Feature Article

Fear of hypoglycemia: a review

Linda Gonder-Frederick

Diabetic Hypoglycemia February 2013, Volume 5, Issue 3: page 3-11

Abstract

The purpose of this paper is to review the current literature on fear of hypoglycemia (FoH) and its impact on quality of life and clinical outcome in people with diabetes, as well as their family members. Medical and psychological predictors of FoH are examined, including the individual’s history of hypoglycemia, especially severe episodes, and personality variables such as trait anxiety. The research on youth with diabetes is reviewed, which indicates increasing levels of FoH from early to later childhood, with levels plateauing between ages 9 and 11 then remaining constant through adolescence. The research on parents of youths with type 1 diabetes is also reviewed, showing that parents experience higher levels of FoH than those observed in adults with type 1 diabetes themselves. FoH in spouses and partners of adults with diabetes receives attention as well, including studies finding more marital conflict and hypoglycemia-related sleep disturbances in couples with higher levels of fear. Evidence is presented that documents the negative effect of FoH on emotional status and well-being, and its negative impact on the ability to achieve optimal diabetes management and control. Interventions which effectively reduce FoH are surveyed, ranging from surgical, medical, technological and behavioral approaches to hypoglycemia prevention and detection. The review concludes that, given the clinical significance of FoH, there is a pressing need for increased efforts to develop interventions aimed at reducing the burden of this problem, beginning with programs designed to improve the education patients and their families receive about hypoglycemia and its management.

Keywords: diabetes, hypoglycemia, fear of hypoglycemia