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2019 Publications

PLOS ONE
October, 2019

Attitudes and perceptions towards hypoglycaemia in patients with diabetes
mellitus: A multinational cross-sectional study

Abdallah Y. Naser, Ian C. K. Wong, Cate Whittlesea, Hassan Alwafi, Amjad Abuirmeileh, Zahra
Khalil Alsairafi, Fawaz Mohammad Turkistani, Nedaa Saud Bokhari, Maedeh Y. Beykloo, Dalal Al-

Taweel, Mai B. Almane, Li Wei1
Background
Preventing hypoglycaemia is an essential component of diabetes self-management that is affected by
patients’ attitudes and perceptions. This study aimed to explore the hypoglycaemia problem-solving
ability of patients who have diabetes mellitus and factors that determine their attitudes and perceptions
towards their previous events.
Methodology
A cross-sectional study was conducted between October 2017 and May 2018 in three Arab countries
(Jordan, Saudi Arabia and Kuwait) in patients with diabetes mellitus, who were prescribed antidiabetic
therapy and had experienced hypoglycaemic events in the past six months. The Hypoglycaemia
Problem-Solving Scale was used in this study. This scale contains two subscales, problem orientation
(six questions) and problem-solving skills (eighteen questions), using a five-point Likert scale (range
0–4). Multiple linear regression analysis was used to identify predictors of hypoglycaemia problem-
solving abilities.
Results
A total of 895 patients participated in this study from the three countries (300 in Jordan, 302 in Saudi
Arabia, and 293 in Kuwait). The average age of the patients was 53.5 years (standard deviation = 13.7)
and 52.4% (n = 469) were males. Patients had moderate overall problem- solving ability with a
median score of 63.00 (interquartile range = 13.00). Patients’ problem-solving skills score (68.1%)
was better than their problem-orientation skills score (58.3%). The highest sub-scale scores were for
detection control, setting problem solving goals, and evaluating strategies, 75.0%. The lowest sub-
scale score was for problem solving perception and immediate management, 50.0%. Older age, being
educated, being married, having T2DM, prescribed insulin therapy, and not having been admitted to
hospital for hypoglycaemia were important predictors of patients’ problem-solving ability (p < 0.05).
Conclusions
Healthcare professionals are advised to provide more education to patients on how to selfmanage
hypoglycaemic events. Specifically, they should focus on the overall problem-solving perception of
hypoglycaemia and its immediate management
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0222275

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