Abstract
Diabetes is a major public health problem in China. Diabetes self-management is critical for patients to achieved better health outcomes, however, previous studies have shown suboptimal diabetes self-management performance. We conducted a systematic review and meta-analysis to identify factors associated with diabetes self-management in Chinese adults. The results showed that confrontation, resignation, overall health beliefs, perceived susceptibility, perceived barriers, and self-efficacy were factors associated with overall diabetes self-management performance and six aspects of diabetes self-management behaviors. There is some limited evidence to suggest that provider-patient communication, married individuals, higher educational level, and higher household income level may also be linked to better diabetes self-management practice. Having healthcare insurance and utilizing chronic illness resources generally appeared to have a favorable effect on diabetes self-management performance. In addition, there were a number of factors for which the evidence is too limited to be able to ascertain its strength of association with diabetes self-management practice. The findings of this review suggest that diabetes self-management behaviors are affected by a wide range of personal and environmental factors, which allow health care providers to develop theory-based strategies to improve diabetes-self-management behaviors in this population.
Highlights
Diabetes is a major public health problem worldwide and it is increasing by epidemic proportions.Globally, the total number of people living with diabetes is projected to rise from 382 million cases in 2013 to 592 million cases by 2035, with over 80% of cases living in low- and middle-income countries [1].In China alone, about 114 million (11.6%) adults had diabetes in 2010, a two-fold increase over the past decade [2]
Convincing evidence has shown that improving Diabetes self-management (DSM) was important to achieve better health outcomes [8], including better glycemic control [9], improved quality of life [10], and reduced incidence of complications
A total of 45 articles were excluded, among which five articles were duplicates across databases, 32 studies were not designed primarily to examine which factors were related to DSM behaviors, and the remaining seven articles were carried out in places other than Mainland China
Summary
Diabetes is a major public health problem worldwide and it is increasing by epidemic proportions.Globally, the total number of people living with diabetes is projected to rise from 382 million cases in 2013 to 592 million cases by 2035, with over 80% of cases living in low- and middle-income countries [1].In China alone, about 114 million (11.6%) adults had diabetes in 2010, a two-fold increase over the past decade [2]. Diabetes is a major public health problem worldwide and it is increasing by epidemic proportions. It is estimated that in China 102.5 to 108.2 million individuals have T2D. Individuals with T2D perform about 95% of their own care [5]. Diabetes self-management (DSM) is an essential element of diabetes care, and refers to daily behaviors that individuals perform to manage their T2D such as self-monitoring blood glucose (SMBG), diet and physical activity [6]. DSM is complex, requires major lifestyle changes and behavioral tasks that are incorporated into an individual’s daily routine and high levels of adherence for effective management and halting disease progression [7]. Convincing evidence has shown that improving DSM was important to achieve better health outcomes [8], including better glycemic control [9], improved quality of life [10], and reduced incidence of complications
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