Glycemic Control, Self-Efficacy and Fear of Hypoglycemia among Iranian Children with Type 1 Diabetes
Journal of Diabetes & Metabolism
Managing diabetes in children presents many challenges and we hypothesized some factors including child's fear of hypoglycemia and beliefs about their ability to manage their illness, could affect glycemic control. This study was designed to test the reliability of a Persian version of two questionnaires to assess whether these questionnaires can be useful tools for quick assessment and developing targeted educational interventions or not. Also, this study examined the level of fear of
... mia and self-efficacy for diabetes management and their association with HbA1c and parents' demographic characteristics in a sample of children with type 1 diabetes. Methods: Sixty one children with type 1 diabetes (35 boys, age: 6.0-12.7 years) were assessed using the Hypoglycemia Fear Survey-Child version (HFS-C) and Self-Efficacy for Diabetes Scale-Child version (SED-C).Their glycemic control was evaluated by glycated hemoglobin (HbA1c) levels. Results: Internal consistency of the Persian version of HFS-C and SED-C were very good. Our results showed that children >10 years old report lower level of fear and worry about hypoglycemia which is likely relate to higher level of self-efficacy(r=-.3, p=.025 and r=-.3, p=.02 respectively). 42.3% of girls and 31.4% of boys reported that low blood sugar is a big problem for them. These findings suggest that fear of hypoglycemia is a significant concern for this target group. Only 19.7% of children had controlled diabetes based on HbA1c which trended higher in children 10 and older. There was no significant association between higher HbA1c and other variables including HFS-C, SED-C and parents' demographic characteristics (education and employment). Conclusions: The Persian version of HFS-C and SED-Care reliable and valid measure of the fear of hypoglycemia and self-efficacy in children with type 1 diabetes and these questionnaires could be used in our country for identifying those children who may need diabetes education and other supports. Association between greater self-efficacy and lower fear of hypoglycemia recommend that training can reduce levels of fear and improve disease management. Although children are dependent to their parents for managing diabetes, we have focus on children more in diabetes management because they have much potency to do it and increased knowledge by educating diabetes self-management tasks could result in better glycemic control and alleviate fear of hypoglycemia.