Managing hypoglycemia in diabetes may be more fear management than glucose management: a practical guide for diabetes care providers.
Diabetes management is complex and requires significant effort from the person with diabetes to achieve recommended self-management behaviours. Achieving guideline concordant self-management is made easier when the person with diabetes is committed to the behaviours. Ambivalence is the psychological state in which a person experiences inconsistent drives; both toward and away from the recommended behaviour. Ambivalence about achieving recommended control over blood glucose is expected in situations of hypoglycaemia, due to the associated dangers. In this paper we demonstrate that hypoglycaemia is a fear event and is likely to elicit strong drives to avoid future hypoglycaemia as a fear coping strategy. For many, this results in hyperglycaemia. If hyperglycaemia to avoid hypoglycaemia is a fear management strategy, then hypoglycaemia management should involve fear management. Few diabetes healthcare providers are trained, skilled and confident in fear management. The purpose of this paper is to review the evidence on the psychological consequences of hypoglycaemia and to outline fear management strategies that can be implemented by diabetes care providers. A step-by-step guide is provided to facilitate understanding of the process of the intervention.
Michael
M
Vallis
Allan
A
Jones
Diabetes Management Centre, c/o Primary Care, Suite 265, Mumford Professional Centre, 6960 Mumford Rd, Halifax NS Canada B3L 4P1. tvallis@dal.ca.
Frans
F
Pouwer
D001007:Anxiety / Q000150:complications / Q000523:psychology*; D015928:Cognitive Behavioral Therapy; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000523:psychology*; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000517:prevention & control / Q000523:psychology*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D055118:Medication Adherence / Q000523:psychology; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D012648:Self Care / Q000523:psychology*
D007004:Hypoglycemic Agents