Using Patient Health Profile Evaluation for Predicting the Likelihood of Retinopathy in Patients with Type 2 Diabetes: A Cross-Sectional Study Using Latent Profile Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design, Setting and Participants
2.2. Dependent Variable
2.3. The Questionnaires
2.4. Linking to Biomarkers
2.5. LPA Results
2.6. Statistical Analyses
3. Results
3.1. Basic Characteristics
3.2. Multivariable Logistic Regression Model
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Saeedi, P.; Petersohn, I.; Salpea, P.; Malanda, B.; Karuranga, S.; Unwin, N.; Colagiuri, S.; Guariguata, L.; Motala, A.A.; Ogurtsova, K.; et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res. Clin. Pract. 2019, 157, 107843. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Lin, X.; Xu, Y.; Pan, X.; Xu, J.; Ding, Y.; Sun, X.; Song, X.; Ren, Y.; Shan, P.-F. Global, regional, and national burden and trend of diabetes in 195 countries and territories: An analysis from 1990 to 2025. Sci. Rep. 2020, 10, 14790. [Google Scholar] [CrossRef]
- Sampath Kumar, A.; Maiya, A.G.; Shastry, B.A.; Vaishali, K.; Ravishankar, N.; Hazari, A.; Gundmi, S.; Jadhav, R. Exercise and insulin resistance in type 2 diabetes mellitus: A systematic review and meta-analysis. Ann. Phys. Rehabil. Med. 2019, 62, 98–103. [Google Scholar] [CrossRef] [PubMed]
- Galicia-Garcia, U.; Benito-Vicente, A.; Jebari, S.; Larrea-Sebal, A.; Siddiqi, H.; Uribe, K.B.; Ostolaza, H.; Martín, C. Pathophysiology of Type 2 Diabetes Mellitus. Int. J. Mol. Sci. 2020, 21, 6275. [Google Scholar] [CrossRef] [PubMed]
- Trikkalinou, A.; Papazafiropoulou, A.K.; Melidonis, A. Type 2 diabetes and quality of life. World J. Diabetes 2017, 8, 120–129. [Google Scholar] [CrossRef] [PubMed]
- American Diabetes Association Professional Practice Committee. Summary of Revisions: Standards of Medical Care in Diabetes—2020. Diabetes Care 2020, 43 (Suppl. S1), S4–S6. [Google Scholar] [CrossRef] [Green Version]
- Kornelius, E.; Chiou, J.Y.; Yang, Y.S.; Lu, Y.L.; Peng, C.H.; Huang, C.N. The Diabetes Shared Care Program and Risks of Cardiovascular Events in Type 2 Diabetes. Am. J. Med. 2015, 128, 977–985.e3. [Google Scholar] [CrossRef]
- Stolar, M. Glycemic control and complications in type 2 diabetes mellitus. Am. J. Med. 2010, 123 (Suppl. S3), S3–S11. [Google Scholar] [CrossRef]
- Boussageon, R.; Pouchain, D.; Renard, V. Prevention of complications in type 2 diabetes: Is drug glucose control evidence based? Br. J. Gen. Pract. J. R. Coll. Gen. Pract. 2017, 67, 85–87. [Google Scholar] [CrossRef]
- Cheung, N.; Mitchell, P.; Wong, T.Y. Diabetic retinopathy. Lancet 2010, 376, 124–136. [Google Scholar] [CrossRef]
- Thomas, R.L.; Halim, S.; Gurudas, S.; Sivaprasad, S.; Owens, D.R. IDF Diabetes Atlas: A review of studies utilising retinal photography on the global prevalence of diabetes related retinopathy between 2015 and 2018. Diabetes Res. Clin. Pract. 2019, 157, 107840. [Google Scholar] [CrossRef] [PubMed]
- Mohamed, Q.; Gillies, M.C.; Wong, T.Y. Management of Diabetic RetinopathyA Systematic Review. JAMA 2007, 298, 902–916. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- The Diabetes Control; Complications Trial Research Group. The relationship of glycemic exposure (HbA1c) to the risk of development and progression of retinopathy in the diabetes control and complications trial. Diabetes 1995, 44, 968–983. [Google Scholar] [CrossRef]
- Al-Khawaldeh, O.A.; Al-Hassan, M.A.; Froelicher, E.S. Self-efficacy, self-management, and glycemic control in adults with type 2 diabetes mellitus. J. Diabetes Its Complicat. 2012, 26, 10–16. [Google Scholar] [CrossRef]
- Lee, A.A.; Piette, J.D.; Heisler, M.; Janevic, M.R.; Rosland, A.M. Diabetes self-management and glycemic control: The role of autonomy support from informal health supporters. Health Psychol. Off. J. Div. Health Psychol. Am. Psychol. Assoc. 2019, 38, 122–132. [Google Scholar] [CrossRef]
- King, D.K.; Glasgow, R.E.; Toobert, D.J.; Strycker, L.A.; Estabrooks, P.A.; Osuna, D.; Faber, A.J. Self-Efficacy, Problem Solving, and Social-Environmental Support Are Associated with Diabetes Self-Management Behaviors. Diabetes Care 2010, 33, 751–753. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Harrington, M.; Gibson, S.; Cottrell, R.C. A review and meta-analysis of the effect of weight loss on all-cause mortality risk. Nutr. Res. Rev. 2009, 22, 93–108. [Google Scholar] [CrossRef] [Green Version]
- Salas-Salvadó, J.; Bulló, M.; Babio, N.; Martínez-González, M.; Ibarrola-Jurado, N.; Basora, J.; Estruch, R.; Covas, M.I.; Corella, D.; Arós, F.; et al. Reduction in the incidence of type 2 diabetes with the Mediterranean diet: Results of the PREDIMED-Reus nutrition intervention randomized trial. Diabetes Care 2011, 34, 14–19. [Google Scholar] [CrossRef] [Green Version]
- Powers, M.A.; Bardsley, J.; Cypress, M.; Duker, P.; Funnell, M.M.; Fischl, A.H.; Maryniuk, M.D.; Siminerio, L.; Vivian, E. Diabetes Self-management Education and Support in Type 2 Diabetes: A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. Clin. Diabete A Publ. Am. Diabetes Assoc. 2016, 34, 70–80. [Google Scholar] [CrossRef] [Green Version]
- Lin, S.-M.; Lin, S.-L.; Wu, Y.-C.; Chang, C.-M.; Wu, H.-L. Validity and Reliability of a Chinese Translation of a Perceived Diabetes Self-Management Scale. J. Nurs. Healthc. Res. 2011, 7, 198–206. [Google Scholar]
- Vivienne Wu, S.F.; Courtney, M.; Edwards, H.; McDowell, J.; Shortridge-Baggett, L.M.; Chang, P.J. Development and validation of the Chinese version of the Diabetes Management Self-efficacy Scale. Int. J. Nurs. Stud. 2008, 45, 534–542. [Google Scholar] [CrossRef]
- Williams, G.C.; McGregor, H.A.; Zeldman, A.; Freedman, Z.R.; Deci, E.L. Testing a self-determination theory process model for promoting glycemic control through diabetes self-management. Health Psychol. Off. J. Div. Health Psychol. Am. Psychol. Assoc. 2004, 23, 58–66. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Goodman, L.A. Exploratory latent structure analysis using both identifiable and unidentifiable models. Biometrika 1974, 61, 215–231. [Google Scholar] [CrossRef]
- Savage, M.; Devine, F.; Cunningham, N.; Taylor, M.; Li, Y.; Hjellbrekke, J.; Le Roux, B.; Friedman, S.; Miles, A. A New Model of Social Class? Findings from the BBC’s Great British Class Survey Experiment. Sociology 2013, 47, 219–250. [Google Scholar] [CrossRef] [Green Version]
- Hernandez-Tejada, M.A.; Campbell, J.A.; Walker, R.J.; Smalls, B.L.; Davis, K.S.; Egede, L.E. Diabetes empowerment, medication adherence and self-care behaviors in adults with type 2 diabetes. Diabetes Technol. 2012, 14, 630–634. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Centers for Disease Control and Prevention. Preventive-care knowledge and practices among persons with diabetes mellitus—North Carolina, Behavioral Risk Factor Surveillance System, 1994–1995. MMWR Morb. Mortal. Wkly. Rep. 1997, 46, 1023–1027. [Google Scholar]
- Avery, L.; Flynn, D.; van Wersch, A.; Sniehotta, F.F.; Trenell, M.I. Changing physical activity behavior in type 2 diabetes: A systematic review and meta-analysis of behavioral interventions. Diabetes Care 2012, 35, 2681–2689. [Google Scholar] [CrossRef] [Green Version]
- Newsom, J.T.; Huguet, N.; McCarthy, M.J.; Ramage-Morin, P.; Kaplan, M.S.; Bernier, J.; McFarland, B.H.; Oderkirk, J. Health behavior change following chronic illness in middle and later life. J. Gerontol. B Psychol. Sci. Soc. Sci. 2012, 67, 279–288. [Google Scholar] [CrossRef]
- Buis, L.R.; Hirzel, L.; Turske, S.A.; Des Jardins, T.R.; Yarandi, H.; Bondurant, P. Use of a text message program to raise type 2 diabetes risk awareness and promote health behavior change (part II): Assessment of participants’ perceptions on efficacy. J. Med. Internet Res. 2013, 15, e282. [Google Scholar] [CrossRef]
- Wing, R.R.; Lang, W.; Wadden, T.A.; Safford, M.; Knowler, W.C.; Bertoni, A.G.; Hill, J.O.; Brancati, F.L.; Peters, A.; Wagenknecht, L.; et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care 2011, 34, 1481–1486. [Google Scholar] [CrossRef] [Green Version]
- Shrivastava, S.R.; Shrivastava, P.S.; Ramasamy, J. Role of self-care in management of diabetes mellitus. J. Diabetes Metab. Disord. 2013, 12, 14. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Raaijmakers, L.G.; Martens, M.K.; Bagchus, C.; de Weerdt, I.; de Vries, N.K.; Kremers, S.P. Correlates of perceived self-care activities and diabetes control among Dutch type 1 and type 2 diabetics. J. Behav. Med. 2015, 38, 450–459. [Google Scholar] [CrossRef] [PubMed]
- American Association of Diabetes. Intensive diabetes management: Implications of the DCCT and UKPDS. Diabetes Educ. 2002, 28, 735–740. [Google Scholar] [CrossRef] [PubMed]
- Williams, G.C.; Freedman, Z.R.; Deci, E.L. Supporting autonomy to motivate patients with diabetes for glucose control. Diabetes Care 1998, 21, 1644–1651. [Google Scholar] [CrossRef]
- Yau, J.W.Y.; Rogers, S.L.; Kawasaki, R.; Lamoureux, E.L.; Kowalski, J.W.; Bek, T.; Chen, S.-J.; Dekker, J.M.; Fletcher, A.; Grauslund, J.; et al. Global Prevalence and Major Risk Factors of Diabetic Retinopathy. Diabetes Care 2012, 35, 556–564. [Google Scholar] [CrossRef] [Green Version]
- Schmidt, M.I.; Bracco, P.; Canhada, S.; Guimarães, J.M.N.; Barreto, S.M.; Chor, D.; Griep, R.; Yudkin, J.S.; Duncan, B.B. Regression to the Mean Contributes to the Apparent Improvement in Glycemia 3.8 Years after Screening: The ELSA-Brasil Study. Diabetes Care 2020, 44, 81–88. [Google Scholar] [CrossRef]
- Romero-Aroca, P.; Navarro-Gil, R.; Valls-Mateu, A.; Sagarra-Alamo, R.; Moreno-Ribas, A.; Soler, N. Differences in incidence of diabetic retinopathy between type 1 and 2 diabetes mellitus: A nine-year follow-up study. Br. J. Ophthalmol. 2017, 101, 1346–1351. [Google Scholar] [CrossRef] [Green Version]
- Shani, M.; Eviatar, T.; Komaneshter, D.; Vinker, S. Diabetic Retinopathy-Incidence And Risk Factors In A Community Setting—A Longitudinal Study. Scand. J. Prim. Health Care 2018, 36, 237–241. [Google Scholar] [CrossRef] [Green Version]
- Fong, D.S.; Aiello, L.; Gardner, T.W.; King, G.L.; Blankenship, G.; Cavallerano, J.D.; Ferris, F.L.; Klein, R. Retinopathy in Diabetes. Diabetes Care 2004, 27 (Suppl. S1), s84–s87. [Google Scholar] [CrossRef] [Green Version]
- Wong, J.; Molyneaux, L.; Constantino, M.; Twigg, S.M.; Yue, D.K. Timing Is Everything: Age of Onset Influences Long-Term Retinopathy Risk in Type 2 Diabetes, Independent of Traditional Risk Factors. Diabetes Care 2008, 31, 1985–1990. [Google Scholar] [CrossRef] [Green Version]
- Solomon, S.D.; Chew, E.; Duh, E.J.; Sobrin, L.; Sun, J.K.; VanderBeek, B.L.; Wykoff, C.C.; Gardner, T.W. Diabetic Retinopathy: A Position Statement by the American Diabetes Association. Diabetes Care 2017, 40, 412–418. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Zhang, X.; Lim, S.C.; Tavintharan, S.; Yeoh, L.Y.; Sum, C.F.; Ang, K.; Yeo, D.; Low, S.; Kumari, N. Association of central arterial stiffness with the presence and severity of diabetic retinopathy in Asians with type 2 diabetes. Diabetes Vasc. Dis. Res. 2019, 16, 498–505. [Google Scholar] [CrossRef] [PubMed]
- Lima, V.C.; Cavalieri, G.C.; Lima, M.C.; Nazario, N.O.; Lima, G.C. Risk factors for diabetic retinopathy: A case–control study. Int. J. Retin. Vitr. 2016, 2, 21. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Niazi, M.K.; Akram, A.; Naz, M.A. Duration of Diabetes as a Significant Factor for Retinopathy. Pak. J. Ophthalmol. 2010, 26, 182–186. [Google Scholar]
- Cho, N.H.; Kim, T.H.; Woo, S.J.; Park, K.H.; Lim, S.; Cho, Y.M.; Park, K.S.; Jang, H.C.; Choi, S.H. Optimal HbA1c cutoff for detecting diabetic retinopathy. Acta Diabetol. 2013, 50, 837–842. [Google Scholar] [CrossRef]
- Lee, M.-K.; Han, K.-D.; Lee, J.-H.; Sohn, S.-Y.; Hong, O.-K.; Jeong, J.-S.; Kim, M.-K.; Baek, K.-H.; Song, K.-H.; Kwon, H.-S. Normal-to-mildly increased albuminuria predicts the risk for diabetic retinopathy in patients with type 2 diabetes. Sci. Rep. 2017, 7, 11757. [Google Scholar] [CrossRef] [Green Version]
- Park, H.C.; Lee, Y.K.; Cho, A.; Han, C.H.; Noh, J.W.; Shin, Y.J.; Bae, S.H.; Kim, H. Diabetic retinopathy is a prognostic factor for progression of chronic kidney disease in the patients with type 2 diabetes mellitus. PLoS ONE 2019, 14, e0220506. [Google Scholar] [CrossRef] [Green Version]
- Kaewput, W.; Thongprayoon, C.; Rangsin, R.; Ruangkanchanasetr, P.; Mao, M.A.; Cheungpasitporn, W. Associations of renal function with diabetic retinopathy and visual impairment in type 2 diabetes: A multicenter nationwide cross-sectional study. World J. Nephrol. 2019, 8, 33–43. [Google Scholar] [CrossRef]
- Yang, J.; Zhang, Z.; Zhang, L.; Su, Y.; Sun, Y.; Wang, Q. Relationship between Self-Care Behavior and Cognitive Function in Hospitalized Adult Patients with Type 2 Diabetes: A Cross-Sectional Study. Diabetes Metab. Syndr. Obes. 2020, 13, 207–214. [Google Scholar] [CrossRef] [Green Version]
- Cuevas, H.E.; Stuifbergen, A.K.; Brown, S.A. Targeting cognitive function: Development of a cognitive training intervention for diabetes. Int. J. Nurs. Pract. 2020, 26, e12825. [Google Scholar] [CrossRef]
- Srikanth, V.; Sinclair, A.J.; Hill-Briggs, F.; Moran, C.; Biessels, G.J. Type 2 diabetes and cognitive dysfunction—Towards effective management of both comorbidities. Lancet Diabetes Endocrinol. 2020, 8, 535–545. [Google Scholar] [CrossRef]
- Sinclair, A.J.; Girling, A.J.; Bayer, A.J. Cognitive dysfunction in older subjects with diabetes mellitus: Impact on diabetes self-management and use of care services. All Wales Research into Elderly (AWARE) Study. Diabetes Res. Clin. Pract. 2000, 50, 203–212. [Google Scholar] [CrossRef]
3 Classes | 4 Classes | 5 Classes | ||||
---|---|---|---|---|---|---|
AIC | 19,851.923 | 19,625.590 | 19,568.176 | |||
BIC | 20,121.353 | 19,964.550 | 19,976.666 | |||
Adjusted BIC | 19,924.530 | 19,716.935 | 19,678.258 | |||
Entropy | 0.844 | 0.854 | 0.865 | |||
Mean | C1 | C2 | C3 | C4 | C5 | |
Proportion | 9.8% | 8.2% | 5.8% | 16.3% | 59.8% | |
Health education score | 7.111 | 6.759 | 5.740 | 7.440 | 7.250 | 7.323 |
Medication | 4.654 | 4.724 | 4.766 | 2.680 | 4.738 | 4.804 |
Health diet | 3.942 | 3.955 | 2.992 | 3.181 | 3.605 | 4.257 |
Monitoring blood sugar | 3.920 | 4.000 | 2.908 | 3.112 | 3.964 | 4.121 |
Regular exercise | 3.687 | 3.671 | 1.902 | 3.030 | 3.380 | 4.111 |
DMESE | 45.604 | 45.379 | 34.186 | 41.456 | 44.712 | 47.963 |
TSRQd_a | 34.848 | 34.989 | 29.379 | 34.507 | 35.760 | 35.376 |
TSRQd_c | 26.485 | 27.442 | 21.813 | 25.186 | 27.189 | 26.904 |
SBP | 0.194 | 0.211 | 0.204 | 0.252 | 0.151 | 0.197 |
HbA1C | 0.565 | 0.509 | 0.525 | 0.398 | 0.480 | 0.625 |
LDL | 0.594 | 0.624 | 0.693 | 0.473 | 0.580 | 0.588 |
HDL | 0.650 | 0.638 | 0.674 | 0.551 | 0.252 | 0.780 |
TG | 0.730 | 0.739 | 0.801 | 0.636 | 0.262 | 0.872 |
CR | 0.888 | 0.262 | 0.957 | 0.898 | 0.980 | 0.972 |
ACR | 0.724 | 0.436 | 0.833 | 0.662 | 0.543 | 0.828 |
Total | Retinopathy None | Retinopathy Positive | p | |||||
---|---|---|---|---|---|---|---|---|
n | % | n | % | n | % | |||
Mean | ±SD | Mean | ±SD | Mean | ±SD | |||
Sex | Female | 226 | 39.6 | 162 | 40.3 | 64 | 38.1 | 0.64 |
Male | 344 | 60.4 | 240 | 59.7 | 104 | 51.9 | ||
Age (mean ± SD) | 61.6 | 12.7 | 60.0 | 12.7 | 65.4 | 12.0 | <0.001 * | |
Education | Primary school | 114 | 20.0 | 66 | 16.4 | 48 | 28.6 | 0.002 * |
Junior High | 74 | 13.0 | 48 | 11.9 | 26 | 15.5 | ||
Senior High | 161 | 28.2 | 117 | 29.1 | 44 | 26.2 | ||
College (above) | 251 | 3838 | 171 | 42.5 | 50 | 29.8 | ||
Health status * | Worse | 91 | 16.0 | 61 | 30.9 | 30 | 17.9 | 0.731 |
Neutral | 303 | 53.3 | 216 | 53.9 | 87 | 51.8 | ||
Better | 175 | 30.8 | 124 | 15.2 | 51 | 30.4 | ||
Health education score | 7.12 | 1.92 | 7.25 | 1.81 | 6.82 | 2.15 | 0.018 | |
Medication | 4.66 | 0.67 | 4.64 | 0.71 | 4.70 | 0.53 | 0.338 | |
Health diet | 3.94 | 1.04 | 3.91 | 0.99 | 4.02 | 1.15 | 0.218 | |
Monitoring blood sugar | 3.92 | 1.39 | 3.94 | 1.38 | 3.87 | 1.43 | 0.575 | |
Regular exercise | 3.69 | 1.34 | 3.66 | 1.34 | 3.75 | 1.34 | 0.428 | |
Diabetes duration | 11.43 | 7.70 | 10.61 | 7.35 | 13.37 | 8.16 | <0.001 * | |
DMSES (mean ± SD) | 45.59 | 7.06 | 45.84 | 6.70 | 45.00 | 7.83 | 0.200 | |
TSRQd-A (mean ± SD) | 34.85 | 4.21 | 35.10 | 4.01 | 34.26 | 4.61 | 0.031 * | |
TSRQd-C (mean ± SD) | 26.49 | 5.51 | 26.74 | 5.44 | 25.87 | 5.65 | 0.088 | |
SBP | 0.19 | 0.15 | 0.21 | 0.16 | 0.16 | 0.14 | 0.002 * | |
HbA1C | 0.57 | 0.34 | 0.61 | 0.33 | 0.49 | 0.34 | <0.001 * | |
LDL | 0.59 | 0.34 | 0.59 | 0.34 | 0.60 | 0.35 | 0.758 | |
HDL | 0.65 | 0.38 | 0.66 | 0.38 | 0.64 | 0.38 | 0.585 | |
TG | 0.73 | 0.31 | 0.74 | 0.30 | 0.72 | 0.32 | 0.387 | |
CR | 0.89 | 0.25 | 0.90 | 0.23 | 0.86 | 0.27 | 0.110 | |
ACR | 0.73 | 0.40 | 0.76 | 0.36 | 0.61 | 0.45 | <0.001 * | |
LPA | C1 | 56 | 9.8 | 33 | 58.9 | 23 | 41.1 | 0.024 * |
C2 | 47 | 8.2 | 29 | 61.7 | 18 | 38.3 | ||
C3 | 33 | 5.8 | 28 | 84.8 | 5 | 15.2 | ||
C4 | 93 | 16.3 | 61 | 65.6 | 32 | 34.4 | ||
C5 | 341 | 59.8 | 251 | 73.6 | 90 | 26.4 |
OR | 95% UP OR | 95% LO OR | p | ||
---|---|---|---|---|---|
Sex | Male | 1.189 | 0.794 | 1.780 | 0.400 |
Age | 1.028 | 1.008 | 1.047 | 0.005 * | |
Education | Primary school | 0.200 | |||
Junior High | 0.922 | 0.480 | 1.772 | 0.808 | |
Senior High | 0.694 | 0.393 | 1.225 | 0.208 | |
College (above) | 0.568 | 0.321 | 1.005 | 0.052 | |
Health status * | Worse | 0.843 | |||
Neutral | 1.050 | 0.584 | 1.889 | 0.871 | |
Better | 0.925 | 0.539 | 1.589 | 0.778 | |
Diabetes duration | 1.030 | 1.004 | 1.056 | 0.025 * | |
LPA | C5 | 0.032 * | |||
C1 | 1.655 | 0.889 | 3.078 | 0.112 | |
C2 | 2.168 | 1.093 | 4.302 | 0.027 | |
C3 | 0.689 | 0.252 | 1.878 | 0.466 | |
C4 | 1.788 | 1.058 | 3.022 | 0.030 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Chiou, S.-J.; Liao, K.; Lin, K.-C.; Lin, W. Using Patient Health Profile Evaluation for Predicting the Likelihood of Retinopathy in Patients with Type 2 Diabetes: A Cross-Sectional Study Using Latent Profile Analysis. Int. J. Environ. Res. Public Health 2022, 19, 6084. https://doi.org/10.3390/ijerph19106084
Chiou S-J, Liao K, Lin K-C, Lin W. Using Patient Health Profile Evaluation for Predicting the Likelihood of Retinopathy in Patients with Type 2 Diabetes: A Cross-Sectional Study Using Latent Profile Analysis. International Journal of Environmental Research and Public Health. 2022; 19(10):6084. https://doi.org/10.3390/ijerph19106084
Chicago/Turabian StyleChiou, Shang-Jyh, Kuomeng Liao, Kuan-Chia Lin, and Wender Lin. 2022. "Using Patient Health Profile Evaluation for Predicting the Likelihood of Retinopathy in Patients with Type 2 Diabetes: A Cross-Sectional Study Using Latent Profile Analysis" International Journal of Environmental Research and Public Health 19, no. 10: 6084. https://doi.org/10.3390/ijerph19106084