Fear of Hypoglycemia: Quantification, Validation, and Utilization

  1. John Butterfield, MD
  1. University of Virginia Medical Center Charlottesville, Virginia Cambridge University Medical School Cambridge, United Kingdom
  1. Address correspondence and reprint requests to Dr. Daniel J. Cox, Behavioral Medicine Center, University of Virginia Medical Center, Charlottesville, VA 22901.


Hypoglycemia can lead to various aversive symptomatic, affective, cognitive, physiological, and social consequences, which in turn can lead to the development of possible phobic avoidance behaviors associated with hypoglycemia. On the other hand, some patients may inappropriately deny or disregard warning signs of hypoglycemia. This study presents preliminary reliability and validity data on a psychometric instrument designed to quantify this fear: the hypoglycemic fear survey. The instrument was found to have internal consistency and test-retest stability, to covary with elevated glycosylated hemoglobin, and to be sensitive to a behavioral treatment program designed to increase awareness of hypoglycemia.

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