Socioeconomic disparities in type 2 diabetes mellitus prevalence and self-management behaviors in rural southwest China

- Type 2 diabetes has a considerable public health impact in China. Western studies showed an inverse relationship between literacy and racial/ethnic minority status and self-efficacy in diabetes management. However, little data are available concerning the associations between socioeconomic variables and diabetes self-management in China.
- The findings indicate a relatively low prevalence rate of diabetes and low levels of self-management among different ethnic minority groups in rural China.
- This study demonstrated the existence of socio-economic gradients in both diabetes prevalence and self-management behaviors among diabetic patients.

BackgroundThis study examines how socioeconomic factors are associated with prevalence and self-management of diabetes among ethnic minority groups in the rural Yunnan province, which has the most ethnic minority groups per province in southwest China.MethodsA cross-sectional survey was carried out in 2014 in a rural southwest population consisting of 5532 consenting individuals aged ⩾35 years. Information about participants' demographic characteristics, as well as diabetes diagnosis, treatment, and self-management behaviors, were obtained using a standard questionnaire. Fasting blood sugar levels were recorded for each individual. A socioeconomic position (SEP) index was constructed using principal component analysis.ResultsThe age-standardized prevalence of diabetes in the study population was 4.8%. In persons with diabetes, 23.1% regularly self-monitored blood glucose, 43.2% adhered to taking prescribed anti-diabetic drugs or insulin injections, and 63.1% took at least one measure to control blood glucose. Individual educational level was found to be negatively associated with the prevalence of diabetes, whereas individuals with greater household assets and higher SEP were more likely to be suffered from diabetes. Persons with diabetes with greater household assets, higher level of education, and higher SEP had a greater probability of regularly self-monitoring blood glucose, compliance to prescribed medicines, and taking measures to control diabetes. Access to medical services was positively associated with regularly self-monitoring blood glucose and compliance to prescribed medicines.ConclusionsSocioeconomic disparities in diabetes prevalence and self-management do exist. Future interventions to further control diabetes and improve diabetes management must be tailored to address socioeconomic factors.