Fear of hypoglycemia and sleep in children with type 1 diabetes and their parents

Front Endocrinol (Lausanne). 2024 Dec 16:15:1419502. doi: 10.3389/fendo.2024.1419502. eCollection 2024.

Abstract

Aims: To compare impact of pump treatment and continuous glucose monitoring (CGM) with predictive low glucose suspend (SmartGuard) or user initiated CGM (iscCGM) on sleep and hypoglycemia fear in children with type 1 Diabetes and parents.

Methods: Secondary analysis of data from 5 weeks pump treatment with iscCGM (A) or SmartGuard (B) open label, single center, randomized cross-over study was performed. At baseline and end of treatment arms, sleep and fear of hypoglycemia were evaluated using ActiGraph and questionnaires.

Results: 31 children (6-14 years, male: 50%) and 30 parents (28-55 years) participated. Total sleep minutes did not differ significantly for children (B vs. A: -9.27; 95% CI [-24.88; 6.34]; p 0.26) or parents (B vs. A: 5.49; 95% CI [-8.79; 19.77]; p 0.46). Neither daytime sleepiness nor hypoglycemia fear in children or parents differed significantly between the systems. Neither group met recommended sleep criteria.

Conclusion: Lack of sleep and fear of hypoglycemia remain a major burden for children with diabetes and their parents. Whilst no significant differences between the systems were found, future technology should consider psychosocial impacts of diabetes and related technologies on children and parents' lived experience to ensure parity of esteem between physical and mental health outcomes.

Clinical trial registration: www.ClinicalTrials.gov, identifier NCT03103867.

Keywords: children; fear of hypoglycemia; iscCGM; parents; sensor augmented pump; sleep; type 1 diabetes (T1D).

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Blood Glucose / analysis
  • Blood Glucose Self-Monitoring
  • Child
  • Cross-Over Studies*
  • Diabetes Mellitus, Type 1* / complications
  • Diabetes Mellitus, Type 1* / psychology
  • Fear* / psychology
  • Female
  • Humans
  • Hypoglycemia* / psychology
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Insulin Infusion Systems
  • Male
  • Middle Aged
  • Parents* / psychology
  • Sleep* / physiology

Substances

  • Insulin
  • Blood Glucose
  • Hypoglycemic Agents

Associated data

  • ClinicalTrials.gov/NCT03103867

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This is an investigator-initiated study. Medtronic contributed in kind to the devices (insulin pumps, transmitter, I-Pro 2) and to the accessories (glucose sensors).