Analysis of influencing factors and mediating effects of diabetes self-management behavior in patients with type 2 diabetes mellitus

Background : Few studies have investigated the relationship among self-management, self-efficacy, and dietary behavior compliance. We evaluated type 2 diabetes mellitus (T2DM) self-management behavior and analyzed whether dietary behavior compliance can mediate self-management behavior in patients with T2DM through self-efficacy management. Methods : Patients with T2DM in a community in Fujian Province were enrolled between January 2024 and December 2024 using a convenient sampling method. Data were collected through a mixed method of patient self-reported and investigator-led interviews, using a self-designed basic data scale for patients with T2DM, the Summary of Diabetes Self-Care Activities, the Diabetes Management Self-Efficacy Scale, and the Dietary Behavior Compliance Scale. Influencing factors of diabetes self-management behavior were analyzed using multiple linear regression. Spearman correlation analysis was used to investigate the correlation between self-management behavior, self-efficacy, and dietary behavior compliance. The mediating effect of dietary behavior compliance on self-efficacy and self-management was analyzed using the PROCESS 3.4 macro model. Results : Overall, 235 patients with T2DM were included. The self-management, self-efficacy, and dietary behavior compliance scores were 43.40 ± 13.80, 121.80 ± 48.61, and 77.02 ± 13.40, respectively. Age, diabetes treatment, type of hypoglycemic drugs currently used, regular screening for diabetes complications, diabetes complications, dietary behavior compliance, and self-efficacy were influencing factors of self-management. Self-efficacy was positively correlated with dietary behavior compliance, and both were positively correlated with self-management. Self-management, self-efficacy, and dietary behavior compliance in patients with T2DM exhibited partial mediating effects, with a total effect of 0.118 (indirect effect = 0.041 [34.92%]). Conclusions : Self-efficacy directly affects self-management and indirectly affects it through dietary behavior compliance. Clinical trial number : Not applicable.