title: Experiences of hypoglycaemia unawareness amongst people with Type 1 diabetes: A qualitative investigation.
abstract: OBJECTIVE
  To explore the experiences of people who have hypoglycaemia unawareness and its impact on their everyday lives.
  
  
  METHODS
  In-depth interviews with 38 people with Type 1 diabetes who have hypoglycaemia unawareness. Data analysis used an inductive, thematic approach.
  
  
  RESULTS
  Participants reported imposed and self-imposed changes to their lives following onset of hypoglycaemia unawareness including: leaving employment, curtailing pastimes and spending more time at home or being supervised by others. However, some reported getting on with life by downplaying the significance and impact of their condition, which could put their health and safety at risk. Many relied on frequent self-monitoring of blood glucose and/or prompting from others to detect hypoglycaemia. Some expressed concerns about becoming a burden on family and/or responding in irrational and aggressive ways to others' suggestions to test for and treat hypoglycaemia. Participants reported responding best to composed and directive prompts from family. Health professionals mainly advised on clinical aspects, and did not enquire about the emotional and psychosocial impact of hypoglycaemia unawareness.
  
  
  CONCLUSIONS
  Hypoglycaemia unawareness can have a profound impact on people's confidence, careers and personal relationships. Healthcare professionals should pay more attention during consultations to the emotional and social aspects of living with hypoglycaemia unawareness.
authors.affiliation: Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK a.d.rankin@ed.ac.uk.
authors.forename: D
authors.initials: D
authors.lastname: Rankin
authors.affiliation: Academic Unit of Diabetes, Endocrinology and Metabolism, University of Sheffield, Sheffield, UK.
authors.forename: J
authors.initials: J
authors.lastname: Elliott
authors.affiliation: Academic Unit of Diabetes, Endocrinology and Metabolism, University of Sheffield, Sheffield, UK.
authors.forename: S
authors.initials: S
authors.lastname: Heller
authors.affiliation: Diabetes Research Offices, Weston Education Centre, King's College London, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Amiel
authors.affiliation: Diabetes Research Offices, Weston Education Centre, King's College London, London, UK.
authors.forename: H
authors.initials: H
authors.lastname: Rogers
authors.affiliation: Diabetes Research Offices, Weston Education Centre, King's College London, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: DeZoysa
authors.affiliation: Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK.
authors.forename: J
authors.initials: J
authors.lastname: Lawton
mesh_terms: D000328:Adult; D000368:Aged; D001364:Awareness; D001786:Blood Glucose / Q000032:analysis; D015190:Blood Glucose Self-Monitoring; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications*; D004644:Emotions; D004651:Employment; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis* / Q000523:psychology*; D007407:Interviews as Topic; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012944:Social Support
chemical_list: D001786:Blood Glucose
keywords: Type 1 diabetes; hypoglycaemia; hypoglycaemia unawareness; patient experiences; qualitative research