Fear of hypoglycemia relates to glycemic levels during and after real-world physical activity in adolescents with type 1 diabetes.

Creator(s)

Susana R. Patton
Simon Bergford
Robin L. Gal
Peter Calhoun
Mark A. Clements, Children's Mercy HospitalFollow
Jennifer L. Sherr
Michael C. Riddell

Document Type

Article

Publication Date

4-2025

Identifier

DOI: 10.1111/dme.15482

Abstract

BACKGROUND: We explore the association between hypoglycaemia fear (FH) and glycaemia during and after exercise sessions in a large sample of physically active youth with type 1 diabetes (T1D).

METHODS: We used data from the Type 1 Diabetes Exercise Initiative Paediatric (T1DEXIP) Study. Youth self-reported on FH using the Hypoglycaemia Fear Survey-Child (HFS-C). They used a smart phone application to self-report food intake and insulin dosing (multiple daily injection only). We collected pump and continuous glucose monitoring data directly from the device.

RESULTS: Our sample included n = 251 youth (mean age: 14 ± 2 years, 55% closed loop pump; 42% women). Youth reporting higher HFS-C Total and Helplessness/Worry scores (HFS-C subscale) had slightly fewer competitive and fewer high intensity exercise events compared to youth with lower HFS-C Total and Helplessness/Worry scores. Youth reporting the highest Maintain High Blood Glucose scores (HFS-C subscale) had the lowest percent glucose time in range, higher mean glucose levels, and higher percent time above range during exercise. Youth reporting the highest Maintain High Blood Glucose scores also tended to have higher mean glucose levels post-exercise and a smaller drop in glucose during exercise.

CONCLUSION: FH relates to glycaemia during and after exercise in adolescents with T1D and may signal an inclination for some youth to engage in avoidance behaviours to reduce their vulnerability to exercise-induced hypoglycaemia.

Journal Title

Diabetic medicine : a journal of the British Diabetic Association

Volume

42

Issue

4

First Page

15482

Last Page

15482

MeSH Keywords

Humans; Diabetes Mellitus, Type 1; Hypoglycemia; Adolescent; Female; Male; Fear; Exercise; Blood Glucose; Insulin; Blood Glucose Self-Monitoring; Insulin Infusion Systems; Child; Hypoglycemic Agents

PubMed ID

39645661

Keywords

glucose variability; hypoglycaemia fear; paediatric diabetes; type 1 diabetes

Comments

Grants and funding

• Leona M. and Harry B. Helmsley Charitable Trust

Recommended Citation

Patton SR, Bergford S, Gal RL, et al. Fear of hypoglycemia relates to glycemic levels during and after real-world physical activity in adolescents with type 1 diabetes. Diabet Med. 2025;42(4):e15482. doi:10.1111/dme.15482