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Parents' Fear of Hypoglycemia and Its Association With Diabetes Treatment Modality, Management, and Outcomes in Young

Nanna Lind1, Patricia DeCosta2, Lene Lyngsøe1

  • 1Department of Clinical and Translational Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark.

Journal of Diabetes Science and Technology
|August 12, 2026
PubMed

Insights

Parental fear of hypoglycemia (FoH) in type 1 diabetes (T1D) management varies within families, with mothers reporting higher levels than fathers. This fear did not correlate with children's glycemic control, suggesting individual assessment is key.

Area of Science:

  • Pediatric Endocrinology
  • Diabetes Management
  • Psychosocial Aspects of Chronic Illness

Background:

  • Parental fear of hypoglycemia (FoH) significantly impacts type 1 diabetes (T1D) management in children.
  • Understanding FoH is crucial for family well-being and perceived safety.
  • This study investigates FoH in parents of young children with T1D.

Purpose of the Study:

  • To describe FoH using the Children's Hypoglycemia Index (CHI) in parents of young children with T1D.
  • To examine parent-level differences and interparent agreement regarding FoH.
  • To explore associations between FoH and clinical parameters, treatment, and glycemic outcomes.

Main Methods:

  • Cross-sectional cohort study linking parent questionnaires with clinical and device data.
  • Individual and dyadic parent-level analyses, including intraclass correlation coefficients (ICCs) and Bland-Altman analyses.
  • Mixed-effects models assessed associations with HbA1c and CGM metrics, adjusted for covariates.

Main Results:

  • Mothers reported higher CHI scores than fathers, except for behavioral fear (P < .001-.003).
  • Low parental agreement (ICC 0.00-0.38) indicated substantial within-family variability in FoH.
  • No significant associations were found between CHI scores and HbA1c, CGM metrics, or child characteristics.

Conclusions:

  • FoH levels differ between mothers and fathers, but FoH varies significantly within families.
  • Observed FoH did not correlate with glycemic outcomes, though high automated insulin delivery (AID) use limits interpretation.
  • Individual assessment of FoH in both parents is recommended for effective T1D management support.
Abstract

Keywords:
Children’s Hypoglycemia Indexfear of hypoglycemiaparentpatient-reported outcomespediatrictype 1 diabetes

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