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On the Analysis of Blood Glucose Levels of Diabetic Patients Fortune J Health Sci 2021; 4 (1): 257-283 DOI: 10.26502/fjhs021 Original Article On The Analysis of Blood Glucose Levels of Diabetic Patients Onyenanu O. Adaobi1, Iheanyi S. Iwueze2, Emmanuel O. Biu1, Christopher Onyema Arimie3* 1Department of Mathematics and Statistics, University of Port Harcourt, Rivers State 2Department of Mathematics and Statistics, Federal University of Technology Owerri, Imo State, Nigeria 3Department of Radiology, University of Port Harcourt Teaching Hospital, Rivers State, Nigeria *Corresponding Author: Christopher Onyema Arimie, Department of Radiology, University of Port Harcourt Teaching Hospital, Rivers State, Nigeria; E-mail: [email protected] Received: 09 December 2020; Accepted: 19 December 2020; Published: 16 February 2021 Citation: Onyenanu O. Adaobi, Iheanyi S. Iwueze, Emmanuel O. Biu, Christopher Onyema Arimie. On The Analysis of Blood Glucose Levels of Diabetic Patients. Fortune Journal of Health Sciences 4 (2021): 257-283. Abstract difference between blood glucose testing on arrival Paired observation tests (Paired t-test, Wilcoxon and blood glucose testing after resting for one hour. signed ranked test and Sign test) were employed to The level of change in blood glucose after two hours determine if there is any significant difference for fasting patients was not the same with the level of between fasting blood sugar and oral glucose change two hours after glucose administration. It was tolerance tests of 47 diabetic patients. First, Jarque- concluded that a single fasting blood glucose test is Bera (JB) test was done to check for normality and it sufficient to diagnose diabetes on a visit to the showed that not all the mean differences were laboratory while oral glucose tolerance test normally distributed. Two sample t-test was used to conducted hourly is necessary to monitor the blood to check whether the level of change in blood glucose know when the glucose level is going high or low. for fasting patients and patients who had glucose intake are the same. The fasting blood sugar test and Keywords: Diabetic patients; Blood glucose level; oral glucose tolerance test were done hourly on two Paired Observation tests; Normality test; Diabetes different occasions. The results revealed no Fortune Journal of Health Sciences Vol. 4 No. 1 - March 2021 257 Fortune J Health Sci 2021; 4 (1): 257-283 DOI: 10.26502/fjhs021 1. Introduction testing consist of fasting blood glucose and glucose Diabetes is a disease associated with high level of intake measurements. The fasting blood sugar is used glucose (sugar) in the blood of the sufferer. It is very to diagnose diabetes while glucose intake is harmful to the body. Blood glucose testing involves conducted to measure the blood glucose level. Oral measuring the levels of blood glucose after fasting glucose tolerance test (OGTT) measures first and and after glucose intake. Fasting blood sugar test is second stage insulin response to glucose. It compares required to diagnose diabetes and Oral glucose the level of glucose in the blood before and after tolerance test (OGTT), done after glucose intake, administering glucose. After testing the blood helps to monitor the glucose level in the blood of a glucose level in the patient fasting, 75grams of patient. A hormone called insulin manages or glucose dissolved in water is given to the patient and regulates the glucose level in the body. When the another test conducted at one hour and two hours‟ body cannot produce enough insulin or when the interval. A glucometer (glucose meter) is used to insulin produced cannot work effectively owing to measure blood glucose and the unit of measurement some other conditions, the blood sugar level rises is mg/dl or mmol/l. Blood glucose level outside the causing diabetes. If it is too high or too low, medical normal range may be an indicator of a medical attention will be needed. condition. If the blood sugar measured is greater than 140gm/dl two hours after, it means the person is pre- Statistical tests such as Paired Observation tests diabetic. If it is greater than 199mg/dl two hours (including parametric and Non-parametric tests) are after, it means the person has full blown diabetes. If useful for ascertaining if there is any significant mean the result is 139mg/dl, it is considered as normal. The difference between the two measurements (before purpose of testing blood glucose several times per and after administration of glucose). Also, two day is to discover when the blood glucose level is sample t-test is useful for checking whether the level going too low or too high. This will help the doctor to of change in fasting blood sugar after two hours is the timely take steps to prevent the occurrence of low or same with the level of change after administration of high blood glucose levels. The test becomes a glucose. In paired observation, we have Univariate warning to those who fall into the category of pre- case and Multivariate cases. In Univariate case, two diabetic and full blown diabetes as it enables them to samples obtained are correlated and must be change their lifestyle and cut down the intake of dependent. The two samples are reduced to one by foods that has the capacity to increase blood glucose working the differences between the paired level. It is also beneficial in the sense that it gives observations. Here, the assumptions are: X and Y information on whether the body can tolerate glucose have a bivariate normal distribution and, X and Y are or not. correlated [1]. It is the practice in hospitals that when a patient The approach used in controlling diabetes is the arrives, the patient is kept two hours before blood glucose testing. This test measures the administration of glucose thereafter, the patient is concentration of glucose in the blood. Blood glucose kept for another two hours to monitor glucose level Fortune Journal of Health Sciences Vol. 4 No. 1 - March 2021 258 Fortune J Health Sci 2021; 4 (1): 257-283 DOI: 10.26502/fjhs021 [2]. The problem here is to ascertain whether the 2. Review of Literature resting period of two hours is adequate or not and 2.1 Review of works on glucose test secondly, is the level of change after two hours for Glucose, the simplest form of sugar, is the body‟s fasting glucose and the level of change two hours major source of energy while, glucose test measures after glucose administration the same? The purpose the amount of glucose in the blood. A hormone called of this study is to determine whether there is any Insulin regulates blood glucose level in the body. significant difference between fasting blood sugar According to Martel (2012) [3], Diabetes occurs test and oral glucose tolerance test by performing a when the body does not produce enough insulin statistical analysis on blood glucose measurements thereby causing the blood glucose to rise, or when the obtained from the medical laboratory department of a body cannot use the insulin produced effectively. If University Teaching Hospital in Nigeria. diabetes is left untreated, the high blood glucose level will cause damages in the organs. People with The specific objectives are to: diabetes normally go for blood glucose test to 1. Determine statistically the adequate period determine whether their condition is being managed of rest before the administration of glucose. well or not. A high blood glucose level is an 2. Determine whether the glucose level indication of poor management of the diabetes. Blood increased after one hour, two hours after glucose testing provides information that helps the glucose administration. physician to make decisions on diet and medication 3. Determine if the level of change after two dosage. hours, for fasting glucose is the same with the level of change two hours after glucose Saudek et al (2006) [4], states that since there is administration. increasing rate of diabetes, there is need to learn how to successfully control blood glucose level as this, There are many paired observation test statistics leads to significant reduction in mortality due to available but this research is limited to three paired diabetes, where assessing glycaemia in diabetes is observation tests (parametric Paired t-test, Non- challenging. parametric Wilcoxon ranked sign test and Sign test) only. Sign test of the median, Wilcoxon signed rank According to Haller et al. (2004) [5], blood glucose test and paired t-test, were performed to ascertain testing helps in administration of medication e.g., whether the level of change after one hour and two deciding the dosage to take. It also tells when the hour intervals for fasting glucose and after glucose blood glucose level is high or low. An important administration, respectively was the same. The two benefit of blood sugar testing is that diabetic patients sample t–tests was performed to check whether the are sensitized to read and interpret their results thus, level of change in blood glucose for fasting blood enabling them to take proper actions to improve sugar test was the same with the test done two hours control of the disease. People on insulin therapy or after glucose intake. other medications should test their blood glucose level regularly so as to know when their blood Fortune Journal of Health Sciences Vol. 4 No. 1 - March 2021 259 Fortune J Health Sci 2021; 4 (1): 257-283 DOI: 10.26502/fjhs021 glucose level is going too low or too high. Fasting dependent on one another. In this case, the null blood sugar test is used to diagnose diabetes while hypothesis is such that the mean difference is equal to Oral glucose tolerance test is conducted to measure zero. Paired t – test involves comparing two means blood glucose level.
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