|Zelalem Mehari Nigussie (firstname.lastname@example.org)|
|statistics, Jimma university,ethiopia|
Introduction: Diabetes mellitus (DM) is a catabolic multisystem disease with both biochemical and anatomical consequences. It is a chronic disease of carbohydrate, fat and protein metabolism caused by either absolute lack of insulin or insulin resistance or
Diabetes mellitus may present with characteristic symptoms such as thirst, polyuria, blurring of vision, and weight loss.
Diabetes mellitus is a chronic disease with a high prevalence and a growing concern worldwide.
More than 371 million people have diabetes in the world and now a day the burden is increasing
particularly in developing countries. In Ethiopia, the number of deaths attributed to diabetes
reached over 23,869.00 in 2012.
Objectives: To fit an appropriate statistical model and identify associated factors of fasting blood
sugar level of adult diabetic patients in Jimma University Specialized hospital.
Methods: This study used data obtained from a retrospective cohort follow up study from adult
diabetic patients who have been under follow up from 2011-2012 in Jimma University specialized
hospital. All patients included in this study were those diabetic patients whose age 18 and above
years and who have been followed at least two times. For fasting blood sugar measurement in
mg/dL, a linear mixed model (LMM) approach was used to model the relationship of fasting blood
sugar level and covariates over time. For the categorized fasting blood sugar level, Generalized
Estimating Equation, Generalized Linear Mixed model, and Marginalized Multilevel model were
used to assess whether good control of fasting blood sugar changed over time and to identify the
associated factors of good control of fasting blood sugar level for diabetic patients.
Result and Discussion: From the result of this study, fasting blood sugar level of adult diabetic
patients decreased over time. Follow up time, weight, DBP and time interaction with weight are
significant factors for fasting blood sugar level. Follow up time, weight, DBP and quadratic time
interaction have significant factors for good control fasting blood sugar level of adult diabetic
Conclusion: Linear mixed model with quadratic time random effect fits well to the continuous
measurement of fasting blood sugar level in mg/dL of adult diabetic patients and generalized models (GEE, GLMM and MMM) with quadratic time effect fits well for the categorized fasting blood sugar level.