title: Fear of hypoglycemia: Influence on glycemic variability and self-management behavior in young adults with type 1 diabetes.
abstract: OBJECTIVE
  The purpose of this study was to examine how fear of hypoglycemia (FOH) is associated with glycemic variability (GV) and self-management behavior in young adults (aged 18-35) with type 1 diabetes (T1DM).
  
  
  METHODS
  Using a prospective repeated-measures design, in 35 young adults, within- and between-person and temporal associations of FOH, specific self-management behaviors, and GV were measured. The data were collected using questionnaires and real-time measures using daily diaries, insulin pump downloads, actigraphy, and continuous glucose monitoring.
  
  
  RESULTS
  FOH was associated with greater glycemic variability. Significant temporal associations emerged. Concurrent day (glucose SD, p=.011) and previous-evening fear levels were associated with GV (glucose SD, p=.007). FOH was also associated with greater calorie intake (r=.492, p=.003) and less physical activity (light activity, r=-.341, p=.045).
  
  
  CONCLUSIONS
  The significant associations of FOH with GV, dietary patterns, and physical activity provide evidence for FOH as an important psychological factor associated with diabetes care.
authors.affiliation: University of Illinois at Chicago, College of Nursing, Chicago, IL. 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, Chicago, IL.
authors.forename: Laurie
authors.initials: L
authors.lastname: Quinn
authors.affiliation: Loyola University Chicago, Marcella Niehoff School of Nursing, Chicago, IL.
authors.forename: Sue
authors.initials: S
authors.lastname: Penckofer
authors.affiliation: University of Illinois at Chicago, College of Nursing, Chicago, IL.
authors.forename: Chang
authors.initials: C
authors.lastname: Park
authors.affiliation: Rush University, College of Nursing, Chicago, IL.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Hofer
authors.affiliation: University of Illinois at Chicago, College of Nursing, Chicago, IL.
authors.forename: Larisa
authors.initials: L
authors.lastname: Burke
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000150:complications / Q000209:etiology; D001786:Blood Glucose / Q000032:analysis; D002641:Chicago; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000523:psychology; D017281:Cost of Illness; D048909:Diabetes Complications / Q000517:prevention & control / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000523:psychology / Q000628:therapy*; D003927:Diet, Diabetic / Q000009:adverse effects / Q000523:psychology; D015444:Exercise / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007003:Hypoglycemia / Q000517:prevention & control*; D007332:Insulin Infusion Systems / Q000009:adverse effects; D008297:Male; D018670:Monitoring, Ambulatory / Q000009:adverse effects / Q000523:psychology; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D000073278:Self-Management / Q000523:psychology; D013315:Stress, Psychological / Q000150:complications / Q000209:etiology*; D055815:Young Adult
chemical_list: D001786:Blood Glucose
keywords: Behavior; Fear of hypoglycemia; Glycemic variability; Self-management; Type 1 diabetes