To examine sociodemographic, clinical and psychological factors associated with fear of hypoglycaemia in adults with Type�1 diabetes.

Data were obtained from Diabetes MILES – The Netherlands, an online self‐report national survey. This cross‐sectional analysis focused on participants with Type�1 diabetes who completed the 18‐item Hypoglycaemia Fear Survey – Second Version Worry subscale (HFS–II–W; possible total score range 0–72, higher scores indicating higher fear) (n�=�288). To explore correlates of fear of hypoglycaemia, a hierarchical linear regression analysis was performed in participants with full data on sociodemographic, clinical and psychological factors (n�=�232; younger and more highly educated than those excluded).

HFS–II–W mean score was 11.1���11.1. Gender, age, education and having a partner (model�1) were not associated with fear of hypoglycaemia. In model�2, history of severe hypoglycaemia (irrespective of number of events) was associated with (greater) fear of hypoglycaemia, whereas diabetes duration, pump therapy and HbA_1c were not. Type�D personality was positively correlated (model�3), as were symptoms of depression, but not anxiety (model�4). Adding loneliness (model�5) did not improve the model. The fully adjusted analysis showed that fear of hypoglycaemia was associated with depressive symptoms (β�=�0.38, P�<�0.001) and history of hypoglycaemia (1–2 events: β�=�0.30, P�<�0.001; ≥�3 events: β�=�0.19, P�=�0.002). Total explained variance was 23%.

Depressive symptoms and history of hypoglycaemia are associated with fear of hypoglycaemia in adults with Type�1 diabetes. These factors may help to identify people with excessive fear, who may particularly benefit from interventions to reduce hypoglycaemia risk and worries.