Background: Type 1 diabetes mellitus (T1DM) in children carries significant psychological stress for families, as well as considerable long-term complications if good metabolic control is not achieved. Tighter metabolic control carries increased risk of hypoglycaemic episodes, and previous research suggests that families with a high fear of hypoglycaemia will run blood sugars higher in order to avoid this. Continuous glucose monitoring (CGM) provides real time temporal measurements of blood glucose levels and a recent Cochrane meta-analysis showed that CGM technology can reduce HbA1c level without increase of hypoglycaemia.
Objective and hypotheses: To investigate fear of hypoglycaemia before and after use of CGM.
Method: Parents of children and patients aged over 12 years using CGM for a minimum of 6 months were asked to complete a modified version of the Hypoglycaemia Fear Survey for parents of young children (HFS-PYC), a measure designed to assess fear and avoidance behaviours associated with hypoglycaemia, for before and after CGM.
Results: Questionnaires were returned for 13 patients (eight male), nine patients were 12 years or older (age range 219 years, median 13 years) of which six returned patient questionnaires. Two patients and one parent were excluded from analysis as incomplete. Significant improvement was seen for parental fear of hypoglycaemia following use of CGM (P<0.001). Three out of four patient questionnaires analysed showed decreased fear of hypoglycaemia following CGM use, however these figures were not statistically significant (P=0.10). Mean HbA1c in the preceding 6 months before CGM use was 66.7 mmol/mol compared to 61.4 mmol/mol 6 months post-CGM (P=0.52).
Conclusion: Parental fear of hypoglycaemia was significantly reduced following the use of CGM in children with T1DM. Reducing the level of fear of hypoglycaemia is an important aspect in helping patients and families work towards improving metabolic control in T1DM.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology