Advertisement

Fear of hypoglycemia and its predictive factors among diabetic pregnant women

Published:November 29, 2022DOI:https://doi.org/10.1016/j.pcd.2022.11.009

      Highlights

      • Diabetic pregnant women experience Fear of hypoglycemia (FoH).
      • Higher FoH was observed among those with a history of hypoglycemia.
      • Young age, less educated and having depression predict FoH of pregnant women.

      Abstract

      Objective

      The purpose of the present study was to investigate the fear of hypoglycemia (FoH) and its predictors among diabetic pregnant women.

      Study design

      Cross-sectional conducted between January to August 2022.

      Methods

      In the present study, 250 diabetic pregnant women from Qazvin province participated. Demographic and fertility characteristics, FoH, adherence to treatment, self-efficacy, anxiety and depression were assessed. Data were analyzed using univariable and multivariable linear regression models.

      Results

      The participants’ mean age was 31.02 years (SD=4.72). The FoH mean score was 32.88 (out of 72). Based on the multivariable linear regression model, having a history of hypoglycemia (β = 0.44, p < 0.001), lower education (β = 0.17, p = 0.001), being treated with insulin (β = 0.22, p < 0.001), being treated with both insulin and diet (β = 0.16 p = 0.003), being of younger age (β = −0.13, p = 0.008), and depression (β = 0.16, p = 0.002) were independent predictors of FoH among pregnant women.

      Conclusion

      Diabetic pregnant women experience FoH, particularly those with a history of hypoglycemia. Therefore, providing education and counseling concerning hypoglycemia, complications, and necessary measures for this group of diabetic pregnant women are needed along with those who are younger, less educated, and have comorbid mental health conditions.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Primary Care Diabetes
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. Lapolla A., Metzger B.E. Gestational diabetes: A decade after the HAPO Study: Karger Medical and Scientific Publishers; 2019.

        • Moore L.E.
        1st ed.,. Diabetes in Pregnancy: The Complete Guide To Management. IX. Springer Cham, New York2018: 254
        • Cho N.H.
        • Shaw J.
        • Karuranga S.
        • Huang Y.
        • da Rocha Fernandes J.
        • Ohlrogge A.
        • et al.
        IDF diabetes atlas: global estimates of diabetes prevalence for 2017 and projections for 2045.
        Diabetes Res. Clin. Pract. 2018; 138: 271-281
        • Shen Z.
        • Yang C.
        • Zhu P.
        • Tian C.
        • Liang A.
        Protective effects of syringin against oxidative stress and inflammation in diabetic pregnant rats via TLR4/MyD88/NF-κB signaling pathway.
        Biomed. Pharmacother. 2020; 131110681
        • Voaklander B.
        • Rowe S.
        • Sanni O.
        • Campbell S.
        • Eurich D.
        • Ospina M.B.
        Prevalence of diabetes in pregnancy among Indigenous women in Australia, Canada, New Zealand, and the USA: A systematic review and meta-analysis.
        Lancet Glob. Health. 2020; 8: e681-e698
        • Wilson C.A.
        • Newham J.
        • Rankin J.
        • Ismail K.
        • Simonoff E.
        • Reynolds R.
        • et al.
        Is there an increased risk of perinatal mental disorder in women with gestational diabetes? A systematic review and meta‐analysis.
        Diabet. Med. 2020; 37: 602-622
        • Lai F.Y.
        • Johnson J.A.
        • Dover D.
        • Kaul P.
        Outcomes of singleton and twin pregnancies complicated by pre-existing diabetes and gestational diabetes: a population-based study in Alberta, Canada, 2005–11.
        J. Diabetes. 2016; 8: 45-55
        • Delanerolle G.
        • Phiri P.
        • Zeng Y.
        • Marston K.
        • Tempest N.
        • Busuulwa P.
        • et al.
        A systematic review and meta-analysis of gestational diabetes mellitus and mental health among BAME populations.
        EClinicalMedicine. 2021; 38101016
        • OuYang H.
        • Chen B.
        • Abdulrahman A.-M.
        • Li L.
        • Wu N.
        Associations between gestational diabetes and anxiety or depression: a systematic review.
        J. Diabetes Res. 2021; 20219959779
        • Feig D.S.
        • Berger H.
        • Donovan L.
        • Godbout A.
        • Kader T.
        • Keely E.
        • et al.
        Erratum to diabetes and pregnancy.
        Can. J. Diabetes. 2018; 42 (Canadian Journal of Diabetes. 2018;42(3):337): S255-S282
        • Chivese T.
        • Hoegfeldt C.A.
        • Werfalli M.
        • Yuen L.
        • Sun H.
        • Karuranga S.
        • et al.
        IDF Diabetes Atlas: The prevalence of pre-existing diabetes in pregnancy – a systematic reviewand meta-analysis of studies published during 2010–2020.
        Diabetes Res. Clin. Pract. 2022; 183109049
        • Wang H.
        • Li N.
        • Chivese T.
        • Werfalli M.
        • Sun H.
        • Yuen L.
        • et al.
        IDF Diabetes Atlas: estimation of global and regional gestational diabetes mellitus prevalence for 2021 by International Association of Diabetes in Pregnancy Study Group’s Criteria.
        Diabetes Res. Clin. Pract. 2022; 183109050
        • Carson L.
        • Henderson J.N.
        • King K.
        • Kleszynski K.
        • Thompson D.M.
        • Mayer P.
        American Indian diabetes beliefs and practices: anxiety, fear, and dread in pregnant women with diabetes.
        Diabetes Spectr. 2015; 28: 258-263
        • Böhme P.
        • Bertin E.
        • Cosson E.
        • Chevalier N.
        • group G.
        Fear of hypoglycaemia in patients with type 1 diabetes: do patients and diabetologists feel the same way?.
        Diabetes Metab. 2013; 39: 63-70
        • Barendse S.
        • Singh H.
        • Frier B.
        • Speight J.
        The impact of hypoglycaemia on quality of life and related patient‐reported outcomes in Type 2 diabetes: a narrative review.
        Diabet. Med. 2012; 29: 293-302
        • Cox D.J.
        • Irvine A.
        • Gonder-Frederick L.
        • Nowacek G.
        • Butterfield J.
        Fear of hypoglycemia: quantification, validation, and utilization.
        Diabetes Care. 1987; 10: 617-621
        • Momeni M.
        • Ziaee A.
        • Ghorbani A.
        Predictors of hypoglycemia fear in patients with type 2 diabetes under treatment of oral anti hyperglycemic agents.
        Iran. J. Endocrinol. Metab. 2016; 18: 28-36
        • Schwarzer R.
        • Jerusalem M.
        The general self-efficacy scale (GSE).
        Anxiety Stress Coping. 2010; 12: 329-345
        • Asgharnejad T.
        • Ahmadi D.M.
        • Farzad V.E.
        • Khodapanahi M.K.
        Psychometric properties of Sherer's General Self-Efficacy Scale.
        J. Psychol. 2006; 10: 262-274
        • Thompson K.
        • Kulkarni J.
        • Sergejew A.
        Reliability and validity of a new medication adherence rating scale (MARS) for the psychoses.
        Schizophr. Res. 2000; 42: 241-247
        • Aflakseir A.
        Role of illness and medication perceptions on adherence to medication in a group of Iranian patients with type 2 diabetes.
        J. Diabetes. 2012; 4: 243-247
        • Zigmond A.S.
        • Snaith R.P.
        The hospital anxiety and depression scale.
        Acta Psychiatr. Scand. 1983; 67: 361-370
        • Bjelland I.
        • Dahl A.A.
        • Haug T.T.
        • Neckelmann D.
        The validity of the hospital anxiety and depression scale: an updated literature review.
        J. Psychosom. Res. 2002; 52: 69-77
        • Montazeri A.
        • Vahdaninia M.
        • Ebrahimi M.
        • Jarvandi S.
        The hospital anxiety and depression scale (HADS): translation and validation study of the Iranian version.
        Health Qual. Life Outcomes. 2003; 1: 1-5
        • Bahrami J.
        • Tomlinson G.
        • Murphy H.R.
        • Feig D.S.
        • Group C.C.
        Impaired awareness of hypoglycaemia in women with type 1 diabetes in pregnancy: Hypoglycaemia fear, glycaemic and pregnancy outcomes.
        Diabet. Med. 2022; 39e14789
        • Sheikhi M.
        • Moradi M.
        • Shahsavary S.
        • Alimoradi Z.
        • Salimi H.R.
        The effect of eye movement desensitization and reprocessing on the fear of hypoglycemia in type 2 diabetic patients: a randomized clinical trial.
        BMC Psychol. 2020; 8: 1-8
        • Yeke Fallah L.
        • Talebi F.
        • Ghorbani A.
        • Mafi M.
        Factors affecting hypoglycemia fear in patients with type 2 diabetes.
        J. Inflamm. Dis. 2019; 23: 104-115
        • McCoy R.G.
        • Van Houten H.K.
        • Ziegenfuss J.Y.
        • Shah N.D.
        • Wermers R.A.
        • Smith S.A.
        Self-report of hypoglycemia and health-related quality of life in patients with type 1 and type 2 diabetes.
        Endocr. Pract. 2013; 19: 792-799
        • Sakane N.
        • Kotani K.
        • Tsuzaki K.
        • Nishi M.
        • Takahashi K.
        • Murata T.
        • et al.
        Fear of hypoglycemia and its determinants in insulin‐treated patients with type 2 diabetes mellitus.
        J. Diabetes Investig. 2015; 6: 567-570
        • H Hajós T.R.
        • Polonsky W.H.
        • Pouwer F.
        • Gonder-Frederick L.
        • Snoek F.J.
        Toward defining a cutoff score for elevated fear of hypoglycemia on the hypoglycemia fear survey worry subscale in patients with type 2 diabetes.
        Diabetes Care. 2014; 37: 102-108
        • Gjerløw E.
        • Bjørgaas M.R.
        • Nielsen E.W.
        • Olsen S.E.
        • Åsvold B.O.
        Fear of hypoglycemia in women and men with type 1 diabetes.
        Nurs. Res. 2014; 63: 143-149
        • Martyn-Nemeth P.
        • Farabi S.S.
        • Mihailescu D.
        • Nemeth J.
        • Quinn L.
        Fear of hypoglycemia in adults with type 1 diabetes: impact of therapeutic advances and strategies for prevention-a review.
        J. Diabetes Complicat. 2016; 30: 167-177
        • Beléndez M.
        • Hernández-Mijares A.
        Beliefs about insulin as a predictor of fear of hypoglycaemia.
        Chronic Illn. 2009; 5: 250-256
        • McConville A.
        • Noser A.E.
        • Nelson E.L.
        • Clements M.A.
        • Majidi S.
        • Patton S.R.
        Depression as a predictor of hypoglycemia worry in parents of youth with recent‐onset type 1 diabetes.
        Pediatr. Diabetes. 2020; 21: 909-916
        • Krawczyk J.
        • Duda-Sobczak A.
        • Zozulińska-Ziółkiewicz D.
        Fear of hypoglycaemia—from normality to pathology. Diagnostic criteria and therapeutic directions.
        Clin. Diabetol. 2020; 9: 487-492