Prevalence of diabetes, self-management behaviors, and their association with activities of daily living among older adults in rural southwest China

This study aimed to examine the prevalence of diabetes and impaired ADL in Yunnan residents aged 60 years and over, as well as detect associations between impaired ADL and self-management behavior. Further, to investigate diabetes diagnosis’ and self-management behaviors’ ability to predict ADL impairment when adjusted for sociodemographic factors. Data were collected from a cross-sectional health interview and examination survey of 4,150 older adults aged ≥ 60 years in rural southwest China from 2022 to 2023. Fasting blood glucose levels were recorded for each participant. ADL was evaluated using the Lawton and Brody scale. The overall prevalence of diabetes, physical activity of daily life (PADL), instrumental activity of daily life (IADL), and ADL impairment was 12.7%, 8.7%, 27.2%, and 28.1%, respectively. In older adults with diabetes, 96.0% regularly self-monitored blood glucose, 48.9% adhered to taking doctor prescribed anti-diabetic drugs or insulin injections, and 52.1% took at least one measure to control blood glucose. Older adults with high annual household income had higher prevalence of diabetes than their counterparts ( p < 0.05). The rate of regularly self-monitoring blood glucose decreased with age ( p < 0.05) and was higher in older adults with a higher level of education and household income than their counterparts ( p < 0.05). Similarly, the higher rate of taking measures to control diabetes was also observed among the subgroups categorized by ethnic minority, the higher level of education and annual household income ( p < 0.01). Multivariable logistic regression analysis found that older adults with diabetes had a greater probability of being PADL impaired ( p < 0.01). Among respondents with diabetes, compliance to anti-diabetic drugs or insulin injection and regularly self-monitoring blood glucose were negatively associated with PADL and IADL impairment, respectively. Taking measures to control diabetes was found to be negatively associated with IADL and ADL impairment ( p < 0.01). There are significant socioeconomic differences in the prevalence of diabetes and diabetes self-management behaviors, and both diabetes and diabetes self-management behaviors have strong associations with ADL impairment among older adults in rural southwest China.