Fear of hypoglycemia and quality of life in young people with type 1 diabetes and their parents in the era of sensor glucose monitoring
Open accessAbstract
Introduction: It is crucial to understand psychosocial outcomes in children and adolescents with type 1 diabetes (T1D) and their families to provide optimal family-centered care. Hence, the aim of this study was to explore psychosocial outcomes in young people with T1D and their parents using currently available glucose monitoring devices in a real-life clinic setting. Methods: Children and adolescents aged 2-18 years with T1D for more than 6 months and their parents were recruited into a cross-sectional study to complete the Hypoglycemia Fear Survey (HFS) and the Pediatric Quality of Life Inventory (PedsQL) Generic Score Scales, Diabetes Module and Family Impact Module. Demographics and diabetes-specific parameters were obtained from medicals records. Results: Fifty-nine children and adolescents (mean age 15.1 ± 3.0 years) and 49 parents of children (mean age of children 12.5± 3.3 years) of which 44 were child-parent dyads completed the questionnaires. Parents had a higher mean (SD) FOH total and worry subscore than children, total score was 37.9 (14.6) vs. 32.2 (11.9), p = 0.047 and worry subscore was 17.8 (10.4) vs. 12.8 (9.0), p = 0.01. Furthermore, lower parental diabetes-specific QoL score was observed in parents, 78.8 (12.2) vs. 82.7 (10.3), p=0.02. No difference in FOH and QoL between real-time continuous glucose monitoring (rtCGM) and intermittently scanned glucose monitoring (isCGM) users and users of devices with and without alerts was observed. In isCGM users (n=36 completing the child questionnaires, n=33 completing parent questionnaires), higher parental FOH and lower parental diabetes-specific QoL correlated with higher scanning frequency, r = 0.399, p = 0.021, and r = -0.464, p = 0.007 respectively. No significant correlation was documented between scanning frequency and child questionnaire scores. Conclusions: Parents are more likely to perceive higher levels of psychosocial burden related to their child's diabetes than children and adolescents with T1D, especially parents of younger children. This highlights the need for family-based education and treatment resources to support parents in diabetes management in addition to rapidly advancing diabetes technology. In isCGM users, higher parental FOH and lower parent-perceived QoL correlated with a higher scanning frequency, indicating the potential impact of glucose monitoring modality on psychosocial outcomes or vice versa.
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Reduced diabetes distress and improved quality of life may contribute to better treatment adherence and long-term engagement with self-management behaviors.
“Reduced diabetes distress and improved quality of life may contribute to better treatment adherence and long-term engagement with self-management behaviors [[48], [49], [50]].”
From Effectiveness of continuous glucose monitoring systems on glycemic control in adults with type 1 diabetes: A systematic review and meta-analysis (2025) · cites this paper as [50]
The Introduction (page unavailable) says psychosocial coping may affect glycemic outcomes, which supports a possible link between psychosocial well-being and diabetes management. It does not say that reduced distress or improved quality of life improves treatment adherence or long-term self-management engagement. The Discussion (page unavailable) cautions against assuming causality between psychosocial and glycemic outcomes. (LLM, conf=0.77)
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- Authors
- Glocker, V., Bachmann, S., Hess, M., Szinnai, G., & Burckhardt, M.-A.
- Affiliations
- University of Basel (CH)
- Corresponding author
- Burckhardt, Marie-Anne
- Venue
- Frontiers in Endocrinology
- Publisher
- Frontiers Media SA
- Published
- 2022-07-28
- Volume
- 13
- Pages
- 958671-958671
- ISSN
- 1664-2392 (ISSN-L)
- PMC
- PMC9367634
- OpenAlex
- W4288084491
- Cited by
- 25
- References
- 33
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 3 · 2023: 5 · 2022: 2
- FWCI
- 3.34
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Endocrinology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Diabetes-Stiftung
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- type 1 diabetes, fear of hypoglycemia, quality of life, children and adolescents, parents, continuous glucose monitoring, scanning frequency, psychosocial burden, family-centered care, PedsQL, parent-child dyads, parental worry
- MeSH terms
- Adolescent, Blood Glucose, Child, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Fear, Humans, Hypoglycemia, Parents, Quality of Life, Blood Glucose Self-Monitoring
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