The association between the availability of health guidance and self-management activities among patients with type 2 diabetes: a generalized linear mixed model incorporating patient- and GP-level factors
- 1School of General Practice and Continuing Education, Capital Medical University, Beijing, China
- 2Department of General Practice, Beijing Luhe Hospital, Capital Medical University, Beijing, China
- 3Department of General Practice, Beijing Tongren Hospital, Capital Medical University, Beijing, China
Abstract
Background: The availability of health guidance (AHG) provided by general practitioners (GPs) may vary in complex primary care settings. This study aimed to assess the AHG for patients with type 2 diabetes mellitus (T2DM) in general practice setting and examine the association between AHG and the patients’ diabetes self-management activities.
Methods: A cross-sectional study was conducted in seven community health service centers (CHSCs) in Beijing, China. Data on patient and GP characteristics, perceived AHG, and self-management measured by the Summary Diabetes Self-Care Activities (SDSCA) were collected through questionnaire surveys. The AHG included accessibility of health guidance from a GP and AHG on diet, exercise, psychological support, hypoglycemia prevention, and complication identification. A two-level generalized linear mixed model (GLMM) was used to examine the association between the AHG and diabetes self-management considering both patient- and GP-level characteristics.
Results: A total of 28 GPs and 716 patients were recruited. The mean AHG score was 3.97 ± 1.84 (range: 0–6). Among AHG domains, complication identification guidance showed the poorest availability (40.5%). AHG was significantly associated with diabetes self-management activities (P < 0.001). In the GLMM, higher AHG scores remained associated with better self-management activities after adjustment for both patient- and GP-level factors. In addition, T2DM duration of more than 10 years was positively associated with self-management activities, while the presence of comorbidities was negatively associated with self-management activities.
Conclusions: Perceived GP-provided health guidance was significantly associated with self-management activities among patients with T2DM in primary care settings. Improving the capacity of GP-led primary care teams and promoting the active participation of team members in delivering individualized and comprehensive health guidance may contribute to better self-management activities among patients with T2DM and enhance the effectiveness of diabetes management in primary care.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12875-026-03491-3.
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BibTeX
@article{li2026association,
title = {{The association between the availability of health guidance and self-management activities among patients with type 2 diabetes: a generalized linear mixed model incorporating patient- and GP-level factors}},
author = {Ting Li and Feiyue Wang and Yajia Cui and Yun Wei and Zhaolu Pan and Yuan Lin and Xiaoqin Lu and Guanghui Jin},
journal = {BMC Primary Care},
year = {2026},
month = aug,
doi = {10.1186/s12875-026-03491-3},
url = {https://doi.org/10.1186/s12875-026-03491-3},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - The association between the availability of health guidance and self-management activities among patients with type 2 diabetes: a generalized linear mixed model incorporating patient- and GP-level factors
AU - Ting Li
AU - Feiyue Wang
AU - Yajia Cui
AU - Yun Wei
AU - Zhaolu Pan
AU - Yuan Lin
AU - Xiaoqin Lu
AU - Guanghui Jin
PY - 2026
DA - 2026/08/11
JO - BMC Primary Care
DO - 10.1186/s12875-026-03491-3
UR - https://doi.org/10.1186/s12875-026-03491-3
AB - Background: The availability of health guidance (AHG) provided by general practitioners (GPs) may vary in complex primary care settings. This study aimed to assess the AHG for patients with type 2 diabetes mellitus (T2DM) in general practice setting and examine the association between AHG and the patients’ diabetes self-management activities. Methods: A cross-sectional study was conducted in seven community health service centers (CHSCs) in Beijing, China. Data on patient and GP characteristics, perceived AHG, and self-management measured by the Summary Diabetes Self-Care Activities (SDSCA) were collected through questionnaire surveys. The AHG included accessibility of health guidance from a GP and AHG on diet, exercise, psychological support, hypoglycemia prevention, and complication identification. A two-level generalized linear mixed model (GLMM) was used to examine the association between the AHG and diabetes self-management considering both patient- and GP-level characteristics. Results: A total of 28 GPs and 716 patients were recruited. The mean AHG score was 3.97 ± 1.84 (range: 0–6). Among AHG domains, complication identification guidance showed the poorest availability (40.5%). AHG was significantly associated with diabetes self-management activities (P < 0.001). In the GLMM, higher AHG scores remained associated with better self-management activities after adjustment for both patient- and GP-level factors. In addition, T2DM duration of more than 10 years was positively associated with self-management activities, while the presence of comorbidities was negatively associated with self-management activities. Conclusions: Perceived GP-provided health guidance was significantly associated with self-management activities among patients with T2DM in primary care settings. Improving the capacity of GP-led primary care teams and promoting the active participation of team members in delivering individualized and comprehensive health guidance may contribute to better self-management activities among patients with T2DM and enhance the effectiveness of diabetes management in primary care. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12875-026-03491-3.
SN - 2731-4553
ER -