Parents’ Fear of Hypoglycemia and Its Association With Diabetes Treatment Modality, Management, and Outcomes in Young Children With Type 1 Diabetes: A Danish Cross-Sectional Study
Nanna Lind, Patricia DeCosta, Lene Lyngsøe, Nanja Holland Hansen, Jannet SvenssonBackground:
Parental fear of hypoglycemia (FoH) may influence diabetes management, family well-being, and perceptions of safety in young children with type 1 diabetes (T1D). The aim was to describe FoH among parents of young children with T1D using a validated version of the Children’s Hypoglycemia Index (CHI) and to examine parent-level differences, interparent agreement, and associations with clinical parameters, treatment modality, and glycemic outcomes of their children.
Methods:
Cross-sectional cohort linking parent-reported questionnaire data with clinical and device-derived data. Analyses were conducted at the individual parent level and dyadic (parent-pair) level. Parental agreement was assessed using intraclass correlation coefficients (ICCs) and Bland-Altman analyses to evaluate mean differences and variability. Associations with HbA1c and continuous glucose monitoring metrics were analyzed using mixed-effect models adjusted for age, sex, and automated insulin delivery (AID) use.
Results:
Among 135 children (mean age 6.8 ± 2.1 years; HbA1c 6.8% ± 0.7%; 89.6% using AID), mothers reported higher CHI scores than fathers (β = .35- .58,
Conclusions:
Although mothers reported higher FoH at the group level, low agreement indicates that FoH varies within families. No association with glycemic outcomes was observed, although interpretations are limited by high AID use and low HbA1c variability. Individual assessment of FoH in both parents may be clinically relevant.