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

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.