Cluster-Based Immunization Patterns in Diabetes Mellitus: Insights for Personalized Preventive Care.

Abstract

Background: We investigated immunization status and preventive care among diabetes mellitus (DM) patients by stratifying them into clinically distinct risk clusters based on comorbidities, reflecting a personalized medicine approach. Methods: Using the Austrian health interview survey 2019, we identified four groups: cluster 1 (DM, arterial hypertension (aHTN), dyslipidemia; n = 215), cluster 2 (DM, aHTN, dyslipidemia, obesity class II; n = 33), cluster 3 (DM, aHTN, dyslipidemia, depression; n = 65), and a control cohort (DM without hyperlipidemia, hypertension, depression, or obesity class II; n = 214). The cohorts were compared by chi² tests. By logistic regression the association of the cluster-related variables and the vaccination status/preventive care variables were analyzed. Results: Significant differences in intact diphtheria immunization between the cohorts exist (cluster 1: 45.6%, cluster 2: 27.3%, cluster 3: 52.3%, control: 51.9%, p-value 0.047). Differences in intact tetanus (42.4% vs. 64%, p = 0.027) and diphtheria (27.3% vs. 51.9%, p = 0.013) immunization between cluster 2 and control cohort were investigated. Cluster 2 was negatively associated with tetanus (OR 0.83, p = 0.009) and diphtheria (OR 0.85, p = 0.018) immunization. Cluster 1 reports higher rates of fecal occult blood test (50.7% vs. 39.3%, p = 0.022) and cluster 2 reports a higher rate of colonoscopy (24.2% vs. 8.9%, p = 0.015) in comparison to the control cohort. Conclusions: A personalized medicine approach reveals that DM patients with specific comorbidity patterns, particularly those with hypertension, dyslipidemia, and obesity class II, have lower immunization rates-highlighting the need for targeted preventive strategies.