Coolen Manon, Aalders Jori, Broadley Melanie, Aanstoot Henk-Jan, Hartman Esther, Hendrieckx Christel, Nefs Giesje, Pouwer Frans
Department of Psychology, University of Southern Denmark, Odense, Denmark.
Center of Research on Psychological and Somatic disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
Diabet Med. 2021 Aug;38(8):e14565. doi: 10.1111/dme.14565. Epub 2021 Apr 12.
To examine whether frequency, perceived severity and fear of hypoglycaemia are independently associated with diabetes-specific quality of life in adolescents with type 1 diabetes.
Cross-sectional self-reported data on demographics, frequency and perceived severity of both self-treated and severe hypoglycaemia, fear of hypoglycaemia (Hypoglycaemia Fear Survey-Child version) and diabetes-specific quality of life (Pediatric Quality of Life Diabetes Module; PedsQL-DM) were obtained from the project 'Whose diabetes is it anyway?'. Hierarchical regression analyses were performed for the total scale and recommended summary scores of the PedsQL-DM as dependent variables; independent variables were entered in the following steps: (1) age, gender and HbA , (2) frequency of hypoglycaemia, (3) perceived severity of hypoglycaemia and (4) fear of hypoglycaemia.
Adolescents (12-18 years; n = 96) completed questionnaires. In the first three steps, female gender (p < 0.05), higher HbA (p < 0.05), higher frequency of severe hypoglycaemia (p < 0.05) and higher perceived severity of severe (p < 0.05) and self-treated hypoglycaemia (p < 0.001) were significantly associated with lower diabetes-specific quality of life (β ranging from 0.20 to 0.35). However, in the final model only fear of hypoglycaemia was significantly associated with QoL (p < 0.001). Adolescents with greater fear reported lower diabetes-specific quality of life, with 52% explained variance. This pattern was observed across subdomains of diabetes-specific quality of life.
Fear of hypoglycaemia was the only factor independently associated with diabetes-specific quality of life, whereas frequency and perceived severity of hypoglycaemia were not. These findings highlight the importance of awareness and assessment of fear of hypoglycaemia in clinical practice.
探讨低血糖发生频率、感知严重程度以及对低血糖的恐惧是否与1型糖尿病青少年的糖尿病特异性生活质量独立相关。
从“这到底是谁的糖尿病？”项目中获取有关人口统计学、自我治疗和严重低血糖的发生频率及感知严重程度、对低血糖的恐惧（低血糖恐惧调查-儿童版）以及糖尿病特异性生活质量（儿童生活质量糖尿病模块；PedsQL-DM）的横断面自我报告数据。以PedsQL-DM的总量表和推荐汇总分数为因变量进行分层回归分析；自变量按以下步骤纳入：（1）年龄、性别和糖化血红蛋白（HbA），（2）低血糖发生频率，（3）低血糖感知严重程度，（4）对低血糖的恐惧。
12至18岁的青少年（n = 96）完成了问卷调查。在前三个步骤中，女性（p < 0.05）、较高的HbA（p < 0.05）、较高的严重低血糖发生频率（p < 0.05）以及较高的严重低血糖（p < 0.05）和自我治疗低血糖（p < 0.001）感知严重程度与较低的糖尿病特异性生活质量显著相关（β范围为0.20至0.35）。然而，在最终模型中，只有对低血糖的恐惧与生活质量显著相关（p < 0.001）。恐惧程度较高的青少年报告的糖尿病特异性生活质量较低，方差解释率为52%。在糖尿病特异性生活质量的各个子领域均观察到这种模式。
对低血糖的恐惧是与糖尿病特异性生活质量独立相关的唯一因素，而低血糖发生频率和感知严重程度并非如此。这些发现凸显了在临床实践中认识和评估对低血糖恐惧的重要性。
