Fear of hypoglycaemia in patients with type 1 and 2 diabetes: a systematic review

Abstract

Aims and objectives To summarise and thematise fear of hypoglycaemia (FOH) in individuals with type 1 diabetes (T1D) and type 2 diabetes (T2D) to provide a theoretical basis for the development of effective interventions. Background FOH is common in this population and can reduce quality of life (QOL) and adversely impact upon diabetes self‐care management. Design A systematic review. Methods Articles published between 2000–2019 were searched in PubMed, MEDLINE, EMBASE, Web of Science and three Chinese databases (CNKI, Wan‐fang data and VIP). Eligible articles were selected using the Preferred Reporting Item for Systematic Review and Meta‐analysis (PRISMA) guidelines. The quality of all articles finally included was evaluated by the Joanna Briggs Institute (JBI) Critical Appraisal tools. Results Eighteen studies from 8654 papers were included. The sample size of each study ranged from 48–3812 subjects. FOH negatively impacted QOL, particularly psychosocial functioning, daily life and sleep quality. Conclusions FOH is a common and serious problem for patients, leading to poor QOL. It has been suggested that psychological concerns, QOL and effective countermeasures in individuals with T1D and T2D should be taken seriously. Advanced technology should be evaluated for its benefits before being used by patients. Relevance to Clinical Practice The review highlights that FOH negatively impacts QOL, including psychosocial factors, daily life and sleep quality. Healthcare providers should develop targeted and professional assessment tools for FOH and QOL for patients with T2D, especially for patients who are about 60 years old. Advanced technology should be evaluated for its benefits before being used by patients.

Compliance with treatment and fear of hypoglycaemia in patients with type 2 diabetes

“…One of the important problems observed in patients with type 2 diabetes is FOH (ADA, 2020; SEMT, 2019). FOH impairs the patients’ personal and social life, quality of life, sleep quality, behaviour related to the self‐management of the disease, productivity and compliance with treatment (Zhang et al, 2020). It was demonstrated that hypoglycaemia is responsible for 6%–10% of diabetes‐related mortality.…”

The Evolution of Insulin Administration in Type 1 Diabetes

“…Iatrogenic hypoglycemia continues to limit achievement of normoglycemia in T1D [16]. Additionally, fear of hypoglycemia is common in individuals with T1D and parents of children with T1D with significant impact on quality of life [94] and conflicting evidence on glycemic control [95] LGS, including less time spent < 70 mg/dL. PLGS also demonstrates reduction in fear of hypoglycemia and improvements in sleep quality while maintaining stable glycemic control [102].…”

The experience of a severe hypoglycaemic event from the perspective of people with diabetes and their caregivers: “What am I going to do?”

“…In one study, 16 people with diabetes in Canada were interviewed about their roles in preventing or self‐managing hypoglycaemia 6,18 . Other studies have focused on the fear of hypoglycaemia or the impact of hypoglycaemia and impaired awareness about hypoglycaemia on the day‐to‐day lives of people with type 1 diabetes and their family members 19–27 …”

“… 6 , 18 Other studies have focused on the fear of hypoglycaemia or the impact of hypoglycaemia and impaired awareness about hypoglycaemia on the day‐to‐day lives of people with type 1 diabetes and their family members. 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 Generally, however, primary data regarding the experiences of people with diabetes, including those with type 2 diabetes who use insulin, and their caregivers in managing an SH event are lacking. To address this gap in the literature, the present study explored the experiences during SH events among adults in the United States from the perspectives of both people with diabetes who use insulin and caregivers who assist them in order to inform healthcare providers and in hopes of elevating conversations about SH risk and management.…”