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Parents’ fear of hypoglycaemia impacts on children’s diabetes management

Monday 12 April 2010

Parents who live in fear of their children having hypoglycaemic episodes might have a negative effect on their child’s diabetes control, says a new study.

Good provision of psychological support for parents and their children with diabetes is therefore crucial.

The study, published in the journal Diabetic Medicine, found that parents who showed high levels of emotional distress resulting from their fear of hypoglycaemia had children with higher blood glucose levels.

This can cause an increased risk of potential long-term complications including heart disease, stroke, amputation, blindness and kidney disease. The parents' fear was also associated with higher frequency of problematic hypoglycaemic episodes in the past year.

Researchers based at Bergen University College, Norway, followed 200 parents of 115 children with Type 1 diabetes aged one to 15 years old.

Mothers of children with diabetes reported higher levels of fear than fathers and parents who reported an additional disease or mental disorder in their child also had more fear of hypoglycaemia then parents of children without an additional disease.

The study showed that parents were more likely to use inappropriate behaviour to avoid hypoglycaemia  if their child used injections to control their diabetes rather than an insulin pump.

A worrying time

Access to psychological support needed

“Having a child diagnosed with diabetes has major implications for a family," said Dr Iain Frame, Director of research at Diabetes UK.

"It can be a worrying time and therefore it is crucial that the child and their parents have access to psychological support.

Happy childhood still possible

Although diabetes is a serious condition, it is also important to remember that having diabetes does not prevent a child from having a normal, happy childhood.”

Helping to identify what support is needed

Lead researcher Anne Haughstvedt from Bergen University College, said “We were keen to establish the link between parental emotional distress, fear of hypoglycaemia and the diabetes management of a child with diabetes.

"We hope that our findings will help identify the type of support that children with diabetes and their parents should receive.”

The researchers underlined the fact that their study could not identify cause and effect, but a reasonable interpretation might be that experiences with problematic hypoglycaemic episodes worry parents and subsequently lead to more restrictive insulin doses and poorer diabetes control in the child.

What is hypoglycaemia?

Hypoglycaemia (or a ‘hypo’) occurs when the level of glucose in the blood falls too low.

If left untreated the person having an hypo might, eventually, become unconscious.

Warning signs

When a hypo happens the person often experiences ‘warning signs’, which occur as the body tries to raise the blood glucose level. These ‘warning signs’ vary from person to person but often include feeling shaky, sweating, tingling in the lips, going pale, heart pounding, confusion and irritability. These symptoms may frighten a child with diabetes and their parents.

Diabetes UK-funded research

In the UK, researchers at Warwick University are also conducting a similar research project, which is funded by Diabetes UK.

Lead Researcher Dr Krystyna Matyka from Warwick University said: "The main aim of our study is to examine the prevalence of fear of hypoglycaemia in a cohort of children and young people and their parents in the Midlands.

"We are collecting data in a number of psychological domains to explore the day-to-day lives of families living with diabetes and will also explore predisposing factors to increased worry by examining personality traits.

"This information will improve our understanding of the impact of fear of hypoglycaemia on glycaemic control and the possible barriers to appropriate self-care.

"It is hoped that relevant and effective interventions may be designed to prevent fear of hypoglycaemia that may become maladaptive.”