Background: China has 148 million people with diabetes, a heavy disease burden for the country. Health-seeking behaviour, as a core component of disease management, plays a critical role in diabetes control.
Objective: To identify multidimensional patterns of health-seeking behaviour among patients with type 2 diabetes, examine their associations with glycemic control and health resource utilization, informing targeted diabetes management.
Methods: Using follow-up and clinical data from 30,509 patients with type 2 diabetes in Putuo District, Shanghai (2023), latent class analysis (LCA) was applied to identify latent classes of health-seeking behaviour. Multinomial logistic regression was used to assess demographic, behavioral, and clinical determinants of health-seeking behaviour patterns. Multivariable logistic regression was then applied to evaluate the effects of health-seeking behaviour patterns and other factors on annual glycemic control.
Results: LCA identified four distinct patterns: specialist-dominated (14.68%), community-based (23.47%), enhanced community-based (38.72%), and comprehensive-complex (23.13%). Multinomial logistic regression showed that patients aged ≥60 were more likely to adopt community-based or enhanced community-based patterns (OR=2.117-2.667, P<0.001); longer disease duration reduced the likelihood of community-based pattern (OR=0.983, P<0.01) but increased the likelihood of comprehensive-complex pattern (OR=1.041, P<0.001); patients with complications or comorbidities were significantly more likely to fall into the enhanced community-based (OR=1.498-2.506) or comprehensive-complex patterns (OR=3.003-3.865, P<0.001). Multivariable logistic regression indicated that compared with the specialist-dominated pattern, both enhanced community-based (OR=0.923, P=0.041) and comprehensive-complex patterns (OR=0.791, P<0.001) were associated with poorer glycemic control; regular physical activity (OR=1.107, P=0.002) and HbA1c testing ≥2 times/year were protective factors for achieving annual glycemic control (OR=2.891-4.126, P<0.001).
Conclusions Health seeking behaviour among patients with type 2 diabetes shows significant heterogeneity. Age, disease duration, and complications are key drivers of behavioral differentiation. Glycemic outcomes vary significantly across health-seeking behaviour patterns, emphasizing multidisciplinary collaboration in specialist-dominated pattern, enhancing integrated management in community-based pattern, and optimizing resource allocation for patients with complex needs to achieve stratified and targeted interventions.
Declarations
Not applicable.
Ethical approval and consent to participate
The study received approval from Shanghai Municipal Center for Disease Control and Prevention Ethical Review Committee(Approval No. 2025-53).
Consent for publication
Not applicable.
Funding
Not applicable.
Declaration of competing interest
The authors declare that they have no competing interest.
Acknowledgements
Not applicable.
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