First name
Steven
Middle name
M
Last name
Willi

Title

The Impact of Fear of Hypoglycaemia on Sleep in Adolescents with Type I Diabetes.

Year of Publication

2023

Number of Pages

e15066

Date Published

02/2023

ISSN Number

1464-5491

Abstract

AIMS: Fear of hypoglycaemia (FOH) can contribute to impaired sleep for adults with Type 1 Diabetes (T1D) and parents of children with T1D, although it is unknown how fear of hypoglycaemia (FOH) may affect sleep for adolescents with T1D. This study examines the relationship between adolescent FOH and sleep and assessed the influences of continuous glucose monitor (CGM) and insulin pump use.

METHODS: Adolescents ages 14-18 years with T1D completed questionnaires evaluating FOH (Child Hypoglycemia Fear Survey) and sleep (Pittsburgh Sleep Quality Index, PSQI). Analyses included linear and logistic regression, t-tests, and Fisher's exact tests.

RESULTS: Participants included 95 adolescents (52 female) with a median (IQR) age of 16.5 (15.3-17.7) years and a T1D duration of 5.7 (2.5-9.6) years. Analyses showed increased FOH-Worry subscale scores were associated with reduced sleep duration (β = -0.03, p = 0.042, adjusting for BMI z-score, race and ethnicity) and increased sleep disturbances (OR = 1.1, p = 0.038, adjusting for race and ethnicity). Frequent CGM users had longer sleep duration (average 7.5 hours) compared to infrequent or non-CGM users (average = 6.8 hours; p = 0.029), and pump users had overall improved sleep health as determined by PSQI score (p=0.019). Technology use did not have significant interactions in the relationships between FOH and sleep duration or sleep disturbances.

CONCLUSIONS: Worry about hypoglycaemia was associated with impaired sleep for adolescents with T1D. Diabetes technology users have some sleep improvements, but CGM and pump use does little to alter the relationship between FOH and sleep outcomes.

DOI

10.1111/dme.15066

Alternate Title

Diabet Med

PMID

36786042
Featured Publication
No

Title

Youth Involvement in the Decision to Start CGM Predicts Subsequent CGM Use.

Year of Publication

2020

Date Published

2020 Jul 23

ISSN Number

1935-5548

Abstract

<p><strong>OBJECTIVE: </strong>The ability of continuous glucose monitoring (CGM) to improve diabetes outcomes depends upon consistent use. To identify factors that facilitate long-term use of CGM, this study tested the hypothesis that youth involvement in the decision to initiate this therapy would influence subsequent CGM use and that CGM self-efficacy and satisfaction mediate this relationship.</p>

<p><strong>RESEARCH DESIGN AND METHODS: </strong>Before initiating CGM, parent-youth dyads (i.e., pairs) from an academic endocrinology clinic completed assessments, including a measure of the child's involvement in the decision to start CGM. Two months into CGM use, youth completed measures of CGM self-efficacy and satisfaction. Fidelity of CGM use between weeks 5 and 12 was accessed via a cloud-based data repository. Hypotheses were tested with linear mixed effects models, accounting for patients clustered within provider and repeated measures within patients.</p>

<p><strong>RESULTS: </strong>CGM use in 108 dyads (youth mean age 13.4 ± 2.7 years; 73% white) was positively predicted by baseline parent report of youth involvement in the CGM decision ( &lt; 0.0001), and this relationship was mediated by youth's perceptions of CGM self-efficacy ( &lt; 0.0001) and hassle ( = 0.014). So, when the youth shared their opinions about CGM with parents and participated in the decision to start, they perceived higher self-efficacy and lower hassle at 2-month follow-up, which predicted more days of use. This pattern held in models adjusting for youth race and sex and family income.</p>

<p><strong>CONCLUSIONS: </strong>To achieve maximum clinical benefit from CGM use, providers should facilitate youth involvement in the decision to initiate the device.</p>

DOI

10.2337/dc20-0348

Alternate Title

Diabetes Care

PMID

32703764

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