Abstract
OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.