Cancer Nutrition Education for Black Women: Policy Responsibility in a Systematic Review.

Managing type 1 diabetes (T1D) in very young children (<7 years) requires continuous parent involvement due to young children’s limited hypoglycaemia awareness and variable eating and activity patterns [,]. In parents of very young children, fear of hypoglycaemia (FH) is common [,] and related to greater parenting stress [], increased diabetes distress [], and higher child glycaemia []. Nighttime presents a particularly challenging context for parental FH [], as parents often perform overnight glucose checks, respond to device alarms, and engage in anticipatory behaviour (e.g., raising glucose targets) to prevent nighttime hypoglycaemia. Despite advances in diabetes technology, continuous glucose monitors (CGM) and advanced insulin delivery systems (AID) have not eliminated these demands; parents continue to experience significant stress, sleep disruption, and sustained vigilance related to nighttime T1D care [–]. These challenges are concerning because they accumulate over time increasing parent fatigue and impairing mood, attention, and daily functioning[,]. Because parents are primarily responsible for T1D management in very young children, fatigue and sleep disturbance may also have important clinical implications if they undermine T1D treatment decision-making, including glucose monitoring and insulin administration []. Parallel work with parents of adolescents suggest that these challenges persist across developmental periods, with parents describing substantial FH at nighttime, worries about missing alarms or device malfunction, and ongoing overnight monitoring even when using AID []. Together, nighttime FH-related vigilance is a pervasive burden for families and underscores the need to examine its specific impact on parents’ sleep in families of very young children []. Despite the conceptual link between FH-related vigilance and parental sleep disturbance, empirical data in parents of young children with T1D remain limited, particularly in samples using CGM and AID [,]. In addition, few studies have examined whether FH contributes uniquely to sleep disruptions after accounting for broader psychosocial factors that can impact sleep quality, such as depressive symptoms, general anxiety, and diabetes distress []. Clarifying whether FH has an independent association with parent sleep disturbance is an important next step to identify which parents are at greatest risk and inform the development of tailored clinical screening protocols. Moreover, determining the unique contribution of FH could guide intervention targets by distinguishing modifiable, anxiety-driven behaviour from those driven by technology demands or general T1D care.