Self-management and Self-rated Health Among Middle-aged and Older Adults with Type 2 Diabetes in China: A Structural Equation Model

This study assesses the association between self-rated health (SRH) and diabetes self-management (DSM) factors (i.e., conventional self-care, holistic health practices, and insulin injection) among age 40 and older Chinese with type 2 diabetes in China. Three models are proposed and tested using structural equation model techniques analyzing the data from the Chinese Health and Nutrition Survey (1997–2006). All models have acceptable fit with the data. In all three models, insulin injection is negatively associated with SRH. Conventional self-care and holistic health practices predict impaired SRH only when examined separately. Whereas the connection between insulin injection and lower SRH is not surprising, the negative effect of holistic health practices and conventional self-care on SRH warrants further attention. The findings potentially suggest more complex theoretical or conceptual models should be developed to explain the relationship between DSM and SRH in a non-Western context. In addition, health care professionals might consider the benefits of DSM on health and wellness among middle-aged and older diabetics, and cogitate developing effective interventions and instructions for DSM in China that acknowledge the relationship between DSM and SRH.