Motivation, which is another latent variable affecting self management behavior, is composed of the subject's attitude toward self-management behavior outcome and social support. Even though motivation did not directly affect self-management behavior, it indirectly affected self-management behavior through the mediating factor of behavioral skills (i.e., self efficacy). This result is somewhat different from the findings of previous studies [36,39e41], which reported that belief about treatment effect, family support, or social support significantly affected self management behavior directly. This might result from the characteristics of patients who were under 45 years of age. Although they had very positive attitudes toward the outcome of self management behavior, they tended to manage their life and disease independently, rather than seeking help from others. This tendency may lead to a less direct effect of support on self management behavior. Furthermore, even though motivation was satisfactory, it did not directly lead to self-management behaviors. Under such circumstances, the behavior skills, which mean self efficacy, should be improved to enhance self-management behavior. Therefore, to create change and encourage maintenance of the behaviors used to control blood glucose level in young people with type 2 diabetes, the appropriate intervention should improve self efficacy for applying self-management behavior into daily life.