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In Frontiers in pharmacology

Purpose: The objective of this study was to evaluate the efficacy of machine learning algorithms in predicting risks of complications and poor glycemic control in nonadherent type 2 diabetes (T2D). Materials and Methods: This study was a real-world study of the complications and blood glucose prognosis of nonadherent T2D patients. Data of inpatients in Sichuan Provincial People's Hospital from January 2010 to December 2015 were collected. The T2D patients who had neither been monitored for glycosylated hemoglobin A nor had changed their hyperglycemia treatment regimens within the last 12 months were the object of this study. Seven types of machine learning algorithms were used to develop 18 prediction models. The predictive performance was mainly assessed using the area under the curve of the testing set. Results: Of 800 T2D patients, 165 (20.6%) met the inclusion criteria, of which 129 (78.2%) had poor glycemic control (defined as glycosylated hemoglobin A ≥7%). The highest area under the curves of the testing set for diabetic nephropathy, diabetic peripheral neuropathy, diabetic angiopathy, diabetic eye disease, and glycosylated hemoglobin A were 0.902 ± 0.040, 0.859 ± 0.050, 0.889 ± 0.059, 0.832 ± 0.086, and 0.825 ± 0.092, respectively. Conclusion: Both univariate analysis and machine learning methods reached the same conclusion. The duration of T2D and the duration of unadjusted hypoglycemic treatment were the key risk factors of diabetic complications, and the number of hypoglycemic drugs was the key risk factor of glycemic control of nonadherent T2D. This was the first study to use machine learning algorithms to explore the potential adverse outcomes of nonadherent T2D. The performances of the final prediction models we developed were acceptable; our prediction performances outperformed most other previous studies in most evaluation measures. Those models have potential clinical applicability in improving T2D care.

Fan Yuting, Long Enwu, Cai Lulu, Cao Qiyuan, Wu Xingwei, Tong Rongsheng


HbA1c, diabetic complications, machine learning, patient nonadherence, type 2 diabetes