Amin S.M.Abdallah H.M.M.Zoromba M.A.Ghayth E.I.Alkubati S.A.Alqarawi N.Atta M.H.R.Alasqah I.AbouZeid N.A.M.A.S.Farghaly Abdelaliem S.M.Ruksakulpiwat S.Mahidol University2026-04-092026-04-092026-01-01Frontiers in Psychology Vol.17 (2026)https://repository.li.mahidol.ac.th/handle/123456789/116006Introduction: 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. Aim: To examine the influence of fear of hypoglycemia and frailty on self-efficacy in diabetes management among older adults with T2DM. Methods: A cross-sectional study was conducted at diabetic clinics, with 300 adults aged ≥ 60 years using convenience sampling. Validated tools included the Fear of Hypoglycemia Screener, Chinese Frailty Screening Scale, and Diabetes Management Self-Efficacy Scale. Results: Mean scores for fear of hypoglycemia, frailty, and self-efficacy were 36.13 ± 7.70, 12.93 ± 2.28, and 19.95 ± 3.33, respectively. Fear of hypoglycemia correlated positively with frailty (r = 0.277, p < 0.01) and negatively with self-efficacy (r = −0.270, p < 0.01). Frailty also showed a moderate negative correlation with self-efficacy (r = −0.454, p < 0.01). Regression analysis identified higher fear of hypoglycemia and frailty scores predicted lower self-efficacy (p < 0.05). Conclusion: Interventions addressing fear of hypoglycemia and frailty are essential to enhance self-efficacy and improve diabetes self-management in older adults.PsychologyArticleSCOPUS10.3389/fpsyg.2026.17143232-s2.0-10503370901616641078