title: Fear of hypoglycemia in adults with type 1 diabetes: impact of therapeutic advances and strategies for prevention - a review.
abstract: OBJECTIVE
  This review summarizes the current state of the science related to fear of hypoglycemia (FOH) in adults with type 1 diabetes. Fear of hypoglycemia is a critical deterrent to diabetes self-management, psychological well-being, and quality of life. We examine the influence of contemporary treatment regimens, technology, and interventions to identify gaps in knowledge and opportunities for research and practice.
  
  
  METHODS
  A literature search was conducted of MEDLINE, PsycINFO, and EMBASE. Fifty-three studies that examined fear of hypoglycemia were included.
  
  
  RESULTS
  Fear of hypoglycemia influences diabetes management and quality of life. Gender and age differences exist in experiences and responses. Responses vary from increased vigilance to potentially immobilizing distress. Fear of hypoglycemia is greater at night and may contribute to poor sleep quality. Strategies to reduce fear of hypoglycemia have had varying success. Newer technologies hold promise but require further examination.
  
  
  CONCLUSIONS
  Fear of hypoglycemia remains a problem, despite advances in technology, insulin analogs, and evidence-based diabetes management. Clinical care should consistently include assessment for its influence on diabetes self-management and psychological health. Further research is needed regarding the influence of newer technologies and individualized strategies to reduce fear of hypoglycemia while maintaining optimal glucose control.
authors.affiliation: University of Illinois at Chicago, College of Nursing, Department of Biobehavioral Health Science, 845S. Damen Ave. (MC 802), Chicago, IL 60612. Electronic address: pmartyn@uic.edu.
authors.forename: Pamela
authors.initials: P
authors.lastname: Martyn-Nemeth
authors.affiliation: University of Illinois at Chicago, College of Nursing, Department of Biobehavioral Health Science, 845S. Damen Ave. (MC 802), Chicago, IL 60612. Electronic address: sschwa24@uic.edu.
authors.forename: Sarah
authors.initials: S
authors.lastname: Schwarz Farabi
authors.affiliation: University of Illinois at Chicago, Department of Medicine, Chicago, IL 60612. Electronic address: danmih@uic.edu.
authors.forename: Dan
authors.initials: D
authors.lastname: Mihailescu
authors.affiliation: Linden Oaks, Edward Hospital and Health Center, Naperville, IL 60540. Electronic address: jeffreymnemeth@lewisu.edu.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Nemeth
authors.affiliation: University of Illinois at Chicago, College of Nursing, Department of Biobehavioral Health Science, 845S. Damen Ave. (MC 802), Chicago, IL 60612. Electronic address: lquinn1@uic.edu.
authors.forename: Laurie
authors.initials: L
authors.lastname: Quinn
mesh_terms: D000328:Adult; D001007:Anxiety / Q000150:complications / Q000209:etiology / Q000517:prevention & control*; D001294:Attitude to Health; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000639:trends; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000523:psychology / Q000628:therapy; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000639:trends; D057285:Precision Medicine / Q000639:trends; D011788:Quality of Life; D012648:Self Care / Q000523:psychology / Q000639:trends; D020377:Self Efficacy
chemical_list: D007004:Hypoglycemic Agents
keywords: Adults; Fear; Hypoglycemia; Review; Type 1 diabetes