(DCP045) GENDER DIFFERENCES IN HYPOGLYCEMIA-RELATED WORRIES AND BEHAVIORS IN ADULTS WITH TYPE 1 DIABETES

Background: Hypoglycemia is a complication of type 1 diabetes (T1D) treatment that impacts the quality of life and can cause fear of hypoglycemia. However, there is little information on gender-specific worries and behaviours related to hypoglycemia. This analysis explores gender differences in hypoglycemia-related worries and behaviours among adults with T1D.

METHODS AND RESULTS: Self-reported data by adults living with T1D who filled out the baseline questionnaire from a Canadian online registry were analyzed using logistic regression. Hypoglycemia worries (15 items) and behaviours (18 items) were extracted from the validated Hypoglycemia Fear Survey-II.The regression models were adjusted for age, insulin pump use, and hypoglycemia history.

Results: In a sample of 900 adults (average age 44 ± 15 years, T1D duration 26 ± 15 years, and 34% with HbA1c ≤7.0%), 66% self-identified as women. The history of severe hypoglycemia (≥1 episode in the past year) was similar between genders (15% in men and women, p=0.915). However, women reported more serious hypoglycemia episodes ( < 3 mmol/L) in the past month compared to men (median [IQR]: 4 [2, 10] and 3 [1, 8], respectively, p=0.015).
Compared to men, women were less likely to consume large snacks (odds ratio [95% confidence interval]:0.63 [0.47, 0.85]) to prevent hypoglycemia. However, they reported limiting physical activity (1.72 [1.27, 2.35]) and travel (2.34 [1.49, 3.67)] and keeping glycemia high to avoid hypoglycemia (1.42 [1.06, 1.91]) more often than men. Additionally, in contrast to men, women were more worried about hypoglycemia consequences such as “passing out in public” (2.02 [1.16, 3.51]), “making a mistake or having an accident” (1.69 [1.15, 2.49]), and “having hypoglycemia while alone” (1.84 [1.36, 2.50]) or when sleeping (1.65 [1.22, 2.23]).

Conclusion: These results suggest that women with T1D experience more hypoglycemia-related worries and adapt their behaviour in a manner that may lead to more time spent in the hyperglycemic range. Additionally, these worries can negatively affect diabetes management and further increase the mental burden of living with T1D, particularly for women. Awareness of these gender differences should prompt clinicians to acknowledge gender-specific concerns and eventually adapt their practices for more targeted and personalized patient care.