Correlates of fear of hypoglycemia among patients with type 1 and 2 diabetes mellitus in outpatient hospitals in Zambia
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ORIGINAL ARTICLE
Correlates of fear of hypoglycemia among patients with type 1 and 2 diabetes mellitus in outpatient hospitals in Zambia Given Hapunda 1
&
Amina Abubakar 2,3,4
&
Frans Pouwer 5,6,7
&
Fons van de Vijver 2,8,9
Received: 15 October 2019 / Accepted: 27 May 2020 # Research Society for Study of Diabetes in India 2020
Abstract Background Severe hypoglycemia is a burdensome complication of diabetes mellitus that can induce fear of hypoglycemia and contribute to suboptimal glycemic control. The challenge is to achieve and maintain adequate glycemic control while avoiding episodes of severe hypoglycemia. The purpose of the study was to determine how common fear of hypoglycemia was in Zambian out-patients with diabetes and also to explore correlates of fear of hypoglycemia. Methods One hundred fifty-seven individuals with types 1 and 2 diabetes participated in the study. Fear of Hypoglycemia Scale, Diabetes Self-Care Inventory, Problem Areas in Diabetes, and the Major Depression Inventory were completed. Multiple linear regression models were computed to assess the association between fear of hypoglycemia and psychological factors. Results About 19% [16.3% type 1 and 12.6% type 2] of individuals with diabetes based on item endorsement expressed fear of hypoglycemia especially among individuals with type 1 diabetes. After controlling for demographic variables, diabetes self-care (ß = 0.24, p < 0.05), and diabetes specific distress (ß = 0.41, p < 0.001) were associated with fear of hypoglycemia. Conclusion Fear of hypoglycemia was common and was positively associated with diabetes specific emotional distress and diabetes self-care. Interventions to avert fear of hypoglycemia are needed while optimizing glycemic control through managing diabetes care and emotion distress in individuals with diabetes. Keywords Fear of hypoglycemia . Hypoglycemia . Fear . HFS . Correlates
Introduction * Given Hapunda [email protected] 1
Department of Psychology, University of Zambia, P.O Box 32379, Lusaka, Zambia
2
Department of Culture Studies, Tilburg University, Tilburg, The Netherlands
3
Neuroassessment, Centre for Geographic Medicine Research, Kilifi, Kenya
4
Department of Public Health, Pwani University, Kilifi, Kenya
5
Department of Psychology, University of Southern Denmark, Odense, Denmark
6
STENO Diabetes Center Odense, Odense, Denmark
7
School of Psychology, Deakin University, Geelong, Australia
8
Work Well Unit, North-West University, Potchefstroom, South Africa
9
School of Psychology, University of Queensland, Brisbane, Australia
Diabetes mellitus along with hypertension are major risk factors for cardiovascular diseases. Treating these risk factors are cost effective and can help boost productivity [1, 2]. One other neglected complication in diabetes research in Sub Saharan Africa is hypoglycemia. The American Diabetes Association defines hypoglycemia as a condition characterized by abnormally low blood glucose levels usually less than 70 mg/dl [3]. However, because of individual differ
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