Prevalence and Predictors of Post-coital Hypoglycemia in Diabetes Mellitus

Post-coital hypoglycemia is a significant yet often overlooked complication in diabetes management. This cross-sectional study aimed to assess the prevalence and associated factors of post-coital hypoglycemia among patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) in Al-Ahsa, Saudi Arabia. A total of 821 participants were interviewed via telephone using a structured questionnaire. The study revealed that 17.9% of participants experienced hypoglycemic events during or after sexual activity. Insulin use was strongly associated with post-coital hypoglycemia, with 28.3% of insulin users reporting such events compared to only 3.0% of non-insulin users (p<0.001). T1DM patients were significantly more likely to experience post-coital hypoglycemia than T2DM patients (92.5% vs 7.5%, p<0.001). Younger age groups, higher educational levels, and married status were also associated with increased incidence. Common symptoms reported included sweating (47.6%), palpitations (42.0%), and dizziness (37.3%). The use of certain oral diabetic medications, including metformin, sitagliptin, and gliclazide-sulfonylurea, was also associated with higher rates of post-coital hypoglycemia. These findings highlight the need for increased awareness and targeted interventions to address post-coital hypoglycemia in diabetes management. Healthcare providers should incorporate discussions about sexual health and hypoglycemia risk into routine diabetes care, particularly for high-risk groups such as insulin users and T1DM patients. Future research should focus on developing effective strategies to prevent and manage post-coital hypoglycemia, thereby improving the quality of life for individuals with diabetes.