The Prediction Model of Disease Progression of Micro and Macro-complication in Diabetes Mellitus

INTRODUCTION: This study purposed to develop a comprehensive computer simulation model of type 2 diabetes mellitus (T2DM) for analyzing prevention strategies for T2DM and its complications, comorbidities, and disability adjusted life year. METHODS: A Markov type model with Monte Carlo techniques was used. Age and gender of cohort was based on Korean data. Diabetes complication model is as follows : First, diabetic retinopathy model was defined as no retinopathy, nonprofilerative retinopathy, profilerative retinopathy, macular edema, and blindness. Second, diabetic nephropathy model was defined as microalbuminuria, clinical nephropathy, end-stage renal disease (ESRD), and ESRD with transplant. Third, diabetic neuropathy model was defined as peripheral neuropathy and lower-extremity amputation. Forth, diabetic cardiovascular disease model was defined as unrecognized myocardial infarction, history of angina, and history of cardiac arrest or myocardial infarction. Fifth, diabetic stroke model was defined as history of stroke. Sixth, death model was defined by ESRD, lower-extremity amputation, CVD, stroke, and other cause. Incidence rates of complications were also based on community and population studies. RESULTS: The prevalence of nonprofilerative retinopathy, profilerative retinopathy, macular edema, and blindness were predicted 25.5%, 16.6%, 3.8%, and 9.5%, respectively, of people with T2DM 10 years. The prevalence of microalbuminuria, clinical nephropathy, and end-stage renal disease were predicted to be 19.3%, 5.0%, and 0.1%, respectively, at 10 years. The prevalences of peripheral neuropathy and lower-extremity amputation were predicted to be 28.1% and 4.0%, respectively, at 10 years. The prevalence of unrecognized myocardial infarction, history of angina, and history of cardiac arrest or myocardial infarction were predicted to be 44.4%, 5.2%, and 7.3% at 10 years. The prevalence of history of stroke was predicted to be 0.3% at 10 years. Over 10 years, year of life lost due to death was estimated to be 41,161 person-year, and year lived with disability was estimated to be 209,278 person-year. the disability adjusted life year was estimated to be 250,439 person-year at 10 years. CONCLUSIONS: This computer simulation model predicted survival and the diabetic retinopathy, diabetic neuropathy, diabetic nephropathy, diabetic cardiovascular, and diabetic stroke complication observed in the Korean cohort with T2DM. The model could be used to evaluate the effects of preventive interventions on the natural history of T2DM.

Author dc:creator

• 이, 수진

Contributors dc:contributor

• 전, 기홍
• 대학원 의생명과학과
• 200427746

• 당뇨병 합병증
• 마르코프 과정
• 몬테카를로 시뮬레이션
• 전이확률
• diabetes complication
• markov process
• monte carlo simulation
• transition probability

Language dc:language

ko

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000013533
000000013533

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/8586