Utilization of K-means Clustering for Classifying Diabetes Risk Populations According to Health Behaviors and 3Es-2Ss Health Literacy

Abstract

This study focused on classifying populations at risk for diabetes using K-means clustering integrated with the 3Es–2Ss health literacy framework: eating, exercise, emotion, smoking cessation, and alcohol cessation. Biological, behavioral, and health literacy data were analyzed. The dataset was collected from 126 participants identified as at-risk individuals in Ngao District, Lampang Province, Thailand. This relatively small, community-based sample provides valuable insights into local health behaviors but limits the generalizability and statistical power of the findings to broader populations. The K-means clustering analysis, guided by the Elbow method, identified k = 4 as the optimal number of clusters, yielding four distinct groups with different socio-demographic and health characteristics. These clusters revealed variations in health profiles, economic status, and behavioral literacy within the Thai population. Despite the small sample size and limited generalizability, missing data and inconsistencies were systematically addressed through data cleaning and normalization to maintain analytical reliability. The results suggest that K-means clustering can serve as an effective decision-support tool for public health planning, particularly for Non-Communicable Disease (NCD) prevention and diabetes management at the local level.