Abstract: Objective From demographic factors and self-awareness level, this paper analyzed the influencing factors of the compliance of community patients with type 2 diabetes in tiered medical services, taking diabetes as an example, and explored effective measures to improve the tiered medical services of chronic diseases in China. Methods Convenient sampling was used to conduct a questionnaire survey on type 2 diabetic patients who met the inclusion criteria in four community health service centers in Qingpu District, Xuhui District and Fengxian District of Shanghai. T-test, one-way ANOVA and Pearson correlation analysis were used to analyze the factors affecting the patients' compliance with tiered medical services. Finally, a multivariate hierarchical regression model was established. Results In this study, 536 questionnaires were collected, with a recovery rate of 92.41%, of which 518 were valid, with an effective rate of 96.64%. Among the valid questionnaires collected, the elderly were the main ones, with an average age of (70.41±10.37) years. There were 42.1% of the respondents had had diabetes more than 10 years, and 73.0% of them had signed a family doctor. Univariate analysis showed that the course of the disease, whether to sign a family doctor and severity of illness were related to the compliance of diabetic patients with tiered medical services. The correlation analysis showed that self-efficacy, self-judgment and cognitive level of tiered medical services were the factors influencing the compliance of diabetic patients with tiered medical services. Multivariate regression model showed that age, insulin using, self-efficacy and cognitive level of tiered medical services were the main factors predicting patient compliance. Specifically, the older the patients were, the less insulin they were suitable, the higher their self-efficacy, and the higher their cognitive level of tiered medical services, the better their compliance with tiered medical services. Conclusion The compliance of community type 2 diabetic patients with tiered medical services is still acceptable. In order to improve the compliance, we should respect the wishes of the masses, actively publicize and guide, deepen inter-agency cooperation, clarify the referral criteria, improve grass-roots service ability and train excellent general practitioners.