Fear of needles in children with type 1 diabetes mellitus on multiple daily injections and continuous subcutaneous insulin infusion.

Abstract

OBJECTIVE:

To assess the prevalence of fear of needles and its effect on glycemic control in children with type 1 diabetes mellitus (T1DM) on multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII).

METHODS:

Patients aged 6 to 17 years with T1DM on MDI or CSII (n = 150) were enrolled. All caregivers and patients aged ≥11 years completed a "Diabetes Fear of Injecting and Self-testing Questionnaire" (D-FISQ). Needle phobia was defined as a score ≥6 for fear of self-testing (FST), fear of injections (FI), and fear of infusion-site changes (FISC).

RESULTS:

Positive FST scores were noted in 10.0% and positive FI or FISC scores in 32.7% (caregivers' responses). Patients aged 6 to 10 years on CSII had greater fear (FISC) than those on MDI (FI) (P = .010). FST was inversely related to the number of daily blood sugar checks (P = .003). Patients with positive scores for FI/FISC or FST had significantly higher glycated hemoglobin (HbA1c) levels than those without. An inverse association was noted between positive FI/FISC scores and age of the patient (P = .029). Based on patient responses, FST severity was directly related to the age of the patient (P = .013).

CONCLUSION:

Needle phobia is common in children with T1DM. Although FI/FISC are more common in younger children, especially in those on CSII, FST is more often encountered in older patients. Patients with a more intense fear of needles have higher HbA1c levels and less frequent blood sugar monitoring. Identifying these patients may help improve glycemic control.

• Authors: Ayse Pinar Cemeroglu, Argun Can, Alan T Davis, Ozlem Cemeroglu, Lora Kleis, Maala S Daniel, Jessica Bustraan, Tracy J Koehler
• Journal: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists (Endocr Pract) Vol. 21 Issue 1 Pg. 46-53 (Jan 2015) ISSN: 1530-891X [Print] United States
• PMID: 25100395 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Glycated Hemoglobin A
• Insulin
• hemoglobin A1c protein, human

Topics

• Adolescent
• Blood Glucose Self-Monitoring
• Child
• Cross-Sectional Studies
• Diabetes Mellitus, Type 1 (blood, drug therapy)
• Fear
• Glycated Hemoglobin (analysis)
• Humans
• Injections, Subcutaneous
• Insulin (therapeutic use)
• Insulin Infusion Systems
• Needles
• Prospective Studies