{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T09:22:28Z","timestamp":1792142548015,"version":"4.4.0"},"reference-count":14,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2017,2,1]],"date-time":"2017-02-01T00:00:00Z","timestamp":1485907200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Technology & Therapeutics"],"published-print":{"date-parts":[[2017,2]]},"abstract":"\n Background:<\/jats:title>\n While research designed to understand the concerns about hypoglycemia among patients with diabetes has been primarily focused on the investigation of fear and anxiety, recent evidence suggests a potentially important and conceptually distinct element\u2014hypoglycemic confidence. To investigate this dimension, we developed the Hypoglycemic Confidence Scale (HCS); herein, we describe the construction and validation of the HCS and examine how key patient factors are associated with hypoglycemic confidence.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n Items were developed from interviews with six type 1 diabetes (T1D) adults, six insulin-using type 2 diabetes (T2D) adults, and seven diabetes healthcare professionals, resulting in nine self-report items. Separate exploratory factor analyses (EFAs) were conducted with T1D adults (\n N<\/jats:italic>\n \u2009=\u2009326), with T2D adults using both basal and prandial insulins (T2D-BP,\n N<\/jats:italic>\n \u2009=\u2009145) and with T2D adults using only basal insulin (T2D-BO,\n N<\/jats:italic>\n \u2009=\u200982). Construct validity for the HCS was established with overall well-being (World Health Organization-5), diabetes distress (Diabetes Distress Scale), global anxiety (Generalized Anxiety Disorder), hypoglycemic fear (Hypoglycemic Fear Survey-II), and glycemic control (self-reported A1C). Hierarchical regression analyses examined the unique contribution of HCS scores, independent of hypoglycemic fear, on key psychosocial constructs and A1C.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n EFAs of the nine HCS items yielded a single factor solution for each of the three subject samples, accounting for 50.8%, 65.1%, and 73.7% of the variance for the T1D, T2D-BP, and T2D-BO groups, respectively. Construct validity was established by significant correlations with criterion variables. The HCS was associated with well-being and diabetes distress in the T1D (in both cases,\n P<\/jats:italic>\n \u2009<\u20090.001) and T2D-BP groups (in both cases,\n P<\/jats:italic>\n \u2009<\u2009.05) and for self-reported A1C in the T2D-BP group (\n P<\/jats:italic>\n \u2009<\u2009.05) independent of hypoglycemic fear.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Hypoglycemic confidence is a unique dimension of patient experience, different from hypoglycemic fear, and is deserving of further study. The HCS is a reliable valid measure of hypoglycemic confidence for adults with T1D and insulin-using T2D.<\/jats:p>\n <\/jats:sec>","DOI":"10.1089\/dia.2016.0366","type":"journal-article","created":{"date-parts":[[2016,12,20]],"date-time":"2016-12-20T12:19:36Z","timestamp":1482236376000},"page":"131-136","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":107,"title":["Investigating Hypoglycemic Confidence in Type 1 and Type 2 Diabetes"],"prefix":"10.1177","volume":"19","author":[{"given":"William H.","family":"Polonsky","sequence":"first","affiliation":[{"name":"University of California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Fisher","sequence":"additional","affiliation":[{"name":"University of California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Hessler","sequence":"additional","affiliation":[{"name":"University of California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven V.","family":"Edelman","sequence":"additional","affiliation":[{"name":"University of California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,2,1]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2007.05.003"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.3111\/13696998.2011.610852"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.10.5.617"},{"key":"e_1_3_4_5_2","volume-title":"Handbook of Psychology and Diabetes","author":"Irvine A","year":"1994","unstructured":"Irvine A, , Cox D, , Gonder-Frederick L: The fear of hypoglycaemia scale. In: Bradley C, ed. Handbook of Psychology and Diabetes. New York, NY: Harwood Academic Publishers, 1994."},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2015.08.002"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2015.01.012"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1037\/hea0000387"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12040"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.3.626"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1080\/00325481.2015.1045815"},{"key":"e_1_3_4_13_2","first-page":"3","article-title":"Fear of hypoglycemia: a review","volume":"5","author":"Gonder-Frederick L","year":"2013","unstructured":"Gonder-Frederick L: Fear of hypoglycemia: a review. Diabetic Hypoglycemia, 2013; 5:3\u201311.","journal-title":"Diabetic Hypoglycemia"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/1479164113496828"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2015.01.012"}],"container-title":["Diabetes Technology & Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/dia.2016.0366","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/dia.2016.0366","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/dia.2016.0366","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T06:27:44Z","timestamp":1779431264000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/dia.2016.0366"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,2]]}},"alternative-id":["10.1089\/dia.2016.0366"],"URL":"https:\/\/doi.org\/10.1089\/dia.2016.0366","relation":{},"ISSN":["1520-9156","1557-8593"],"issn-type":[{"value":"1520-9156","type":"print"},{"value":"1557-8593","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,2]]}}}