Metabolic clusters and knowledge of vascular complications among adults with type 2 diabetes: A cross-sectional study in East Java, Indonesia

ABSTRACT Background: Vascular complications contribute substantially to morbidity and mortality in individuals with type 2 diabetes mellitus (T2DM). However, evidence linking the knowledge of microvascular and macrovascular complications with metabolic profiles remains limited. Objective: To assess vascular complication knowledge among individuals with T2DM and explore its relationship with metabolic characteristics. Materials and Methods: This exploratory cross-sectional study included 85 adults with T2DM attending a primary healthcare center in Indonesia. The knowledge of microvascular and macrovascular complications was assessed using a structured questionnaire comprising 12 microvascular and eight macrovascular items. Metabolic indicators included random blood glucose, systolic and diastolic blood pressure, and body mass index. The associations were explored using tertile-based analyses, K-means clustering, multivariable linear regression adjusted for age and sex, and principal component analysis (PCA). Results: Participants correctly answered 66.76% of microvascular items and 57.50% of macrovascular items, with significantly higher microvascular than macrovascular knowledge scores ( P = 0.002). Tertile analyses showed no significant associations between individual metabolic indicators and knowledge scores. K-means clustering identified three metabolic profiles. Participants in the hyperglycemia-predominant cluster had lower macrovascular knowledge scores, and this association persisted after adjustment for age and sex ( β = −3.20, P = 0.001). Exploratory PCA suggested that vascular knowledge items varied together statistically and were largely distinct from metabolic variables. Conclusion: Individual metabolic indicators were not clearly associated with vascular complication knowledge. However, exploratory clustering suggested that a hyperglycemia-predominant metabolic profile may be associated with poorer macrovascular knowledge. Given the limited sample size, these findings should be interpreted cautiously and validated in larger studies.