The relationship of health-related quality of life to fear of hypoglycemia among Iranian patients with type 2 diabetes treated with oral antihyperglycemic agents
Fear of hypoglycemia is an additional psychological burden imposed on patients with type 2 diabetes mellitus (T2DM) and may reduce their health-related quality of life (HRQoL). The present study aimed to investigate the relationship between HRQoL and fear of hypoglycemia in patients with T2DM who have been taking oral antihyperglycemic agents in Iran. In this cross-sectional study, 357 patients with T2DM who were using oral anti-diabetic drugs were selected by convenient sampling. Data was collected using a three-part questionnaire [i.e., socio-demographic, the EuroQoL (EQ-5D-3L) and the worry subscale of the hypoglycemia fear survey II (HSF-II)]. Hypoglycemic severity was categorized by the recommendations of the American Diabetes Association Workgroup on Hypoglycemia. Logistic and OLS regression models were used to investigate fear of hypoglycemia and other factors associated with EQ-5D score. The mean age of patients was 54.1±11.5 years and 56.6% were male. The mean EQ-5D and VAS scores were 0.579±0.313 and 48.76±20.09, respectively. In OLS regression models, EQ-5D score was greater in males (B=0.076, P<0.01) and patients with education level >12 years (B=0.118, P<0.015). At the same time, it was lower in patients with fear of hypoglycemia (B=-0.004, P<0.001), selected cardiovascular conditions (B=-0.151, P<0.001) and lower extremity lesions (B=-0.075, P<0.042). Fear of hypoglycemia levels should be evaluated and patients with higher levels of fear of hypoglycemia should be monitored closely. Therefore, clinicians and health systems should incorporate screening for fear of hypoglycemia into the routine health assessment of all patients with T2DM.