A Correlational Study on Diabetes - related Stress and Self-management Behaviors in Middle-aged and Young Patients with Type 2 Diabetes

Background and Aim: As a common chronic metabolic disease, Type 2 diabetes mellitus affects a large number of people globally and in China, with a notable trend of younger onset. Middle-aged and young diabetic patients often face multiple stressors. This study aims to investigate the relationship between diabetes-related stress and self-management behaviors in middle-aged and young patients with type 2 diabetes, providing insights for blood glucose control and health improvement. Materials and Methods: Using convenience sampling, we recruited type 2 diabetic patients aged 18–59 years admitted to the endocrinology departments of two hospitals in Xuchang City between October 2024 and February 2025. Data were collected via a cross-sectional survey using a demographic questionnaire, the Summary of Diabetes Self-Care Activities Measure (SDSCA), and the Appraisal of Diabetes Stress Scale (ADS). Descriptive statistics, univariate analysis, and Pearson correlation analysis were performed to analyze the data. Results: A total of 317 questionnaires were collected, with 286 valid responses (response rate: 90.2%). The mean score on the diabetes stress scale was 3.12±0.57, and the mean score on the self-management scale was 3.89±0.98. Significant differences in self-management behaviors were observed by gender and the presence of diabetic complications, with male patients and those with complications demonstrating lower behavioral compliance. Diabetes-related stress was negatively correlated with self-management behaviors (r =−0.561, P<0.01). Conclusion: There is a significant correlation between diabetes-related stress and self-management behaviors in middle-aged and young type 2 diabetic patients, where higher stress is associated with lower self-management behavior levels. Among self-management behaviors, foot care scored the lowest, with male patients and those with diabetic complications exhibiting poorer self-management. It is recommended to establish a multi-dimensional support system, address psychological stress in complicated cases, and enhance foot care capabilities among male patients. However, the study’s limitation in sampling from only two hospitals necessitates further validation of the findings’ generalizability.