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Correlates of fear of hypoglycemia among patients with type 1 and 2 diabetes mellitus in outpatient hospitals in Zambia

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Abstract

Background

Severe hypoglycemia is a burdensome complication of diabetes mellitus that can induce fear of hypoglycemia and contribute to suboptimal glycemic control. The challenge is to achieve and maintain adequate glycemic control while avoiding episodes of severe hypoglycemia. The purpose of the study was to determine how common fear of hypoglycemia was in Zambian out-patients with diabetes and also to explore correlates of fear of hypoglycemia.

Methods

One hundred fifty-seven individuals with types 1 and 2 diabetes participated in the study. Fear of Hypoglycemia Scale, Diabetes Self-Care Inventory, Problem Areas in Diabetes, and the Major Depression Inventory were completed. Multiple linear regression models were computed to assess the association between fear of hypoglycemia and psychological factors.

Results

About 19% [16.3% type 1 and 12.6% type 2] of individuals with diabetes based on item endorsement expressed fear of hypoglycemia especially among individuals with type 1 diabetes. After controlling for demographic variables, diabetes self-care (ß = 0.24, p < 0.05), and diabetes specific distress (ß = 0.41, p < 0.001) were associated with fear of hypoglycemia.

Conclusion

Fear of hypoglycemia was common and was positively associated with diabetes specific emotional distress and diabetes self-care. Interventions to avert fear of hypoglycemia are needed while optimizing glycemic control through managing diabetes care and emotion distress in individuals with diabetes.

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Acknowledgments

A Jacobs Foundation International Society for the Study of Behavioral Development (ISSBD) mentored fellowship was given to the first author. We also want to thank all participants for giving us the data we needed and the Diabetes Association of Zambia for helping with access to participants. We dedicate this work to Prof Fons van de Vijver who unfortunately died before we published this article.

Author information

Authors and Affiliations

  1. Department of Psychology, University of Zambia, P.O Box 32379, Lusaka, Zambia

    Given Hapunda

  2. Department of Culture Studies, Tilburg University, Tilburg, The Netherlands

    Amina Abubakar & Fons van de Vijver

  3. Neuroassessment, Centre for Geographic Medicine Research, Kilifi, Kenya

    Amina Abubakar

  4. Department of Public Health, Pwani University, Kilifi, Kenya

    Amina Abubakar

  5. Department of Psychology, University of Southern Denmark, Odense, Denmark

    Frans Pouwer

  6. STENO Diabetes Center Odense, Odense, Denmark

    Frans Pouwer

  7. School of Psychology, Deakin University, Geelong, Australia

    Frans Pouwer

  8. Work Well Unit, North-West University, Potchefstroom, South Africa

    Fons van de Vijver

  9. School of Psychology, University of Queensland, Brisbane, Australia

    Fons van de Vijver

Authors
  1. Given Hapunda
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  2. Amina Abubakar
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  3. Frans Pouwer
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  4. Fons van de Vijver
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Contributions

GH collected data, analyzed, and drafted the manuscript. AA verified analysis and reviewed the manuscript. FV and FP reviewed and approved the manuscript.

Corresponding author

Correspondence to Given Hapunda.

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Competing interests

The authors declare that they have no conflict of interest.

The study obtained consent from adults participants and assent from children after their guardians consented for their participation.

Ethical approval and consent

The study was approved by the ethics committee of the School of Humanities and Social Sciences, University of Zambia on 29th April, 2011 (reference number IRB: 00006464, IORG: 005376). The study only used data from participants that consented to participate in the study. Assent was obtained from participants younger than 18 years old.

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Hapunda, G., Abubakar, A., Pouwer, F. et al. Correlates of fear of hypoglycemia among patients with type 1 and 2 diabetes mellitus in outpatient hospitals in Zambia. Int J Diabetes Dev Ctries 40, 619–626 (2020). https://doi.org/10.1007/s13410-020-00835-2

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  • DOI: https://doi.org/10.1007/s13410-020-00835-2

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