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Published on: August 12, 2016

Defining a Clinically Meaningful Cut-Point for the Hypoglycemia Fear Survey-Parents of Young Children

Susana R Patton1, Nicole Kahhan2, Holly K O'Donnell3

  • 1Center for Healthcare Delivery Science, Nemours Children's Health, 807 Children's Way, Jacksonville, FL, 32207, USA.

Canadian Journal of Diabetes
|July 21, 2026
PubMed

Insights

A new cut-point of 61 on the Hypoglycemia Fear Survey-Parents of Young Children (HFS-PYC) effectively identifies parents experiencing significant fear of hypoglycemia (FH). This score correlates with increased parental anxiety, diabetes distress, and higher child glucose levels.

Area of Science:

  • Pediatric Endocrinology
  • Psychology
  • Diabetes Management

Background:

  • Parental fear of hypoglycemia (FH) is common in young children with type 1 diabetes (T1D) and linked to elevated child glucose levels.
  • The Hypoglycemia Fear Survey-Parents of Young Children (HFS-PYC) is a validated tool for assessing parental FH but lacks a clinical cut-point.
  • Identifying a clinically meaningful cut-point for the HFS-PYC is crucial for targeted interventions and research.

Purpose of the Study:

  • To establish a preliminary, clinically interpretable cut-point for the HFS-PYC.
  • To determine if this cut-point associates with increased parental anxiety, diabetes distress, and specific child glycemic metrics.
  • To evaluate the diagnostic accuracy of potential cut-points.

Main Methods:

  • 180 parents of children with T1D completed the HFS-PYC, PROMIS-Anxiety (PROMIS-A), and Problem Areas in Diabetes Parent-Revised (PAID-PR).
  • Candidate cut-points were derived using modal score distribution, mean + one standard deviation, and an elevated-item rule.
  • Groups were compared based on HFS-PYC scores relative to cut-points for anxiety, distress, and child glycemic control, with diagnostic accuracy calculated against a reference standard.

Main Results:

  • Candidate cut-points included ≥61 (Mode) and ≥77 (SD).
  • The Mode cut-point (≥61) demonstrated the highest diagnostic accuracy (sensitivity=0.77, specificity=0.57) and differentiated parents on anxiety, distress, and some glycemic metrics.
  • A score of ≥61 on the HFS-PYC identified parents with significantly higher anxiety and diabetes distress compared to those below the cut-point.

Conclusions:

  • A preliminary HFS-PYC total score of ≥61 is proposed as a clinically useful cut-point.
  • This cut-point effectively identifies parents experiencing heightened anxiety and diabetes distress, and children with elevated glycemic metrics.
  • The ≥61 cut-point offers a practical tool for clinical screening and future research in parental fear of hypoglycemia in T1D.
Abstract

Keywords:
cut-pointhypoglycemia fearparentsscreeningtype 1 diabetes

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