# Self-reported hypoglycemia and associated factors among patients living with T1D s at University of Gondar Comprehensive Specialized Hospital, Northwest, Ethiopia: a cross-sectional study

## TL;DR

This study found that most type 1 diabetes patients in Ethiopia experience hypoglycemia, with low knowledge of insulin use linked to higher risk.

## Contribution

The study provides real-world evidence on hypoglycemia prevalence and its association with insulin knowledge in a T1D population in Ethiopia.

## Key findings

- 86.6% of T1D patients reported hypoglycemia, with 31% experiencing severe cases.
- Low knowledge of insulin self-administration was significantly associated with increased hypoglycemia risk.
- 71.8% of patients had impaired awareness of hypoglycemia symptoms.

## Abstract

Hypoglycemia is a major public health problem that negatively influences blood glucose control in the treatment of type 1 diabetes. It has more severe clinical and economic effects in patients living with T1D patients. However, real-world clinical evidence of reported hypoglycemia is limited. Thus, the purpose of the study was to determine the prevalence of self-reported hypoglycemia and its associated factors among patients living with T1Dat the University of Gondar Comprehensive Specialized Hospital (UOGCSH).

A prospective hospital-based cross-sectional study was conducted among patients living with T1D attending the ambulatory clinic of UOGCSH from November 1, 2021, to April 30, 2022. To select the study participants, a convenient sampling technique was used. Multivariable binary logistic regression was used to identify predictors of self-reported hypoglycemia. A P-value < 0.05 was considered statistically significant and reported as a 95% Confidence Interval (CI).

A total of 216 patients living with T1D (mean age: 50.91 ± 18.98 years) were included. The mean duration of DM diagnosis and insulin use were 9.41 ± 8.00 and 7.10 ± 6.00 years, respectively. Self-reported hypoglycemia was prevalent among 86.6% (95% CI: 82.1-91.0) of the study participants, with 69% experiencing non-severe and 31% experiencing severe hypoglycemia. More than half of the patients, 122 (56.5%), reported experiencing four or more (≥ 4) episodes of hypoglycemia. Knowledge of insulin self-administration, specifically a low level of knowledge (AOR=4.87; 95% CI: 1.55-15.26), was significantly associated with self-reported hypoglycemia. The majority of patients living with T1D, 155 (71.8%), had impaired awareness of hypoglycemia.

Self-reported hypoglycemia was considerably high among Patients living with T1D. Knowledge of insulin self-administration, specifically at a low level, was associated with an increased risk of reported hypoglycemia. Thus, continued health education of Patients living with T1D regarding insulin self-administration and awareness of hypoglycemia symptoms is necessary to prevent further complications.