and 1 other(s)
Randomized clinical trials of insulin pump therapy and continuous glucose monitoring have shown that diabetes technology can prevent severe hypoglycemia, albeit without improving hypoglycemia awareness (HA). Aim of the study was to assess general psychopathology in insulin pump users in relation to HA status. Measures of psychological assessment, the T1-DDS exploring diabetes distress (DD), the SCL-10R assessing psychological distress, and the DSQ-40 assessing defense mechanisms, were distributed to 40 adults with Type 1 DM on insulin pump therapy. HA status was assessed using the Gold score. Sixteen people had impaired hypoglycaemia awareness (IHA) and 24 intact HA [(mean±SD) age: 40.67±9.13 vs. 42.11±8.52 years, diabetes duration: 27.0±10.7 vs. 27.11±10.6 years, HbA1c: 7.14±0.5% vs. 7.13±0.8%; p=NS]. Adults with IHA reported higher levels of psychological disturbance (t=2.05, p=0.041). Significant differences were observed in psychoticism reflecting alienation and cognitive difficulty (feeling that something is wrong with one’s mind), (t=2.73, p=0.009), obsessive compulsiveness reflecting difficulty in making decisions (t=2.21, p=0.033), phobic avoidance (t=2.08, p=0.044) and paranoid ideation in being talked about or watched by others (t= 3.66, p=0.001). Participants with IHA had higher scores on the defense mechanisms of projection (t=3.68, p=0.001) and denial (t=3.84, p<0.001). They also experienced higher levels of DD in their social environment (t=2.05, p=0.047). Results indicate that despite the use of insulin pump therapy, IHA remains present in people with elevated levels of psychological disturbances. Psychological assessment to identify those who are less likely to benefit from modern diabetes technology should direct targeted interventions to improve hypoglycaemia awareness.
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