Introduction Type 2 Diabetes Mellitus (T2DM) presents a global health challenge. The interplay between affective symptoms and patient empowerment significantly influences glycaemic control and health-related quality of life (HRQOL). This study aims to identify T2DM patient subgroups and analyze differential responses to person-centered interventions.

Methods Latent class analysis (LCA) was applied to identify subgroups within the INDICA cohort,¹ using anxiety, depression, diabetes-related distress, patient empowerment, and diabetes knowledge as indicators. The sample size comprised 1220 patients. Comparative assessments of demographic and clinical characteristics were conducted. The impact of classes on the effectiveness of both patient- focused and professional-focused INDICA interventions on HbA1c and HRQOL was examined using mixed models.

Results LCA revealed two classes: Class 1 (less empowered, with affective symptoms and diabetes- related distress) and Class 2 (more empowered, without affective symptoms or diabetes-related distress). Significant sociodemographic and clinical differences emerged. Being female, more comorbidities, reduced diet adherence and lower HRQOL were associated with higher likelihood of being Class 1. Class 1 exhibited significantly lower HRQOL at 12- (B=-0.45, p=0.013) and 24-month follow-ups (B=-0.52, p<0.001). At 12-month follow-up, no significant interaction between class and intervention was observed. However, at 24-month follow-up, a significant interaction emerged, suggesting that Class 1 derived greater benefits from the intervention aimed at professionals (B=0.33, p=0.039). No interaction effect was found for HbA1c.

Discussion Identifying distinct T2DM patient classes highlights the complexity of managing this condition. Notable HRQOL differences and the enhanced response of Class 1 to the professional- focused intervention at 24-months emphasize the importance of personalized strategies.

Conclusions Recognizing diverse needs within T2DM populations is crucial for refining approaches and enhancing the effectiveness of person-centered interventions.

Reference

1. Ramallo-Fariña Y, García-Pérez L, Castilla-Rodríguez I, Perestelo-Pérez L, Wägner AM, de Pablos-Velasco P, ... & INDICA team. Effectiveness and cost-effectiveness of knowledge transfer and behavior modification interventions in type 2 diabetes mellitus patients—the INDICA study: a cluster randomized controlled trial. Implement Sci. 2015;10(47):1–15.