Fear of Self-Injecting and Self-Testing and the Related Risk Factors in Adolescents with Type 1 Diabetes: A Cross-Sectional Study

Introduction: This study was conducted to investigate the fear of self-injecting and self-testing and its related risk factors among adolescents with type 1 diabetes mellitus (T1DM). Methods: From December 2015 to April 2016, a cross-sectional study was performed at the Diabetes Treatment Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia on 142 registered T1DM patients between 13 and 19 years of age. Selection of the respondents was done deliberately and carefully, and the suitable patients were given specific identification numbers. A trained interviewer administered the short Diabetes Fear of Injecting and Self-testing Questionnaire to each patient. It included two subscales estimating the fear of self-injection (FSI) and fear of self-testing (FST). Each patient's age, gender, weight, height, adjusted body mass index (BMI), duration of the diabetic condition, treatment modality, insulin dosage, and glycosylated hemoglobin (HbA1c) were recorded. Results: The study found that the overall mean score of FSI was 2.44 +/- 0.96, whereas that of FST was 2.25 +/- 1.04. Adolescents above 16 years of age, treated with multiple daily insulin (MDI), on higher insulin doses, having poor glycemic control, and fewer finger pricks were observed to show significant risk factors for fear of self-injection of insulin, whereas in those patients having a long duration of T1DM, MDI treated, on higher insulin doses, with poor glycemic control, and fewer finger pricks showed significant risk factors for fear of self-testing of blood glucose. From the regression analysis it was evident that the variables of higher age, MDI treatment, and fewer finger pricks were independent risk factors for fear of self-injection of the insulin, whereas a fewer number of finger pricks was an independent risk factor for fear of self-testing the blood glucose. Conclusion: Fear of self-injecting and fear of self-testing are common among adolescents with T1DM. Therefore, it is essential to ensure comprehensive multidisciplinary diabetes education to lower the risk factor of fear of injections.