Ethnic differentials of trends in the prevalence and self-management behaviors of diabetes among the Han majority and the Na Xi ethnic minority in rural southwestern China

Objectives This study aimed to investigate ethnic differences in the trends of diabetes prevalence and self-management behaviors between the Han majority and the Na Xi ethnic minority in rural southwestern China. Design Data were collected from two waves of cross-sectional health interviews and examination surveys administered 10 years apart among individuals aged ≥ 35 years in rural China. Fasting blood sugar levels were recorded for each participant. Results From 2013 to 2023, the prevalence and treatment rate of diabetes increased significantly from 6.1% and 75.3% to 8.8% and 96.5%, respectively, among Han majority participants from 3.3% and 67.2% to 12.5% and 94.1%, respectively, among Na Xi ethnic minority participants (P < 0.01), with the greatest relative increase occurring among Na Xi ethnic minority participants. Although the overall awareness and control rates of diabetes did not differ between 2013 and 2023 for both nationalities (P > 0.05), a significant increasing trend in the control rate was observed among diabetic patients with poor access to medical services for both nationalities (P < 0.01). The overall rate of compliance with antidiabetic drugs or insulin injection during the 12 months prior to the survey increased significantly in both the Han majority (71.9% vs. 97.9%) and the Na Xi ethnic minority (67.2% vs. 95.4%, P < 0.01), whereas the increasing rate of having taken measures to control diabetes during the two weeks prior to the survey and regular blood glucose self-monitoring in the prior 12 months was found only among Na Xi ethnic minority participants (P < 0.01). Conclusions The prevalence and treatment of diabetes have increased substantially, and significant changes in diabetes self-management behaviors have occurred in rural southwestern China over the ten years studied, with striking ethnic differences in temporal trends for the observed rates. Our findings highlight the importance of addressing ethnicity in future interventions to further control diabetes and improve self-management behaviors among diabetic patients.