Introduction:

Hypoglycaemic phobia is a significant barrier to activity for people with Type 1 Diabetes.

Issue:

Hypoglycaemic phobia or, the ‘fear of getting low’, can present itself as fear of driving, fear of leaving home, caution about staying out late, and even about going into busy shops. People get edgy when there is nowhere to eat, they avoid going out when sugars are low, and often wake up multiple times at night to blood test.

This fear can be partly reduced by the use of a CGMS and/or insulin pump, but this is an avenue not available to all people for financial reasons.

In addition, a CGMS cannot answer questions like ‘why am I low?’, ‘how long will this last?’ and ‘am I good for one hour?’

A diabetes simulator (ManageBGL.com) can predict blood sugars three to five hours ahead, using the same input data as an insulin pump. It can also be used by MDI patients such as those undertaking DAFNE programs.

After a short training period to refine ratios (if required), the simulator is able to predict what will happen to blood sugars hours ahead, with a ‘Virtual CGMS’. This provides a level of confidence for those with phobia.

It can also show when to test for Hypos, and if a patient has under-dosed or over-dosed for a meal based on a blood test sixty minutes after a meal rather than having to wait for the full Active Insulin Time to expire.

Recommendations: Diabetes simulators are a valuable tool for people with diabetes. Both pump and MDI patients can make use of diabetes simulators as a confidence tool to help them minimize fear and make their lives more normal.