Wu Xia, Li Guo-Hui, Liu Lan, Li Hui-Fang, Zhao Yi, Golden Allison Rabkin, Cai Le
Yunnan Provincial Key Laboratory of Public Health and Biosafety & School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Cheng Gong New City, Kunming, 650500, China.
The Second Affiliated Hospital of Kunming Medical University, 374 Yunnan- Myanmar Avenue, Wu Hua District, Kunming, 650106, China.
BMC Public Health. 2025 Feb 13;25(1):594. doi: 10.1186/s12889-025-21763-y.
This study aimed to uncover the changing prevalence of pre-diabetes and diabetes as well as diabetes self-management behaviors across socioeconomic gradients in rural southwest China.
A two-wave, community-based, cross-sectional survey was conducted. A total of 7,747 and 7,536 individuals aged ≥ 35 years, residing in rural southwest China, were selected using a three-stage stratified random sampling method. Demographic characteristics and self-management behaviors were collected through face-to-face interviews, and physical indicators were measured through on-site examinations. An individual socioeconomic position (SEP) index was constructed using principal component analysis based on three variables: education, annual household income, and access to medical services.
In 2022, the overall prevalence of pre-diabetes and diabetes (15.7% and 7.6%) were lower than in 2013 (18.3% and 8.2%) (P < 0.05). This decline was also observed in subgroups including women, those aged 45-54 years, those of Han ethnicity, those with a high educational level, those with a high annual household income, and those with good access to medical services and high SEP (P < 0.05). In contrast, higher rates were found among ethnic minorities, those with low annual household income, and those with low SEP. The overall rate of compliance with anti-diabetic medications or insulin injection was higher in 2022 (95.9%) compared to 2013 (76.5%), with the largest relative increase occurring among participants with a low level of education and income, poor access to medical services, and low SEP (P < 0.01). The proportion of individuals having taken measures to control diabetes was lower in 2022 (39.7%) compared to 2013 (53.3%) (P < 0.01). This lower rate was also observed among the subgroups categorized by sex, education, and income level, in the Han majority, and among participants with good access to medical services and high SEP (P < 0.05). Furthermore, while the overall rate of regular self-monitoring of blood glucose did not differ between the two survey years (41.8% and 44.7%, P > 0.05), a higher rate was uncovered among patients with low education level, low annual household income, poor access to medical services, and low SEP in 2022 compared to 2013 (P < 0.05).
The prevalence of pre-diabetes and diabetes, as well as the rate of taking measures to control diabetes, were lower among the rural Chinese adult population in 2022 compared with 2013. However, compliance with anti-diabetes medications or insulin injections was higher. Additionally, socioeconomic disparities are associated with these Changes.
本研究旨在揭示中国西南部农村地区糖尿病前期和糖尿病患病率的变化情况，以及不同社会经济梯度人群的糖尿病自我管理行为。
开展了一项基于社区的两阶段横断面调查。采用三阶段分层随机抽样方法，选取了中国西南部农村地区共7747名和7536名年龄≥35岁的个体。通过面对面访谈收集人口统计学特征和自我管理行为信息，并通过现场检查测量身体指标。基于教育程度、家庭年收入和医疗服务可及性这三个变量，采用主成分分析构建个体社会经济地位（SEP）指数。
2022年，糖尿病前期和糖尿病的总体患病率（分别为15.7%和7.6%）低于2013年（分别为18.3%和8.2%）（P<0.05）。在女性、45 - 54岁人群、汉族人群、高学历人群、高家庭年收入人群、医疗服务可及性良好且社会经济地位较高的亚组中也观察到了这种下降趋势（P<0.05）。相比之下，少数民族、家庭年收入低以及社会经济地位低的人群患病率较高。2022年抗糖尿病药物或胰岛素注射的总体依从率（95.9%）高于2013年（76.5%），教育程度和收入水平低、医疗服务可及性差且社会经济地位低的参与者相对增幅最大（P<0.01）。2022年采取措施控制糖尿病的个体比例（39.7%）低于2013年（53.3%）（P<0.01）。在按性别、教育程度和收入水平分类的亚组、汉族多数群体以及医疗服务可及性良好且社会经济地位较高的参与者中也观察到了这种较低的比例（P<0.05）。此外，虽然两个调查年份的血糖常规自我监测总体率没有差异（分别为41.8%和44.7%，P>0.05），但2022年教育程度低、家庭年收入低、医疗服务可及性差且社会经济地位低的患者中，自我监测率高于2013年（P<0.05）。
与2013年相比，2022年中国农村成年人群中糖尿病前期和糖尿病的患病率以及采取措施控制糖尿病病的比例较低。然而，抗糖尿病药物或胰岛素注射的依从性较高。此外，社会经济差异与这些变化有关。
