HYPE
Research type
Research Study
Full title
Fear of Hyperglycaemia in people with Type 1 Diabetes
IRAS ID
288601
Contact name
Nick Oliver
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
1 years, 6 months, 30 days
Research summary
Summary of Research
We have been researching aversion to high blood glucose (hyperglycaemia) in people living with type 1 diabetes because we know that for some people this can be very distressing, and it can lead to problems with low blood glucose (hypoglycaemia).
Two hundred and fifty-three people with type 1 diabetes completed a survey which included questions about themselves and their diabetes, as well as a number of questionnaires. One of those questionnaires was the Hyperglycaemia Avoidance Scale (HAS). The UK version of this scale has not yet been validated, which means that we do not yet know much about the questionnaire. We used the surveys to learn more about the questionnaire, including the different aspects of hyperglycaemia aversion that it measures, as well as other things that hyperglycaemia aversion is associated with. For example, we found that insulin pump users tended to score higher on the HAS than those who used insulin injections, suggesting greater avoidance of hyperglycaemia.
We then interviewed 19 people with type 1 diabetes, some of whom were averse to hyperglycaemia, and some of whom were not. We found that many people who were averse to hyperglycaemia held very high standards for themselves and often had a strong preference for control in their lives. While many were motivated to avoid high blood glucose in order to reduce their risk of diabetes-related complications in the future, the main thing that high blood glucose levels were associated with was self-criticism and frustration with themselves for not meeting the high standards for blood glucose levels that they had set themselves. A number of people also experienced anxiety with a high or rising blood glucose level. Sometimes people were so motivated to avoid higher blood glucose levels that their actions led to hypoglycaemia. People described a range of thoughts that helped to maintain their blood glucose management preference. For example, many participants said that hypoglycaemia was so much quicker and easier to fix than hyperglycaemia, and some described much less concern about hypo- than hyperglycaemia. People described how in some ways their diabetes monitoring technology had been helpful to them and reduced their sense of burden from living with type 1 diabetes, but how it also played a role in facilitating their blood glucose management preference, made them feel more self-critical and also further raised their blood glucose standards.
We hope that the results of this study will help diabetes clinicians to identify and support people living with type 1 diabetes who might be experiencing physical or psychological difficulties related to hyperglycaemia aversion.Summary of Results
We have been researching aversion to high blood glucose (hyperglycaemia) in people living with type 1 diabetes because we know that for some people this can be very distressing, and it can lead to problems with low blood glucose (hypoglycaemia).Two hundred and fifty-three people with type 1 diabetes completed a survey which included questions about themselves and their diabetes, as well as a number of questionnaires. One of those questionnaires was the Hyperglycaemia Avoidance Scale (HAS). The UK version of this scale has not yet been validated, which means that we do not yet know much about the questionnaire. We used the surveys to learn more about the questionnaire, including the different aspects of hyperglycaemia aversion that it measures, as well as other things that hyperglycaemia aversion is associated with. For example, we found that insulin pump users tended to score higher on the HAS than those who used insulin injections, suggesting greater avoidance of hyperglycaemia.
We then interviewed 19 people with type 1 diabetes, some of whom were averse to hyperglycaemia, and some of whom were not. We found that many people who were averse to hyperglycaemia held very high standards for themselves and often had a strong preference for control in their lives. While many were motivated to avoid high blood glucose in order to reduce their risk of diabetes-related complications in the future, the main thing that high blood glucose levels were associated with was self-criticism and frustration with themselves for not meeting the high standards for blood glucose levels that they had set themselves. A number of people also experienced anxiety with a high or rising blood glucose level. Sometimes people were so motivated to avoid higher blood glucose levels that their actions led to hypoglycaemia. People described a range of thoughts that helped to maintain their blood glucose management preference. For example, many participants said that hypoglycaemia was so much quicker and easier to fix than hyperglycaemia, and some described much less concern about hypo- than hyperglycaemia. People described how in some ways their diabetes monitoring technology had been helpful to them and reduced their sense of burden from living with type 1 diabetes, but how it also played a role in facilitating their blood glucose management preference, made them feel more self-critical and also further raised their blood glucose standards.
We hope that the results of this study will help diabetes clinicians to identify and support people living with type 1 diabetes who might be experiencing physical or psychological difficulties related to hyperglycaemia aversion.
REC name
South West - Cornwall & Plymouth Research Ethics Committee
REC reference
20/SW/0174
Date of REC Opinion
16 Dec 2020
REC opinion
Further Information Favourable Opinion