American Diabetes Association
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Symptoms of anxiety and depression are independently associated with impaired awareness of hypoglycaemia in type 1 diabetes

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posted on 2022-08-25, 15:11 authored by Beatrice A. Pieri, Gabriella A. I. Bergin-Cartwright, Anna Simpson, Julian Collins, Anna Reid, Janaka Karalliedde, Anna Brackenridge, Matthew Hotopf, Sufyan Hussain



We tested the hypothesis that impaired awareness of hypoglycemia (IAH) is independently associated with symptoms of anxiety and depression in type 1 diabetes.


Cross-sectional observational study in 950 adults with type 1 diabetes. Associations were examined using multiple regression models, adjusting for sociodemographic and clinical characteristics. 


Prevalence for probable anxiety, depression and IAH were 9.4%, 9.8%, and 22.6%, respectively. When included in separate regression models, both depression and anxiety were independently associated with increased odds of IAH and robust to adjustment, OR 3.64(95% CI 2.19–6.04), and OR 2.46(95% CI 1.46–4.14) respectively. Further analysis demonstrated a dose-response relationship between increased severity of probable mental disorder and increased odds of having IAH (p<0.001). 


The robust independent relationship between probable anxiety and depression with IAH demonstrates the need for routine psychological assessment and management of people with type 1 diabetes and IAH. 


This paper represents independent research part-funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.