Hypoglycemic Confidence in the Partners of Adults with Type 1 Diabetes

Authors: Polonsky WH, Fortmann AL, Johnson KE, Nguyen A, Beebe C.

Abstract

Background: Hypoglycemic confidence (HC) represents the degree to which an individual feels secure regarding his or her ability to stay safe from hypoglycemia-related problems. Self-report scales assessing HC in adults with type 1 diabetes (T1D) have found that greater HC is associated with better glycemic control and that HC rises significantly after real-time continuous glucose monitoring is introduced. To determine whether HC might be similarly meaningful in the partners of T1D adults, we developed the Hypoglycemic Confidence Scale for Partners (Partner-HCS). This article describes the construction and validation of the Partner-HCS and examines how HC in T1D partners is related to hypoglycemia-related experience and key psychosocial constructs. Methods: Items were developed from interviews with seven T1D partners, resulting in 12 self-report items. Exploratory factor analysis (EFA) was then conducted on data collected from T1D partners (n = 218). Variables to establish construct validity for the Partner-HCS included partner-reported diabetes distress, hypoglycemic fear, generalized anxiety, and confidence regarding glucagon use, as well as frequency of recent severe hypoglycemia in the T1D adult. Hierarchical regression analyses examined the unique contribution of Partner-HCS scores, independent of hypoglycemic fear, to key psychosocial constructs and hypoglycemia-related factors. Results: EFA of the 12 items yielded a single-factor solution, accounting for 51.2% of the variance. Construct validity was demonstrated by significant univariate associations with key psychosocial constructs. Importantly, Partner-HCS total score was, independent of hypoglycemic fear, significantly associated with diabetes distress (P < 0.05), overall relationship satisfaction (P = 0.004), number of severe hypoglycemic episodes in the last 6 months (P < 0.05), and confidence using glucagon (P = 0.007). In total, 38.5% of T1D partners indicated relatively low HC. Conclusions: HC is an important facet of the experiences of T1D partners. It is related to, yet distinct from, hypoglycemic fear. The Partner-HCS is a reliable, valid method for assessing HC in partners of T1D adults.

Source: https://pubmed.ncbi.nlm.nih.gov/31638424/

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BDI hosts the San Diego-wide, monthly case consultation meeting (for mental health professionals working in the field of diabetes). Contact us at [email protected] if you are in the greater San Diego area and would like further information about this program.

It will be a busy time for BDI staff at the American Diabetes Association’s 85th Scientific Sessions (Chicago, IL). Exciting new study results to be presented, new projects to be discussed, and old friends to see.

At the Abbott Diabetes Care booth at this years ADA Scientific Sessions in Chicago Il, Dr. Guzman, BDI Director of Clinical Education, will be moderating the panel discussion, Above the Bias.

At the American Diabetes Association’s 85th Scientific Sessions (Chicago, IL), Dr. Polonsky, BDI President, will be speaking on Tell Me Why—Using CGM to Drive Changes in Diabetes Self-Care. He also serves a co-author on six poster presentations on that day:

At the American Diabetes Association’s 85th Scientific Sessions (Chicago, IL), Dr. Fisher, BDI Research Director, will present Reducing Diabetes Distress Leads to Positive Glycemic Change—Results from the EMBARK Trial

August 8 – 10. Taking Control of Your Diabetes (TCOYD) will be hosting the in-person ONE event, an amazing weekend experience here in San Diego for more than 500 people with type 1 diabetes and their loved ones. Dr. Polonsky is honored to be one of the presenters, and we will hope to see many of you there. There are still a few spaces left, so if you’d like to know more, please visit: