The Impact of Diabetes Fear of Self-injecting (FSI) and Fear of Self-testing (FST) on Glycemic Control and Diabetes Self-management

ABSTRACT

BACKGROUND: This study was done to examine the impact of diabetes fear of self-injecting (FSI) and fear of self-testing (FST) on glycemic control and diabetes self-management. METHODS: A questionnaire survey was performed in the form of one-on-one interviews with 100 insulin-treated diabetic patients. The questions included subject traits, FSI/FST, and confidence in diabetes self-care (CIDS). Glycemic control was determined by the measurement of glycated hemoglobin (Hemoglobin A1C). RESULTS: The patients who did not have a spouse and were less well educated showed high FSI/FST scores and low CIDS scores. The patients who had taken high quantities of insulin, had diabetes related complications, and performed self-monitoring of blood glucose less frequently showed high FSI/FST scores. The patients who had received diabetes education, possessed glucometer and performed self-monitoring of blood glucose frequently had high CIDS scores. High FSI/FST scores were positively related to each other, negatively related to low CIDS scores and not significantly related to Hemoglobin A1C. On the other hand, a significant correlation was seen between CIDS scores and Hemoglobin A1C. CONCLUSION: High levels of FSI and/or FST were associated with high diabetes-related distress, poor general well-being, and psychologic comorbidity as well as poorer adherence to the diabetes treatment regimen. It is important in diabetes care to lower injection-related fears and improve diabetes self-management through systematic desensitization, relaxation therapy, the use of pen-type injection device, and proper education such as insulin injection amount adjustment, properties of insulin, and the risk of hypoglycemia for the patients and their families.