Study: Fear of hypoglycemia is reduced in patients who receive therapy
Professor Pamela Martyn-Nemeth is lead author on the paper, which received the Editor’s Choice Award from the Journal of Psychosomatic Research in October.
Nursing faculty hosted study on hypoglycemia
For some individuals with type 1 diabetes, fear of hypoglycemia—or low blood sugar—can lead to sleeplessness, anxiety, increased glucose variability, and difficulty managing their disease.
“It’s appropriate to feel some worry, but [in focus groups we heard from] people living with type 1 diabetes who had consistently and repeatedly identified how fear of hypoglycemia was a barrier and a stressor in their ability to care for their diabetes — an ever-present anxiety,” says UIC Nursing professor Pamela Martyn-Nemeth, PhD, RN, FAHA, FPCNA, FAAN.
To address this, Martyn-Nemeth and her team undertook a pilot study of 50 young adults aged 18 to 35 with fear of hypoglycemia to test an eight-week cognitive behavioral therapy intervention called FREE [Fear Reduction Efficacy Evaluation].
What they found is that study participants who received the intervention had a significant reduction in fear of hypoglycemia compared to a control group, according to a paper published in the Journal of Psychosomatic Research in June. They also had a significant improvement in self-management behavior and glucose control, based on time-in-range standards. Martyn-Nemeth was the lead author on the paper, which received the journal’s Editor’s Choice Award in October.
Those individuals in the FREE group received eight weekly one-hour individual sessions using cognitive behavior therapy, a type of counseling aimed to modify maladaptive thoughts and behaviors through cognitive restructuring, relaxation training, and exposure therapy. Those individuals in the control group received eight weekly one-hour individual diabetes education sessions.
Both groups received continuous glucose monitoring technology, but only those in the FREE group were taught to use the information as a “biofeedback cue,” a check on their decision-making.
Sessions were conducted in-person initially but shifted to videoconferencing during the COVID-19 pandemic. There was no difference in results based on whether the counseling was in-person counseling or remote, according to the paper.
Martyn-Nemeth says she hopes to expand the study – this time conducting it entirely remotely – to see whether it could be scaled or even integrated into general diabetes care.
“We did focus groups with participants after the study,” Martyn-Nemeth says. “That was very eye-opening because whether they received [the intervention] in-person or remotely, they indicated how essential and important this was for them. [They shared] how they began to think about diabetes in a different way and that they never considered how their emotions could play into it. Many thought eight weeks wasn’t enough; this was just the tip of the iceberg. They wanted more.”
Co-authors from UIC Nursing included: Katherine M. Minnich Endowed Professor Laurie Quinn, PhD ’96, RN, FAAN, FAHA, CDE; research assistant professor Chang Park, PhD; and research specialist Minsun Park, PhD ’16. Three-time alum Sue Penckofer, PhD ’93, MS ’82, BSN ’79, RN, FAAN, emeritus professor Marcella Niehoff School of Nursing at Loyola University Chicago was also a co-author.