Caspian Journal of Internal Medicine
Babol University of Medical Sciences
Tue, Mar 18, 2025
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Volume 15, Issue 4 (Autumn 2024)
Caspian J Intern Med 2024, 15(4): 615-622 |
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Rohani T, Hajian-Tilaki K, Hajiahmadi M, Heidari B, Rahimi Rahimabadi N, Geraili Z. Factors affecting blood sugar changes in diabetic patients using a three-level model in analysis of longitudinal data. Caspian J Intern Med 2024; 15 (4) :615-622
URL: http://caspjim.com/article-1-3883-en.html
URL: http://caspjim.com/article-1-3883-en.html
Tahereh Rohani 
, Karimollah Hajian-Tilaki * , Mahmoud Hajiahmadi , Behzad Heidari , Natali Rahimi Rahimabadi , Zahra Geraili
, Karimollah Hajian-Tilaki * , Mahmoud Hajiahmadi , Behzad Heidari , Natali Rahimi Rahimabadi , Zahra Geraili
Dept of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran , drhajian@yahoo.com
Abstract: (1144 Views)
Background: Diabetes, a currently threatening disease, has severe consequences for individuals’ health conditions. The present study aimed to investigate the factors affecting the changes in the longitudinal outcome of blood sugar using a three-level analysis with the presence of missing data in diabetic patients.
Methods: A total of 526 diabetic patients were followed longitudinally selected from the annual data collected from the rural population monitored by Tonekabon health centers in the North of Iran during 2018-2019 from the Iranian Integrated Health System (SIB) database. In analyzing this longitudinal data, the three-level model (level 1: observation (time), level 2: subject, level 3: health center) was carried out with multiple imputations of possible missing values in longitudinal data.
Results: Results of fitting the three-level model indicated that every unit of change in the body mass index (BMI) significantly increased the fasting blood sugar by an average of 0.5 mg/dl (p=0.024). The impact of level 1 (observations) was insignificant in the three-level model. Still, the random effect of level 3 (healthcare centers) showed a highly significant measure for health centers (14.62, p<0.001).
Conclusion: The BMI reduction, the healthcare centers' socioeconomic status, and the health services provided have potential effects in controlling diabetes.
Methods: A total of 526 diabetic patients were followed longitudinally selected from the annual data collected from the rural population monitored by Tonekabon health centers in the North of Iran during 2018-2019 from the Iranian Integrated Health System (SIB) database. In analyzing this longitudinal data, the three-level model (level 1: observation (time), level 2: subject, level 3: health center) was carried out with multiple imputations of possible missing values in longitudinal data.
Results: Results of fitting the three-level model indicated that every unit of change in the body mass index (BMI) significantly increased the fasting blood sugar by an average of 0.5 mg/dl (p=0.024). The impact of level 1 (observations) was insignificant in the three-level model. Still, the random effect of level 3 (healthcare centers) showed a highly significant measure for health centers (14.62, p<0.001).
Conclusion: The BMI reduction, the healthcare centers' socioeconomic status, and the health services provided have potential effects in controlling diabetes.
Keywords: Blood sugar change, Diabetic patients, Body mass index, Health care centers, Three-level model, Missing data, FCS imputation algorithm, Longitudinal data
Type of Study: Original Article |
Subject:
Health
Received: 2023/03/11 | Accepted: 2023/11/6 | Published: 2024/08/29
Received: 2023/03/11 | Accepted: 2023/11/6 | Published: 2024/08/29
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