Predicting three-month fasting blood glucose and glycated hemoglobin changes in patients with type 2 diabetes mellitus based on multiple machine learning algorithms

Abstract

Fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c) are key indicators reflecting blood glucose control in type 2 diabetes mellitus (T2DM) patients. The purpose of this study is to establish a predictive model for blood glucose changes in T2DM patients after 3 months of treatment, achieving personalized treatment.A retrospective study was conducted on type 2 diabetes mellitus real-world medical data from 4 cities in Sichuan Province, China from January 2015 to December 2020. After data preprocessing, data inputting, data sampling, and feature screening, 16 kinds of machine learning methods were used to construct prediction models, and 5 prediction models with the best prediction performance were screened respectively. A total of 100,000 cases were included to establish the FBG model, and 2,169 cases were established to establish the HbA1c model. The best prediction model both of FBG and HbA1c finally obtained are realized by ensemble learning and modified random forest inputting, the AUC values are 0.819 and 0.970, respectively. The most important indicators of the FBG and HbA1c prediction model were FBG and HbA1c. Medication compliance, follow-up outcome, dietary habits, BMI, and waist circumference also had a greater impact on FBG levels. The prediction accuracy of the models of the two blood glucose control indicators is high and has certain clinical applicability.HbA1c and FBG are mutually important predictors, and there is a close relationship between them.

Figure 1

Data analysis flow chart.

Figure 2

Feature importance bar chart—(A) FBG; (B) HbA1c (inputting method: not; screening method: lasso screening).

Figure 2

Feature importance bar chart—(A) FBG; (B) HbA1c (inputting method: not; screening method: lasso screening).

Figure 3

ROC curves of the five best predictive models (A FBG; B HbA1c).

Figure 4

P-R curves of the five best predictive models(A FBG; B HbA1c).