Teasdale Stephanie L, Griffin Alison, Barrett Helen L, Coutts Clare, Vitanza Margaret, Headey Alan
Queensland Diabetes and Endocrine Centre, Mater Misericordiae Hospital, Brisbane, Australia.
School of Medicine, University of Queensland, Brisbane, Australia.
Diabetes Spectr. 2022 Summer;35(3):322-326. doi: 10.2337/ds21-0066. Epub 2022 Jan 18.
Fear of hypoglycemia in people with type 1 diabetes has a detrimental effect on glycemic control and quality of life. The association between continuous glucose monitoring (CGM) and hypoglycemia confidence and fear has not previously been assessed in the young adult population.
This was a prospective cohort study using questionnaires to assess the impact of CGM on hypoglycemia confidence (using the Hypoglycemia Confidence Scale [HCS]) and hypoglycemia fear (using the Hypoglycemia Fear Survey II [HFS]) in 40 young adults with a preexisting diagnosis of type 1 diabetes.
Scores on the HCS were greater at baseline for those with a longer duration of diabetes. Participants with higher general anxiety scores on the Generalized Anxiety Disorder 7-item scale had higher hypoglycemia fear at baseline (total score and worry component, but not behavior component of the HFS). Between baseline and follow-up, HCS scores increased on average by 0.2 (95% CI 0.1-0.4, = 0.01) on a scale of 1-4. HFS scores decreased by 1.8 (95% CI -3.0 to -0.5, = 0.006) on a scale of 0-24 for the worry component and by 2.5 (95% CI -4.4 to -0.6, = 0.01) on a scale of 0-44 for total (worry + behavior components). At follow up, 83% of participants planned to continue using CGM all or most of the time. There was a very high self-reported effect of CGM on life with diabetes (median 8.0 [interquartile range 6.5-10.0], where 10 indicated a very big difference).
Hypoglycemia confidence and fear improve with CGM use in young adults.
1型糖尿病患者对低血糖的恐惧会对血糖控制和生活质量产生不利影响。此前尚未在年轻成年人群体中评估持续葡萄糖监测（CGM）与低血糖信心及恐惧之间的关联。
这是一项前瞻性队列研究，采用问卷调查评估40名先前已诊断为1型糖尿病的年轻成年人中CGM对低血糖信心（使用低血糖信心量表[HCS]）和低血糖恐惧（使用低血糖恐惧调查问卷II [HFS]）的影响。
糖尿病病程较长者在基线时的HCS得分更高。在广泛性焦虑障碍7项量表上总体焦虑得分较高的参与者在基线时低血糖恐惧更高（HFS的总分及担忧部分，但不包括行为部分）。在基线和随访之间，HCS得分在1 - 4的量表上平均增加了0.2（95%置信区间0.1 - 0.4，P = 0.01）。HFS得分在0 - 24的量表上，担忧部分降低了1.8（95%置信区间 - 3.0至 - 0.5，P = 0.006），在0 - 44的量表上，总分（担忧 + 行为部分）降低了2.5（95%置信区间 - 4.4至 - 0.6，P = 0.01）。在随访时，83%的参与者计划全部或大部分时间继续使用CGM。CGM对糖尿病生活的自我报告影响非常大（中位数8.0 [四分位间距6.5 - 10.0]，其中10表示差异非常大）。
年轻成年人使用CGM可改善低血糖信心和恐惧。
