Fear of needles among children and adolescents with type 1 diabetes mellitus : relationship with metabolic control (HbA1c) and quality of life

Abstract

Objective: The aim of this study was to assess the prevalence of fear of needles among children and adolescents with type 1 diabetes mellitus and its effects on the quality of metabolic control measured with haemoglobin A1c (HbA1c) and quality of life.Method: 33 patients aged 9-16 years old with type 1 diabetes mellitus were enrolled in the study as well as their primary caregiver. Patients and caregivers completed two questionnaires, D-FISQ (evaluating fear of needles) and DISABKIDS (evaluating quality of life), and caregivers answered a background questionnaire as well. Other data collected were Hba1c levels and average blood glucose levels obtained from the patient’s medical records. Results: Fear of self-injecting (FI) with insulin (or fear of infusion-site changes) was more common with children and adolescents with type 1 diabetes mellitus (30,3% - 33,3%) than fear of self-testing (FST) blood glucose (6,1% - 21,2%). Positive FI or FST did not significantly affect HbA1c levels, but children with positive FI, based on the caregivers’ responses, had significantly lower scores on the DISABKIDS, demonstrating worse quality of life (p<.05). Patients using insulin pumps had significantly higher HbA1c levels (p<.05) than those on multiple daily injections. Conclusion: Fear of needles is common among children and adolescents with type 1 diabetes mellitus. Based on the caregivers’ responses, fear of needles seems to negatively affect quality of life but having fear of needles has no effect on metabolic control, which is inconsistent with previous studies. Keywords: Fear of needles, quality of life, HbA1c, type 1 diabetes mellitus