关键词: 糖尿病, 2型；低血糖症；低血糖恐惧感；影响因素分析

Abstract: Background　Hypoglycemia is a major barrier to the management of diabetes.Uncomfortable symptoms induced by hypoglycemia can easily result in fear of hypoglycemia（FOH），affecting the disease management.Objective　To analyze the prevalence and influencing factors of FOH in patients with type 2 diabetes mellitus（T2DM）.Methods　This study was carried out from June to October 2019.By use of convenience sampling，T2DM inpatients with a attack history of hypoglycemia within half a year were randomly selected from three tertiary hospitals in Suzhou City and Yangzhou City to attend an onsite survey using a questionnaire consisting of four parts〔demographics，Hypoglycemia Fear Survey-Ⅱ（HFS-Ⅱ），Chinese version of Diabetes Distress Scale（DDS），Summary of Diabetes Self-Care Activities（SDSCA）〕.Researchers with unified survey-related training distributed the questionnaires and collected them after the participants completed.Multiple linear regression analysis was performed to determine the influencing factors of FOH.Spearman rank correlation analysis was used to analyze the correlations of FOH with the degree of distress and self-care activities.Results　The response rate of the questionnaire was 90.2%（258/286）.The average total score of HFS-Ⅱ，Chinese version of DDS and SDSCA was 35.0（27.8，47.0），（36.9±11.0）and（33.2±6.7），respectively，for the 258 respondents.The total score of HFS-Ⅱ among the respondents differed significantly by course of T2DM，therapeutic regimen，understanding of T2DM，number of hypoglycemia attacks within half a year，total average score of Chinese version of DDS and total score of SDSCA，past history of hypoglycemia，severe hypoglycemia，and nocturnal hypoglycemia（P<0.05）.Multiple linear regression analysis showed that，course of T2DM〔B=0.259，95%CI（0.074，0.443）〕，understanding of T2DM〔clear understanding：B=0.362，95%CI（0.003，0.722）〕，number of hypoglycemia attacks within half a year〔3 to 6 times：B=0.737，95%CI（0.428，1.045）；over 6 times：B=0.322，95%CI（0.123，0.520）〕，nocturnal hypoglycemia〔B=0.263，95%CI（0.072，0.454）〕，total scores of Chinese version of DDS〔B=0.711，95%CI（0.600，0.822）〕and SDSCA〔B=-0.019，95%CI（-0.031，-0.006）〕were associated with FOH in patients with T2DM（P<0.05），accounting for 64.3% of the total variants.Spearman rank correlation analysis showed that，in terms of total score，HFS-Ⅱ was positively correlated with Chinese version of DDS（rs=0.749，P<0.01），but was negatively correlated with SDSCA（rs=-0.204，P<0.01）.Conclusion　FOH prevalence is relatively high in patients with T2DM，which is correlated with the levels of distress and self-care activities.Moreover，it is associated with the course and understanding of T2DM，number of hypoglycemia attacks within half a year，nocturnal hypoglycemia，total scores of Chinese version of DDS and SDSCA.Thus，medical workers should pay attention to early psychological screening in such patients and guide them to develop self-management behaviors in an appropriate way.

Key words: Diabetes mellitus, type 2；Hypoglycemia；Fear of hypoglycemia；Root cause analysis