Correlates and outcomes of worries about hypoglycemia in family members of adults with diabetes: The second Diabetes Attitudes, Wishes and Needs (DAWN2) study.
We examined (a) the demographic and clinical correlates of worries about hypoglycemia in adult family members of adults with diabetes, and (b) the association of these worries with measures of diabetes support.



The second multinational Diabetes Attitudes, Wishes and Needs (DAWN2) study cross-sectionally surveyed 2057 family members from 17 countries. Participants completed questions about demographics, diabetes, and psychosocial functioning, including worry about overall and nocturnal hypoglycemia. Analyses included hierarchical ordinal and linear regression.



Eighty-five percent of family members (n=1661) were at least occasionally very worried about the risk of hypoglycemic events overall. Correlates of worries about hypoglycemia included female gender, higher age and lower education in the family member, younger age of the person with diabetes and this person being a parent or another adult (versus spouse or partner), insulin or non-insulin injectable treatment, severe or non-severe hypoglycemia in the past 12months, and family member recognition of hypoglycemia. Elevated worries about hypoglycemia had a significant independent association with increased odds of diabetes-related family arguments and family member frustration in providing helpful support (OR range 1.60-3.72). High levels of worries about hypoglycemia were associated with increased odds of attending diabetes-related health-care visits. Worries about hypoglycemia were not associated with family member involvement in diabetes care. Similar results were found for worries about nocturnal events.



Worries about hypoglycemia were common in family members and were associated with suboptimal diabetes support. This issue therefore deserves increased clinician attention.
CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands. Electronic address: g.m.nefs@tilburguniversity.edu.
Giesje
G
Nefs
CoRPS - Center of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
François
F
Pouwer
Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Richard I G
RI
Holt
Global Health Economics and Outcomes Research, Novo Nordisk, Denmark.
Søren
S
Skovlund
Research Institute of the Diabetes Academy Mergentheim (FIDAM) Diabetes Centre Mergentheim, Germany; University of Bamberg, Germany.
Norbert
N
Hermanns
Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy.
Antonio
A
Nicolucci
Department of Sociology, Loyola University Maryland, Baltimore, MD, USA.
Mark
M
Peyrot
D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D004644:Emotions; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D038622:Internationality; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D007004:Hypoglycemic Agents; D007328:Insulin
Diabetes; Family; Hypoglycemia; Support; Worry