Hypoglycemia in Type 2 Diabetes: A Survey of Physicians from Three Developing Regions

Abstract Hypoglycemia in type 2 diabetes (T2D) is primarily linked to certain antihyperglycemic therapies. However, limited data exist on physicians' knowledge and clinical practices regarding hypoglycemia, particularly in developing regions. To assess physicians' knowledge of hypoglycemia and accuracy in treatment decision-making across three developing regions with high diabetes prevalence. A total of 269 physicians from the Middle East, Africa, and Southeast Asia completed a 6-month online survey (July–December 2021). The questionnaire used multiple-choice and scenario-based questions to evaluate hypoglycemia knowledge, clinical attitudes, and management decisions. Respondents were mostly senior physicians (78.4%), with 42.4% being endocrinologists. Nearly 79.3% correctly recognized that both type 1 diabetes and T2D are susceptible to hypoglycemia, and insulin (95.5%) and sulfonylureas (83.2%) were most commonly identified as high-risk drugs. Only 53.8% could correctly identify severe hypoglycemia. Top concerns included hypoglycemia unawareness (76.0%), renal failure (61.3%), and advanced age (47.9%). Knowledge significantly varied by specialty, with endocrinologists performing better in scenario-based decision-making. Physician knowledge of hypoglycemia remains variable. Improving hypoglycemia-related education and optimizing pharmacologic therapy are essential for reducing the risk and fear of hypoglycemia in patients with T2D.