Predictors of fear of hypoglycemia in adolescents with type 1 diabetes and their parents
Predictors of fear of hypoglycemia in adolescents with type 1 diabetes and their parents
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DOI：
10.1111/j.1399-5448.2006.00182.x
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发表时间：
2006-08-01
影响因子：
3.4
通讯作者：
Clarke, William L.
中科院分区：
文献类型：
--
作者：
Gonder-Frederick, Linda A.;Fisher, Craig D.;Clarke, William L.
目的：本研究检验了特质焦虑和低血糖史均导致1型糖尿病（T1 DM）青少年及其父母对低血糖（FOH）的恐惧的假设，以及FOH与其他变量（包括代谢控制、症状感知和胰岛素泵治疗的使用）之间的关系。39对父母-青少年完成了问卷调查，评估背景和临床信息，低血糖发作，FOH和特质焦虑。青少年的血液也采样糖化血红蛋白A1 C（HbA 1C）measurement.Results：在青少年中，特质焦虑和严重低血糖发作的频率是FOH的显着预测因子，一起占近50%的方差。父母的FOH不是由他们自己的特质焦虑或他们孩子的低血糖史预测的，而是由他们是否相信他们的孩子携带紧急葡萄糖。FOH与代谢控制无关，尽管近期发生重度低血糖（SH）伴意识丧失的青少年HbA 1c显著升高。父母特质焦虑与儿童特质焦虑显著相关，但亲子FOH水平无关。无论是特质焦虑，也没有FOH报告的症状，和FOH不低于父母与胰岛素泵therapy.Conclusions：从成人患者人群的调查结果一致，特质焦虑水平和最近的经验，低血糖预测FOH在青少年T1 DM。然而，在父母中，对青少年科普低血糖发作能力的信念预测了FOH。T1 DM青少年及其父母的FOH是一个复杂的结构，受多重人格、情境和行为因素的影响，其对糖尿病管理的影响尚不清楚。
Objectives: This study tested the hypothesis that both trait anxiety and hypoglycemic history contribute to fear of hypoglycemia (FOH) both in adolescents with type 1 diabetes mellitus (T1DM) and in their parents, and relationships between FOH and other variables including metabolic control, symptom perception, and use of insulin pump therapy.Study Design: Thirty-nine parent-adolescent pairs completed questionnaires assessing background and clinical information, hypoglycemic episodes, FOH, and trait anxiety. Adolescent blood was also sampled for glycosylated hemoglobin A1c (HbA1c) measurement.Results: In adolescents, both trait anxiety and frequency of severe hypoglycemic episodes were significant predictors of FOH, together accounting for almost 50% of the variance. Parental FOH was not predicted by their own trait anxiety or their child's hypoglycemic history but by whether they believed that their child carried emergency glucose. FOH was not related to metabolic control, although adolescents who experienced recent severe hypoglycemia (SH) with unconsciousness had significantly higher HbA1c. Parental trait anxiety significantly correlated with child trait anxiety, but parent-child levels of FOH were unrelated. Neither trait anxiety nor FOH related to reported symptoms, and FOH was not lower in parents with insulin pump therapy.Conclusions: Consistent with findings from adult patient populations, trait anxiety levels and recent experiences with hypoglycemia predict FOH in adolescents with T1DM. In parents, however, beliefs about their adolescents' ability to cope with hypoglycemic episodes predicted FOH. FOH in adolescents with T1DM and their parents is a complex construct influenced by multiple personality and situational and behavioral factors, and its impact on diabetes management remains unclear.