Objective To analyze the influence pathway of self-management on social isolation in elderly patients with type 2 diabetes mellitus(T2DM)and the mediating role of social participation.Methods The social isolation status of older adults with T2DM treated in hospitals or community health service centers in Beijing from May to November 2023 was investigated with the Lubben social network scale-6,the summary of diabetes self-care activities and impact on partic-ipation and autonomy questionnaire.Structural equation model of social isolation and self-management and social partici-pation were constructed to analyze the mediating effects of social participation.Results Among 496 older adults with T2DM,227 experienced social isolation,and the incidence was 45.77%.The older adults experienced social isolation in family dimension and friend dimension were 74(14.92%)and 239(48.19%),respectively.The structural equation model parameter estimated converge well,while the posterior predicted P-value of the model was 0.371>0.05,which meant a good fit.The model showed that exercise management and smoking had a negative direct effect on social isolation(-0.136 and-0.132),and also indirect effected through social participation(-0.201 and-0.079),with a mediation effect ratio of 59.47%and 37.44%.Conclusion Self-management(exercise and smoking)and social participation in elderly patients with type 2 diabetes can predict the occurrence of social isolation.Social participation plays a mediating role in the relationship between diabetes self-management(exercise and smoking)and social isolation.
Type 2 diabetes mellitusOlder adultSocial isolationSocial participationSelf-managementMediating effect