Gu Shuyan, Wang Xiaoyong, Shen Fangfang, Gu Hai, Zhang Ning, Zhou Yuan, Wang Xiaoling
Center for Health Policy and Management Studies, School of Government, Nanjing University, Nanjing, China.
Health Insurance Office, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
Int J Public Health. 2025 May 30;70:1608067. doi: 10.3389/ijph.2025.1608067. eCollection 2025.
To investigate type 2 diabetes self-management behaviors and glycemic control under the impacts of COVID-19 legacy and Diabetes Prevention and Control Action, and explore the heterogeneous impacts of five self-management activities on glycemic control and how these impacts differ across key groups.
A cross-sectional survey was conducted between April and September 2023 in hospitals and communities in China. Overall, 1817 adults with type 2 diabetes and normal cognitive and behavioral capacities completed a questionnaire regarding diabetes self-management behaviors and glycemic control. Ordinary least squares regression analyses were conducted.
Mean score of overall self-management behaviors was 5.89. About 26.86% reported good glycemic control. Among five self-management activities, medication adherence was the best (mean = 6.77) but glucose-monitoring adherence was the worst (mean = 5.18). Overall self-management behaviors and the five activities (coefficient = 0.031-0.146, all p < 0.001) all exerted positive impacts on glycemic control, with dietary control showing the greatest impact while medication adherence the least. Younger persons, rural persons, and persons with financial difficulties were key groups benefiting less from self-management.
Diabetes self-management behaviors and glycemic control were suboptimal. Customized health promotions should focus on key groups and addressing the deficiencies in self-management activities especially dietary control.
探讨2型糖尿病自我管理行为及血糖控制在新冠疫情遗留影响和糖尿病防控行动下的情况，探究五项自我管理活动对血糖控制的异质性影响以及这些影响在关键群体中的差异。
2023年4月至9月在中国的医院和社区开展了一项横断面调查。共有1817名认知和行为能力正常的2型糖尿病成年人完成了一份关于糖尿病自我管理行为和血糖控制的问卷。进行了普通最小二乘法回归分析。
总体自我管理行为的平均得分为5.89。约26.86%的人报告血糖控制良好。在五项自我管理活动中，用药依从性最佳（均值 = 6.77），但血糖监测依从性最差（均值 = 5.18）。总体自我管理行为及五项活动（系数 = 0.031 - 0.146，均p < 0.001）均对血糖控制产生积极影响，其中饮食控制的影响最大，用药依从性的影响最小。年轻人、农村居民和经济困难人群是从自我管理中获益较少的关键群体。
糖尿病自我管理行为和血糖控制情况欠佳。定制化的健康促进措施应聚焦于关键群体，并解决自我管理活动中的不足，尤其是饮食控制方面的不足。
