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


METHODS
A cross-sectional survey was carried out in 2014 in a rural southwest population consisting of 5532 consenting individuals aged ⩾35years. 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.


RESULTS
The 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.


CONCLUSIONS
Socioeconomic 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.
School of Public Health, Kunming Medical University, 1168 Yu Hua street Chun Rong Road, Cheng Gong New City, Kunming 650500, China. Electronic address: caile002@hotmail.com.
Cai
C
Le
School of Public Health, Kunming Medical University, 1168 Yu Hua street Chun Rong Road, Cheng Gong New City, Kunming 650500, China.
Su
S
Rong
School of Public Health, Kunming Medical University, 1168 Yu Hua street Chun Rong Road, Cheng Gong New City, Kunming 650500, China.
You
Y
Dingyun
School of Public Health, Kunming Medical University, 1168 Yu Hua street Chun Rong Road, Cheng Gong New City, Kunming 650500, China.
Cui
C
Wenlong
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000628:therapy; D005006:Ethnicity; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D012648:Self Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
D001786:Blood Glucose
China; Diabetes; Prevalence; Self-management; Socioeconomic status