Evidence map›Paper›PMID 36846513›Full record

ArticleJournal of diabetes research2023

Using Artificial Intelligence to Develop a Multivariate Model with a Machine Learning Model to Predict Complications in Mexican Diabetic Patients without Arterial Hypertension (National Nested Case-Control Study): Metformin and Elevated Normal Blood Pressure Are Risk Factors, and Obesity Is Protective.

Sergio A Zaizar-Fregoso, Agustin Lara-Esqueda, Carlos M Hernández-Suarez, Josuel Delgado-Enciso, Arturo Garcia-Nevares, Luis M Canseco-Avila, Jose Guzman-Esquivel, Iram P Rodriguez-Sanchez, Margarita L Martinez-Fierro, Gabriel Ceja-Espiritu and 4 more

Full text read
In one paragraph

Article in Journal of diabetes research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Sergio A Zaizar-FregosoFacultad de Medicina, Universidad de Colima, Colima 28040, Mexico.ORCID https://orcid.org/0000-0002-8984-6971
Agustin Lara-EsquedaFacultad de Psicología y Terapia de la Comunicación Humana de la Universidad Juárez del Estado Durango, Durango 81301, Mexico.
Carlos M Hernández-SuarezFacultad de Medicina, Universidad de Colima, Colima 28040, Mexico.
Josuel Delgado-EncisoFundacion para la Etica Educacion e Investigacion del Cancer del Instituto Estatal de Cancerologia de Colima AC, Colima 28085, Mexico.
Arturo Garcia-NevaresFacultad de Medicina, Universidad de Colima, Colima 28040, Mexico.
Luis M Canseco-AvilaFacultad de Ciencias Químicas Campus IV, Universidad Autónoma de Chiapas, Tapachula, 30700 Chiapas, Mexico.
Jose Guzman-EsquivelInstituto Mexicano del Seguro Social, Delegación Colima, Villa de Alvarez, 28983 Colima, Mexico.
Iram P Rodriguez-SanchezFacultad de Ciencias Biológicas, Universidad Autonoma de Nuevo Leon, San Nicolás de los Garza, 66455 Nuevo Leon, Mexico.
Margarita L Martinez-FierroUnidad de Medicina Humana y Ciencias de La Salud, Universidad Autonoma de Zacatecas, Zacatecas 98160, Mexico.ORCID https://orcid.org/0000-0003-1478-9068
Gabriel Ceja-EspirituFacultad de Medicina, Universidad de Colima, Colima 28040, Mexico.
Hector Ochoa-Díaz-LopezDepartamento de Salud, El Colegio de La Frontera Sur, San Cristóbal de Las Casas, 29290 Chiapas, Mexico.
Francisco Espinoza-GomezFacultad de Medicina, Universidad de Colima, Colima 28040, Mexico.
Iyari Sanchez-DiazSubdirección de Prevención y Protección a la Salud, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de Mexico, 14070, Mexico.
Ivan Delgado-EncisoFacultad de Medicina, Universidad de Colima, Colima 28040, Mexico.ORCID https://orcid.org/0000-0001-9848-862X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Diabetes mellitus is a disease with no cure that can cause complications and even death. Moreover, over time, it will lead to chronic complications. Predictive models have been used to identify people with a tendency to develop diabetes mellitus. At the same time, there is limited information regarding the chronic complications of patients with diabetes. Our study is aimed at creating a machine-learning model that will be able to identify the risk factors of a diabetic patient developing chronic complications such as amputations, myocardial infarction, stroke, nephropathy, and retinopathy. The design is a national nested case-control study with 63,776 patients and 215 predictors with four years of data. Using an XGBoost model, the prediction of chronic complications has an AUC of 84%, and the model has identified the risk factors for chronic complications in patients with diabetes. According to the analysis, the most crucial risk factors based on SHAP values (Shapley additive explanations) are continued management, metformin treatment, age between 68 and 104 years, nutrition consultation, and treatment adherence. But we highlight two exciting findings. The first is a reaffirmation that high blood pressure figures across patients with diabetes without hypertension become a significant risk factor at diastolic > 70 mmHg (OR: 1.095, 95% CI: 1.078-1.113) or systolic > 120 mmHg (OR: 1.147, 95% CI: 1.124-1.171). Furthermore, people with diabetes with a BMI > 32 (overall obesity) (OR: 0.816, 95% CI: 0.8-0.833) have a statistically significant protective factor, which the paradox of obesity may explain. In conclusion, the results we have obtained show that artificial intelligence is a powerful and feasible tool to use for this type of study. However, we suggest that more studies be conducted to verify and elaborate upon our findings.

Indexed as

Diabetes MellitusHypertensionMetforminAgedAged, 80 and overArtificial IntelligenceBlood PressureCase-Control StudiesHumansMachine LearningObesityRisk FactorsMetformin

Identifiers

PMID36846513
PMCPMC9949947

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.