Fear of hypoglycemia and sleep in children with type 1 diabetes and their parents
Open accessAbstract
Aims: To compare impact of pump treatment and continuous glucose monitoring (CGM) with predictive low glucose suspend (SmartGuard) or user initiated CGM (iscCGM) on sleep and hypoglycemia fear in children with type 1 Diabetes and parents. Methods: Secondary analysis of data from 5 weeks pump treatment with iscCGM (A) or SmartGuard (B) open label, single center, randomized cross-over study was performed. At baseline and end of treatment arms, sleep and fear of hypoglycemia were evaluated using ActiGraph and questionnaires. Results: 31 children (6-14 years, male: 50%) and 30 parents (28-55 years) participated. Total sleep minutes did not differ significantly for children (B vs. A: -9.27; 95% CI [-24.88; 6.34]; p 0.26) or parents (B vs. A: 5.49; 95% CI [-8.79; 19.77]; p 0.46). Neither daytime sleepiness nor hypoglycemia fear in children or parents differed significantly between the systems. Neither group met recommended sleep criteria. Conclusion: Lack of sleep and fear of hypoglycemia remain a major burden for children with diabetes and their parents. Whilst no significant differences between the systems were found, future technology should consider psychosocial impacts of diabetes and related technologies on children and parents' lived experience to ensure parity of esteem between physical and mental health outcomes. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT03103867.
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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 [48]
The Introduction discusses the effects of diabetes management and fear of hypoglycemia on sleep and quality of life, while the Results report fear-of-hypoglycemia scores. Neither section links reduced diabetes distress or improved quality of life to treatment adherence or long-term self-management engagement. Searches for adherence, long-term engagement, and related terms found no passage making that link. (LLM, conf=0.73)
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Alfadli, S. F., Alotaibi, Y. S., Aqdi, M. J., Almozan, L. A., Alzubaidi, Z. B., Altemani, H. A., Almutairi, S. D., Alabdullah, H. A., Almehmadi, A. A., Alanzi, A. L., et al. (2025) · Metabolism Open · doi:10.1016/j.metop.2025.100382 · Cited by 11 · see citing works
- Authors
- Schierloh, U., Aguayo, G. A., Fichelle, M., De Melo Dias, C., Schritz, A., Vaillant, M., Barnard-Kelly, K., Cohen, O., Gies, I., & de Beaufort, C.
- Affiliations
- Centre Hospitalier de Luxembourg (LU)
- Luxembourg Institute of Health (LU)
- Southern Health NHS Foundation Trust (GB)
- Sheba Medical Center (IL)
- Vrije Universiteit Brussel (BE)
- Corresponding author
- Schierloh, Ulrike
- ORCID
- Venue
- Frontiers in Endocrinology
- Publisher
- Frontiers Media SA
- Published
- 2024-12-16
- Volume
- 15
- Pages
- 1419502-1419502
- ISSN
- 1664-2392 (ISSN-L)
- PMC
- PMC11682895
- OpenAlex
- W4405457042
- Cited by
- 7
- References
- 35
- Citations by year
- 2026: 4 · 2025: 3
- FWCI
- 2.31
- 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)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- type 1 diabetes, children, fear of hypoglycemia, sleep, continuous glucose monitoring, insulin pump therapy, parental burden, sleepiness
- MeSH terms
- Adolescent, Adult, Blood Glucose, Child, Diabetes Mellitus, Type 1, Fear, Female, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Insulin Infusion Systems, Male, Middle Aged, Parents, Sleep, Blood Glucose Self-Monitoring, Cross-Over Studies
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