Predictive factors of fear of hypoglycemia in type 2 diabetes patients; an analytical study on the role of hypoglycemic episodes and their interpretation

Introduction: Fear of hypoglycemia (FoH) is a prevalent psychosocial issue among individuals with type 2 diabetes, often leading to maladaptive behaviors such as elevated blood glucose levels, reduced physical activity, and inappropriate insulin management. Objectives: The current study seeks to identify predictors of this fear and examine its interpretative role in managing diabetes, emphasizing the necessity for targeted interventions that address both the psychological and physiological aspects of diabetes care. Patients and Methods: This descriptive-analytical study involved 260 patients with type 2 diabetes receiving treatment at Velayat clinic and Bu Ali hospital in Qazvin city. Data was collected using a demographic questionnaire and the hypoglycemia fear survey II (HFS-II). The demographic questionnaire gathered information on participants’ age, gender, marital status, educational background, occupation, duration of diabetes, treatment modality, co-existing medical conditions, and religious affiliation. To assess the FoH, the HFS-II was employed, focusing on a worry dimension. To explore the factors affecting the FoH univariate and multivariate linear regression was used. Results: The analysis of predictors of FoH in patients with type 2 diabetes revealed several significant associations, including a positive correlation between the number of hypoglycemic episodes in the past six months and fear levels. Educational attainment influenced fear, with those having academic education reporting lower fear compared to those with guidance education. Economic status revealed that patients in poorer conditions experienced higher fear levels than those with moderate status. Insulin treatment was associated with greater fear compared to oral tablet treatment, while the presence of long-term diabetes complications and a history of hypoglycemia were linked to increased fear. Conclusion: In conclusion, the analysis of predictors of FoH in patients with type 2 diabetes highlights the need for a comprehensive, patient-centered approach that considers demographic, clinical, and psychosocial factors. Healthcare providers should tailor interventions to individual patient characteristics, provide targeted education and support, and address both physiological and psychological aspects of diabetes management to effectively mitigate the FoH and improve the overall quality of life for patients with type 2 diabetes.