Relationships of hypoglycemia awareness, hypoglycemia beliefs, and continuous glucose monitoring glycemic profiles with anxiety and depression symptoms in adults with type 1 diabetes using continuous glucose monitoring systems

Yu Kuei Lin, Emily Hepworth, Nicole de Zoysa, Jessica McCurley, Mary Ellen Vajravelu, Wen Ye, Gretchen A. Piatt, Stephanie A. Amiel, Simon J. Fisher, Rodica Pop-Busui, James E. Aikens

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Aims: To evaluate relationships of hypoglycemia awareness, hypoglycemia beliefs, and continuous glucose monitoring (CGM) glycemic profiles with anxiety and depression symptoms in adults with type 1 diabetes (T1D) who use CGM. Methods: A cross-sectional survey and data collections were completed with 196 T1D adults who used CGM (59% also used automated insulin delivery devices (AIDs)). We assessed hypoglycemia awareness (Gold instrument), hypoglycemia beliefs (Attitudes to Awareness of Hypoglycemia instrument), CGM glycemic profiles, demographics, and anxiety and depression symptoms (Hospital Anxiety and Depression Scale). Analysis included simple and multiple linear regression analyses. Results: Lower hypoglycemia awareness, weaker “hypoglycemia concerns minimized” beliefs, stronger “hyperglycemia avoidance prioritized” beliefs were independently associated with higher anxiety symptoms (P < 0.05), with similar trends in both subgroups using and not using AIDs. Lower hypoglycemia awareness were independently associated with greater depression symptoms (P < 0.05). In participants not using AIDs, more time in hypoglycemia was related to less anxiety and depression symptoms (P < 0.05). Being female and younger were independently associated with higher anxiety symptoms, while being younger was also independently associated with greater depression symptoms (P < 0.05). Conclusion: Our findings revealed relationships of impaired hypoglycemia awareness, hypoglycemia beliefs, CGM-detected hypoglycemia with anxiety and depression symptoms in T1D adults who use CGMs.

Original languageEnglish
Article number111596
JournalDiabetes Research and Clinical Practice
Volume209
DOIs
StatePublished - Mar 2024

Bibliographical note

Publisher Copyright:
© 2024 Elsevier B.V.

Funding

This work was supported by the Michigan Center for Clinical and Translational Research Pilot and Feasibility Grant ( P30DK092926 , 2020), National Institute of Diabetes and Digestive and Kidney Diseases ( K23DK129724 , 2021) and University of Michigan Caswell Diabetes Institute (Clinical and Translational Research Scholars Program, 2021).

FundersFunder number
University of Michigan Caswell Diabetes Institute
National Institute of Diabetes and Digestive and Kidney DiseasesK23DK129724
National Institute of Diabetes and Digestive and Kidney Diseases

    Keywords

    • Anxiety
    • Continuous glucose monitoring
    • Depression
    • Hypoglycemia
    • Type 1 diabetes

    ASJC Scopus subject areas

    • Internal Medicine
    • Endocrinology, Diabetes and Metabolism
    • Endocrinology

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