Cumulative burdens as determinants of diabetes self-management: examining disparities across income levels
Authors' conclusion
Income-related disparities in diabetes self-management are compounded by cumulative disadvantages. Comprehensive interventions that address multiple domains simultaneously are required to reduce these inequities.
Study context
- Population
- Korean adults with diabetes, 2024 Community Health Survey
- Participants
- 32,761 adults
- Exposure
- Lowest vs highest income quintile; cumulative social burdens
- Outcome
- Diabetes self-management across four domains: diabetes treatment, exercise or dietary control, HbA1c monitoring, complication screening
Methodological detailspopulation-based survey (2024 Community Health Survey)
- Population-based survey (2024 Community Health Survey)
Main finding
As reported in the abstract
Self-management behaviors by income
Exercise or dietary control, lowest vs highest quintile
34.6 % vs 49.5 %
HbA1c monitoring, lowest vs highest quintile
68.6 % vs 91.0 %
Complication screening, lowest vs highest quintile
29.1 % vs 37.1 %
Observational data: associations, not effects.
Further findings
Cumulative burden (≥4 burdens) and self-management
- Exercise or dietary control, aOR
- 0.575
- HbA1c monitoring, aOR
- 0.284
- Complication screening, aOR
- 0.657
- Dose-response effects of cumulative burden
- Adjusted for sociodemographic covariates
Individual barriers
- Low education, rural residence and unmet healthcare needs associated with reduced self-management engagement
Original publication
Cumulative burdens as determinants of diabetes self-management: examining disparities across income levels. Diabetes Res Clin Pract. Published 3 November 2025. doi:10.
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