T1D Exchange at ADCES22: Diabetes Distress & Hypoglycemia - T1D Exchange

Today, the T1D Exchange team heads to the Association of Diabetes Care & Education Specialists’ Annual Conference. Over the next few days, we’ll present four posters focusing on different aspects of severe hypoglycemia and diabetes distress.

Learn more about all four posters below!

Healthcare Providers’ Perspectives on Implementing a New Screener for Fear of Hypoglycemia into Clinical Practice

As the T1D Exchange team has previously presented, we’ve developed and validated a short, actionable 9-item screener that assesses fear of hypoglycemia.

Now, we’ve conducted two focus groups with 11 healthcare providers to explore the feasibility of implementing this screener into clinical practice.

Through these focus groups, the healthcare providers indicated their primary reasons for implementing this screener, including:

• The need for a validated fear of hypoglycemia screener to address their patients’ psychosocial problems
• The desire of the providers to implement the screener in clinical setup

The participating healthcare providers indicated that the most significant barriers to implementing the screener include:

• Limited time during clinic visits
• Prioritizing patients for screening
• Access to mental health professionals
• Limited resources

These focus group results align with the American Diabetes Association’s position statement, emphasizing the importance of screening for fear of hypoglycemia.

View the poster presentation

Prevalence of Fear of Hypoglycemia in Adults with T1D: Results of a Newly Developed Screener

For this study, we used the newly validated fear of hypoglycemia screener mentioned in the above study, we evaluated the prevalence and characteristics associated with fear of hypoglycemia in adults with type 1 diabetes (T1D).

Of 553 adults with T1D:

• 30% had high fear of hypoglycemia scores.
• Most participants either agreed or strongly agreed that they experienced fear of hypoglycemia while driving, sleeping, when they were out in public, or alone.
• Most participants either agreed or strongly agreed that they ate more than needed to avoid low blood glucose levels.
• Higher fear of hypoglycemia scores were associated with higher A1c, more comorbidities, and a higher threshold for what blood glucose level starts to feel “low.”
• Higher fear of hypoglycemia scores were also associated with more frequent severe hypoglycemic events and higher impaired awareness of hypoglycemia.

Using this tool in a clinical setting could help identify fear of hypoglycemia in adults with T1D and inform timely interventions.

View the poster presentation

Psychosocial Impact of Severe Hypoglycemia and Perceptions of Nasal Glucagon in Young Adults with Type 1 Diabetes

This poster, an encore from the American Diabetes Association’s Scientific Sessions in June, examined whether young adults perceive psychosocial benefits from nasal glucagon.

Of 364 young adults with T1D included in this survey:

• Roughly one-third agreed/strongly agreed that possible severe hypoglycemia events limited their engagement in social activities.
• 63.7% agreed/strongly agreed that treating a severe hypoglycemia event was distressing.
• Of the 326 participants who reported some amount of distress about severe hypoglycemia, 49.7% reported reduced distress since having nasal glucagon. Another 48.8% of participants reported no change in how distressed they feel about severe hypoglycemia events.
• Since having nasal glucagon, 30.9% reported their freedom to engage in social activities improved/greatly improved, and 67.4% reported no change.

These study results suggest that nasal glucagon may provide meaningful psychosocial benefits for T1D management in young adults.

View the poster presentation

Diabetes Distress in Adult CGM Users with Type 1 Diabetes

Diabetes distress, a negative emotional experience from having diabetes, has been associated with higher A1cs. On the other hand, continuous glucose monitoring (CGM) has been associated with lower A1cs, but its association with diabetes distress is unclear. Some past research has found that CGM users report lower levels of diabetes distress, while other research has found no difference or even greater distress among CGM users.

Through this study, we aimed to describe the emotional burden and regimen-related distress among 244 participants recruited from the T1D Exchange Registry.

Some key findings include:

• People with T1D who use a CGM still experience moderate to severe diabetes distress.
• Younger participants reported higher levels of diabetes distress
• Higher levels of diabetes distress were also associated with higher A1cs.

The results of our study suggest that even in CGM users, diabetes distress occurs. Diabetes educators should continue to assess diabetes distress despite a person with T1D’s use of technology.

View the poster presentation