Fear of Hypoglycemia in the Parents of Children and Adolescents With Diabetes: Maladaptive or Healthy Response?

Marrero, David G.; Guare, John; Vandagriff, Julie L.; Fineberg, Naomi S.

doi:10.1177/014572179702300306

Cited by 81 publications

(83 citation statements)

References 9 publications

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“…Moreover, since avoiding episodes of severe hypoglycaemia was one of the key priorities of the DTTP, some patients may have accepted higher glucose levels rather than risking severe hypoglycaemia. Patients' ability to perceive episodes of glucose dysregulation, and balancing this risk : benefit ratio could therefore be attributed to the structured training intervention programme, even though metabolic control is impaired for the benefit of fewer hypoglycaemic episodes [19]. However, less exposure to chronically elevated plasma glucose levels for a few years after the DTTP could be of overall biological significance in terms of the following points, as demonstrated by the EDIC study [3].…”

Section: Discussionmentioning

confidence: 99%

Long-term evaluation of a structured outpatient education programme for intensified insulin therapy in patients with Type 1 diabetes: a 12-year follow-up

et al. 2004

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Aims/hypothesis. This study was conducted to evaluate the long-term outcome of a structured outpatient diabetes teaching and treatment programme (DTTP) for intensified insulin therapy in patients with Type 1 diabetes, which aims to improve metabolic control without increasing the risk of severe hypoglycaemia. Methods. All 123 diabetic outpatients (age 41±14 years; 64 women; BMI 23.5±3.1; diabetes duration 17± 11 years; HbA 1 c 7.9±1.6%; 32 patients with a history of severe hypoglycaemia; 18 with overt nephropathy; 22 with proliferative retinopathy) who participated in the DTTP between June 1989 and June 1990 were invited for follow-up visits after 3, 6 and 12 years. Results. Out of the 123 patients, 11 died during the follow-up period, two were lost for follow-up, and one was not willing to participate in re-evaluation after 12 years. Mean HbA 1 c levels decreased from 7.9± 1.6% to 7.1±1.2% (p<0.01) after 3 years, and were 7.8±1.5% (NS) and 7.8±1.2% (NS) after 6 and 12 years respectively. Frequency of hypoglycaemia decreased from 0.49 episodes per patient per year to 0.14 after 3 years (p<0.01), 0.19 after 6 years (p<0.01) and 0.16 after 12 years (p<0.01). Of the participants, 41% were able to lower HbA 1 c levels without episodes of severe hypoglycaemia and to maintain this improvement at all follow-up visits over the 12-year period. At follow-up, intensified insulin therapy was carried out by 94% of the patients. Conclusions/interpretation. A sustained reduction of the incidence of severe hypoglycaemia was observed in patients with Type 1 diabetes after participation in a structured outpatient DTTP over a 12-year period.

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Section: Discussionmentioning

confidence: 99%

Long-term evaluation of a structured outpatient education programme for intensified insulin therapy in patients with Type 1 diabetes: a 12-year follow-up

et al. 2004

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“…150 Fear of hypoglycaemia may itself be associated with poor metabolic control (e.g. deliberately maintaining high glucose levels or over-treating early symptoms).…”

Section: Fear Of Hypoglycaemiamentioning

confidence: 99%

“…deliberately maintaining high glucose levels or over-treating early symptoms). 150 A survey instrument, the Hypoglycaemia Fear Survey (HFS), 151 has been developed to assess patients' fear. The HFS is a 27-item questionnaire, with a five-point Likert scale format.…”

Section: Fear Of Hypoglycaemiamentioning

confidence: 99%

Clinical and cost-effectiveness of continuous subcutaneous insulin infusion for diabetes

Colquitt¹,

Green²,

Sidhu³

et al. 2004

Health Technol Assess

106

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“…Parents' anxiety regarding their child's asthma may also be important to disease management because, as has been found in pediatric diabetes, [27][28][29][30] asthma-related anxiety may impede parents from coping and may lead to maladaptive behaviors and, consequently, to poor disease control. Despite these possibilities, no studies have examined parent asthma-related anxiety.…”

Section: Introductionmentioning

confidence: 99%

Youth and Parent Versions of the Asthma-Related Anxiety Scale: Development and Initial Testing

Bruzzese

Unikel

Shrout

et al. 2011

Pediatric Allergy, Immunology, and Pulmonology

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Among adults, anxiety related to asthma has been acknowledged to influence asthma self-management. However, it has not been addressed in pediatric samples and there have been no measures developed to assess asthma-related anxiety in youth or parents. The objective of this study was to develop and test the psychometric properties of novel instruments assessing asthma-related anxiety: the Youth Asthma-Related Anxiety Scale (YAAS) and Parent Asthma-Related Anxiety Scale (PAAS). Scale items were analyzed for content validity. We determined the factor structure using exploratory factor analysis and tested the scales' psychometric properties with 285 Hispanic and African American early adolescents with uncontrolled asthma (mean age = 12.8) and their parents (n = 230) who participated in a larger randomized control trial testing the efficacy of an asthma intervention; control group families (134 youth and 103 parents) provided follow-up data to assess temporal stability. Both the YAAS and PAAS contained 2 factors with Cronbach alpha coefficients ranging from 0.75 to 0.90. The 2 factors, anxiety about asthma severity and about disease-related restrictions, were highly correlated within each measure. The measures displayed content and construct validity and demonstrated moderate temporal stability over 2-3 months (range: 0.36-0.42). The YAAS and PAAS have adequate psychometric properties and can meaningfully contribute to the assessment of asthma-related anxiety in adolescents and their parents, filling a clinical need in this population.

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Fear of Hypoglycemia in the Parents of Children and Adolescents With Diabetes: Maladaptive or Healthy Response?

Cited by 81 publications

References 9 publications

Long-term evaluation of a structured outpatient education programme for intensified insulin therapy in patients with Type 1 diabetes: a 12-year follow-up

Long-term evaluation of a structured outpatient education programme for intensified insulin therapy in patients with Type 1 diabetes: a 12-year follow-up

Clinical and cost-effectiveness of continuous subcutaneous insulin infusion for diabetes

Youth and Parent Versions of the Asthma-Related Anxiety Scale: Development and Initial Testing

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