Abstract
Hypoglycemia occurs frequently in children with type 1 diabetes (T1D). However, the relationship between fear of hypoglycemia (FOH) and use of diabetes technology with different insulin delivery systems has not been well studied. Similarly, little is known about the relationship of diabetes treatment satisfaction with advances in diabetes technology in the pediatric population. Caregivers of children 6-17 years with T1D (n=104, 84% female caregivers, median T1D duration 5.3 years, mean GMI 7.5 ± 0.7%, 93% insulin pump users, 92% CGM users) using any insulin delivery system (8% MDI, 0.05% pump alone, 31% sensor augmented pump, 23% predictive low glucose suspend, 38% hybrid closed loop) completed the Hypoglycemia Fear Survey - Parent (HFS-P) and the Diabetes Treatment Satisfaction Questionnaire - Parent (DTSQ-P). Youth 13-17 years (n=35, 56% males) also completed the HFS - Child (HFS-C) and DTSQ - Child (DTSQ-C). Linear regression was used to look for associations between HFS and DTSQ scores and clinical factors, and paired t-tests were used to compare scores between caregivers and youth. Female caregivers had higher mean HFS Worry and Behavior scores than male caregivers (Worry 1.4 ± 0.18 vs. 0.88 ± 0.16, p=0.004; Behavior 4.9 ± 0.39 vs. 3.9 ± 0.3, p=0.008). Longer duration of diabetes, duration of pump use, and duration of CGM use were all associated with higher mean HFS-C Worry scores, but not with HFS-P Worry scores. The use of different insulin delivery systems was not associated with any HFS scores. Caregivers had a higher mean HFS Behavior score (4.8 ± 0.29) than youth (2.2 ± 0.078) (p <0.0001). The only clinical factor that was associated with a lower DTSQ-P score was higher GMI (β-coefficient -0.22 ± 0.11, p=0.05). These data suggest that despite recent advancements in diabetes technology, FOH and diabetes treatment satisfaction still remain significant concerns and need to be addressed in clinical contexts. Disclosure F. Abdulhussein: None. J. C. Wong: Advisory Panel; Self; Provention Bio, Inc., Research Support; Self; Dexcom, Inc., Tandem Diabetes Care.
Published Version
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