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Exercise self-management behavioral phenotypes in type 2 diabetes: a multicenter cross-sectional study
Xi Chen1, Liya Zhang2, Huili Jiang3
1Department of Clinical Research Unit, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
Background:
Exercise management is important in type 2 diabetes mellitus (T2DM). However, individual variability in exercise-related knowledge, attitudes, and practices (KAP) is significantly associated with behavioral adherence yet is often overlooked in average-based analyses. This study applied Latent profile analysis (LPA) to characterize this heterogeneity and explored associations between the resulting behavioral profiles and clinical indicators.
Methods:
We conducted a multicenter cross-sectional study of 516 adults with T2DM in China. LPA was performed using standardized exercise-related KAP indicators. Candidate solutions were evaluated using fit indices, classification diagnostics, interpretability, and bootstrap reproducibility. Clinical associations were examined using adjusted regression and posterior-probability pseudo-class analyses.
Results:
Four exploratory profiles were identified: Favorable Engagement (7.0%), Average Engagement (59.7%), Knowledge-Constrained (21.7%), and Attitude-Practice Constrained (11.6%). After covariate adjustment, BMI differed across profiles; only the Average Engagement contrast remained significant after accounting for classification uncertainty. Glycemic indicators and diabetes-related complications did not differ robustly. The adjusted association with other chronic disease was sensitive to classification uncertainty.
Conclusion:
Exercise self-management heterogeneity included distinct knowledge-related and attitude-practice constraints. These exploratory patterns may inform tailored support, but profile instability and cross-sectional data require independent prospective validation.
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