Predicting onset of complications from diabetes: a graph based approach

Abstract

Diabetes is a significant health concern with more than 30 million Americans living with diabetes. Onset of diabetes increases the risk for various complications, including kidney disease, myocardial infractions, heart failure, stroke, retinopathy, and liver disease. In this paper, we study and predict the onset of these complications using a network-based approach by identifying fast and slow progressors. That is, given a patient's diagnosis of diabetes, we predict the likelihood of developing one or more of the possible complications, and which patients will develop complications quickly. This combination of "if a complication will be developed" with "how fast it will be developed" can aid the physician in developing better diabetes management program for a given patient.

Keywords: Diabetes; Disease network; Disease prediction; Heart failure; Kidney disease; Liver disease; Myocardial infarction; Real-world data; Retinopathy.

Fig. 1

Above is a flowchart depicting the cleaning and standardization process which (1) combines and QCs the raw data files, (2) combines variables, standardizes, and cleans using a dictionary specific to the data source, and finally (3) removes variable outliers and normalizes using a universal clinical parameter dictionary

Fig. 2

Above is an example of a patient network which contains demographic information, lab results, and diagnoses codes, for a patient who develops heart failure as a fast progressor. The most significant edges and nodes, as determined by the two-sided Z-test, marked in red, are used in patient risk calculation. Circles represent ICD diagnoses, hexagons demographic information, and squares clinical variables. Age and clinical variables had been quartiled such that 3.0 Age represents a patient whose age is in the top 75 percent of patients, and where 1.0 eGFR represents someone whose eGFR is between 25-50 percent when compared to the patient population

Fig. 3

Above is a graph of the values shown in Table 6

Fig. 4

By graphing how many patients are diagnosed with each complication rate per year (starting one year after a diabetes diagnosis), we can see that most patients develop complications quickly. We want to identify what will delay complication onset by comparing the patients who are slow and fast progressors, with the fast progressors occupying the left hand side of the chart. Abbreviations: Myocardial infarction (MYO), Heart failure (HFL), Kidney disease (KID), Liver disease (LIV), Retinopathy (RET), Stroke (STR)