P-198: Parental disagreement in fear of hypoglycemia living with a young child with type 1 diabetes: a psychometric evaluation using multiple statistical approaches
N Lind, P DeCosta, L Lyngsøe, N H Hansen, J SvenssonAbstract
Introduction
Fear of hypoglycemia (FoH) in parents of young children with type 1 diabetes (T1D) may affect diabetes management and glycemic outcomes. It remains unclear whether mothers and fathers report FoH similarly and whether their perceptions relate to the child’s glycemic status and treatment.
Objectives
To examine agreement between mothers’ and fathers’ reported FoH using the Children’s Hypoglycemia Index (CHI) and assess associations with clinical characteristics and glycemic outcomes.
Methods
In a cross-sectional cohort of 135 children with T1D (mean age 6.8 ± 2.1 years), paired parental CHI responses were analyzed using intraclass correlation coefficients (ICC) and linear mixed-effects models accounting for repeated measures within children. Associations with HbA1c and continuous glucose monitoring (CGM) metrics were assessed using multivariable mixed models adjusted for age, sex, and clinical covariates, including the use of automated insulin delivery systems.
Results
Mothers reported significantly higher CHI scores than fathers across all domains (β = 0.35–0.58, p < 0.001–0.003), except behavioral fear. Agreement varied by CHI domains, with modest agreement for situational fear (ICC = 0.38, 95% CI 0.11–0.60, p=0.003) and poor agreement for general (ICC ≈ 0.00, 95% CI -0.28–0.28, p=0.50) and behavioral fear (ICC = 0.14, 95% CI -0.14–0.41, p=0.16). The difference remained significant after adjustment, and no associations between CHI scores and child age, sex, insulin treatment modality, HbA1c, or CGM metrics (TIR, TBR), or parent-by-glycemia interactions were detected.
Conclusions
Parental FoH are not compatible. Mothers reported significantly higher CHI scores than fathers. FoH was not associated with glycemic outcomes, suggesting parental perceptions are largely independent of the child’s metabolic status. These findings highlight the importance of assessing both parents separately in clinical practice and research.