title: Severe hypoglycaemia and its association with psychological well-being in Australian adults with type 1 diabetes attending specialist tertiary clinics.
abstract: OBJECTIVE
  To investigate severe hypoglycaemia (SH) in adults with type 1 diabetes and its associations with impaired awareness of hypoglycaemia (IAH), clinical, psychological and socio-demographic factors.
  
  
  METHODS
  Attendees of three specialist diabetes clinics in Melbourne, Australia completed questions about frequency of SH in the past six months; impaired awareness of hypoglycaemia (Gold score); and measures of general emotional well-being (WHO-5), diabetes-specific positive well-being (subscale of W-BQ28), diabetes-related distress (PAID) and fear of hypoglycaemia (HFS).
  
  
  RESULTS
  Of 422 participants (mean ± SD age 37.5 ± 15.0 years; 54% women), 78 (18.5%) reported at least one SH event and 86 (20.5%) had IAH. SH and IAH frequencies were similar at all clinics. In total, 194 SH events were reported, with 10 people experiencing 40% of events. Compared with those without SH, participants with SH had longer diabetes duration, were younger at diabetes onset and more likely to have IAH (p<0.01). Those with SH had greater fear of hypoglycaemia and diabetes-related distress, poorer general emotional well-being, and lower diabetes-specific positive well-being, (p<0.01). There were no associations with age, gender, insulin regimen or HbA1c.
  
  
  CONCLUSIONS
  This study has identified that SH and IAH in Australian adults with type 1 diabetes exist at similar levels to those reported in US and European research. SH was significantly associated with IAH and fear of hypoglycaemia. Assessment of hypoglycaemia, IAH and psychological well-being as part of a routine diabetes clinic visit was well accepted by attendees and enabled identification of those who may benefit from medical, educational or therapeutic interventions.
authors: The Australian Centre for Behavioural Research in Diabetes, Diabetes Australia-Vic, 570 Elizabeth Street, Melbourne, VIC, Australia; Centre for Mental Health and Well-being Research, School of Psychology, Deakin University, Burwood, VIC, Australia. Electronic address: chendrieckx@acbrd.org.au.
authors: C
authors: C
authors: Hendrieckx
authors: The Australian Centre for Behavioural Research in Diabetes, Diabetes Australia-Vic, 570 Elizabeth Street, Melbourne, VIC, Australia; Centre for Mental Health and Well-being Research, School of Psychology, Deakin University, Burwood, VIC, Australia.
authors: J A
authors: JA
authors: Halliday
authors: Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, VIC, Australia.
authors: J P
authors: JP
authors: Bowden
authors: Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, VIC, Australia.
authors: P G
authors: PG
authors: Colman
authors: Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia.
authors: N
authors: N
authors: Cohen
authors: University of Melbourne, Department of Medicine, St Vincent's Hospital, Melbourne, VIC, Australia.
authors: A
authors: A
authors: Jenkins
authors: The Australian Centre for Behavioural Research in Diabetes, Diabetes Australia-Vic, 570 Elizabeth Street, Melbourne, VIC, Australia; Centre for Mental Health and Well-being Research, School of Psychology, Deakin University, Burwood, VIC, Australia; AHP Research, Hornchurch, Essex, UK.
authors: J
authors: J
authors: Speight
mesh_terms: D000328:Adult; D001315:Australia; D001364:Awareness; D048909:Diabetes Complications / Q000175:diagnosis / Q000523:psychology*; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000523:psychology*; D005239:Fear; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000523:psychology*; D007004:Hypoglycemic Agents / Q000009:adverse effects*; D007328:Insulin / Q000009:adverse effects; D008297:Male; D062606:Tertiary Care Centers; D013997:Time Factors
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Fear of hypoglycaemia; Impaired awareness of hypoglycaemia; Severe hypoglycaemia; Type 1 diabetes; Well-being