{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:57:22Z","timestamp":1784545042831,"version":"3.55.0"},"reference-count":70,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004242","name":"Princess Nourah bint Abdulrahman University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004242","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004242","name":"Princess Nourah bint Abdulrahman University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004242","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine the influence of fear of hypoglycemia and frailty on self-efficacy in diabetes management among older adults with T2DM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted at diabetic clinics, with 300 adults aged \u2265 60\u202fyears using convenience sampling. Validated tools included the Fear of Hypoglycemia Screener, Chinese Frailty Screening Scale, and Diabetes Management Self-Efficacy Scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean scores for fear of hypoglycemia, frailty, and self-efficacy were 36.13\u202f\u00b1\u202f7.70, 12.93\u202f\u00b1\u202f2.28, and 19.95\u202f\u00b1\u202f3.33, respectively. Fear of hypoglycemia correlated positively with frailty (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.277,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01) and negatively with self-efficacy (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f\u22120.270,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01). Frailty also showed a moderate negative correlation with self-efficacy (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f\u22120.454,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.01). Regression analysis identified higher fear of hypoglycemia and frailty scores predicted lower self-efficacy (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Interventions addressing fear of hypoglycemia and frailty are essential to enhance self-efficacy and improve diabetes self-management in older adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2026.1714323","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T06:52:58Z","timestamp":1773211978000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["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"],"prefix":"10.3389","volume":"17","author":[{"given":"Shaimaa Mohamed","family":"Amin","sequence":"first","affiliation":[{"name":"Department of Community, Psychiatric, and Mental Health Nursing, College of Nursing, Qassim University","place":["Buraydah, Saudi Arabia"]},{"name":"Nursing Services Department, Qassim University Medical City","place":["Buraydah, Saudi Arabia"]},{"name":"Community Health Nursing Department, Faculty of Nursing, Damanhour University","place":["Damanhour, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haitham Mokhtar Mohamed","family":"Abdallah","sequence":"additional","affiliation":[{"name":"College of Nursing, Jouf University","place":["Sakaka, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Ali","family":"Zoromba","sequence":"additional","affiliation":[{"name":"Nursing Department, College of Nursing, Prince Sattam Bin Abdulaziz University","place":["Al-Kharj, Saudi Arabia"]},{"name":"Psychiatric and Mental Health Nursing, Faculty of Nursing, Mansoura University","place":["Mansoura, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esteer Ibrahim","family":"Ghayth","sequence":"additional","affiliation":[{"name":"Geriatric Nursing Department, Faculty of Nursing, Sohag University","place":["Sohag, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer A.","family":"Alkubati","sequence":"additional","affiliation":[{"name":"Department of Medical-Surgical Nursing, College of Nursing, University of Ha\u2019il","place":["Ha\u2019il, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nada","family":"Alqarawi","sequence":"additional","affiliation":[{"name":"Department of Community, Psychiatric, and Mental Health Nursing, College of Nursing, Qassim University","place":["Buraydah, Saudi Arabia"]},{"name":"Nursing Services Department, Qassim University Medical City","place":["Buraydah, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Hussein Ramadan","family":"Atta","sequence":"additional","affiliation":[{"name":"Nursing Department, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University","place":["Wadi Ad-Dawasir, Saudi Arabia"]},{"name":"Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Alexandria University","place":["Alexandria, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Alasqah","sequence":"additional","affiliation":[{"name":"Department of Community, Psychiatric, and Mental Health Nursing, College of Nursing, Qassim University","place":["Buraydah, Saudi Arabia"]},{"name":"Nursing Services Department, Qassim University Medical City","place":["Buraydah, Saudi Arabia"]},{"name":"School of Health, University of New England","place":["Armidale, NSW, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nesreen AbdelMonaem AbdelSataar","family":"AbouZeid","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Nursing, College of Nursing, Princess Nourah bint Abdulrahman University","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally Mohammed","family":"Farghaly Abdelaliem","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculty of Allied Health Sciences, Kuwait University","place":["Kuwait City, Kuwait"]},{"name":"Department of Nursing Administration, Faculty of Nursing, Alexandria University","place":["Alexandria, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suebsarn","family":"Ruksakulpiwat","sequence":"additional","affiliation":[{"name":"Department of Medical Nursing, Faculty of Nursing, Mahidol University","place":["Bangkok, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1548","DOI":"10.1016\/j.jdiacomp.2016.07.027","article-title":"Hypoglycemia, frailty and dementia in older people with diabetes: reciprocal relations and clinical implications","volume":"30","author":"Abdelhafiz","year":"2016","journal-title":"J. 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