title: Influence of health locus of control and fear of hypoglycaemia on glycaemic control and treatment satisfaction in people with Type 1 diabetes on insulin pump therapy.
abstract: To assess the influence of health locus of control and fear of hypoglycaemia on metabolic control and treatment satisfaction in people with Type 1 diabetes mellitus on continuous subcutaneous insulin infusion.
  
  
  
  People with Type 1 diabetes on continuous subcutaneous insulin infusion for at least 1 year, sub-classified as an 'acceptable glucose control' group [HbA1c≤ 58 mmol/mol (7.5%)] and a 'suboptimum glucose control' group [HbA1c> 58 mmol/mol (7.5%)], were consecutively enrolled in a multicentre cross-sectional study. Questionnaires were administered to assess health locus of control [Multidimensional Health Locus of Control (MHLC) scale, with internal and external subscales], fear of hypoglycaemia [Hypoglycaemia Fear Survey II (HFS-II)] and treatment satisfaction [Diabetes Treatment Satisfaction Questionnaire (DTSQ)].
  
  
  
  We enrolled 214 participants (mean ± sd age 43.4 ± 12.1 years). The suboptimum glucose control group (n = 127) had lower mean ± sd internal MHLC and DTSQ scores than the acceptable glucose control group (19.6 ± 5.2 vs 21.0 ± 5.0, P = 0.04 and 28.8 ± 4.8 vs 30.9 ± 4.5, P < 0.001). HFS-II scores did not differ between the two groups. Internal MHLC score was negatively associated with HbA1c(r = -0.15, P < 0.05) and positively associated with the number of mild and severe hypoglycaemic episodes (r = 0.16, P < 0.05 and r = 0.18, P < 0.001, respectively) and with DTSQ score (r = 0.17, P < 0.05). HFS-II score was negatively associated with DTSQ score (r = -0.18, P < 0.05) and positively with number of severe hypoglycaemic episodes (r = 0.16, P < 0.5).
  
  
  
  In adults with Type 1 diabetes receiving continuous subcutaneous insulin infusion, high internal locus represents the most important locus of control pattern for achieving good metabolic control.
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Verona.
authors.forename: L
authors.initials: L
authors.lastname: Indelicato
authors.affiliation: Division of Metabolic Diseases, Department of Medicine, University of Padova, Padova.
authors.forename: V
authors.initials: V
authors.lastname: Mariano
authors.affiliation: Division of Metabolic Diseases, Department of Medicine, University of Padova, Padova.
authors.forename: S
authors.initials: S
authors.lastname: Galasso
authors.affiliation: Division of Metabolic Diseases, Department of Medicine, University of Padova, Padova.
authors.forename: F
authors.initials: F
authors.lastname: Boscari
authors.affiliation: Division of Metabolic Diseases, Department of Medicine, University of Padova, Padova.
authors.forename: E
authors.initials: E
authors.lastname: Cipponeri
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, Azienda Ospedaliera Universitaria Integrata Verona, Verona.
authors.forename: C
authors.initials: C
authors.lastname: Negri
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Frigo
authors.affiliation: Division of Metabolic Diseases, Department of Medicine, University of Padova, Padova.
authors.forename: A
authors.initials: A
authors.lastname: Avogaro
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Verona.
authors.forename: E
authors.initials: E
authors.lastname: Bonora
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Verona.
authors.forename: M
authors.initials: M
authors.lastname: Trombetta
authors.affiliation: Division of Metabolic Diseases, Department of Medicine, University of Padova, Padova.
authors.forename: D
authors.initials: D
authors.lastname: Bruttomesso
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D005239:Fear / Q000502:physiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000517:prevention & control / Q000523:psychology*; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects; D007332:Insulin Infusion Systems / Q000523:psychology; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D012648:Self Care
chemical_list: D001786:Blood Glucose; D007328:Insulin