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Impact of fear of hypoglycaemia on self-management in patients with type 2 diabetes mellitus: structural equation modelling

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A Correction to this article was published on 21 March 2022

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Abstract

Aims

This study aimed to explore the effect of fear of hypoglycaemia (FOH) on self-management and its specific action path in patients with type 2 diabetes mellitus (T2DM) to provide a basis for developing targeted nursing interventions.

Design

A cross-sectional study.

Methods

From June to October 2019, we recruited 258 patients with T2DM from the endocrinology department of three hospitals to complete questionnaires, including the Hypoglycaemia Fear Survey-II, Diabetes Distress Scale, Self-Stigma Scale, Social Support Rating Scale and Summary of Diabetes Self-Care Activities, in Jiangsu Province, China. Pearson’s correlation analyses and structural equation modelling were conducted to explore the relationship and influence path among the above variables.

Results

The correlation analysis of FOH, distress, self-stigma, social support and self-management showed that, except for social support not being correlated with FOH and distress (P > 0.05), all variables were correlated in pairs (r = − 0.19–0.77, P < 0.01). The final model fit well, and the fitting indexes of the model were as follows: χ2/df = 2.191, GFI = 0.934, CFI = 0.954, TLI = 0.934, RMSEA = 0.068, and SRMR = 0.0649. The effects of FOH on self-management in patients with T2DM included one direct path and two indirect paths: (a) FOH had a direct impact on self-management (P < 0.05); (b) FOH had an indirect impact on self-management through distress (P < 0.05); and (c) FOH had an indirect impact on self-management through self-stigma and social support (P < 0.05).

Conclusions

FOH could directly influence self-management in patients with T2DM. Furthermore, distress, self-stigma and social support were important mediating variables of FOH influencing self-management. Researchers can develop personalized interventions to improve the self-management of patients with T2DM by regulating distress, self-stigma and social support levels.

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Data availability statement

The data used to support the findings of this study are available from the corresponding author on reasonable request.

Change history

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Acknowledgements

The authors sincerely thank the network equipment support policy of the School of Nursing, Yangzhou University, China. We are also grateful to American Journal Experts (AJE) for their language polishing of the manuscript.

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Authors and Affiliations

  1. School of Nursing, Yangzhou University, Jiangyang Road 136, Yangzhou, China

    Shuang Li, Lu Zhang, Yaxin Bi, Yan Zou, Lin Liu, Yuan Yuan, Weijuan Gong & Yu Zhang

  2. Department of Nursing, Taicang First People’s Hospital, Suzhou, China

    Shuang Li & Hong Zhang

  3. Intensive Care Unit, Taicang First People’s Hospital, Suzhou, China

    Yehui Li

  4. Department of Nursing, Affiliated Hospital of Yangzhou University, Yangzhou, China

    Yuan Yuan

  5. Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, China

    Yu Zhang

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  1. Shuang Li
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Correspondence to Yu Zhang.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the ethics committee of the university and the affiliated hospital (2019-YKL05-30).

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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All persons gave their informed consent prior to their inclusion in the study. The privacy rights of subjects were observed.

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The original online version of this article was revised: Corresponding authorship of author Shuang Li deleted. Order of author affiliations updated.

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Li, S., Li, Y., Zhang, L. et al. Impact of fear of hypoglycaemia on self-management in patients with type 2 diabetes mellitus: structural equation modelling. Acta Diabetol 59, 641–650 (2022). https://doi.org/10.1007/s00592-021-01839-y

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