Psychosomatic symptom profiles identified by latent profile analysis and their psychosocial and clinical correlates in patients with type 2 diabetes mellitus: A cross-sectional study

Psychosomatic symptoms are highly prevalent among individuals with type 2 diabetes mellitus (T2DM), yet they often cluster into heterogeneous patterns that are inadequately characterized by single-symptom assessments or composite scores. This study aimed to identify latent psychosomatic symptom profiles in T2DM and to examine their associations with clinical characteristics, psychosocial resources, and health-related quality of life. This single-center cross-sectional study enrolled 312 adults with T2DM. Six psychosomatic symptom domains (depressive symptoms, anxiety, fatigue, sleep quality, pain intensity, and diabetes-related distress) were assessed as continuous indicators and analyzed using latent profile analysis. Sociodemographic and clinical variables, psychosocial resources (self-efficacy and perceived social support), and quality-of-life measures were compared across identified profiles. Multinomial logistic regression was conducted with the low symptom burden profile as the reference, using a clinical model (age, diabetes duration, and glycated hemoglobin) and an extended model incorporating psychosocial resources. Among the 312 participants (mean age 58.5 ± 10.3 years; 59.6% male), a 3-profile solution provided optimal fit (entropy = 0.93; Lo-Mendell-Rubin test P = .012). The profiles comprised a low symptom burden group (59.6%), a high fatigue-emotional distress group (21.8%), and a high overall symptom burden group (18.6%). Symptom severity differed significantly across profiles (all P < .001). Compared with the low symptom burden profile, individuals in the high symptom burden profile were older, had longer diabetes duration, and more frequently reported neuropathy and prior hypoglycemia (all P ≤ .05), whereas glycated hemoglobin and body mass index did not differ significantly. In multivariable analyses, greater self-efficacy (odds ratio 0.66, 95% confidence interval 0.56-0.78) and higher perceived social support (odds ratio 0.92, 95% confidence interval 0.89-0.95) were independently associated with reduced odds of belonging to the high symptom burden profile. Health-related quality of life demonstrated a clear gradient across profiles, with the poorest physical and mental health scores in the high symptom burden group (P < .001). Distinct psychosomatic symptom profiles were identified among patients with T2DM. A high symptom burden profile was characterized by greater clinical complexity, diminished psychosocial resources, and substantially impaired quality of life, independent of glycemic control.