Research Round Up

Research Round Up - fear of hypoglycemia, impaired awareness of hypoglycemia, and diabetes and cognitive function

Martin Gilmour of the Diabetic Hypoglycemia Editorial Team

Diabetic Hypoglycemia June 2008, Volume 1, Issue 1: page 10-11

This issue's research round up covers the related topics of: fear of hypoglycemia; impaired awareness of hypoglycemia and diabetes and cognitive function.

Fear of hypoglycemia in patients with diabetes is often greater than the patient’s concern about the long-term consequences of hyperglycemia, and can therefore act as a barrier to their medication-use and glycemic control. However, a recent review of the literature by Wild et al, does suggest that such fear can be reduced with blood glucose awareness training (BGAT) or cognitive behavioural therapy (CBT).

The conclusions of the review also stated that more work was needed to identify the causes and impact of fear of hypoglycemia, but some important facts could be drawn from the literature. For example, some patients with diabetes are more vulnerable to developing fear of hypoglycemia including: those who have had a recent traumatic episode of hypoglycemia, those who have preexisting anxiety disorders, adults who live alone, patients with poor awareness of hypoglycemia, and parents of children who have experienced hypoglycemic-induced seizures. To tackle the fear of hypoglycemia, CBT, which includes relaxation training and reframing catastrophic cognitions, has been shown to alleviate panic attacks related to hypoglycemia. In addition, BGAT interventions that are more focused on disease management may help to reduce a patient’s sense of loss of control relating to hypoglycemia and increase confidence in their ability to anticipate hypoglycemic episodes.