Hypoglycaemia and diabetes-specific quality of life in adolescents with type 1 diabetes

AimsTo examine whether frequency, perceived severity and fear of hypoglycaemia are independently associated with diabetes‐specific quality of life in adolescents with type 1 diabetes.

MethodsCross‐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, HbA1c, 2) frequency of hypoglycaemia; 3) perceived severity of hypoglycaemia and 4) fear of hypoglycaemia.

ResultsAdolescents (12‐18 years; n=96) completed questionnaires. In the first three steps, female gender (p<0.05), higher HbA1c (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.

ConclusionsFear 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.