Abstract

Hypoglycaemia is a condition when blood sugar levels in body are too low. This condition is usually a side effect of insulin treatment in diabetic patients. Symptoms of hypoglycaemia vary not only between individuals but also within individuals making it difficult for the patients to recognize their hypoglycaemia episodes. Given this condition, and because the symptoms are not exclusive to only hypoglycaemia, it is very important for patients to be able to identify that they are having a hypoglycaemia episode. Consistency models are statistical models that quantify the consistency of individual symptoms reported during hypoglycaemia. Because there are variations of consistency model, it is important to identify which model best fits the data. The aim of this paper is to asses and verify the models. We developed an assessment method based on stochastic latent residuals and performed posterior predictive checking as the model verification. It was found that a grouped symptom consistency model with multiplicative form of symptom propensity and episode intensity threshold fits the data better and has more reliable predictive ability as compared to other models. This model can be used in assisting patients and medical practitioners to quantify patients' reporting symptoms capability, hence promote awareness of their hypoglycaemia episodes so that corrective actions can be quickly taken.

Highlights

  • Hypoglycaemia is a condition of low glucose level in blood, i.e. below 4mmol/L

  • It is crucial to treat a hypoglycaemia episode promptly to avoid severe hypoglycaemia episode, where patient needs other people’s help to recover. It is not easy for the patient to identify a hypoglycaemia episode because symptoms of hypoglycaemia vary within individuals

  • A given symptom is not covarying with blood glucose levels [1] implying a degree of between-subject variability

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Summary

Introduction

Hypoglycaemia is a condition of low glucose level in blood, i.e. below 4mmol/L. It is a common side effect of insulin treatment in diabetic patients. It is crucial to treat a hypoglycaemia episode promptly to avoid severe hypoglycaemia episode, where patient needs other people’s help to recover. It is not easy for the patient to identify a hypoglycaemia episode because symptoms of hypoglycaemia vary within individuals. Zulkafli et al [5] introduced the grouped symptoms models as one of the consistency estimations models This model adds another source of variation to symptoms’ reportings by distributing the 26 symptoms to several groups according to the causes. Other functional form was briefly introduced as an alternative to be used in the consistency models [5]

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