Clinic-Wide Screening of Fear of Hypoglycemia in Mothers and Fathers of Children with Type 1 Diabetes

Abstract

Background: The American Diabetes Association (ADA) recommends anxiety screening in individuals with type 1 diabetes (T1D); however, screening in parents is not addressed. This study describes fear of hypoglycemia (FOH) in parents who were screened as part of their children’s routine T1D clinic visit. Methods: Mothers (n=234) and fathers (n=79) completed the Hypoglycemia Fear Survey - Parent comprising 3 subscales: Maintaining High Blood Glucose (BG), Worry/Helplessness About Low BG, and Worry About Negative Social Consequences. Scores of ≥7, ≥24, and ≥9, respectively, were used as clinical cutoffs. Higher scores indicate greater fear/worry about hypoglycemia. Results: Child characteristics were: 53% female; mean age = 13.9±2.2 years; mean A1C = 9.3±2.2%, mean T1D duration = 5.1±4.1 years; 58% CSII. Percentage of mothers and fathers exceeding the clinical cutoffs were: 18%, 14% on Maintaining High BG; 15%, 3% Worry/Helplessness About Low BGs; and 14%, 1% Worry About Negative Social Consequences. Compared to fathers, mothers reported significantly more helplessness about low BGs (t(173.6)=3.24, p=0.001), but not more worry about negative social consequences (t(223.4)=1.42, p=0.16), or engaging in behaviors to maintain high BGs (t(290)=0.68, p=0.50). Parents of older children (≥13 years) worried equally about hypoglycemia (p>0.05), but reported engaging in fewer behaviors to maintain high BGs than parents of younger children (10-12 years) (t(307)=3.27, p<0.001). Conclusions: FOH is common in both mothers and fathers. Mothers reported more feelings of helplessness than fathers, whereas both mothers and fathers of younger children reported engaging in more behaviors to maintain high BGs than parents of older children. These results support the need to screen parents - not just patients with T1D - for FOH and provide intervention when indicated. Consideration should be given to including recommendations about FOH screening parents in the ADA Medical Standards of Care. Disclosure S. Majidi: None. H. O'Donnell: None. K. Benson: None. K.A. Driscoll: None.