Nefs G, Bevelander S, Hendrieckx C, Bot M, Ruige J, Speight J, Pouwer F
Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, The Netherlands.
The Australian Centre for Behavioural Research in Diabetes (ACBRD), Diabetes Australia - Vic, Melbourne, Australia.
Diabet Med. 2015 Oct;32(10):1289-96. doi: 10.1111/dme.12739. Epub 2015 Mar 28.
To examine sociodemographic, clinical and psychological factors associated with fear of hypoglycaemia in adults with Type 1 diabetes.
Data were obtained from Diabetes MILES - The Netherlands, an online self-report national survey. This cross-sectional analysis focused on participants with Type 1 diabetes who completed the 18-item Hypoglycaemia Fear Survey - Second Version Worry subscale (HFS-II-W; possible total score range 0-72, higher scores indicating higher fear) (n = 288). To explore correlates of fear of hypoglycaemia, a hierarchical linear regression analysis was performed in participants with full data on sociodemographic, clinical and psychological factors (n = 232; younger and more highly educated than those excluded).
HFS-II-W mean score was 11.1 ± 11.1. Gender, age, education and having a partner (model 1) were not associated with fear of hypoglycaemia. In model 2, history of severe hypoglycaemia (irrespective of number of events) was associated with (greater) fear of hypoglycaemia, whereas diabetes duration, pump therapy and HbA1c were not. Type D personality was positively correlated (model 3), as were symptoms of depression, but not anxiety (model 4). Adding loneliness (model 5) did not improve the model. The fully adjusted analysis showed that fear of hypoglycaemia was associated with depressive symptoms (β = 0.38, P < 0.001) and history of hypoglycaemia (1-2 events: β = 0.30, P < 0.001; ≥ 3 events: β = 0.19, P = 0.002). Total explained variance was 23%.
Depressive symptoms and history of hypoglycaemia are associated with fear of hypoglycaemia in adults with Type 1 diabetes. These factors may help to identify people with excessive fear, who may particularly benefit from interventions to reduce hypoglycaemia risk and worries.
研究1型糖尿病成年患者中与低血糖恐惧相关的社会人口学、临床和心理因素。
数据来自荷兰糖尿病MILES在线自我报告全国性调查。这项横断面分析聚焦于完成18项低血糖恐惧调查问卷第二版担忧分量表（HFS-II-W；总分范围0 - 72，分数越高表明恐惧程度越高）的1型糖尿病患者（n = 288）。为探究低血糖恐惧的相关因素，对具备社会人口学、临床和心理因素完整数据的参与者进行了分层线性回归分析（n = 232；比被排除者更年轻且受教育程度更高）。
HFS-II-W平均分为11.1 ± 11.1。性别、年龄、教育程度和有伴侣情况（模型1）与低血糖恐惧无关。在模型2中，严重低血糖病史（不论发作次数）与（更强烈的）低血糖恐惧相关，而糖尿病病程、胰岛素泵治疗和糖化血红蛋白则无关。D型人格呈正相关（模型3），抑郁症状也是如此，但焦虑症状并非如此（模型4）。加入孤独感（模型5）并未改善模型。完全调整后的分析表明，低血糖恐惧与抑郁症状（β = 0.38，P < 0.001）和低血糖病史（1 - 2次发作：β = 0.30，P < 0.001；≥ 3次发作：β = 0.19，P = 0.002）相关。总解释方差为23%。
抑郁症状和低血糖病史与1型糖尿病成年患者的低血糖恐惧相关。这些因素可能有助于识别恐惧过度的人群，他们可能特别受益于降低低血糖风险和担忧的干预措施。
