Use of a K-nearest neighbors model to predict the development of type 2 diabetes within 2 years in an obese, hypertensive population

AbstractPrediabetes is a type of hyperglycemia in which patients have blood glucose levels above normal but below the threshold for type 2 diabetes mellitus (T2DM). Prediabetic patients are considered to be at high risk for developing T2DM, but not all will eventually do so. Because it is difficult to identify which patients have an increased risk of developing T2DM, we developed a model of several clinical and laboratory features to predict the development of T2DM within a 2-year period. We used a supervised machine learning algorithm to identify at-risk patients from among 1647 obese, hypertensive patients. The study period began in 2005 and ended in 2018. We constrained data up to 2 years before the development of T2DM. Then, using a time series analysis with the features of every patient, we calculated one linear regression line and one slope per feature. Features were then included in a K-nearest neighbors classification model. Feature importance was assessed using the random forest algorithm. The K-nearest neighbors model accurately classified patients in 96% of cases, with a sensitivity of 99%, specificity of 78%, positive predictive value of 96%, and negative predictive value of 94%. The random forest algorithm selected the homeostatic model assessment –estimated insulin resistance, insulin levels, and body mass index as the most important factors, which in combination with KNN had an accuracy of 99% with a sensitivity of 99% and specificity of 97%. We built a p...
Source: Medical and Biological Engineering and Computing - Category: Biomedical Engineering Source Type: research

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As recently summarized1, there are only four randomized clinical trials (RCTs) in patients with type 2 diabetes mellitus (T2DM) comparing Roux-en-Y gastric bypass (RYGB) with sleeve gastrectomy (SG) and providing level I evidence up to 5 years after randomization.2-5 None of the individual studies were primarily designed and adequately powered to compare the effects of RYGB with SG on T2DM. However, combined analysis of these RCTs (i.e. meta-analysis) in order to increase the sample size and statistical power (RYGB, n=176 versus SG, n=175) would indicate that either there is no significant long-term difference between RYGB...
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Letter to the Editor Source Type: research
Nature Reviews Endocrinology, Published online: 26 March 2020; doi:10.1038/s41574-020-0352-xOrgan-specific microbial signatures in obesity and type 2 diabetes mellitus
Source: Nature Reviews Endocrinology - Category: Endocrinology Authors: Source Type: research
PREVALENCE OF VITAMIN D DEFICIENCY IN URBAN SOUTH INDIANS WITH DIFFERENT GRADES OF GLUCOSE TOLERANCE. Br J Nutr. 2020 Mar 26;:1-24 Authors: Jayashri R, Venkatesan U, Shanthi Rani CS, Deepa M, Anjana RM, Mohan V, Pradeepa R Abstract The present study assessed the prevalence of vitamin D deficiency in an urban south Indian population in individuals with different grades of glucose tolerance.A total of 1,500 individuals [900 normal glucose tolerance(NGT), 300 prediabetes and 300 with type 2 diabetes mellitus(T2DM)] who were not on vitamin D supplementation were randomly selected from the Chennai Urban Ru...
Source: The British Journal of Nutrition - Category: Nutrition Authors: Tags: Br J Nutr Source Type: research
This study aimed to evaluate ertugliflozin in patients with overweight and obesity with type 2 diabetes mellitus. METHODS: Data from three placebo-controlled, randomized, Phase 3 studies were pooled. Patients with baseline BMI ≥ 25 (1,377/1,544; 89%) were assessed with a stratification by BMI subgroup. RESULTS: At week 26, reductions from baseline in glycated hemoglobin A1c (HbA1c), fasting plasma glucose, body weight (BW), and systolic blood pressure (SBP) were greater with ertugliflozin versus placebo. For placebo, ertugliflozin 5 mg, and ertugliflozin 15 mg, respectively, least squares me...
Source: Obesity - Category: Eating Disorders & Weight Management Authors: Tags: Obesity (Silver Spring) Source Type: research
Objective: We sought to compare the short and long-term outcomes of MBS in adolescents vs. adults who have undergone a Roux-en-Y gastric bypass (RYGB) or Sleeve gastrectomy (SG).Design: Retrospective cohort study.Setting: Single tertiary care academic referral center.Participants: One hundred fifty adolescent (≤ 21-years) and adult (>21-years) subjects with severe obesity between 15 and 70 years of age who underwent RYGB or SG.Outcomes: Metabolic parameters, weight and height measures were obtained pre-and post-surgery (at 3 and 6 months, and then annually for 4 years).Results: Median pre-surgical body mass index (BM...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
We examined potential drivers for the comorbidity of epilepsy and T2DM in an attempt to elucidate possible biological mechanisms underlying the development of processes in individuals. We searched PubMed and Medline up to December 2019. Our search yielded 3361 articles, of which 82 were included in the scoping review. We reviewed articles focusing on the association of epilepsy and T2DM, drivers, and biological mechanisms. We found that epilepsy is associated with obesity and obesity is associated with T2DM. Treatment with valproate (either sodium or acid) is associated with weight increase and hyperinsulinemia, while topi...
Source: Epilepsy and Behaviour - Category: Neurology Authors: Tags: Epilepsy Behav Source Type: research
Source: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy - Category: Endocrinology Tags: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy Source Type: research
Authors: Zenno A, Nadler EP Abstract Bariatric surgery is currently the most effective weight loss treatment of severe obesity and its associated comorbidities and is being increasingly used to treat children and adolescents with severe obesity, including those with Type 2 Diabetes (T2D). This review focuses on the conventional management of T2D in children and adolescents, comparison of various types of bariatric surgeries, effect of bariatric surgery on gastrointestinal physiology and metabolism, current literature on the use of bariatric surgery to treat youth with severe obesity and T2D, and the potential compl...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
Authors: Gökçay Canpolat A, ┼×ahin M Abstract This chapter gives an overview of present knowledge and clinical aspects of antidiabetic drugs according to the recently available research evidence and clinical expertise.Many agents are acting on eight groups of pathophysiological mechanisms, which is commonly called as "Ominous Octet" by DeFronzo. The muscle, liver and β-cell, the fat cell, gastrointestinal tract, α-cell, kidney, and brain play essential roles in the development of glucose intolerance in type 2 diabetic individuals (Defronzo, Diabetes 58:773-795, 2009).A treatment par...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
Abstract Multimorbidity is increasingly common and current healthcare strategies are not always aligned to treat this complex burden of disease. COPD, type-2 diabetes mellitus (T2D) and cardiovascular disease, especially atherosclerosis, occur more frequently together than expected, even when risk factors such as smoking, obesity, inactivity and poverty are considered. This supports the possibility of unifying mechanisms that contribute to the pathogenesis or progression of each condition.Neutrophilic inflammation is causally associated with COPD, and increasingly recognised in the pathogenesis of atherosclerosis ...
Source: Respiratory Care - Category: Respiratory Medicine Authors: Tags: Eur Respir Rev Source Type: research
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