nach oben

Acta Diabetologica

Erschienen in:

27.01.2022 | Original Article

Impact of fear of hypoglycaemia on self-management in patients with type 2 diabetes mellitus: structural equation modelling

verfasst von: Shuang Li, Yehui Li, Lu Zhang, Yaxin Bi, Yan Zou, Lin Liu, Hong Zhang, Yuan Yuan, Weijuan Gong, Yu Zhang

Erschienen in: Acta Diabetologica | Ausgabe 5/2022

Einloggen, um Zugang zu erhalten

Abstract

Aims

This study aimed to explore the effect of fear of hypoglycaemia (FOH) on self-management and its specific action path in patients with type 2 diabetes mellitus (T2DM) to provide a basis for developing targeted nursing interventions.

Design

A cross-sectional study.

Methods

From June to October 2019, we recruited 258 patients with T2DM from the endocrinology department of three hospitals to complete questionnaires, including the Hypoglycaemia Fear Survey-II, Diabetes Distress Scale, Self-Stigma Scale, Social Support Rating Scale and Summary of Diabetes Self-Care Activities, in Jiangsu Province, China. Pearson’s correlation analyses and structural equation modelling were conducted to explore the relationship and influence path among the above variables.

Results

The correlation analysis of FOH, distress, self-stigma, social support and self-management showed that, except for social support not being correlated with FOH and distress (P > 0.05), all variables were correlated in pairs (r = − 0.19–0.77, P < 0.01). The final model fit well, and the fitting indexes of the model were as follows: χ²/df = 2.191, GFI = 0.934, CFI = 0.954, TLI = 0.934, RMSEA = 0.068, and SRMR = 0.0649. The effects of FOH on self-management in patients with T2DM included one direct path and two indirect paths: (a) FOH had a direct impact on self-management (P < 0.05); (b) FOH had an indirect impact on self-management through distress (P < 0.05); and (c) FOH had an indirect impact on self-management through self-stigma and social support (P < 0.05).

Conclusions

FOH could directly influence self-management in patients with T2DM. Furthermore, distress, self-stigma and social support were important mediating variables of FOH influencing self-management. Researchers can develop personalized interventions to improve the self-management of patients with T2DM by regulating distress, self-stigma and social support levels.

Nur mit Berechtigung zugänglich

International Diabetes Federation (2020) IDF diabetes atlas 9th edition 2019. International Diabetes Federation. https://www.diabetesatlas.org/en/

Balijepalli C, Druyts E, Siliman G, Joffres M, Thorlund K, Mills E (2017) hypoglycaemia: a review of definitions used in clinical trials evaluating antihyperglycemic drugs for diabetes. Clin Epidemiol 9:291–296. https://doi.org/10.2147/CLEP.S129268CrossRefPubMedPubMedCentral

American Diabetes Association (2019) Standards of medical care in diabetes-2019. Diabetes Care 42(Suppl 1):S1–S193

Felton A-M, LaSalle J, McGill M (2016) Treatment urgency: The importance of getting people with type 2 diabetes to target promptly. Diabetes Res Clin Pract 117:100–103. https://doi.org/10.1016/j.diabres.2016.04.026CrossRefPubMed

Lamounier RN, Geloneze B, Leite SO et al (2018) hypoglycaemia incidence and awareness among insulin-treated patients with diabetes: the HAT study in Brazil. Diabetol Metab Syndr 10(1):83. https://doi.org/10.1186/s13098-018-0379-5CrossRefPubMedPubMedCentral

Schloot NC, Haupt A, Schütt M et al (2016) Risk of severe hypoglycaemia in sulfonylurea-treated patients from diabetes centers in Germany/Austria: How big is the problem? Which patients are at risk? Diabetes Metab Res Rev 32:316–324. https://doi.org/10.1002/dmrr.2722CrossRefPubMed

Workgroup on Hypoglycaemia, American Diabetes Association Workgroup (2005) Defining and reporting hypoglycaemia in diabetes—a report from the American Diabetes Association Workgroup on hypoglycaemia. Diabetes Care 28(5):1245–1249. https://doi.org/10.2337/diacare.28.5.1245CrossRef

Silbert R, Salcido Montenegro A, Rodriguez Gutierrez R, Katabi A, Rozalina GM (2018) hypoglycaemia among patients with type 2 diabetes: epidemiology, risk factors, and prevention strategies. Curr DiabRep 18(8):53. https://doi.org/10.1007/s11892-018-1018-0CrossRef

Gonder-Frederick LA, Schmidt KM, Vajda KA et al (2011) Psychometric properties of the hypoglycaemia fear survey-ii for adults with type 1 diabetes. Diabetes Care 34(4):801–806. https://doi.org/10.2337/dc10-1343CrossRefPubMedPubMedCentral

10.

Leiter LA, Boras D, Woo VC (2014) Dosing irregularities and self-treated hypoglycaemia in type 2 diabetes: results from the Canadian cohort of an international survey of patients and healthcare professionals. Can J Diabetes 38(1):38–44. https://doi.org/10.1016/j.jcjd.2013.08.270CrossRefPubMed

11.

Orozco-Beltran D, Artola S, Jansa M, Lopez de la Torre-Casares M, Fuster E (2018) Impact of hypoglycemic episodes on health-related quality of life of type-2 diabetes mellitus patients: development and validation of a specific QoLHYPO((c)) questionnaire. Health Qual Life Outcomes 16(1):52. https://doi.org/10.1186/s12955-018-0875-1CrossRefPubMedPubMedCentral

12.

Seaquist ER, Anderson J, Childs B et al (2013) hypoglycaemia and diabetes: a report of a workgroup of the American Diabetes Association and the Endocrine Society. Diabetes Care 36(5):1384–1395. https://doi.org/10.2337/dc12-2480CrossRefPubMedPubMedCentral

13.

Thanakwang K, Thinganjana W, Konggumnerd R (2014) Psychometric properties of the Thai version of the Diabetes Distress Scale in diabetic seniors. Clin Interv Aging 9:1353–1361. https://doi.org/10.2147/cia.s67200CrossRefPubMedPubMedCentral

14.

Zhou H, Zhu J, Liu L et al (2017) Diabetes-related distress and its associated factors among patients with type 2 diabetes mellitus in China. Psychiatr Res 252:45–50. https://doi.org/10.1016/j.psychres.2017.02.049CrossRef

15.

Hessler DM, Fisher L, Polonsky WH, Masharani U (2017) Diabetes distress is linked with worsening diabetes management over time in adults with Type 1 diabetes. Diabet Med 34(9):1228–1234. https://doi.org/10.1111/dme.13381CrossRefPubMedPubMedCentral

16.

Li S, Fang L, Lee A et al (2021) The association between diabetes-related distress and fear of hypoglycaemia in patients with type 2 diabetes mellitus: a cross-sectional descriptive study. Nurs Open 00:1–10. https://doi.org/10.1002/nop2.800CrossRef

17.

Langford CPH, Bowsher J, Maloney JP, Lillis PP (2010) Social support: a conceptual analysis. J Adv Nurs 25(1):95–100. https://doi.org/10.1046/j.1365-2648.1997.1997025095.xCrossRef

18.

McEwen MM, Pasvogel A, Gallegos G, Barrera L (2010) Type 2 diabetes self-management social support intervention at the US-Mexico border. Public Health Nurs 27(4):310–319. https://doi.org/10.1111/j.1525-1446.2010.00860.xCrossRefPubMedPubMedCentral

19.

Song Y, Nam S, Park S, Shin I-S, Ku BJ (2017) The impact of social support on self-care of patients with diabetes: What Is the Effect of Diabetes Type? Syst Rev Meta-Anal Diabetes Educ 43(4):396–412. https://doi.org/10.1177/0145721717712457CrossRef

20.

Botchway M, Davis R, Merchant A, Appiah L, Moore S. (2021) Diabetes-related stigma and its influence on social networks, social support, and HbA1c in Ghana. Ethn Dis 31(1), 57–66. https://doi.org/10.18865/ed.31.1.57

21.

Seo K, Song Y (2019) Self-stigma among Korean patients with diabetes: a concept analysis. J Clin Nurs 28(9):1794–1807. https://doi.org/10.1111/jocn.14789CrossRefPubMed

22.

Kato A, Fujimaki Y, Fujimori S et al (2016) Association between self-stigma and self-care behaviors in patients with type 2 diabetes: a cross-sectional study. BMJ Open Diabetes Res Care 4(1):e000156. https://doi.org/10.1136/bmjdrc-2015-000156CrossRefPubMedPubMedCentral

23.

Hayek AAA, Robert AA, Braham RB, Issa BA, Sabaan FSA (2015) Predictive risk factors for fear of hypoglycaemia and anxiety-related emotional disorders among adolescents with type 1 diabetes. Med Princ Pract: Int J Kuwait Univer, Health Sci Centre 24(3):222–230. https://doi.org/10.1159/000375306CrossRef

24.

Saulnier PJ, Briet C, Gand E et al (2019) No association between fear of hypoglycaemia and blood glucose variability in type 1 diabetes: the cross-sectional VARDIA study. J Diabetes Complic 33(8):554–560. https://doi.org/10.1016/j.jdiacomp.2019.05.003CrossRef

25.

Hill R (1949) Family under stress: adjustment to the crises of war separation and return. Harper, Oxford

26.

WHO (2006) Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia. Report of a WHO/IDF consultation. WHO, Geneva, pp 1–30

27.

Kine P (1993) The handbook of psychological testing. Routledge, New York

28.

Cox DJ, Irvine A, Gonder-Frederick L, Nowacek G, Butterfield J (1987) Fear of hypoglycaemia: quantification, validation, and utilization. Diabetes Care 10(5):617–621. https://doi.org/10.2337/diacare.10.5.617CrossRefPubMed

29.

Mu C (2015) Revision of Chinese hypoglycaemia Fear Questionnaire and its application in patients with type 2 diabetes mellitus. Tianjin Medical University.

30.

Polonsky WH, Fisher L, Earles J et al (2005) Assessing psychosocial distress in diabetes: development of the diabetes distress scale. Diabetes Care 28(3):626–631. https://doi.org/10.2337/diacare.28.3.626CrossRefPubMed

31.

Yang Q, Liu L (2010) Reliability and validity of the diabetes distress scale. J Nurs. https://doi.org/10.3969/j.issn.1008-9969.2010.17.003CrossRef

32.

Fisher L, Hessler DM, Polonsky WH, Mullan J (2012) When is diabetes distress clinically meaningful?: Establishing cut points for the Diabetes Distress Scale. Diabetes Care 35(2):259–264. https://doi.org/10.2337/dc11-1572CrossRefPubMedPubMedCentral

33.

Mak WWS, Cheung RYM (2010) Self-stigma among concealable minorities in Hong Kong: conceptualization and unified measurement. Am J Orthopsych 80(2):267–281. https://doi.org/10.1111/j.1939-0025.2010.01030.xCrossRef

34.

Chen Q, NI JY, Ye Y, Wan JB, (2018) Reliability and validity of the Chinese version of self-stigma scale for patients with diabetes. Chin J Pract Nurs 34(32):2501. https://doi.org/10.3760/cma.j.issn.1672-7088.2018.32.005CrossRef

35.

Xiao SY (1994) Theoretical basis and research application of social support rating scale (Chinese). Clin Psychol Med 4:98–100 (CNKI:SUN:LCJS.0.1994-02-019)

36.

Wang M, Sun H, Zhang J, Ruan J (2019) Prevalence and associated factors of elder abuse in family caregivers of older people with dementia in central China cross-sectional study. Int J Geriatr Psych 34(2):299–307. https://doi.org/10.1002/gps.5020CrossRef

37.

Toobert DJ, Hampson SE, Glasgow RE (2000) The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care 23(7):943–950. https://doi.org/10.2337/diacare.23.7.943CrossRefPubMed

38.

Wan QQ, Shang SM, Lai XB, Pan J (2008) Study on the reliability and validity of summary of diabetes self-care activities for type 2 diabetes patients. Chin J Pract Nurs 24(7):26–27. https://doi.org/10.3760/cma.j.issn.1672-7088.2008.07.009CrossRef

39.

Wu ML (2009) Structural equation modeling: operation and application of AMOS. Chongqing University, Chongqing

40.

Byrne BM (2016) Structural equation modeling with AMOS: basic concepts, applications, and programming, 3rd edn. Routledge, New York. https://doi.org/10.4324/9780203726532CrossRef

41.

Hu L, Bentler PM (1999) Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model 6:1–55. https://doi.org/10.1080/10705519909540118CrossRef

42.

Schermelleh-Engel K, Moosbrugger H, Müller H (2003) Evaluating the fit of structural equation models: tests of significance and descriptive goodness-of-fit measures. Methods Psychol Res 8(8):23–74

43.

Jodar-Gimeno E, Alvarez-Guisasola F, Avila-Lachica L, Palomares-Ortega R, Roldan-Suarez C, Lizan-Tudela L (2015) Quality of life and fear for hypoglycaemia in patients with type 2 diabetes mellitus. Rev Clin Esp 215(2):91–97. https://doi.org/10.1016/j.rce.2014.07.009CrossRefPubMed

44.

Sheikhi M, Moradi M, Shahsavary S, Alimoradi Z, Salimi HR (2020) The effect of eye movement desensitization and reprocessing on the fear of hypoglycaemia in type 2 diabetic patients: a randomized clinical trial. BMC Psychol 8(1):2–8. https://doi.org/10.1186/s40359-020-00450-0CrossRef

45.

Sayah FA, Yeung RO, Johnson JA (2019) Association of depressive symptoms and diabetes distress with severe hypoglycaemia in adults with type 2 diabetes. Can J Diabetes 43(5):316–321. https://doi.org/10.1016/j.jcjd.2018.11.002CrossRefPubMed

46.

Fisher L, Polonsky WH, Hessler DM et al (2015) Understanding the sources of diabetes distress in adults with type 1 diabetes. J Diabetes Complicat 29(4):572–577. https://doi.org/10.1016/j.jdiacomp.2015.01.012CrossRef

47.

Bolden LA (2011) A review of on grief and grieving: finding the meaning of grief through the five stages of loss. Couns Values 51(3):235–237. https://doi.org/10.1002/j.2161-007X.2007.tb00081.xCrossRef

48.

Rosland A, Piette J, Trivedi R et al (2018) Engaging family supporters of adult patients with diabetes to improve clinical and patient-centered outcomes: study protocol for a randomized controlled trial. Trials 19(1):394. https://doi.org/10.1186/s13063-018-2785-2CrossRefPubMedPubMedCentral

49.

Chan C, Cockshaw W, Smith K, Holmes-Truscott E, Pouwer F, Speight J (2020) Social support and self-care outcomes in adults with diabetes: the mediating effects of self-efficacy and diabetes distress. Results of the second diabetes MILES—Australia (MILES-2) study. Diabetes Res Clin Pract 166:108314. https://doi.org/10.1016/j.diabres.2020.108314CrossRefPubMed

50.

King D, Glasgow R, Toobert D et al (2010) Self-efficacy, problem solving, and social-environmental support are associated with diabetes self-management behaviors. Diabetes Care 33(4):751–753. https://doi.org/10.2337/dc09-1746CrossRefPubMedPubMedCentral

51.

Young C, Shubrook J, Valencerina E, Wong S, Henry Lo S, Dugan J (2020) Associations between social support and diabetes-related distress in people with type 2 diabetes mellitus. J Am Osteopath Assoc 120(11):721–731. https://doi.org/10.7556/jaoa.2020.145CrossRefPubMed

Titel: Impact of fear of hypoglycaemia on self-management in patients with type 2 diabetes mellitus: structural equation modelling
verfasst von: Shuang Li
Yehui Li
Lu Zhang
Yaxin Bi
Yan Zou
Lin Liu
Hong Zhang
Yuan Yuan
Weijuan Gong
Yu Zhang
Publikationsdatum: 27.01.2022
Verlag: Springer Milan
Erschienen in: Acta Diabetologica / Ausgabe 5/2022
Print ISSN: 0940-5429
Elektronische ISSN: 1432-5233
DOI: https://doi.org/10.1007/s00592-021-01839-y

Periodontitis, age-related diseases and diabetes in an endocrinological outpatient setting (PARADIES): a cross-sectional analysis on predictive factors for periodontitis in a German outpatient facility

Open Access
Original Article

Correction to: Impact of fear of hypoglycaemia on self‑management in patients with type 2 diabetes mellitus: structural equation modelling

Correction

Predictive value of admission glycemia in diabetics with pulmonary embolism compared to non-diabetic patients

Original Article

Predisposition of SOD1, GPX1, CAT genetic variants and their haplotypes in cataractogenesis of type 2 diabetes mellitus in Pakistan

Original Article

Deep transcranial magnetic stimulation in combination with skin thermography in obesity: a window on sympathetic nervous system

Open Access
Original Article

Italian guidelines for the treatment of type 2 diabetes

Open Access
Position Statement

Kompaktes Leitlinien-Wissen Innere Medizin (Link öffnet in neuem Fenster)

Mit medbee Pocketcards schnell und sicher entscheiden.
Leitlinien-Wissen kostenlos und immer griffbereit auf ihrem Desktop, Handy oder Tablet.

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

CDK4/6-Inhibitoren bei Brustkrebs in die Zweitlinie aufschieben?

10.01.2025
Mammakarzinom
Nachrichten

Ergebnisse einer Phase-III-Studie sprechen dafür, dass die Behandlung mit CDK4/6-Inhibitoren bei fortgeschrittenem HR-positivem, HER2-negativem Brustkrebs auch auf die Zweitlinie verschoben werden könnte, ohne die onkologischen Ergebnisse zu kompromittieren.

Inhalative Steroide bei COPD nicht kardioprotektiv

10.01.2025
COPD
Nachrichten

Ob inhalative Kortikosteroide (ICS) COPD-Kranke außer vor akuten Exazerbationen auch vor kardiovaskulären Komplikationen schützen können, ist unklar. Eine bevölkerungsbasierte Studie aus England spricht nicht dafür.

Kaffeegenuss sicher bei Vorhofflimmern

10.01.2025
Kaffeekonsum und die Folgen
Nachrichten

Menschen mit Vorhofflimmern fürchten oft, Kaffee könnte schlecht für ihr Herz sein. Solche Ängste sind offenbar unbegründet: Zwei Schweizer Untersuchungen deuten sogar auf eine reduzierte Rate von kardiovaskulären Ereignissen unter Kaffeetrinkern.

Cannabisextrakt verbessert Antiemese bei Chemotherapie

10.01.2025
Antiemetische Therapie
Nachrichten

Sprechen Krebskranke auf die übliche Antiemese während einer Chemotherapie nicht ausreichend an, lohnt sich möglicherweise eine Behandlung mit Cannabisextrakt. In einer Phase-2/3-Studie ließ sich die antiemetische Response mit einem solchen Extrakt erheblich verbessern.

EKG Essentials: EKG befunden mit System (Link öffnet in neuem Fenster)

In diesem CME-Kurs können Sie Ihr Wissen zur EKG-Befundung anhand von zwölf Video-Tutorials auffrischen und 10 CME-Punkte sammeln.
Praxisnah, relevant und mit vielen Tipps & Tricks vom Profi.

Jetzt 10 CME-Punkte sammeln

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Impact of fear of hypoglycaemia on self-management in patients with type 2 diabetes mellitus: structural equation modelling

Abstract