Psychosocial Aspects


Hannah Chatwin, Melanie Broadley, Bastiaan de Galan, Ellen Bazelmans, Jane Speight, Frans Pouwer, Giesje Nefs

Effectiveness of educational and behavioural interventions for reducing fear of hypoglycaemia among adults with type 1 diabetes: Systematic review and meta- analyses. Diabet Med. 2023 Feb 17;e15071.

Hypoglycemia is an almost unavoidable side effect of T1D treatment: adults with T1D experience 1 to 2 mild hypoglycemia episodes every week and 40% experience severe hypoglycemia (needing external assistance) annually. Since severe hypoglycemia can result in dangerous situations (e.g. in traffic), many people with T1D and their family members are afraid of hypoglycemia, including feelings of shame and embarrassment. Fear of hypoglycemia can interfere with diabetes (self) care, e.g. keeping blood glucose levels too high so as to prevent hypoglycemia, but increasing the risk of long-term complications. Fear of hypoglycemia also decreases quality of life (QoL). Thus, reducing fear of hypoglycemia can improve both clinical and quality of life outcomes. Educational/behavioural interventions aimed at reducing fear of hypoglycemia have been around for some time. However, existing reviews of the literature on these interventions have so far only been descriptive, not assessing their effectiveness. This systematic review and meta-analysis, co-authored by Diabeter psychologist Giesje Nefs, aimed to determine the effectiveness of interventions reducing fear of hypoglycemia.


The literature databases MEDLINE, EMBASE, CINAHL, and PsycINFO were searched from inception to 28 June 2021, using search terms relating to 1) adults with type T1D, 2) fear of hypoglycaemia and 3) behavioural and/or educational intervention, limiting the search to studies including participants 18+ years of age. Of 382 eligible studies, n=5 RCT studies and n=7 observational studies were included.

Key findings:


Concluding, the authors state

"This review shows that there have been some efforts to evaluate the effectiveness of educational and behavioural interventions in reducing fear of hypoglycaemia ……………… No study has examined the effect of behavioural and educational interventions among people with high fear of hypoglycaemia and these are needed urgently " -

Please click here for the full-text.

< Back

© 2024 Diabeter | Terms of Use | Privacy Statement