Mesa Díaz Ángel Manuel, Belmonte Lomas Samuel, Rodríguez de Vera Gómez Pablo, Llanes González María Victoria, Mateo Rodríguez Carmen, Hidalgo Sotelo Lucía, Martínez Brocca María Asunción
Endocrinology and Nutrition Department, Virgen Macarena University Hospital, Seville, Spain.
Front Endocrinol (Lausanne). 2025 May 16;16:1563410. doi: 10.3389/fendo.2025.1563410. eCollection 2025.
Analyze the influence of Fear of Hypoglycemia (FoH) on quality of life and glycemic control in adults with Type 1 Diabetes Mellitus (T1D) who use Flash Glucose Monitoring (FGM).
A cross-sectional study was conducted with 173 adults with T1D. FoH was assessed using the FH15 questionnaire, and quality of life was evaluated using the Spanish Diabetes Quality of Life questionnaire (EsDQOL). Glycemic control was analyzed through FGM-derived metrics (Ambulatory Glucose Profile) and HbA1c. Multivariate multiple linear regression models were developed to analyze the adjusted impact of FoH on quality of life and time in hyperglycemia.
FoH was present in 42% of participants (FH15 ≥28). Patients with FoH exhibited significantly higher EsDQOL scores, reflecting poorer quality of life, and higher HbA1c levels (7.41% vs. 7.08%, p=0.012). FGM metrics revealed higher mean glucose, glucose management indicator (GMI) (p=0.008), and time in hyperglycemia >250 mg/dL (p=0.035) in the FoH group, with lower time in range 70-180 mg/dl (p=0.035). Hypoglycemia unawareness was more frequent in the FoH group (25.4% vs. 6.5%, p=0.011). The FH15 score functioned as an independent predictor of quality of life (β = 1.98 [1.58; 2.37]) and time in hyperglycemia (β = 0.39 [0.17; 0.61]) in the multiple linear regression models.
FoH is significantly associated with poor quality of life and worsened glycemic control in T1D patients, underscoring the need for systematic assessment and individualized interventions. FGM metrics, particularly time in hyperglycemia, may serve as valuable predictors of FoH. Comprehensive management strategies addressing both metabolic and psychological factors are essential for improving patient outcomes.
分析低血糖恐惧（FoH）对使用动态葡萄糖监测（FGM）的1型糖尿病（T1D）成年患者生活质量和血糖控制的影响。
对173例T1D成年患者进行了一项横断面研究。使用FH15问卷评估FoH，并使用西班牙糖尿病生活质量问卷（EsDQOL）评估生活质量。通过FGM得出的指标（动态葡萄糖图谱）和糖化血红蛋白（HbA1c）分析血糖控制情况。建立多变量多重线性回归模型，以分析FoH对生活质量和高血糖时间的调整影响。
42%的参与者存在FoH（FH15≥28）。有FoH的患者表现出明显更高的EsDQOL评分，反映出生活质量较差，以及更高的HbA1c水平（7.41%对7.08%，p=0.012）。FGM指标显示，FoH组的平均血糖、血糖管理指标（GMI）更高（p=0.008），高血糖时间>250mg/dL的情况更多（p=0.035），而血糖在70-180mg/dl范围内的时间更低（p=0.035）。FoH组低血糖无意识的情况更频繁（25.4%对6.5%，p=0.011）。在多重线性回归模型中，FH15评分是生活质量（β = 1.98 [1.58; 2.37]）和高血糖时间（β = 0.39 [0.17; 0.61]）的独立预测因素。
FoH与T1D患者生活质量差和血糖控制恶化显著相关，强调了系统评估和个体化干预的必要性。FGM指标，尤其是高血糖时间，可能是FoH的有价值预测指标。针对代谢和心理因素的综合管理策略对于改善患者结局至关重要。
