Adolescents with Type 1 diabetes mellitus experience psychosensorial symptoms during hypoglycaemia

• Published in: Diabetic medicine Vol. 31; no. 10; pp. 1245 - 1251
• Main Authors: Law, J. R., Yeşiltepe-Mutlu, G., Helms, S., Meyer, E., Özsu, E., Çizmecioğlu, F., Lin, F.C., Hatun, Ş., Calikoglu, A. S.
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Publishing Ltd 01-10-2014; Blackwell; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adolescent Behavior - drug effects; Adolescent Behavior - ethnology; Attention - drug effects; Attitude to Health - ethnology; Biological and medical sciences; Blood Glucose - analysis; Child; Colleges & universities; Diabetes; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - drug therapy; Diabetes Mellitus, Type 1 - ethnology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Feedback, Psychological - drug effects; Feedback, Sensory - drug effects; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Humans; Hypoglycemia - chemically induced; Hypoglycemia - diagnosis; Hypoglycemia - ethnology; Hypoglycemia - physiopathology; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - therapeutic use; Insulin - adverse effects; Insulin - therapeutic use; Male; Medical sciences; North Carolina; Self Care; Severity of Illness Index; Surveys and Questionnaires; Turkey; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vertebrates: endocrinology; North Carolina; Turkey; United States > US; Endocrinopathy; Human; Immunopathology; Obesity; Nutrition; Nutrition disorder; Autoimmune disease; Metabolic diseases; Hypoglycemia; Symptomatology; Type 1 diabetes; Adolescent; Endocrinology; Nutritional status
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/dme.12533

Aim
To describe mood and psychosensorial symptoms of hypoglycaemia in adolescents with Type 1 diabetes mellitus in two countries with different cultures, Turkey and the USA.
Methods
We developed a 68‐item questionnaire assessing physical, behavioural, mood and psychosensorial symptom frequency and ratings [‘good’, ‘bad’, or ‘both’ (sometimes good, sometimes bad)]. Adolescents with Type 1 diabetes were recruited from paediatric diabetes clinics at the University of North Carolina at Chapel Hill in the USA and Kocaeli University in Turkey. The percentages of participants at each clinic who endorsed individual symptoms, symptom categories and symptom ratings were calculated and compared.
Results
Cronbach's α values were > 0.7 for each real symptom category. No symptom items were excluded from the questionnaire analysis based on item‐total correlation results which were all > 0.2. Data were collected from 132 participants (69 from University of North Carolina, 63 from Kocaeli University, 54% male). The mean (sd) age of the participants was 14.9 (1.9) years, HbA1c level was 8.7 (1.8) % and duration of Type 1 diabetes was 5.8 (3.7) years. On average, each physical symptom was experienced by 65.2% of participants, each behavioural symptom by 46.5%, each mood symptom by 42.8%, and each psychosensorial symptom by 48.9%. On average, each physical, behavioral, mood and psychosensorial symptom was rated as ‘good’ or ‘both’ by 23.0, 29.1, 36.9 and 37.2% of participants, respectively. There were no symptom differences between the groups in each country.
Conclusions
In addition to the classic physical symptoms experienced during hypoglycaemia, adolescents with Type 1 diabetes report psychosensorial, mood and behavioral symptoms, and some describe them as positive experiences. Symptom experiences were similar in these two countries with different cultures.
What's new?
There are multiple cases of people reportedly feeling ‘high’ during hypoglycaemia, which may be explained by psychosensorial symptoms (alterations in how one's environment and subjective self are perceived). This is the first study of psychosensorial symptoms during hypoglycaemia in adolescents with Type 1 diabetes
Psychosensorial symptoms are common and are often reported as positive experiences during hypoglycaemia.
There were no differences in how hypoglycaemia symptoms were reported in adolescents from two countries with different cultures.