Using Routine Data to Categorize Poor Control Diabetic Patients: An Application of Cluster Analysis Technique
Abstract
Background: Diabetes mellitus is one of the most important causes of morbidity and mortality all over the world. Chronic high blood glucose is the root cause of developing future micro and macro vascular complications. In current study, we analyzed poorly controlled patients’ information by clustering method in order to find more homogenous sub-groups of patients for planning for further interventions.
Methods: This study was conducted based on medical records of diabetic patients admitted to 23 health care centers in four cities of Iran from 2010 to 2014. Demographic data and physical and biochemical measurements were extracted and analyzed using two-steps cluster analysis method.
Results: Three distinct clusters were derived from 2087 eligible cases. Cluster 1 totally consisted of men without any apparent risk factors. Members of clusters 2 and 3 were illiterate women with obesity. Dyslipidemia was a prominent characteristic in members of cluster 2.
Conclusion: Masculinity would play the main role in diabetes control. Meanwhile, aggregation of obesity, illiteracy and/or dyslipidemia in diabetic women predispose them to poor control condition. Based on these findings, we will be able to plan interventions that are more appropriate for identified groups.
Guariguata L, Whiting D, Hambleton I, Beagley J, Linnenkamp U, Shaw J (2014). Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract, 103(2):137-149.
World Health Organization (2014). The top 10 causes of death.Fact sheet N°310. http://www.who.int/mediacentre/factsheets/fs310/en/
Naslafkih A, Sestier F (2003). Diabetes mellitus related morbidity, risk of hospitalization and disability. J Insur Med, 35(2):102-113.
Stratton IM, Adler AI, Neil HAW, Matthews DR, Manley SE, Cull CA, et al. (2000). Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ, 321(7258):405-412.
Litwak L, Goh S-Y, Hussein Z, Malek R, Prusty V, Khamseh ME (2013). Prevalence of diabetes complications in people with type 2 diabetes mellitus and its association with baseline characteristics in the multinational A1chieve study. Diabetol Metab Syndr, 5(1):57.
American Diabetes Association (2014). Executive summary: Standards of medical care in diabetes--2014. Diabetes Care, 37 (suppl 1): S5- 13.
Almutairi MA, Said SM, Zainuddin H (2013). Predictors of Poor Glycemic Control Among Type Two Diabetic Patients. AJMMS, 3(2):17-21.
Khattab M, Khader YS, Al-Khawaldeh A, Ajlouni K (2010). Factors associated with poor glycemic control among patients with type 2 diabetes. J Diabetes Complications, 24(2):84-9.
Wallace T, Matthews D (2000). Poor glycemic control in type 2 diabetes: a conspiracy of disease, suboptimal therapy and attitude. QJM, 93(6):369-74.
Coleman K, Austin BT, Brach C, Wagner EH (2009). Evidence on the Chronic Care Model in the new millennium. Health Aff (Millwood), 28(1):75-85.
Toh MPHS, Wu CX, Leong HSS (2011). Association of younger age with poor glycemic and cholesterol control in Asians with type 2 Diabetes Mellitus in Singapore. J Endocrinol Metab, 1(1):27-37.
Sailaja G, Dhanalakshmi B, Bharathi Y, Reddy CR (2013). An Incremental clustering algorithm for multi–viewpoint similarity measure. IJETTCS, 2(1):208-12.
Kamal A (2014). Impact of diabetes on renal function parameters. Ind J Fund Appl Life Sci, 4(3):411-6.
Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999). A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Ann Intern Med, 130(6):461-70.
Courtenay WH (2000). Constructions of masculinity and their influence on men's well-being: a theory of gender and health. Soc Sci Med, 50(10):1385-401.
Addis ME, Mahalik JR (2003). Men, masculinity, and the contexts of help seeking. Am Psychol, 58(1):5-14.
Galdas PM, Cheater F, Marshall P (2005). Men and health help‐seeking behaviour: literature review. J Adv Nurs, 49(6):616-23.
Anonymous (2014). Improving men’s health and wellbeing. Victorian Government, Department of Health. https://www2.health.vic.gov.au/Api/downloadmedia/%7BB131BD68-EA4A-4D62-9173-64C2A13B4400%7D.
World Health Organization (2015).Global Health Observatory (GHO) data. non-communicable disease risk factors.obesity. http://www.who.int/gho/ncd/risk_factors/obesity_text/en/.
El-Kebbi IM, Cook CB, Ziemer DC, Miller CD, Gallina DL, Phillips LS (2003). Association of younger age with poor glycemic control and obesity in urban African Americans with type 2 diabetes. Arch Intern Med, 163(1):69-75.
Ji L, Zou D, Liu L, Qian L, Kadziola Z, Babineaux S, et al (2015). Increasing Body Mass Index Identifies Chinese Patients with Type 2 Diabetes Mellitus at Risk of Poor Outcomes. J Diabetes Complications, 29(4):488-96.
Nguyen NT, Nguyen X-MT, Lane J, Wang P (2011). Relationship between obesity and diabetes in a US adult population: findings from the National Health and Nutrition Examination Survey, 1999–2006. Obes Surg, 21(3):351-5.
Gill RS, Sharma AM, Gill SS, Birch DW, Karmali S (2011). The impact of obesity on diabetes mellitus and the role of bariatric surgery. Maturitas, 69(2):137-40.
Harrison L, Martin F, Melick R (1976). Correlation between insulin receptor binding in isolated fat cells and insulin sensitivity in obese human subjects. J Clin Invest, 58(6):1435-1441.
Bano G (2013). Glucose homeostasis, obesity and diabetes. Best Pract Res Clin Obstet Gynaecol, 27(5):715-26.
Monnier L, Colette C (2006). Addition of rapid-acting insulin to basal insulin therapy in type 2 diabetes: indications and modalities. Diabetes Metab, 32(1):7-13.
Yurgin N, Secnik K, Lage MJ (2008). Obesity and the use of insulin: a study of patients with type 2 diabetes in the UK. J Diabetes Complications, 22(4):235-40.
Woldu M, Wami C, Lenjisa J, Tegegne G, Tesafye G (2014). Factors Associated with Poor Glycemic Control among Patients with Type 2 Diabetes Mellitus in Ambo Hospital, Ambo; Ethiopia. Endocrinol Metab Synd, 3:143.
Benoit SR, Fleming R, Philis-Tsimikas A, Ji M (2005). Predictors of glycemic control among patients with Type 2 diabetes: a longitudinal study. BMC Public Health, 5:36.
National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) (2002). Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation, 106(25): 3143- 3421.
Titty FK (2010). Glycaemic control, dyslipidaemia and metabolic syndrome among recently diagnosed diabetes mellitus patients in Tamale Teaching Hospital, Ghana. West Afr J Med, 29(1):8-11.
Alberti K, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al (2009). Harmonizing the Metabolic Syndrome A Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation, 120(16):1640-5.
Wilson PW, D’Agostino RB, Parise H, Sullivan L, Meigs JB (2005). Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation, 112(20):3066-72.
Grundy SM (2004). Obesity, metabolic syndrome, and cardiovascular disease. J Clin Endocrinol Metab, 89(6):2595-600.
Ahmed N, Ahmad T, Hussain SJ, Javed M (2010). Frequency of metabolic syndrome in patients with type-2 diabetes. J Ayub Med Coll Abbottabad, 22(1):139-142.
Schillinger D, Grumbach K, Piette J, Wang F, Osmond D, Daher C, et al (2002). Association of health literacy with diabetes outcomes. JAMA, 288(4):475-82.
Pignone M, DeWalt DA, Sheridan S, Berkman N, Lohr KN (2005). Interventions to improve health outcomes for patients with low literacy. J Gen Intern Med, 20(2):185-92.
DeWalt DA, Berkman ND, Sheridan S, Lohr KN, Pignone MP (2004). Literacy and health outcomes: a systematic review of the literature. J Gen Intern Med, 19(12):1228-1239.
Cavanaugh K, Wallston KA, Gebretsadik T, Shintani A, Huizinga MM, Davis D, et al (2009). Addressing Literacy and Numeracy to Improve Diabetes Care: two randomized controlled trials. Diabetes Care, 32(12):2149-2155.
| Files | ||
| Issue | Vol 46 No 1 (2017) | |
| Section | Short Communication(s) | |
| Keywords | ||
| Diabetes Poor control Cluster analysis | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
