The relationship between components of hypoglycemia worries and avoiding hypoglycemia behavior in type 2 diabetes mellitus with hypoglycemia: a network analysis

Abstract

Background The fear of hypoglycemia in type 2 diabetes mellitus (T2DM) patients with hypoglycemia has seriously affected their quality of life. They are always afraid of hypoglycemia and often take excessive action to avoid it. Yet, researchers have investigated the relationship between hypoglycemia worries and excessive avoiding hypoglycemia behavior using total scores on self-report measures. However, network analysis studies of hypoglycemia worries and excessive avoiding hypoglycemia behavior in T2DM patients with hypoglycemia are lacking. Purpose The present study investigated the network structure of hypoglycemia worries and avoiding hypoglycemia behavior in T2DM patients with hypoglycemia and aimed to identify bridge items to help them correctly treat hypoglycemia and properly deal with hypoglycemia fear. Methods A total of 283 T2DM patients with hypoglycemia were enrolled in our study. Hypoglycemia worries and avoiding hypoglycemia behavior were evaluated with the Hypoglycemia Fear Scale. Network analyses were used for the statistical analysis. Results B9 “Had to stay at home for fear of hypoglycemia” and W12 “I am worried that hypoglycemia will affect my judgment” have the highest expected influences in the present network. In the community of hypoglycemia worries, W17 “I worry about hypoglycemia during sleep” has the highest bridge expected influence. And in the community of avoiding hypoglycemia behavior, B9 “Had to stay at home for fear of hypoglycemia” has the highest bridge expected influence. Conclusion Complex patterns of associations existed in the relationship between hypoglycemia worries and avoiding hypoglycemia behavior in T2DM patients with hypoglycemia. From the perspective of network analysis, B9 “Had to stay at home for fear of hypoglycemia” and W12 “I am worried that hypoglycemia will affect my judgment” have the highest expected influence, indicating their highest importance in the network. W17 “I worry about hypoglycemia during sleep” aspect of hypoglycemia worries and B9 “Had to stay at home for fear of hypoglycemia” aspect of avoiding hypoglycemia behavior have the highest bridge expected influence, indicating they have the strongest connections with each community. These results have important implications for clinical practice, which provided potential targets for interventions to reduce hypoglycemia fear and improve the quality of life in T2DM patients with hypoglycemia.

Hypoglycaemic confidence levels and experiences related to the hypoglycaemia of patients with diabetes: A mixed methods study

“…These findings are supported by prior research (Brown et al, 2019;Gül et al, 2021;Menekli & Şentürk, 2022;Sheikhi et al, 2020;Wu et al, 2023). In the current study, the hypoglycaemic confidence levels of patients with diabetes were moderate, and the hypoglycaemic confidence levels of patients with fear of experiencing hypoglycaemia were lower.…”

“…The physiological and psychological symptoms experienced by patients due to hypoglycaemia may have caused the disruption in their daily lives. In a prior study, it was found that patients experiencing hypoglycaemia experienced fear and anxiety, and as a result, they severely restricted their social lives in order to avoid this (Wu et al., 2023). Restrictions in daily and social life can impair a patient's ability to fulfil diabetes self‐care and therefore jeopardise their health (Martyn‐Nemeth et al., 2019; Przezak et al., 2022).…”

The Relationship Between Fear of Hypoglycemia and Sleep Quality in Individuals with Type 2 Diabetes Mellitus: Descriptive and Relationship Seeking Study

“…23 Türkiye'de DM'si olan yaşlı hastaların uyku kalitesinin değerlendirildiği çalışmada, hastaların %58,6'sında kötü uyku kalitesi olduğu görülmüştür. 24 Daha uzun diyabet süresi, daha yüksek hipoglisemik olay insidansı ve diyabetik komplikasyonlar, kötü uyku kalitesi ile anlamlı şekilde ilişkili olduğunu belirlemişlerdir. 25 Yapılan çalışmalarda görüldüğü gibi DM'si olan bireylerde uyku kalitesini olumsuz yönde etkileyen birçok faktör olabilir.…”

“…Diğer maddelerden daha çok "Uyku sırasında hipoglisemi konusunda endişeleniyorum" ifadesini ele almanın, hipoglisemiden aşırı kaçınma davranışını azaltmada daha etkili olabileceği belirtilmiştir. 24 Tip 2 DM'si olan bireylerde hipoglisemi korkusu ile uyku kalitesi arasındaki etkinin nedenlerinin incelenmesinin uyku kalitesinin geliştirilmesinde faydalı olabileceği düşünülmektedir.…”