title: The relationships among fear of hypoglycaemia, diabetes-related quality of life and psychological well-being in Norwegian adults with Type 1 diabetes.
abstract: OBJECTIVE
  To examine the associations among fear of hypoglycaemia, diabetes-related quality of life and psychological well-being, and determine whether diabetes-related quality of life is a mediator of the relationship between fear of hypoglycaemia and psychological well-being in adults with Type 1 diabetes.
  
  
  METHODS
  A total of 235 of 319 invited adults (18-69years) with Type 1 diabetes agreed to participate. Hierarchical linear regression was applied to 188 individuals with complete data. Mediation analysis was used to determine whether diabetes-related quality of life mediated the relationship between fear of hypoglycaemia and psychological well-being.
  
  
  RESULTS
  Fear of hypoglycaemia was significantly associated with diabetes-related quality of life and psychological well-being. The behaviour and worry components of fear of hypoglycaemia were significantly associated with diabetes-related quality of life (behaviour component: unstandardised coefficient=-0.04, p<0.001, standardised coefficient=-0.40; worry component: unstandardised coefficient=-0.01, p=0.041, standardised coefficient=-0.18). Fear of hypoglycaemia worry had a significant independent association with psychological well-being (unstandardised coefficient=-0.28, p=0.009, standardised coefficient=-0.25), whereas fear of hypoglycaemia behaviour did not. Diabetes-related quality of life mediated approximately half of the association between fear of hypoglycaemia worry and psychological well-being.
  
  
  CONCLUSIONS
  Hypoglycaemic episodes can have serious consequences, and assessing fear of hypoglycaemia might help health care providers offer suitable care strategies to individuals with Type 1 diabetes.
authors.affiliation: Centre for Evidence Based Practice, Bergen University College, Bergen, Norway; Department of Global Public Health and Primary Care, the Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway. Electronic address: Ragnhild.Bjarkoy.Strandberg@hib.no.
authors.forename: Ragnhild B
authors.initials: RB
authors.lastname: Strandberg
authors.affiliation: Centre for Evidence Based Practice, Bergen University College, Bergen, Norway; Department of Paediatrics, Haukeland University Hospital, Bergen, Norway.
authors.forename: Marit
authors.initials: M
authors.lastname: Graue
authors.affiliation: Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway; Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway; Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.
authors.forename: Tore
authors.initials: T
authors.lastname: Wentzel-Larsen
authors.affiliation: Centre for Evidence Based Practice, Bergen University College, Bergen, Norway; Department of Sociology, Loyola University Maryland, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Peyrot
authors.affiliation: Institute of Health and Society, the Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Astrid K
authors.initials: AK
authors.lastname: Wahl
authors.affiliation: Department of Global Public Health and Primary Care, the Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway; Department for Research and Development, Haukeland University Hospital, Bergen, Norway.
authors.forename: Berit
authors.initials: B
authors.lastname: Rokne
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000523:psychology*; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000523:psychology*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009664:Norway; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents
keywords: Diabetes-related quality of life; Fear of hypoglycaemia; Mediation analysis; Psychological well-being; Type 1 diabetes