Abstract
To conduct a systematic review to examine associations between hypoglycemia and quality of life (QoL) in children and adolescents with type 1 diabetes. Four databases (Medline, Cochrane Library, CINAHL, PsycINFO) were searched systematically in November 2019 and searches were updated in September 2021. Studies were eligible if they included children and/or adolescents with type 1 diabetes, reported on the association between hypoglycemia and QoL (or related outcomes), had a quantitative design, and were published in a peer-reviewed journal after 2000. A protocol was registered the International Prospective Register of Systematic Reviews (PROSPERO; CRD42020154023). Studies were evaluated using the Joanna Briggs Institute's critical appraisal tool. A narrative synthesis was conducted by outcome and hypoglycemia severity. In total, 27 studies met inclusion criteria. No hypoglycemia-specific measures of QoL were identified. Evidence for an association between SH and (domains) of generic and diabetes-specific QoL was too limited to draw conclusions, due to heterogenous definitions and operationalizations of hypoglycemia and outcomes across studies. SH was associated with greater worry about hypoglycemia, but was not clearly associated with diabetes distress, depression, anxiety, disordered eating or posttraumatic stress disorder. Although limited, some evidence suggests that more recent, more frequent, or more severe episodes of hypoglycemia may be associated with adverse outcomes and that the context in which hypoglycemia takes places might be important in relation to its impact. There is insufficient evidence regarding the impact of hypoglycemia on QoL in children and adolescents with type 1 diabetes at this stage. There is a need for further research to examine this relationship, ideally using hypoglycemia-specific QoL measures.
Highlights
Type 1 diabetes is one of the most common chronic conditions among children and adolescents and requires a demanding treatment regimen [1, 2]
There is insufficient evidence regarding the impact of hypoglycemia on quality of life (QoL) in children and adolescents with type 1 diabetes at this stage
There is a need for further research to examine this relationship, ideally using hypoglycemia-specific QoL measures
Summary
Type 1 diabetes is one of the most common chronic conditions among children and adolescents and requires a demanding treatment regimen (e.g., insulin administration several times a day, monitoring of glucose levels and regulation of food intake and physical activity) [1, 2]. Hypoglycemia is challenging and complex to manage in children and adolescents with type 1 diabetes for several reasons: this group has less predictable eating, activity, and sleep patterns relative to adults; children’s diabetes is often (co-)managed by the parent; and young children may be unable to communicate their symptoms and needs [9]. Among adolescents, both hormonal changes leading to insulin resistance [10] and developmental changes, such as seeking independence from parents, that add to the burden of self-management, can lead to greater fluctuations in glucose levels and increase the risk of hypoglycemia [11]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
