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Li S, Li Y, Zhang L, Bi Y, Zou Y, Liu L, Zhang H, Yuan Y, Gong W, Zhang Y. Impact of fear of hypoglycaemia on self-management in patients with type 2 diabetes mellitus: structural equation modelling. Acta Diabetol 2022; 59:641-650. [PMID: 35083591 DOI: 10.1007/s00592-021-01839-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 12/13/2021] [Indexed: 11/29/2022]
Abstract
AIMS This study aimed to explore the effect of fear of hypoglycaemia (FOH) on self-management and its specific action path in patients with type 2 diabetes mellitus (T2DM) to provide a basis for developing targeted nursing interventions. DESIGN A cross-sectional study. METHODS From June to October 2019, we recruited 258 patients with T2DM from the endocrinology department of three hospitals to complete questionnaires, including the Hypoglycaemia Fear Survey-II, Diabetes Distress Scale, Self-Stigma Scale, Social Support Rating Scale and Summary of Diabetes Self-Care Activities, in Jiangsu Province, China. Pearson's correlation analyses and structural equation modelling were conducted to explore the relationship and influence path among the above variables. RESULTS The correlation analysis of FOH, distress, self-stigma, social support and self-management showed that, except for social support not being correlated with FOH and distress (P > 0.05), all variables were correlated in pairs (r = - 0.19-0.77, P < 0.01). The final model fit well, and the fitting indexes of the model were as follows: χ2/df = 2.191, GFI = 0.934, CFI = 0.954, TLI = 0.934, RMSEA = 0.068, and SRMR = 0.0649. The effects of FOH on self-management in patients with T2DM included one direct path and two indirect paths: (a) FOH had a direct impact on self-management (P < 0.05); (b) FOH had an indirect impact on self-management through distress (P < 0.05); and (c) FOH had an indirect impact on self-management through self-stigma and social support (P < 0.05). CONCLUSIONS FOH could directly influence self-management in patients with T2DM. Furthermore, distress, self-stigma and social support were important mediating variables of FOH influencing self-management. Researchers can develop personalized interventions to improve the self-management of patients with T2DM by regulating distress, self-stigma and social support levels.
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Affiliation(s)
- Shuang Li
- School of Nursing, Yangzhou University, Jiangyang Road 136, Yangzhou, China
- Department of Nursing, Taicang First People's Hospital, Suzhou, China
| | - Yehui Li
- Intensive Care Unit, Taicang First People's Hospital, Suzhou, China
| | - Lu Zhang
- School of Nursing, Yangzhou University, Jiangyang Road 136, Yangzhou, China
| | - Yaxin Bi
- School of Nursing, Yangzhou University, Jiangyang Road 136, Yangzhou, China
| | - Yan Zou
- School of Nursing, Yangzhou University, Jiangyang Road 136, Yangzhou, China
| | - Lin Liu
- School of Nursing, Yangzhou University, Jiangyang Road 136, Yangzhou, China
| | - Hong Zhang
- Department of Nursing, Taicang First People's Hospital, Suzhou, China
| | - Yuan Yuan
- School of Nursing, Yangzhou University, Jiangyang Road 136, Yangzhou, China
- Department of Nursing, Affiliated Hospital of Yangzhou University, Yangzhou, China
| | - Weijuan Gong
- School of Nursing, Yangzhou University, Jiangyang Road 136, Yangzhou, China
| | - Yu Zhang
- School of Nursing, Yangzhou University, Jiangyang Road 136, Yangzhou, China.
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, China.
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Wang Y, Zeng Z, Ding J, Yuan R, Wang R, Zhang Y, Bai L, Yu H, Tang J. Fear of hypoglycaemia among patients with type 2 diabetes mellitus: a cross-sectional study. Sci Rep 2021; 11:7971. [PMID: 33846441 PMCID: PMC8042064 DOI: 10.1038/s41598-021-86954-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 03/19/2021] [Indexed: 11/17/2022] Open
Abstract
To investigate the fear of hypoglycaemia in patients with type 2 diabetes mellitus (T2DM), to identify factors related to this fear, and thus to provide evidence for clinical assessment. A total of 385 patients with T2DM who were admitted to the departments of endocrinology in five tertiary grade-A hospitals in Chongqing, China were included in this study. A questionnaire for general information and a Chinese version of Hypoglycemia Fear Survey (HFS) were used to collect the data. The average total score on the HFS was 71.67 ± 17.06 (HFS-W was 38.15 ± 10.57; HFS-B was 33.52 ± 9.54).The three items with the highest average score for HFS-W were not recognising low blood glucose (BG), not having food available, experiencing a hypoglycaemic episode alone, and for HFS-B were eating large amount of snacks, measuring BG six or more times per day, and keeping BG > 150 mmol/L. Regressions showed that number of hospitalisations for T2DM, receiving health education on diabetes, age and hypoglycaemia history because of T2DM were associated with fear of hypoglycaemia (all p < 0.05). Fear of hypoglycaemia in hospitalised patients with T2DM was strongly associated with diabetes health education, hospitalisation for diabetes, age, and hypoglycaemia history. Medical professionals should attach importance to the specific psychological interventions, health education on diabetes and the early prevention of hypoglycaemia or diabetic complications for patients with T2DM to reduce the fear of hypoglycaemia and improve their health status.
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Affiliation(s)
- Yanhao Wang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, 98 XiWu Road, Xi'an, 710004, Shaanxi, China.,Department of Orthodontics, Xi'an Jiaotong University School of Stomatology, 98# Xiwu Road, Xi'an, 710000, Shaanxi, China.,College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Zihuan Zeng
- School of Nursing, Chongqing Medical University, 1#, Medical College Road, Chongqing, 400016, China
| | - Jie Ding
- School of Foreign Languages, Chongqing Medical University, Chongqing, China
| | - Ruizhu Yuan
- School of Nursing, Chongqing Medical University, 1#, Medical College Road, Chongqing, 400016, China
| | - Ruiding Wang
- School of Nursing, Chongqing Medical University, 1#, Medical College Road, Chongqing, 400016, China
| | - You Zhang
- School of Foreign Languages, Chongqing Medical University, Chongqing, China
| | - Liyao Bai
- School of Nursing, Chongqing Medical University, 1#, Medical College Road, Chongqing, 400016, China
| | - Huan Yu
- School of Nursing, Chongqing Medical University, 1#, Medical College Road, Chongqing, 400016, China
| | - Jiao Tang
- School of Nursing, Chongqing Medical University, 1#, Medical College Road, Chongqing, 400016, China.
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Chatwin H, Broadley M, Speight J, Cantrell A, Sutton A, Heller S, de Galan B, Hendrieckx C, Pouwer F. The impact of hypoglycaemia on quality of life outcomes among adults with type 1 diabetes: A systematic review. Diabetes Res Clin Pract 2021; 174:108752. [PMID: 33722700 DOI: 10.1016/j.diabres.2021.108752] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/15/2021] [Accepted: 03/05/2021] [Indexed: 01/20/2023]
Abstract
Hypoglycaemia is a common barrier to optimal glycaemic management and often feared among adults with type 1 diabetes. The aim of this systematic review was to summarize current evidence regarding the impact of hypoglycaemia on quality of life (QoL) and related outcomes. Electronic searches of MEDLINE, PsycINFO, CINAHL, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials were conducted. Peer-reviewed empirical studies investigating the relationship between hypoglycaemia and QoL were eligible for inclusion. Thirty studies met the inclusion criteria. Extracted data was summarized in a narrative synthesis according to Synthesis Without Meta-Analysis guidelines. None of the studies examined the impact of hypoglycaemia on general QoL. There was no association between hypoglycaemia and diabetes-specific QoL in four of the 30 studies. Severe hypoglycaemia was associated with greater fear of hypoglycaemia and diabetes distress, and lower general emotional well-being, but not with depression, anxiety, or health status. Self-treated hypoglycaemia was associated with greater fear of hypoglycaemia. With the exception of fear of hypoglycaemia, this review shows mixed associations between hypoglycaemia and psychological outcomes. Further research is needed to investigate the impact of hypoglycaemia on other domains of QoL.
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Affiliation(s)
- Hannah Chatwin
- Department of Psychology, University of Southern Denmark, Odense, Denmark.
| | - Melanie Broadley
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Jane Speight
- Department of Psychology, University of Southern Denmark, Odense, Denmark; School of Psychology, Deakin University, Geelong, Australia; The Australian Centre for Behavioural Research in Diabetes, Melbourne, Australia
| | - Anna Cantrell
- Information Resources Group, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, United Kingdom
| | - Anthea Sutton
- Information Resources Group, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, United Kingdom
| | - Simon Heller
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Bastiaan de Galan
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands; Radboud University Medical Center, Nijmegen, Netherlands
| | - Christel Hendrieckx
- School of Psychology, Deakin University, Geelong, Australia; The Australian Centre for Behavioural Research in Diabetes, Melbourne, Australia
| | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Odense, Denmark; School of Psychology, Deakin University, Geelong, Australia; Steno Diabetes Center Odense, Odense, Denmark
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Zhang Y, Li S, Zou Y, Wu X, Bi Y, Zhang L, Yuan Y, Gong W, Hayter M. Fear of hypoglycemia in patients with type 1 and 2 diabetes: a systematic review. J Clin Nurs 2020; 30:72-82. [PMID: 33091198 DOI: 10.1111/jocn.15538] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/14/2020] [Indexed: 01/17/2023]
Abstract
AIMS AND OBJECTIVES To summarize and thematize fear of hypoglycemia (FOH) in individuals with type 1 diabetes (T1D) and type 2 diabetes (T2D) to provide a theoretical basis for the development of effective interventions. BACKGROUND FOH is common in this population and can reduce quality of life(QOL) and adversely impact upon diabetes self-care management. DESIGN a systematic review METHODS: Articles published between 2000 and 2019 were searched in PubMed, MEDLINE, EMBASE, Web of Science and three Chinese databases (CNKI, Wan-fang data and VIP). Eligible articles were selected using the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) guidelines. The quality of all articles finally included was evaluated by the Joanna Briggs Institute (JBI) Critical Appraisal tools. RESULTS Eighteen studies from 8654 papers were included. The sample size of each study ranged from 48 to 3812 subjects. FOH negatively impacted QOL, particularly psychosocial functioning, daily life and sleep quality. CONCLUSIONS FOH is a common and serious problem for patients, leading to poor QOL. It has been suggested that psychological concerns, QOL and effective countermeasures in individuals with T1D and T2D should be taken seriously. Advanced technology should be evaluated for its benefits before being used by patients. RELEVANCE TO CLINICAL PRACTICE The review highlights that FOH negatively impacts QOL, including psychosocial factors, daily life and sleep quality. Healthcare providers should develop targeted and professional assessment tools for FOH and QOL for patients with T2D, especially for patients who are about 60 years old. Advanced technology should be evaluated for its benefits before being used by patients.
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Affiliation(s)
- Yu Zhang
- School of Nursing, Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, China
| | - Shuang Li
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yan Zou
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Xiaxin Wu
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yaxin Bi
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Lu Zhang
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Yuan Yuan
- School of Nursing, Yangzhou University, Yangzhou, China
- Department of Nursing, Yangzhou University Affiliated Hospital, Yangzhou, China
| | - Weijuan Gong
- School of Nursing, Yangzhou University, Yangzhou, China
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, China
| | - Mark Hayter
- Faculty of Health Science, University of Hull, Hull, UK
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Suteau V, Saulnier PJ, Wargny M, Gonder-Frederick L, Gand E, Chaillous L, Allix I, Dubois S, Bonnet F, Leguerrier AM, Fradet G, Delcourt Crespin I, Kerlan V, Gouet D, Perlemoine C, Ducluzeau PH, Pichelin M, Ragot S, Hadjadj S, Cariou B, Briet C. Association between sleep disturbances, fear of hypoglycemia and psychological well-being in adults with type 1 diabetes mellitus, data from cross-sectional VARDIA study. Diabetes Res Clin Pract 2020; 160:107988. [PMID: 31866527 DOI: 10.1016/j.diabres.2019.107988] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/06/2019] [Accepted: 12/17/2019] [Indexed: 02/01/2023]
Abstract
AIM To assess the relationship between sleep quality, fear of hypoglycemia, glycemic variability and psychological well-being in type 1 diabetes mellitus. METHODS Our data were provided by the VARDIA Study, a multicentric cross-sectional study conducted between June and December 2015. Sleep characteristics were assessed by the Pittsburgh Sleep Quality Index (PSQI). Fear of hypoglycemia and psychological well-being were measured with the Hypoglycemia Fear Survey version II (HFS-II) and the Hospital Anxiety and Depression Scale (HADS), respectively. Glycemic variability (GV) was determined using the CV of three 7-point self-monitoring blood glucose profiles and the mean amplitude of glycemic excursion (MAGE). RESULTS 315 patients were eligible for PSQI questionnaire analysis: 54% women, mean age 47 ± 15, mean diabetes duration of 24 ± 13 years, HbA1c of 7.6 ± 0.9% (60 ± 7,5mmol/mol). Average PSQI score was 6.0 ± 3.3 and 59.8% of the patients had a PSQI score > 5. HFS-II score and HADS were significantly higher among "poor" sleepers (p < 0.0001) and PSQI score was positively associated with HADS (β = 0.22; 95% CI = 0.08;0.35). GV evaluated by CV or MAGE did not differ between "poor" and "good" sleepers (p = 0.28 and 0.54, respectively). CONCLUSIONS Adult patients with type 1 diabetes have sleep disturbances which correlate with psychological well-being. This study suggests that psychological management can be a target to improve sleep quality in adults with type 1 diabetes mellitus.
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Affiliation(s)
- Valentine Suteau
- Institut MITOVASC, UMR CNRS 6015, INSERM 1083, Université d'Angers, 3 rue Roger Amsler, 49100 Angers, France; Diabetes Department, CHU d'Angers, 4 rue Larrey, 49100 Angers, France.
| | - Pierre-Jean Saulnier
- Clinical Investigation Center CIC1402, CHU de Poitiers 2 rue de la Miletrie, 86000 Poitiers, France; CHU Poitiers, Diabetes Department, 2 rue de la Milétrie, CS 90577, 86000 Poitiers, France.
| | - Matthieu Wargny
- L'institut du thorax, CHU Nantes, INSERM CIC1413, Hôpital Nord Laennec Boulevard Jacques-Monod Saint-Herblain, 44093 Nantes Cedex 1, France.
| | | | - Elise Gand
- Clinical Investigation Center CIC1402, CHU de Poitiers 2 rue de la Miletrie, 86000 Poitiers, France.
| | - Lucy Chaillous
- L'institut du thorax, CHU Nantes, INSERM CIC1413, Hôpital Nord Laennec Boulevard Jacques-Monod Saint-Herblain, 44093 Nantes Cedex 1, France.
| | - Ingrid Allix
- Diabetes Department, CHU d'Angers, 4 rue Larrey, 49100 Angers, France.
| | - Séverine Dubois
- Diabetes Department, CHU d'Angers, 4 rue Larrey, 49100 Angers, France; INSERM U1063, Oxidative Stress and Metabolic Pathologies, Université d'Angers, CHU Angers, 4 Rue Larrey, 49933 Angers Cedex 9, France.
| | - Fabrice Bonnet
- CHU Rennes, Diabetes Department, 2 rue Henri Le Guilloux, 35033 Rennes Cedex 9, France.
| | - Anne-Marie Leguerrier
- CHU Rennes, Diabetes Department, 2 rue Henri Le Guilloux, 35033 Rennes Cedex 9, France
| | - Gerard Fradet
- CH Départemental Vendée, Boulevard Stéphane Moreau, 85000 La Roche-sur-Yon, France.
| | | | - Véronique Kerlan
- CHU Brest, Diabetes Department, Hôpital de La Cavale Blanche, Boulevard Tanguy Prigent, 29200 Brest, France.
| | - Didier Gouet
- CH La Rochelle, Diabetes Department, Rue du docteur Schweitzer, 17019 La Rochelle Cedex, France.
| | - Caroline Perlemoine
- CH Bretagne Sud, Diabetes Department, 5 Avenue Choiseul, 56322 Lorient, France.
| | | | - Matthieu Pichelin
- L'institut du thorax, CHU Nantes, INSERM CIC1413, Hôpital Nord Laennec Boulevard Jacques-Monod Saint-Herblain, 44093 Nantes Cedex 1, France.
| | - Stéphanie Ragot
- Clinical Investigation Center CIC1402, CHU de Poitiers 2 rue de la Miletrie, 86000 Poitiers, France.
| | - Samy Hadjadj
- Clinical Investigation Center CIC1402, CHU de Poitiers 2 rue de la Miletrie, 86000 Poitiers, France; CHU Poitiers, Diabetes Department, 2 rue de la Milétrie, CS 90577, 86000 Poitiers, France.
| | - Bertrand Cariou
- L'institut du thorax, CHU Nantes, INSERM CIC1413, Hôpital Nord Laennec Boulevard Jacques-Monod Saint-Herblain, 44093 Nantes Cedex 1, France.
| | - Claire Briet
- Institut MITOVASC, UMR CNRS 6015, INSERM 1083, Université d'Angers, 3 rue Roger Amsler, 49100 Angers, France; Diabetes Department, CHU d'Angers, 4 rue Larrey, 49100 Angers, France.
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Eating behaviours associated with glycaemic variability and fear of hypoglycaemia in adults with type 1 diabetes. DIABETES & METABOLISM 2019; 47:101136. [PMID: 31838059 DOI: 10.1016/j.diabet.2019.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 12/01/2019] [Indexed: 11/23/2022]
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