ReviewCureus2025
Prevalence and Risk Factors of Hypoglycemia Unawareness Among Patients With Type 1 and Type 2 Diabetes Mellitus in Saudi Arabia: A Systematic Review and Meta-Analysis.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveHypoglycemia unawareness (HU), also known as impaired awareness of hypoglycemia (IAH), is a significant complication of insulin therapy that increases the risk of severe neuroglycopenic events in patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Research data from Saudi Arabia on this topic is limited and inconsistent. This systematic review and meta-analysis aimed to identify and summarize studies that report the prevalence, risk factors, and clinical outcomes of HU among individuals with T1DM and T2DM in Saudi Arabia.
methodsFollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search was conducted across PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar up to July 2025 for observational studies that reported the prevalence or risk factors of HU in Saudi adults with diabetes. A total of 11 cross-sectional studies (n = 4,171) met the inclusion criteria. The quality of these studies was appraised using tools from the Joanna Briggs Institute (JBI). Proportions were pooled using a random-effects model (OpenMetaAnalyst), and heterogeneity was assessed using the I-squared (I²) statistic. Leave-one-out sensitivity analyses were performed to evaluate the robustness of the findings.
resultsThe overall pooled prevalence of HU was found to be 41.9% (95% confidence interval [CI]: 21.2-62.6%), with high heterogeneity (I² = 99.7%, p <0.001). Sensitivity analyses indicated minimal fluctuation in the prevalence estimates (ranging from 36.8% to 45.5%) when excluding any single study, confirming the stability of the pooled estimate. Key risk factors identified included poor diabetes knowledge, specifically a lack of awareness regarding insulin type, dosage, and the most recent glycated hemoglobin (HbA1c) levels, insufficient medical follow-up, and macrovascular complications (such as prior stroke and ischemic heart disease). It was also noted that lower daily insulin doses were associated with HU.
conclusionNearly half of insulin-treated diabetes patients in Saudi Arabia display impaired awareness of hypoglycemia. Addressing modifiable factors, particularly inadequate patient education and follow-up, is crucial. Implementing standardized screening protocols for HU and structured diabetes self-management education is essential, as these measures may help reduce the risk of severe hypoglycemic events in this population.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.