Fear of hypoglycaemia in parents of young children with type 1 diabetes: a systematic review.
Fear of hypoglycaemia in parents of young children with type 1 diabetes: a systematic review.
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DOI：
10.1186/1471-2431-10-50
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发表时间：
2010-07-15
期刊：
影响因子：
2.4
通讯作者：
Waugh N
中科院分区：
文献类型：
--
作者：
Barnard K;Thomas S;Royle P;Noyes K;Waugh N
许多患有1型糖尿病的儿童血糖控制不好。由于糖尿病控制和并发症试验（DCCT）显示更严格的控制可以降低并发症发生率，因此人们更加重视强化胰岛素治疗。我们知道，患者和家属都害怕低血糖。我们假设对低血糖的恐惧可能优先于对长期并发症的担忧，并且避免低血糖的行为可能以较差的控制为代价，并旨在评估任何旨在预防低血糖的干预措施的有效性。本综述的目的是系统回顾有关12岁以下1型糖尿病儿童的父母对低血糖的恐惧程度和后果以及减少低血糖的干预措施的研究。数据来源：MEDLINE， EMBASE, PsycINFO, The Cochrane Library, Web of Science， EASD， ADA和Diabetes UK会议摘要，Current Controlled Trials, ClinicalTrials.gov, UK CRN，查阅检索论文的参考书目并联系该领域的专家。纳入：纳入对12岁以下1型糖尿病儿童父母的任何设计的相关研究。主要结果是由于父母对孩子低血糖的恐惧而导致的父母的恐惧程度和影响，对糖尿病控制的影响，以及减少这种恐惧和低血糖避免行为的干预措施的影响。来自6项研究的8篇文章符合纳入标准。所有研究都是横断面研究，大多数质量良好。据报道，父母对低血糖的恐惧、焦虑和抑郁很常见。关于避免低血糖的行为的证据不足，但有一些建议认为，为了避免低血糖，可能允许高于理想的血糖水平。没有研究报告干预可以减少父母对低血糖的恐惧。证据基础有限。1型糖尿病儿童的父母报告说，父母对低血糖有相当大的恐惧，这影响了父母的健康和生活质量。有迹象表明，父母避免低血糖的行为可能会对血糖控制产生不利影响。干预试验，以减少父母的焦虑和低血糖避免行为是必要的。我们建议应该对患有1型糖尿病的幼儿的父母进行结构化教育的试验。
Many children with type 1 diabetes have poor glycaemic control. Since the Diabetes Control and Complications Trial (DCCT) showed that tighter control reduces complication rates, there has been more emphasis on intensified insulin therapy. We know that patients and families are afraid of hypoglycaemia. We hypothesised that fear of hypoglycaemia might take precedence over concern about long-term complications, and that behaviour to avoid hypoglycaemia might be at the cost of poorer control, and aimed to evaluate the effectiveness of any interventions designed to prevent that. The objective of this review was to systematically review studies concerning the extent and consequences of fear of hypoglycaemia in parents of children under 12 years of age with type 1 diabetes, and interventions to reduce it. Data Sources: MEDLINE, EMBASE, PsycINFO, The Cochrane Library, Web of Science, meeting abstracts of EASD, ADA and Diabetes UK, Current Controlled Trials, ClinicalTrials.gov, UK CRN, scrutiny of bibliographies of retrieved papers and contact with experts in the field. Inclusions: Relevant studies of any design of parents of children under 12 years of age with Type 1 diabetes were included. The key outcomes were the extent and impact of fear, hypoglycaemia avoidance behaviour in parents due to parental fear of hypoglycaemia in their children, the effect on diabetes control, and the impact of interventions to reduce this fear and hypoglycaemia avoidance behaviour. Eight articles from six studies met the inclusion criteria. All were cross sectional studies and most were of good quality. Parental fear of hypoglycaemia, anxiety and depression were reported to be common. There was a paucity of evidence on behaviour to avoid hypoglycaemia, but there were some suggestions that higher than desirable blood glucose levels might be permitted in order to avoid hypoglycaemia. No studies reporting interventions to reduce parental fear of hypoglycaemia were found. The evidence base was limited. Parents of children with Type 1 diabetes reported considerable parental fear of hypoglycaemia, affecting both parental health and quality of life. There is some suggestion that hypoglycaemia avoidance behaviours by parents might adversely affect glycaemic control. Trials of interventions to reduce parental anxiety and hypoglycaemia avoidance behaviour are needed. We suggest that there should be a trial of structured education for parents of young children with Type 1 diabetes.
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