Factors associated with quality of life in patients with diabetic hypoglycaemia

To identify determinants of quality of life among patients who had experienced hypoglycaemia and who were undergoing insulin treatment.

Patients with diabetes receiving insulin treatment are at high risk for hypoglycaemia, which tends to affect their quality of life.

With a cross-sectional and observational study design (see the STROBE checklist and Appendix S1).

One hundred and fifty patients with type 2 diabetes who had received insulin treatment and had experienced hypoglycaemia (<70 mg/dl) in the last 6 months were recruited. Data were collected from May 2016-February 2018 using the Knowledge of Hypoglycaemia Scale, Fear of Hypoglycaemia Scale, Social Support Scale and the simplified Taiwanese version of the Quality of Life Scale developed by the World Health Organization.

Factors found to be associated with quality of life in patients with hypoglycaemia included having an educational level of senior high school or above, being on an insulin regimen only, engaging in regular exercise, diabetes complications, fear of hypoglycaemia and greater social support, which accounted for 28.5% of the total variance.

During the process of glycaemic control, patients inevitably experience hypoglycaemic episodes. Therefore, healthcare providers should assist patients with disease management to improve their quality of life. Future studies should also recruit patients who claim to have experienced hypoglycaemic symptoms, rather than considering only those with blood glucose levels below 70 mg/dl, to expand the generalisability of the findings. Future studies may also focus on the management of hypoglycaemia in patients on an insulin regimen, and on examining the effect of health education programmes on prevention of hypoglycaemia.

The present findings could provide a reference for healthcare providers to consolidate nursing care guidelines and to improve such patients' quality of life.