Knowledge and practice of diabetes mellitus among Lahu and Wa populations in southwest China: a cross‑sectional study

Background Diabetes mellitus is a major global health challenge, contributing to substantial morbidity and mortality worldwide. However, rural and ethnic minority communities often experience disparities in diabetes care outcomes compared to other regions. This study aimed to evaluate diabetes-related knowledge and practices, identify influencing factors, and assess the potential association between diabetes knowledge and self-management behaviors among the Lahu and Wa ethnic minority populations in Southwest China. Methods A cross-sectional study was conducted in Yunnan Province (2009–2010) using a multi-stage sampling design. Face-to-face interviews were performed with 2,281 Lahu and 2,876 Wa adults (aged ≥ 18 years) to collect data on socio-demographics, diabetes knowledge (symptoms, risk factors, prevention, and treatment), and practices (smoking, alcohol use, diet, physical activity, and overweight/obesity). Descriptive statistics, χ² tests, and logistic regression were used for analysis. Results Diabetes awareness was low overall (Lahu: 9.20%; Wa: 30.80%), with significant interethnic disparities. The Wa population demonstrated a higher knowledge level (72.20% vs. 62.68%, p = 0.007) and healthier behaviors (e.g., higher vegetable intake, lower female smoking/drinking rates) compared to the Lahu. No significant behavioral improvements were observed in smoking, alcohol use, physical activity, or weight management among participants with diabetes knowledge. Smoking (male: >75%; female: >30%) and alcohol use (male: >65%; female: 14.9–30.2%) remained prevalent across both groups. Female sex and literacy (Wa only) were positively associated with diabetes knowledge. Conclusions The findings highlight the poor knowledge and practice regarding diabetes among the Lahu and Wa populations, with acquired diabetes knowledge failing to translate into measurable behavioral improvements. These results underscore the need for culturally tailored interventions to improve diabetes prevention and management in these underserved communities, especially among male populations.