Influence of health locus of control and fear of hypoglycaemia on glycaemic control and treatment satisfaction in people with Type 1 diabetes on insulin pump therapy

AimTo assess the influence of health locus of control and fear of hypoglycaemia on metabolic control and treatment satisfaction in people with Type 1 diabetes mellitus on continuous subcutaneous insulin infusion. MethodsPeople with Type 1 diabetes on continuous subcutaneous insulin infusion for at least 1 year, sub-classified as an acceptable glucose control' group [HbA(1c) 58 mmol/mol (7.5%)] and a suboptimum glucose control' group [HbA(1c) > 58 mmol/mol (7.5%)], were consecutively enrolled in a multicentre cross-sectional study. Questionnaires were administered to assess health locus of control [Multidimensional Health Locus of Control (MHLC) scale, with internal and external subscales], fear of hypoglycaemia [Hypoglycaemia Fear Survey II (HFS-II)] and treatment satisfaction [Diabetes Treatment Satisfaction Questionnaire (DTSQ)]. ResultsWe enrolled 214 participants (mean sd age 43.4 12.1 years). The suboptimum glucose control group (n = 127) had lower mean sd internal MHLC and DTSQ scores than the acceptable glucose control group (19.6 5.2 vs 21.0 5.0, P = 0.04 and 28.8 4.8 vs 30.9 4.5, P < 0.001). HFS-II scores did not differ between the two groups. Internal MHLC score was negatively associated with HbA(1c) (r = -0.15, P < 0.05) and positively associated with the number of mild and severe hypoglycaemic episodes (r = 0.16, P < 0.05 and r = 0.18, P < 0.001, respectively) and with DTSQ score (r = 0.17, P < 0.05). HFS-II score was negatively associated with DTSQ score (r = -0.18, P < 0.05) and positively with number of severe hypoglycaemic episodes (r = 0.16, P < 0.5). ConclusionsIn adults with Type 1 diabetes receiving continuous subcutaneous insulin infusion, high internal locus represents the most important locus of control pattern for achieving good metabolic control.