Profiles of knowledge, self-efficacy, psychological and physical health in type 2 diabetes and its association with outcomes

Background: Self-management is impacted by knowledge, self-efficacy, psychological health (general mental health and diabetes-related distress) and physical health (KSPP), and variations in KSPP contribute to heterogeneity in diabetes self-management education (DSME) program outcomes. This study aimed to identify unique KSPP profiles, and their associations with self-management behaviors. Methods: A cross-sectional survey was conducted in 518 participants with type 2 diabetes. Diabetes knowledge, self-efficacy, diabetes-related distress, mental and physical health, self-care, medication adherence and social support were assessed. A mixed-model latent profile analysis was conducted on eight KSPP variables, and sociodemographic, self-care (diet, physical activity, and medication adherence), and glycemic levels were compared across profiles. Results: Four unique KSPP profiles were identified: profile 1 (untroubled), profile 2 (distressed: diabetes-specific), profile 3 (distressed: global) and profile 4 (activated). Profile 3 was associated with the lowest self-care, highest glycemic and lowest social support levels. Profile 4 was associated with the highest self-care, lowest glycemic and highest social support levels. Conclusions: Our study identified novel KSPP profiles, which were associated with differential self-management behaviors and metabolic profiles. Practice implications: Identifying KSPP profiles might improve self-management support through identifying clustering of care needs, and support more targeted DSME development.