{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T15:51:37Z","timestamp":1783439497566,"version":"3.54.6"},"reference-count":55,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"unspecified","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,9,29]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to identify distinct patient subgroups based on glycaemic control (glycosylated haemoglobin (HbA1c)), self-efficacy and self-management in patients with type 2 diabetes mellitus (T2DM), and to examine differences in outcomes and identify key predictors associated with cluster characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Chronic disease clinic at Thasala Hospital, Thailand.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Participants with T2DM were recruited using a consecutive sampling approach during their scheduled clinic visits on predefined days and times. A total of 440 participants were included in the final analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes measures<\/jats:title>\n                    <jats:p>The three variables used for K-means cluster analysis were HbA1c, self-efficacy scores and self-management scores. HbA1c values were obtained from medical records, while self-efficacy and self-management were assessed using the Thai versions of the Diabetes Management Self-Efficacy Scale and the Diabetes Self-Management Scale. Demographic and clinical characteristics were included as predictor variables in multiple linear regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four clusters were identified. Cluster 1 (moderate profile, n=124) had fair glycaemic control (HbA1c=7.9%) and moderate self-efficacy (mean=70) and self-management (mean=47). Cluster 2 (underperforming, n=136) exhibited poor glycaemic control (HbA1c=8.7%), regardless of high self-efficacy (mean=79) and low self-management (mean=40). Cluster 3 (high performers, n=135) demonstrated fair glycaemic control (HbA1c=7.5%) with the highest levels of self-efficacy (mean=84) and self-management (mean=51). Cluster 4 (high risk, n=45) had very poor glycaemic control (HbA1c=9.4%) and the lowest scores for both self-efficacy (mean=56) and self-management (mean=34). Regression analysis confirmed the heterogeneity across clusters, with varying predictors and explained variance (adjusted R\u00b2 ranging from 0.014 to 0.182 across significant models).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings highlight the distinct behavioural and clinical profiles among patients with T2DM. Cluster 4 patients with the poorest glycaemic and behavioural outcomes may benefit from intensive behavioural support and closer clinical monitoring, whereas Cluster 2 patients, showing high self-efficacy but poor self-management, indicate the need for structured, skills-based interventions. Clusters 1 and 3 showed balanced profiles, suggesting less urgent need for intervention and potential to maintain current management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-104728","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T09:22:02Z","timestamp":1760520122000},"page":"e104728","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Subgrouping patients with type 2 diabetes using behavioural and clinical factors: a cross-sectional study in a hospital-based setting in Thailand"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8723-9350","authenticated-orcid":false,"given":"Patcharin","family":"Nilmart","sequence":"first","affiliation":[{"name":"Faculty of Physical Therapy, Srinakharinwirot University, Nakhon Nayok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janjira","family":"Namsuk","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Thasala Hospital, Nakhon Si Thammarat, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeeraporn","family":"Songkram","sequence":"additional","affiliation":[{"name":"Thasala Hospital, Nakhon Si Thammarat, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,10,15]]},"reference":[{"key":"2025120415065341000_15.10.e104728.1","unstructured":"Magliano DJ , Boyko EJ . 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