-Centered Medicine: Transforming the Clinical Method. Thousand Oaks, Calif: Sage Publications; 1995.
- Lazare A, Putnam SM, Lipkin M. Three functions of the medical interview. In: Lipkin M, Putnam SM, Lazare A, eds. The Medical Interview: Clinical Care, Education, and Research. New York, NY: Springer-Verlag; 1995:3–19.
- Jacobson AM. The psychological care of patients with insulin-dependent diabetes mellitus. N Engl J Med. 1996;334:1249–53. CrossRef
- Geertz C. The Interpretation of Cultures. New York, NY: Basic Books; 1973.
- McCrimmon RJ, Frier BM. Hypoglycaemia, the most feared complication of insulin therapy. Diabetes Metab. 1994;20:503–12.
- Cryer PE, Fisher JN, Shamoon H. Hypoglycemia. Diabetes Care. 1994;17:734–55.
- Hyden LC. Illness and narrative. Soc Health Illness. 1997;19:48–69.
- Borkin JM, Quirk M, Sullivan M. Finding meaning after the fall: injury narratives from elderly hip fracture patients. Soc Sci Med. 1991;33:947–57. CrossRef
- Bury M. Chronic illness as biographical disruption. Soc Health Illness. 1982;4:167–82. CrossRef
- Frank AW. At the Will of the Body: Reflections on Illness. New York, NY: Houghton Miflin; 1991.
- Broyard A. Intoxicated by My Illness, and Other Writings on Life and Death. New York, NY: Clarkson Patter; 1992.
- Kleinman A. The Illness Narratives: Suffering, Healing, and the Human Condition. New York, NY: Basic Books; 1988.
- Brody H. Stories of Sickness. New Haven, Conn: Yale University Press; 1987.
- Hunter MK. Doctors’ Stories. The Narrative Structure of Medical Knowledge. Princeton, NJ: Princeton University Press; 1991.
- Sacks O. Medicine and the narrative. Mt Sinai Med J. 1993;60:127–31.
- Matthews HF, Lannin DR, Mitchell JP. Coming to terms with advanced breast cancer: black women’s narratives from Eastern North Carolina. Soc Sci Med. 1994;38:789–800. CrossRef
- William G. The genesis of chronic illness: narrative reconstruction. Soc Health Illness. 1984;6:175–200. CrossRef
- Mischler EG. Research Interviewing, Context and Narrative. Cambridge, Mass: Harvard University Press; 1986.
- Frank AW. The Wounded Storyteller: Body Illness and Ethics. Chicago, Ill: Chicago University Press; 1995.
- Conrad P. Qualitative research on chronic illness: a commentary on method and conceptual development. Soc Sci Med. 1990;30:1257–63. CrossRef
- Zitman FG, Mennen MFG, Griez E, Hooper C. The different versions of the Hamilton depression scale. In: Bech P, Coppen A, eds. The Hamilton Scales. Heidelberg, Germany: Springer; 1989.
- Spielberger CD. Anxiety as an emotional state. In: Speilberger CD, ed. Anxiety—Current Trends and Theory and Research. New York, NY: Academic Press; 1972.
- Glaser B, Straus AL. The Discovery of Grounded Theory. New York, NY: Basic Books; 1967.
- Straus AL. Qualitative Analysis for Social Scientists. New York, NY: Cambridge University Press; 1987.
- Somer R, Somer B. A Practical Guide to Behavioral Research. 2nd ed. New York, NY: Oxford University Press; 1986.
- Bruner J. Acts of Meaning. Cambridge, Mass: Harvard University Press; 1990.
- Bruner J. Actual Minds, Possible Worlds. Cambridge, Mass: Harvard University Press; 1986.
- Feudtner C. The want of control: ideas, innovations, and ideals in the modern management of diabetes mellitus. Bull Hist Med. 1995;69:66–90.
- Cryer PE. Hypoglycemia: Pathophysiology, Diagnosis, and Treatment. Oxford, England: Oxford University Press; 1997.
- Cox DJ, Gonder-Frederick L, Polonsky W. A multicenter evaluation of blood glucose awareness training, II. Diabetes Care. 1995;18:523–8. CrossRef
- Anderson RM, Funnell MM, Butler PM, Arnold MS, Fitzgerald JT, Feste CC. Patient empowerment. Diabetes Care. 1995;18:943–9. CrossRef
- Living with hypoglycemia
Journal of General Internal Medicine
Volume 13, Issue 12 , pp 799-804
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