BACKGROUND The increasing prevalence of diabetes is placing important demands on the Chinese healthcare system. Providing self-management programs to the fast-growing number of people with diabetes present an urgent need in rural primary care setting in China. Peer support approach demonstrates effectiveness for individuals with diabetes self-management in urban community in China. As such, developing and evaluating a peer support program and determining whether it is feasible and cost-effective in primary care settings in rural communities of China. OBJECTIVE The aims of this study are to (1) evaluate whether a peer support program for patients with type 2 diabetes improves self-management practices and psychosocial outcomes and whether it is an acceptable, feasible, and cost-effective intervention in the rural primary care setting. (2) get primary intervention results for helping to further design randomized controlled trial program in rural areas in China. METHODS Three township sampled from three different counties of Anhui province as study settings. Participants will recruit based on local primary care health record system. The peer supporter will be recruit from participants. Peer support program will lead by supporter and guide by primary care providers. Mixed-methods will be used to collect data. Qualitative methods will be used to collect information from health care system professionals and rural community leaders. Quantitative method will be used to collect baseline data and pre-test questionnaire on psychosocial factors, self-management practices. RESULTS The results will include (1) quantitative baseline data which will present outcome of participants current situation of individual with type 2 diabetes self-management practices; (2) qualitative data which will identify enablers and barriers for individual with type 2 diabetes self-management practice in rural community; (3) Both qualitative and quantitative evaluation data, after three month intervention, will demonstrate outcome of the feasibility and acceptability of peer support approach for individual with type 2 diabetes self-management. CONCLUSIONS Our findings will inform the design of a guideline and tailored intervention program to improve individuals with type two diabetes in rural primary care settings. If we find that the peer support approach is feasible and acceptable, we will develop larger randomized controlled trial program for evaluating effectiveness in multiple rural settings across countrywide.