Fear of hypoglycaemia and self-management in type 1 diabetes.

Aims: We studied the association between fear of hypoglycaemia (FoH) and various diabetes self-management practices.

Methods: Data from 798 individuals with type 1 diabetes participating in the FinnDiane Study were included. Self-reported questionnaires were used to assess FoH and self-management practices (e.g. dietary intake, insulin administration, physical activity). For glycaemic control, we used both the latest HbA measurements and the serial HbA measurements from the medical files. Factor analysis was used to reveal underlying constructs within the food frequency section of the diet questionnaire.

Results: In all, 44% and 63% of men and women reported FoH, respectively. In men, FoH was associated with higher mean serial HbA levels, higher number of reported self-monitoring of blood glucose (SMBG), higher carbohydrate intake, and lower scores in the "high-fat" factor. In women, FoH was associated with a higher number of reported SMBGs and higher energy intake. No difference was observed in physical activity and insulin administration.

Conclusions: FoH has various implications for the self-management of diabetes. More studies are however needed to assess on one hand the association between FoH and diabetes self-management, and on the other hand, FoH and its long term consequences, such as the emergence of diabetic complications and mortality.