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Predictive factors of hypoglycemia in type 2 diabetes: a prospective study using machine learning.

作者信息

Shabestari Motahare, Mehrabbeik Akram, Barbieri Sebastiano, Marques-Vidal Pedro, Heshmati-Nasab Poria, Azizi Reyhaneh

机构信息

Yazd Cardiovascular Research Center, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Shahid Sadoughi University of Medical Sciences and Health Services, Yazd Diabetic Research Centre, Yazd, Iran.

出版信息

Sci Rep. 2025 May 25;15(1):18143. doi: 10.1038/s41598-025-03030-7.


DOI:10.1038/s41598-025-03030-7
PMID:40415088
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12104344/
Abstract

Hypoglycemia is a serious complication in individuals with type 2 diabetes mellitus. Identifying who is most at risk remains challenging due to the non-linear relationships between hypoglycemia and its associated risk factors. The objective of this study is to evaluate the importance and impact of risk factors related to the incidence of hypoglycemia through an explainable machine learning method. This prospective study enrolled 1306 adults with type 2 diabetes mellitus at a specialized diabetes center. Over three months, participants were asked to do self-monitoring blood glucose measurements and record hypoglycemic events. Nine clinically relevant features were analyzed using five machine learning models. The performance of the models was evaluated by different metrics. The SHapley Additive exPlanation method was used to elucidate how each covariate influenced the risk of hypoglycemia. Overall, 419 participants (32.08%) reported at least one hypoglycemic episode. Our findings highlight the non-linear nature of hypoglycemia risk in individuals with T2DM. Insulin therapy, Diabetes duration (> 13.7 years), and eGFR (< 60.2 mL/min/1.73 m) were the most important predictors of hypoglycemia, followed by age, HbA1C, triglycerides, total cholesterol, gender, and BMI.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e505/12104344/80a124c2c6ac/41598_2025_3030_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e505/12104344/4af6a0ca15db/41598_2025_3030_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e505/12104344/f1ea381710c3/41598_2025_3030_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e505/12104344/fc036d490d40/41598_2025_3030_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e505/12104344/4da72e6aee28/41598_2025_3030_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e505/12104344/80a124c2c6ac/41598_2025_3030_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e505/12104344/4af6a0ca15db/41598_2025_3030_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e505/12104344/f1ea381710c3/41598_2025_3030_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e505/12104344/fc036d490d40/41598_2025_3030_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e505/12104344/4da72e6aee28/41598_2025_3030_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e505/12104344/80a124c2c6ac/41598_2025_3030_Fig5_HTML.jpg

相似文献

[1]
Predictive factors of hypoglycemia in type 2 diabetes: a prospective study using machine learning.

Sci Rep. 2025-5-25

[2]
Hypoglycemia in People with Type 2 Diabetes and CKD.

Clin J Am Soc Nephrol. 2019-4-17

[3]
Frequency and Predictors of Self-Reported Hypoglycemia in Insulin-Treated Diabetes.

J Diabetes Res. 2017-8-20

[4]
Hypoglycemia in Type 2 Diabetes--More Common Than You Think: A Continuous Glucose Monitoring Study.

J Diabetes Sci Technol. 2015-4-27

[5]
Development and Validation of an Electronic Health Record-Based Risk Assessment Tool for Hypoglycemia in Patients With Type 2 Diabetes Mellitus.

J Diabetes Sci Technol. 2025-1

[6]
Unrecognized hypo- and hyperglycemia in well-controlled patients with type 2 diabetes mellitus: the results of continuous glucose monitoring.

Diabetes Technol Ther. 2003

[7]
Relation Between Hypoglycemia and Glycemic Variability in Type 2 Diabetes Patients with Insulin Therapy: A Study Based on Continuous Glucose Monitoring.

Diabetes Technol Ther. 2018-1-2

[8]
Efficacy of Intermittently Scanned Continuous Glucose Monitoring in the Prevention of Recurrent Severe Hypoglycemia.

Diabetes Technol Ther. 2020-5

[9]
Hypoglycemia in patients with type 2 diabetes treated with oral antihyperglycemic agents detected by continuous glucose monitoring: a multi-center prospective observational study in Croatia.

BMC Endocr Disord. 2020-3-10

[10]
Severe Hypoglycemia and Incident Heart Failure Among Adults With Type 2 Diabetes.

J Clin Endocrinol Metab. 2022-2-17

本文引用的文献

[1]
Availability, prices and affordability of self-monitoring blood glucose devices: surveys in six low-income and middle-income countries.

BMJ Public Health. 2025-2-22

[2]
The Virtual DCCT: Adding Continuous Glucose Monitoring to a Landmark Clinical Trial for Prediction of Microvascular Complications.

Diabetes Technol Ther. 2025-3

[3]
Prediction of Incident Diabetic Retinopathy in Adults With Type 1 Diabetes Using Machine Learning Approach: An Exploratory Study.

J Diabetes Sci Technol. 2024-10-28

[4]
Explainable Machine-Learning Models to Predict Weekly Risk of Hyperglycemia, Hypoglycemia, and Glycemic Variability in Patients With Type 1 Diabetes Based on Continuous Glucose Monitoring.

J Diabetes Sci Technol. 2024-10-8

[5]
Enhancing severe hypoglycemia prediction in type 2 diabetes mellitus through multi-view co-training machine learning model for imbalanced dataset.

Sci Rep. 2024-9-30

[6]
Novel Detection and Progression Markers for Diabetes Based on Continuous Glucose Monitoring Data Dynamics.

J Clin Endocrinol Metab. 2024-12-18

[7]
Risk factors and prediction of hypoglycaemia using the Hypo-RESOLVE cohort: a secondary analysis of pooled data from insulin clinical trials.

Diabetologia. 2024-8

[8]
A novel electronic health record-based, machine-learning model to predict severe hypoglycemia leading to hospitalizations in older adults with diabetes: A territory-wide cohort and modeling study.

PLoS Med. 2024-4

[9]
Continuous glucose monitoring in adults with type 2 diabetes: a systematic review and meta-analysis.

Diabetologia. 2024-5

[10]
Efficacy and Safety of Continuous Glucose Monitoring and Intermittently Scanned Continuous Glucose Monitoring in Patients With Type 2 Diabetes: A Systematic Review and Meta-analysis of Interventional Evidence.

Diabetes Care. 2024-1-1

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