Understanding hypoglycemia: Validation of the hypoglycemic attitudes and behavior scale in Turkish type 2 diabetes patients

BackgroundThe Hypoglycemic Attitudes and Behavior Scale (HABS) is designed to assess key aspects of hypoglycemia-related experiences.AimThis study aimed to evaluate the validity and reliability of the Turkish version of HABS in patients with type 2 diabetes mellitus (T2DM), including both insulin users and nonusers.MethodsA total of 181 patients with T2DM (mean age 58.76 ± 10.17 years), including both insulin users and non-users, participated in this study. Exploratory factor analysis (EFA) was performed to determine the factor structure, while confirmatory factor analysis (CFA) was conducted to assess the model fit. Internal consistency reliability was evaluated via Cronbach's alpha (α) coefficient and the test-retest method. Convergent validity was examined by analyzing the correlation between the HABS and the Hypoglycemia Fear Scale (HFS).ResultsCronbach's α coefficient values for the anxiety, avoidance, and confidence sub-dimensions were 0.68, 0.75, and 0.82, respectively. Test-retest correlations for the subdimensions were positive, moderate to high, and statistically significant (<i>P</i> < 0.001). EFA revealed a three-factor structure, similar to the original HABS, with three items removed. CFA confirmed that the modified model had a good fit. A significant positive correlation was found between HABS and HFS subdimensions (<i>P</i> < 0.001), supporting convergent validity.ConclusionsThe Turkish version of HABS demonstrates strong psychometric properties, making it a valuable tool for assessing hypoglycemia-related attitudes and behaviors in Turkish T2DM patients and informing clinical practice.