255-OR: The Relationship between Daytime Child Glycemic Levels and Parent Fear of Hypoglycemia

Introduction: Hypoglycemia (i.e., 70mg/dL) is a common and dangerous complication for youth with type 1 diabetes (T1D). Many parents report significant fear related to potential hypoglycemia and may engage in maladaptive avoidance behaviors to maintain higher glucose levels. Previous studies have mainly relied on HbA1C when examining the relationship between glucose patterns and parent fear of hypoglycemia (FoH). This study, however, examined if daytime child glucose levels, measured continuously, predicted parental FoH. Methods: We recruited 165 caregivers of youth with T1D. We administered the Hypoglycemia Fear Survey for Parents and collected 14 days of glucose data from their child’s personal continuous glucose monitor. We conducted regression models with youth daytime glucose metrics as the independent variable and the parents’ FoH score as the dependent variable. Results: Among caregivers, 89% self-identified as mothers with Mage= 41.76+6.52 years. For youth, 49% were female, Mage= 13.41+2.59 years, MT1D duration= 3.97+3.14 years, and MHbA1C= 7.81 + 1.43. Further, the average percent of glucose values below range= 2.5+3.2%, in range= 51.9+22.7%, and above range= 45.5+24.0%. Results revealed that youth’s percent of glucose values in the hypoglycemic range did not predict parents’ FoH score (p= 0.32). However, average daily glucose (β= 0.32, p 0.01) and glucose SD, or glycemic variability (β= 0.30, p 0.01), were significant predictors of parents’ FoH score. Conclusions: Our results indicate that parents of youth with T1D may report higher FoH if they observe increased fluctuations in their child’s glucose levels, regardless of how often their child’s glucose levels are in the hypoglycemic range. The findings are important to clinicians who should consider screening for parental FoH to determine if glucose management should be a target for diabetes education or to provide strategies to help parents manage their specific worries related to hypoglycemia. Disclosure A. Monzon: None. R. McDonough: Speaker's Bureau; Provention Bio, Inc. S.R. Patton: None.