The Relationship Between Maternal Fear of Hypoglycaemia and Adherence in Children with Type-1 Diabetes
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Regular blood glucose monitoring is important for children with type-1 diabetes; however, the relationship between maternal fear of hypoglycaemia and glycaemic control is not well understood.
The relationship between maternal beliefs about diabetes, concerns about glycaemic control and adherence to recommended blood glucose levels in young children with type-1 diabetes were examined in this study.
Seventy-one mothers with children under 13 were recruited, and a prospective design was used. Demographics, maternal self-reported hypoglycaemic fear and illness perceptions were measured at baseline. Self-report daily blood sugar levels were recorded over 1 week, and glycosylated haemoglobin (HbA1c) blood glucose levels were collected at baseline and 3 months later.
High maternal fears of hypoglycaemia were predictive of suboptimal daily glycaemic control (elevated blood glucose levels), irrespective of illness duration or age at diagnosis.
The results suggest that mothers who worry most about hypoglycaemia compensate by maintaining their child’s blood glucose levels above recommended levels. Elevated blood glucose levels have important consequences for long-term health, and further research could explore ways to target maternal fear of hypoglycaemia.
KeywordsType-1 diabetes Fear of hypoglycaemia Attitudes Adherence
- 5.Diabetes Control and Complications Trial Research Group. Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: diabetes control and complications trial. J Pediatr. 1994;125(2):177–88. doi:10.1016/S0022-3476(94)70190-3.CrossRefGoogle Scholar
- 17.Osborne RH, Batterham R, Livingston J. The evaluation of chronic disease self-management support across settings: the international experience of the health education impact questionnaire quality monitoring system. Nurs Clin North Am. 2011;46(3):255–70. doi:10.1016/j.cnur.2011.05.010.PubMedCrossRefGoogle Scholar
- 22.Wild D, von Maltzahn R, Brohan E, Christensen T, Clauson P, Gonder-Frederick L. A critical review of the literature on fear of hypoglycemia in diabetes: implications for diabetes management and patient education. Patient Educ Couns. 2007;68(1):10–5. doi:10.1016/j.pec.2007.05.003.PubMedCrossRefGoogle Scholar
- 24.Haugstvedt A, Wentzel-Larsen T, Graue M, Søvik O, Rokne B. Fear of hypoglycaemia in mothers and fathers of children with Type 1 diabetes is associated with poor glycaemic control and parental emotional distress: a population-based study. Diabet Med. 2010;27(1):72–8. doi:10.1111/j.1464-5491.2009.02867.x.PubMedCrossRefGoogle Scholar
- 28.Irvine A, Cox D, Gonder-Frederick L. The fear of hypoglycemia scale. In: Bradley C, editor. Handbook of psychology and diabetes. Langhorne, PA, England: Harwood Academic Publishers/Gordon; 1994. p. 133–55.Google Scholar
- 30.Toobert DJ, Glasgow RE. Assessing diabetes self-management: the summary of diabetes self-care activities questionnaire. In: Bradley C, editor. Handbook of psychology and diabetes: a guide to psychological measurement in diabetes research and practice. Langhorne, PA, England: Harwood Academic Publishers/Gordon; 1994. p. 351–75.Google Scholar
- 32.Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Erlbaum; 1988.Google Scholar
- 36.Viswanathan V, Sneeringer MR, Miller A, Eugster EA, DiMeglio LA. The utility of hemoglobin A1c at diagnosis for prediction of future glycemic control in children with type 1 diabetes. Diabetes Res Clin Pract. 2011;92(1):65–8. doi:10.1016/j.diabres.2010.12.032.PubMedCrossRefPubMedCentralGoogle Scholar
- 37.Barnes L, Moss-Morris R, Kaufusi M. Illness beliefs and adherence in diabetes mellitus: a comparison between Tongan and European patients. N Z Med J. 2004;117(1188):1–9.Google Scholar