Does the development of diabetes technology reduce parents fear of hypoglycemia? - A validation study

Background Parents' fear of hypoglycemia may hinder optimal glycemic control in the treatment of their children with type 1 diabetes. Currently, there is no Hungarian adaptation of the Hypoglycemia Fear Survey-Parents version. The main aim of our study is to validate this questionnaire in a sample of parents of children aged 5–14 with type 1 diabetes. We also examined the relationship between parents' fear of hypoglycemia and the characteristics of their children's diabetes-specific clinical profile (e.g., severe hypoglycemic episodes, continuous glucose monitoring use). Methods 403 parents of children aged 5–14 suffering from type 1 diabetes (94.5% female, mean age = 41.5+/-5.70 years) completed the Hypoglycemia Fear Survey-Parents and the Diabetes Distress Survey Parent Version (The Problem Area in Diabetes-Parent) in the form of an online questionnaire. Results The results of the confirmatory factor analysis confirmed the three-factor structure of the survey (χ2(116) = 287; CFI = 0.948; TLI = 0.939; RMSEA = 0.0605). The reliability of the entire scale was good (α = 0.892), together with the „Maintaining High Blood Sugar” (α = 0.854) and the „Helplessness” subscales (α = 0.893). The internal consistency of the „Worry about Negative Social Consequences” subscale (α = 0.658) was acceptable. As evidence of convergent validity, the total score of the Hypoglycemia Fear Survey-Parents and the Diabetes Distress Survey Parent showed a significant, weak, positive correlation ( rs (401) = 0.393, p  < 0.001). The occurrence of severe hypoglycemic episodes in the medical history was associated with significantly higher parents’ fear (U = 7290, p = 0.008 ). In the usage of modern technology, only the subscale „Maintaining High Blood Sugar” (U = 12046, p  = 0.095) showed significant difference on a tendency level. Linear regression analysis showed that fear of hypoglycemia was significantly predicted by higher diabetes distress, perception of more diabetes-related problems, longer duration of diagnosis, and younger age of the child with diabetes. Conclusions The 17-item Hypoglycemia Fear Survey-Parents proved to be a valid and reliable measure of parental fear in the Hungarian sample. A history of severe hypoglycemia and the child’s younger age were predictive factors for its development. It helps to identify parents during diabetes control examinations with clinically significant fear, thus organize additional, personalized educational and supportive programs. The usage of modern technology increased the maladaptive strategy of „Maintaining High Blood Sugar”.