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Influence of health locus of control and fear of hypoglycaemia on glycaemic control and treatment satisfaction in people with Type 1 diabetes on insulin pump therapy
Author(s) -
Indelicato L.,
Mariano V.,
Galasso S.,
Boscari F.,
Cipponeri E.,
Negri C.,
Frigo A.,
Avogaro A.,
Bonora E.,
Trombetta M.,
Bruttomesso D.
Publication year - 2017
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.13321
Subject(s) - medicine , diabetes mellitus , locus of control , insulin pump , type 1 diabetes , insulin , metabolic control analysis , hypoglycemia , type 2 diabetes , gastroenterology , endocrinology , psychology , psychotherapist
Aim To assess the influence of health locus of control and fear of hypoglycaemia on metabolic control and treatment satisfaction in people with Type 1 diabetes mellitus on continuous subcutaneous insulin infusion. Methods People with Type 1 diabetes on continuous subcutaneous insulin infusion for at least 1 year, sub‐classified as an ‘acceptable glucose control’ group [HbA 1c ≤ 58 mmol/mol (7.5%)] and a ‘suboptimum glucose control’ group [HbA 1c > 58 mmol/mol (7.5%)], were consecutively enrolled in a multicentre cross‐sectional study. Questionnaires were administered to assess health locus of control [Multidimensional Health Locus of Control ( MHLC ) scale, with internal and external subscales], fear of hypoglycaemia [Hypoglycaemia Fear Survey II ( HFS ‐ II )] and treatment satisfaction [Diabetes Treatment Satisfaction Questionnaire ( DTSQ )]. Results We enrolled 214 participants (mean ± sd age 43.4 ± 12.1 years). The suboptimum glucose control group ( n = 127) had lower mean ± sd internal MHLC and DTSQ scores than the acceptable glucose control group (19.6 ± 5.2 vs 21.0 ± 5.0, P = 0.04 and 28.8 ± 4.8 vs 30.9 ± 4.5, P < 0.001). HFS ‐ II scores did not differ between the two groups. Internal MHLC score was negatively associated with HbA 1c ( r = −0.15, P < 0.05) and positively associated with the number of mild and severe hypoglycaemic episodes ( r = 0.16, P < 0.05 and r = 0.18, P < 0.001, respectively) and with DTSQ score ( r = 0.17, P < 0.05). HFS ‐ II score was negatively associated with DTSQ score ( r = −0.18, P < 0.05) and positively with number of severe hypoglycaemic episodes ( r = 0.16, P < 0.5). Conclusions In adults with Type 1 diabetes receiving continuous subcutaneous insulin infusion, high internal locus represents the most important locus of control pattern for achieving good metabolic control.

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