Living with hypoglycemia

OBJECTIVE: To increase understanding of the everyday experiences of hypogly cemia for patients with type 1 diabetes through the use of a narrative rese arch approach. SETTING:Center for diabetes treatment and research. DESIGN: Cross-sectional assessment using a narrative research approach. PATIENTS/PARTICIPANTS: Twenty outpatients (aged 21-30 years) diagnosed with type 1 diabetes for at least 10 years. MEASUREMENTS AND MAIN RESULTS: Experiences of hypoglycemia were investigate d during in-depth, semistructured interviews that were tape-recorded, trans cribed, and analyzed to identify common themes. Self-report measures of dep ression (Revised Hamilton Rating Scale for Depression) and anxiety (State-T rait Anxiety Inventory) also were administered. Subjects reported the follo wing common themes: interpersonal conflict including fears of dependency an d loss of control and problems addressing concerns about hypoglycemia with significant others; difficulty making sense of their hypoglycemic behaviors in relation to their usual ways of functioning; and perceived lack of unde rstanding by others, including physicians, about the emotional experiences of hypoglycemia. Subjects were neither clinically depressed nor anxious. CONCLUSIONS: These findings suggest that type 1 diabetes patients' experien ces of hypoglycemia negatively affect their interpersonal relationships and views of themselves. Hypoglycemia also was described as an extremely priva te experience that was rarely discussed with others. Patient education and professional support in the treatment of hypoglycemia are recommended to en hance treatment decision making for patients with type 1 diabetes.