# The influence of fear of hypoglycemia and frailty on self-efficacy in diabetes management among older adults with type 2 diabetes: a cross-sectional study

**Authors:** Shaimaa Mohamed Amin, Haitham Mokhtar Mohamed Abdallah, Mohamed Ali Zoromba, Esteer Ibrahim Ghayth, Sameer A. Alkubati, Nada Alqarawi, Mohamed Hussein Ramadan Atta, Ibrahim Alasqah, Nesreen AbdelMonaem AbdelSataar AbouZeid, Sally Mohammed Farghaly Abdelaliem, Suebsarn Ruksakulpiwat

PMC · DOI: 10.3389/fpsyg.2026.1714323 · Frontiers in Psychology · 2026-03-11

## TL;DR

This study explores how fear of hypoglycemia and frailty affect diabetes self-efficacy in older adults with type 2 diabetes.

## Contribution

The study identifies fear of hypoglycemia and frailty as significant predictors of lower self-efficacy in older diabetes patients.

## Key findings

- Fear of hypoglycemia and frailty are positively correlated in older adults with T2DM.
- Higher fear of hypoglycemia and frailty scores predict lower self-efficacy in diabetes management.
- Frailty shows a stronger negative correlation with self-efficacy than fear of hypoglycemia.

## Abstract

Managing type 2 diabetes mellitus (T2DM) in older adults is challenging, particularly when complicated by fear of hypoglycemia and frailty, both of which can undermine self-efficacy, a key determinant of effective disease control.

To examine the influence of fear of hypoglycemia and frailty on self-efficacy in diabetes management among older adults with T2DM.

A cross-sectional study was conducted at diabetic clinics, with 300 adults aged ≥ 60 years using convenience sampling. Validated tools included the Fear of Hypoglycemia Screener, Chinese Frailty Screening Scale, and Diabetes Management Self-Efficacy Scale.

Mean scores for fear of hypoglycemia, frailty, and self-efficacy were 36.13 ± 7.70, 12.93 ± 2.28, and 19.95 ± 3.33, respectively. Fear of hypoglycemia correlated positively with frailty (r = 0.277, p < 0.01) and negatively with self-efficacy (r = −0.270, p < 0.01). Frailty also showed a moderate negative correlation with self-efficacy (r = −0.454, p < 0.01). Regression analysis identified higher fear of hypoglycemia and frailty scores predicted lower self-efficacy (p < 0.05).

Interventions addressing fear of hypoglycemia and frailty are essential to enhance self-efficacy and improve diabetes self-management in older adults.

## Linked entities

- **Diseases:** type 2 diabetes (MONDO:0005148), hypoglycemia (MONDO:0004946)

## Full-text entities

- **Diseases:** Hypoglycemia (MESH:D007003), T2DM (MESH:D003924), Diabetes (MESH:D003920), Frailty (MESH:D000073496)

## Full text

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## References

70 references — full list in the complete paper: https://tomesphere.com/paper/PMC13013289/full.md

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Source: https://tomesphere.com/paper/PMC13013289