Exploring Core and Bridge Symptoms Among People With Type 2 Diabetes Mellitus in China: A Network Analysis

AIM: To explore the network characteristics of symptom clusters in people with type 2 diabetes mellitus through network analysis, identify the core and bridging symptoms within the symptom network, and provide a foundation for targeted interventions and symptom management in people with T2DM. DESIGN: A cross-sectional survey. METHODS: A total of 360 people with T2DM who were hospitalised in the endocrinology departments of two hospitals with Grade A in Daqing City between August 2024 and February 2025 were selected using a convenience sampling method. The symptoms of people with T2DM were measured using the Chinese version of the Diabetes Symptom Checklist-Revised (DSC-R). Symptom clusters were identified through factor analysis, and network analysis was used to identify core and bridging symptoms. This research adhered to the STROBE guidelines. RESULTS: Six symptom clusters were obtained from factor analysis, which were psychological-behavioural symptom cluster, ophthalmological-neuropathy symptom cluster, cardiovascular symptom cluster, metabolic symptom cluster, body symptom cluster and nephrotic symptom cluster. Symptom network analysis revealed that 'Deteriorating vision' exhibited the highest strength centrality and expected influence. The top three symptoms with the highest bridge strength and bridge expected influence were 'Aching calves when walking', 'Queer feeling in the legs or feet' and 'Sleepiness or drowsiness'. CONCLUSIONS: People with T2DM commonly exhibit a range of symptoms. 'Deteriorating vision' is the most core symptom in people with T2DM. 'Aching calves when walking', 'Queer feeling in the legs or feet' and 'Sleepiness or drowsiness' are identified as the bridging symptoms in the network analysis. Healthcare professionals can design targeted interventions based on symptom clusters, core symptoms and bridging symptoms, thereby improving the efficiency of symptom management and optimising outcomes for people with T2DM. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.