Evidence mapPaperPMID 37423638Full record

Observational studyBMJ open diabetes research & care2023

Prevalence of fear of hypoglycemia in adults with type 1 diabetes using a newly developed screener and clinician's perspective on its implementation.

Megan E Peter, Nicole Rioles, Jingwen Liu, Katherine Chapman, Wendy A Wolf, Huyen Nguyen, Marina Basina, Halis Kaan Akturk, Osagie Ebekozien, Magaly Perez-Nieves and 2 more

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in BMJ open diabetes research & care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
4.4field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 22 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Review
  5. Article
  6. The Urgent Need for Breakthrough Therapies and a World Without Type 1 Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025
    Article
  7. Advanced Hybrid Closed Loop Algorithm Use in Type 1 Diabetes: The French MiniMed™ Glycemic Control and Quality of Life Study.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025
    Article
  8. The Affective Semiosis of the Hypoglycemic Symptom in Type 1 Diabetes Mellitus.Integrative psychological & behavioral science · 2025
    Article
  9. Article
  10. Article
  11. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 1 country.

Megan E PeterT1D Exchange, Boston, Massachusetts, USA.ORCID 0000-0003-3995-2140
Nicole RiolesT1D Exchange, Boston, Massachusetts, USA.
Jingwen LiuT1D Exchange, Boston, Massachusetts, USA.
Katherine ChapmanT1D Exchange, Boston, Massachusetts, USA.
Wendy A WolfT1D Exchange, Boston, Massachusetts, USA.
Huyen NguyenT1D Exchange, Boston, Massachusetts, USA.
Marina BasinaStanford Diabetes Research Center, Stanford, California, USA.
Halis Kaan AkturkUniversity of Colorado, Aurora, Colorado, USA.
Osagie EbekozienT1D Exchange, Boston, Massachusetts, USA.
Magaly Perez-NievesEli Lilly and Company, Indianapolis, Indiana, USA.
Jiat Ling PoonEli Lilly and Company, Indianapolis, Indiana, USA.
Beth MitchellEli Lilly and Company, Indianapolis, Indiana, USA mitchell_beth_d@lilly.com.ORCID 0000-0002-0723-5393
T1D Exchange · USEli Lilly (United States) · USUniversity of Colorado Anschutz Medical Campus · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionFear of hypoglycemia (FoH) affects quality of life, emotional well-being, and diabetes management among people with type 1 diabetes (PwT1D). American Diabetes Association's (ADA) guidelines recommend assessing FoH in clinical practice. However, existing FoH measures are commonly used in research and not in clinical practice. In this study, prevalence of FoH was assessed in PwT1D using a newly developed FoH screener for clinical practice; its association with established measures and outcomes was also determined. In addition, healthcare providers' (HCPs) perspectives on implementing FoH screener into real-world practice were explored. RESEARCH DESIGN AND

methodsThis multiphase observational study used mixed methods in two phases. First, we collected a cross-sectional survey (including the screener) from PwT1D (≥18 years) from T1D Exchange Quality Improvement Collaborative adult clinics. Pearson correlations and regression analyses were performed on diabetes outcome measures using screener scores. Second, we conducted focus groups among HCPs who treat PwT1D and descriptive analysis to summarize results.

resultsWe included 553 PwT1D. Participants had a mean±SD age of 38.9±14.2 years and 30% reported a high FoH total score. Regression analyses showed that higher A1c and higher number of comorbidities were significantly associated with high FoH (p<0.001). High FoH worry and behavior scores were significantly associated with 8-Item Patient Health Questionnaire and 7-Item Generalized Anxiety Disorder Scale scores. Participants with ≥1 severe hypoglycemia event(s) and impaired awareness of hypoglycemia had higher odds of high FoH. Eleven HCPs participated in focus group interviews; they expressed that the FoH screener is clinically necessary and relevant but poses implementation challenges that must be addressed.

conclusionsOur results demonstrate FoH is common in PwT1D and affects their psychosocial well-being and diabetes management. In alignment with ADA position statement, HCP focus group results emphasize importance of screening for FoH. Implementing this newly developed FoH screener may help HCPs identify FoH in PwT1D.

Indexed as

Diabetes Mellitus, Type 1HypoglycemiaAdultCross-Sectional StudiesFearHumansMiddle AgedPrevalenceQuality of LifeYoung AdultFearHypoglycemiaPatient Reported Outcome Measures

Identifiers

PMID37423638
PMCPMC10335552
OpenAlexW4383682194

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.