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fear, gender, hypoglycemia, type 1 diabetes



  1. Gjerlow, Ellen
  2. Bjorgaas, Marit R.
  3. Nielsen, Erik W.
  4. Olsen, Sandra E.
  5. Asvold, Bjorn O.


Background: Severe hypoglycemia is a serious complication of type1 diabetes feared by many who have the disease.


Objectives: The aim of this study was to investigate specific fears related to hypoglycemia in adults with type 1 diabetes and to investigate how aspects of fear of hypoglycemia may differ between genders.


Methods: A cross-sectional study with questionnaires sent to 636 patients with type 1 diabetes, aged 18-75 years, who attended the outpatient clinic at St. Olavs Hospital, Trondheim, Norway. Fears related to hypoglycemia were assessed using the Hypoglycemia Fear Survey II Worry subscale (HFS-II-Worry).


Results: The response rate was 70% (N = 445, 216 women and 229 men). The mean HFS-II-Worry score was higher in women than in men (2.46 [SD = 0.80] vs. 2.22 [SD = 0.74], respectively; p < .001). Women scored higher than men in all items in the HFS-II-Worry, and women's average scores were statistically significantly higher in 5 of the 18 items after correction for multiple comparisons. The largest gender differences in mean scores occurred in the items "low blood glucose interfering with important things," "becoming upset and difficult," "difficulty thinking clearly," and "feeling lightheaded or dizzy." In both women and men, the highest mean scores appeared in the worry items "become hypoglycemic while sleeping" and "not having food available."


Discussion: In this sample of Norwegian adults with type 1 diabetes, women expressed more concerns about hypoglycemia than men. The highest HFS-II-Worry scores occurred in the same items in women and men, but the largest gender differences in mean scores appeared across a variety of other items, some of which were related to social esteem.