International Journal of Behavioral Medicine

, Volume 21, Issue 5, pp 804–810 | Cite as

The Relationship Between Maternal Fear of Hypoglycaemia and Adherence in Children with Type-1 Diabetes

Article

Abstract

Background

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.

Purpose

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.

Method

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.

Results

High maternal fears of hypoglycaemia were predictive of suboptimal daily glycaemic control (elevated blood glucose levels), irrespective of illness duration or age at diagnosis.

Conclusion

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.

Keywords

Type-1 diabetes Fear of hypoglycaemia Attitudes Adherence 

References

  1. 1.
    Lemanek K, Kamps J, Chung N. Empirically supported treatments in pediatric psychology: regimen adherence. J Pediatr Psychol. 2001;26(5):253–75. doi:10.1093/jpepsy/26.5.253.PubMedCrossRefGoogle Scholar
  2. 2.
    Sullivan-Bolyai S, Deatrick J, Gruppuso P, Tamborlane W, Grey M. Constant vigilance: mother’s work parenting young children with type 1 diabetes. Parenting. 2000;18(1):21–9. doi:10.1053/jpdn.2003.4.Google Scholar
  3. 3.
    Patterson CC, Dahlquist GG, Gyürüs E, Green A, Soltész G. Incidence trends for childhood type 1 diabetes in Europe during 1989–2003 and predicted new cases 2005–20: a multicentre prospective registration study. Lancet. 2009;373(9680):2027–33.PubMedCrossRefGoogle Scholar
  4. 4.
    Patterson CC, Gyürüs E, Rosenbauer J, et al. Trends in childhood type 1 diabetes incidence in Europe during 1989–2008: evidence of non-uniformity over time in rates of increase. Diabetologia. 2012;55(8):2142–7. doi:10.1007/s00125-012-2571-8.PubMedCrossRefGoogle Scholar
  5. 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
  6. 6.
    Silverstein J, Klingensmith G, Copeland K, et al. Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes Care. 2005;28(1):186–212. doi:10.2337/diacare.28.1.186.PubMedCrossRefGoogle Scholar
  7. 7.
    Lasker RD. The diabetes control and complications trial: implications for policy and practice. N Engl J Med. 1993;329(14):1035–6. doi:10.1056/NEJM199309303291410.PubMedCrossRefGoogle Scholar
  8. 8.
    Gonder-Frederick A, Zrebiec JF, Bauchowitz AU, et al. Cognitive function Is disrupted by both hypo-and hyperglycemia in school-aged children with type 1 diabetes: a field study. Diabetes Care. 2009;32(6):1001–6. doi:10.2337/dc08-1722.PubMedCrossRefPubMedCentralGoogle Scholar
  9. 9.
    Unger J, Parkin C. Recognition, prevention, and proactive management of hypoglycemia in patients with type 1 diabetes mellitus. Postgrad Med. 2011;123(4):71–80. doi:10.3810/pgm.2011.07.2306.PubMedCrossRefGoogle Scholar
  10. 10.
    McTavish L, Wiltshire E. Effective treatment of hypoglycemia in children with type 1 diabetes: a randomized controlled clinical trial. Pediatr Diabetes. 2011;12(4):381–7. doi:10.1111/j.1399-5448.2010.00725.x.PubMedCrossRefGoogle Scholar
  11. 11.
    Clarke W, Gonder-Frederick A, Snyder A, Cox D. Maternal fear of hypoglycemia in their children with insulin dependent diabetes mellitus. J Pediatr Endocrinol Metab. 1998;11:189–94. doi:10.1515/JPEM.1998.11.S1.189.PubMedCrossRefGoogle Scholar
  12. 12.
    Lacherade JC, Jacqueminet S. Consequences of hypoglycemia. Annales francaises d’anesthesie et de reanimation. 2009;28(5):e201–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Osorio J. Diabetes: severe hypoglycemia associated with risk of vascular events and death. Nat Rev Cardiol. 2010;7(12):666. doi:10.1038/nrcardio.2010.176.PubMedCrossRefGoogle Scholar
  14. 14.
    Sihem T, Leila S, Rim B, et al. Les hypoglycémies graves chez les diabétiques. Diabetes Metab. 2011;37(1, S1):A50. doi:10.1016/s1262-3636(11)70690-5.CrossRefGoogle Scholar
  15. 15.
    Coonrod BA. Overcoming physical barriers to diabetes self-care: reframing disability as an opportunity for ingenuity. Diabetes Spectrum. 2001;14(1):28–32. doi:10.2337/diaspect.14.1.28.CrossRefGoogle Scholar
  16. 16.
    Glasgow R, Toobert D, Gillette C. Psychosocial barriers to diabetes self-management and quality of life. Diabetes Spectrum. 2001;14(1):33–41. doi:10.2337/diaspect.14.1.33.CrossRefGoogle Scholar
  17. 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
  18. 18.
    Wysocki T, Buckloh LM, Lochrie AS, Antal H. The psychologic context of pediatric diabetes. Pediatr Clin N Am. 2005;52(6):1755–78. doi:10.1016/j.pcl.2005.07.003.CrossRefGoogle Scholar
  19. 19.
    Murphy B, Laura M, Thompson Jr R, Morris M. Adherence behavior among adolescents with type I insulin-dependent diabetes mellitus: the role of cognitive appraisal processes. J Pediatr Psychol. 1997;22(6):811–25. doi:10.1093/jpepsy/22.6.811.PubMedCrossRefGoogle Scholar
  20. 20.
    Boyle S, Allan C, Millar K. Cognitive-behavioural interventions in a patient with an anxiety disorder related to diabetes. Behav Res Ther. 2004;42(3):357–66. doi:10.1016/j.brat.2003.11.006.PubMedCrossRefGoogle Scholar
  21. 21.
    Herzer M, Hood KK. Anxiety symptoms in adolescents with type 1 diabetes: association with blood glucose monitoring and glycemic control. J Pediatr Psychol. 2010;35(4):415–25. doi:10.1093/jpepsy/jsp063.PubMedCrossRefPubMedCentralGoogle Scholar
  22. 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
  23. 23.
    Gonder-Frederick A, Fisher CD, Ritterband LM, et al. Predictors of fear of hypoglycemia in adolescents with type 1 diabetes and their parents. Pediatr Diabetes. 2006;7(4):215–22. doi:10.1111/j.1399-5448.2006.00182.x.PubMedCrossRefGoogle Scholar
  24. 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
  25. 25.
    Barnard K, Thomas S, Royle P, Noyes K, Waugh N. Fear of hypoglycaemia in parents of young children with type 1 diabetes: a systematic review. BMC Pediatr. 2010;10(1):50. doi:10.1186/1471-2431-10-50.PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    Patton S, Dolan L, Henry R, Powers S. Parental fear of hypoglycemia: young children treated with continuous subcutaneous insulin infusion. Pediatr Diabetes. 2007;8:362–8. doi:10.1111/j.1399-5448.2007.00242.x.PubMedCrossRefGoogle Scholar
  27. 27.
    Patton S, Dolan L, Henry R, Powers S. Fear of hypoglycemia in parents of young children with type 1 diabetes mellitus. J Clin Psychol Med Settings. 2008;15:252–9. doi:10.1007/s10880-008-9123-x.PubMedCrossRefPubMedCentralGoogle Scholar
  28. 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
  29. 29.
    Weinman J, Petrie K, Moss-Morris R, Horne R. The illness perception questionnaire: a new method for assessing the cognitive representation of illness. Psychol Health. 1996;11(3):431–45. doi:10.1080/08870449608400270.CrossRefGoogle Scholar
  30. 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
  31. 31.
    Cox DJ, Gonder-Frederick L. Major developments in behavioral diabetes research. Journal of Consulting and Clinical Psychology. 1992;60(4):628–38. doi:10.1037/0022-006x.60.4.628.Google Scholar
  32. 32.
    Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Erlbaum; 1988.Google Scholar
  33. 33.
    Urbach SL, LaFranchi S, Lambert L, Lapidus JA, Daneman D, Becker TM. Predictors of glucose control in children and adolescents with type 1 diabetes mellitus. Pediatr Diabetes. 2005;6(2):69–74. doi:10.1111/j.1399-543X.2005.00104.x.PubMedCrossRefGoogle Scholar
  34. 34.
    Helgeson VS, Honcharuk E, Becker D, Escobar O, Siminerio L. A focus on blood glucose monitoring: relation to glycemic control and determinants of frequency. Pediatr Diabetes. 2011;12(1):25–30. doi:10.1111/j.1399-5448.2010.00663.x.PubMedCrossRefPubMedCentralGoogle Scholar
  35. 35.
    Johnson S, Meltzer L. Disentangling the effects of current age, onset age, and disease duration: parent and child attitudes toward diabetes as an exemplar. J Pediatr Psychol. 2002;27(1):77–86. doi:10.1093/jpepsy/27.1.77.PubMedCrossRefGoogle Scholar
  36. 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. 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
  38. 38.
    Griva K, Myers LB, Newman S. Illness perceptions and self efficacy beliefs in adolescents and young adults with insulin dependent diabetes mellitus. Psychol Health. 2000;15(6):733–50.CrossRefGoogle Scholar

Copyright information

© International Society of Behavioral Medicine 2013

Authors and Affiliations

  • Evril Freckleton
    • 1
  • Louise Sharpe
    • 1
  • Barbara Mullan
    • 1
  1. 1.School of PsychologyUniversity of SydneySydneyAustralia

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