IMPACT OF DIABETIC HYPOGLYCEMIA ON PATIENT MANAGEMENT AND OUTCOMES IN FAMILY MEDICINE PRACTICE: A SYSTEMATIC REVIEW

Abstract

Background:
Hypoglycemia remains a major barrier to optimal glycemic control in type 2 diabetes mellitus (T2DM), with implications for morbidity, treatment adherence, and quality of life. Despite clinical guidelines emphasizing prevention, hypoglycemia management in primary care often remains suboptimal.

Objective:
This systematic review aimed to synthesize empirical evidence on the assessment, prevention, and management of diabetic hypoglycemia within family medicine and community-based care settings.

Methods:
Following PRISMA 2020 guidelines, ten empirical studies published between 2017 and 2025 were analyzed, including randomized controlled trials, quasi-experimental, and mixed-methods studies. Data extraction focused on hypoglycemia screening, self-management education, and family doctor–led interventions.

Results:
The review identified significant gaps in hypoglycemia discussions (32%) and medication de-intensification (8.8%) in primary care. Structured diabetes self-management education (DSME) improved glycemic outcomes across multiple studies, with HbA1c reductions ranging from 1.3% to 1.8% (p < 0.001). Family doctor–led interventions demonstrated strong effects on patient knowledge, behavior, and medication adherence (β = 0.135–0.720, p < 0.001).

Conclusion:
Effective hypoglycemia prevention requires integrating routine risk assessment, DSME, and family-based support models into primary care workflows. Evidence supports the pivotal role of family physicians and multidisciplinary collaboration in improving patient safety and self-efficacy.