关键词: 糖尿病；低血糖；低血糖察觉意识受损；血糖管理；混合方法研究

Abstract: Objective: To explore facilitators and barriers to blood glucose management in community-dwelling patients with Impaired Awareness of Hypoglycemia (IAH) and propose improvement strategies, so as to provide a theoretical basis for intervention studies to improve patients' glucose management. Methods: A mixed methods research based on protection motivation theory was used. From January 2024 to August 2025, a survey was conducted among 259 IAH patients from seven community health centers in Changshu, Jiangsu province, using convenience sampling. Binary Logistic regression identified influencing factors. Semi-structured interviews with 19 patients were analyzed. Results: Health literacy and decision dilemma were influencing factors (P<0.05). Three themes (information sources, threat appraisal, coping appraisal) revealed facilitators and barriers. Integration yielded eight facilitators and nine barriers across these themes. Conclusion: Despite multiple barriers, significant facilitators exist. To improve management, information source quality and professional competence should be enhanced, and decision support should be provided to reduce decision dilemmas and improve threat and coping appraisals.

Key words: diabetes mellitus; hypoglycemia; Impaired Awareness of Hypoglycemia; glucose management; mixed methods research