ORIGINAL RESEARCH article
Front. Psychol.
Sec. Health Psychology
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
Shaimaa Mohamed Amin 1
Haitham Mokhtar Mohamed Abdallah 2
Mohamed Zoromba 3
Esteer Ibrahim Ghayth 4
Sameer A. Alkubati 5
Nada Alqarawi 6
Mohamed Hussein Ramadan Atta 3
Ibrahim Alasqah 6
Nesreen AbdelMonaem AbouZeid 7
Sally Mohammed Farghaly 7
Suebsarn Ruksakulpiwat 8
1. Damanhour University, Damanhour, Egypt
2. Alexandria University, Alexandria, Egypt
3. Prince Sattam bin Abdulaziz University, Al Kharj, Saudi Arabia
4. Sohag University, Sohag, Egypt
5. University of Ha'il College of Nursing, Hail, Saudi Arabia
6. Qassim University, Buraydah, Saudi Arabia
7. Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
8. Mahidol University, Salaya, Thailand
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Abstract
Introduction: 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. Aim: To examine the influence of fear of hypoglycemia and frailty on self-efficacy in diabetes management among older adults with T2DM. Methods: 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. Results: 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). Conclusion: Interventions addressing fear of hypoglycemia and frailty are essential to enhance self-efficacy and improve diabetes self-management in older adults.
Summary
Keywords
Community empowerment, Cross-sectional study, Diabetes Mellitus, Frailty, hypoglycemia phobia, Management, Medication Adherence, older adults
Received
06 October 2025
Accepted
02 February 2026
Copyright
© 2026 Amin, Abdallah, Zoromba, Ghayth, Alkubati, Alqarawi, Atta, Alasqah, AbouZeid, Farghaly and Ruksakulpiwat. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Suebsarn Ruksakulpiwat
Disclaimer
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