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Almost 100 years since the discovery of insulin, hypoglycaemia remains a barrier for people with type 1 diabetes to achieve and maintain blood glucose at levels which prevent long‐term diabetes‐related complications. Although hypoglycaemia is primarily attributable to the limitations of current treatment and defective hormonal counter‐regulation in type 1 diabetes, the central role of psycho‐behavioural factors in preventing, recognizing and treating hypoglycaemia has been acknowledged since the early 1980s. Over the past 25 years, as documented in the present review, there has been a substantial increase in psycho‐behavioural research focused on understanding the experience and impact of hypoglycaemia. The significant contributions have been in understanding the impact of hypoglycaemia on a person's emotional well‐being and aspects of life (e.g. sleep, driving, work/social life), identifying modifiable psychological and behavioural risk factors, as well as in developing psycho‐behavioural interventions to prevent and better manage (severe) hypoglycaemia. The impact of hypoglycaemia on family members has also been confirmed. Structured diabetes education programmes and psycho‐behavioural interventions with a focus on hypoglycaemia have both been shown to be effective in addressing problematic hypoglycaemia. However, the findings have also revealed the complexity of the problem and the need for a personalized approach, taking into account the individual's knowledge of, and emotional/behavioural reactions to hypoglycaemia. Evidence is emerging that people with persistent and recurrent severe hypoglycaemia, characterized by deeply entrenched cognitions and lack of concern around hypoglycaemia, can benefit from tailored cognitive behavioural therapy. What's new?: Since 1995, psycho‐behavioural research has demonstrated the profound psychological effects of hypoglycaemia on people with type 1 diabetes and their families.In addition to diabetes‐related factors, the research has identified modifiable psycho‐behavioural risk factors for recurrent severe hypoglycaemia and potential targets for interventions.Based on a biopsychosocial model of hypoglycaemia, psycho‐educational interventions have been shown to improve a person's symptom awareness, reduce fear, and lower the incidence of severe hypoglycaemia.Effective psycho‐educational interventions deserve to be integrated in routine diabetes care, supplemented with sensor‐based technologies for those in need.Further research is needed using the latest advances in diabetes and data collection technologies to progress understanding of the real‐time impact of hypoglycaemia. [ABSTRACT FROM AUTHOR]

Aims To develop an empirically derived short version of the Hypoglycaemia Fear Survey II that still accurately measures fear of hypoglycaemia. Methods Item response theory methods were used to generate an 11-item version of the Hypoglycaemia Fear Survey from a sample of 487 people with Type 1 or Type 2 diabetes mellitus. Subsequently, this scale was tested on a sample of 2718 people with Type 1 or insulin-treated Type 2 diabetes taking part in DIALOG, a large observational prospective study of hypoglycaemia in France. Results The short form of the Hypoglycaemia Fear Survey II matched the factor structure of the long form for respondents with both Type 1 and Type 2 diabetes, while maintaining adequate internal reliability on the total scale and all three subscales. The two forms were highly correlated on both the total scale and each subscale (Pearson's R > 0.89). Conclusions The short form of the Hypoglycaemia Fear Survey II is an important first step in more efficiently measuring fear of hypoglycaemia. Future prospective studies are needed for further validity testing and exploring the survey's applicability to different populations. [ABSTRACT FROM AUTHOR]