# A Review of the Fear of Hypoglycemia Literature in Children and Adolescents with Type 1 Diabetes and their Caregivers

## TL;DR

This paper reviews recent studies on fear of hypoglycemia in children with type 1 diabetes and their caregivers, highlighting the need for updated tools and interventions.

## Contribution

The paper provides an updated review of fear of hypoglycemia literature from 2016 to 2025, focusing on youth with type 1 diabetes and their caregivers.

## Key findings

- The Hypoglycemia Fear Surveys are widely used to assess fear of hypoglycemia in youth with type 1 diabetes and their caregivers.
- Only two randomized clinical trials have been conducted to reduce fear of hypoglycemia in this population.
- More research is needed to update assessment tools and test interventions to reduce fear of hypoglycemia.

## Abstract

To provide an updated review of the fear of hypoglycemia (FOH) literature published from 2016 to 2025, in youth with type 1 diabetes (T1D) and their caregivers.

The Hypoglycemia Fear Surveys (HFS) are the most used questionnaires to assess FOH in studies conducted in the United States and internationally. The factor structure of the Parent and Child versions of the HFS have been updated to better reflect only maladaptive aspects of managing FOH. Diabetes technology studies routinely include the HFS to assess FOH as a secondary outcome. Only two randomized clinical trials (RCT) to reduce FOH have been conducted with youth with T1D and their caregivers.

FOH is a common psychological complication occurring in youth with T1D and their caregivers. More research is needed to update the HFS to reflect modern T1D self-management and test interventions that aim to reduce FOH in RCTs.