International Journal of Health and Medical Sciences volume 5 pp. 08-16 doi: https://dx.doi.org/10.20469/ijhms.5.30002-1

The Prevalence of Diabetes in the Republic of Based on Regression Analysis Methods

A. Mukasheva ∗ N. Saparkhojayev Department of Cybersecurity, Khoja Akhmet Yassawi International Data Processing and Storage, Kazakh-Turkish University, Satbayev University, , Kazakhstan Turkestan, Kazakhstan Z. Akanov A. Algazieva Kazakh Society for Study of Diabetes, Academy of Civil Aviation, Member of AASD, Almaty, Kazakhstan Almaty, Kazakhstan

Abstract: In this research paper, experimental studies of regression analysis methods for predicting diabetes mellitus patients for 2019 in the Republic of Kazakhstan were conducted. Linear, polynomial, and exponential regressions meth- ods were considered, after which appropriate graphs were built. According to these results, the growth of development of patients with diabetes mellitus will not decrease. This is another confirmation that researchers need to apply new modern information technologies based on machine learning and artificial intelligence to struggle with the growth of this disease. Based on the results obtained, it can be concluded that early detection of the disease and preventive measures to increase risk awareness and complications of diabetes in the population is an important vector in preventing diabetes.

Keywords: Regression analysis, diabetes mellitus, statistics, forecasting

Received: 03 January 2019; Accepted: 02 February 2019; Published: 08 March 2019

I. INTRODUCTION the following research paper [5] published a report where According to research published by the World Health the study of the relationship between medical literacy, Organization, the prevalence of diabetes mellitus is in- awareness of complications and diabetic control among creasing rapidly in countries with medium and low in- patients with diabetes of second type is being studied. come [1]. The Global Diabetes Report claims that the Early diagnosis of diabetes and its timely treatment in- disease is one of the four priority non-infectious diseases, creases the patient’s chances of not starting the disease the consequences, and complications of which lead to until the last stage. In this regard, it is recommended in substantial economic costs for both people and the health the conditions of primary health care to recommend to system of any country as a whole [2]. To date, interna- the population to have access to undergo an examination tional and state organizations provide reliable statistical for the analysis of the level of glucose in the blood [2]. information and an estimation of the prevalence of the Such an experiment was conducted by researchers [6] disease around the world. Propagation of such agencies in order to identify the level of awareness and knowl- in the field of prevention directed to raise public aware- edge about diabetes of second type and its complications ness in promoting specific models of care and resources among university students. A similar experiment [7] was to fight the people with the disease [3, 4]. The authors of conducted among the adult urban population of India and ∗Correspondence concerning this article should be addressed to A. Mukasheva, Department of ybersecurity, Data Processing and Storage, Satbayev University, Almaty, Kazakhstan. E-mail: [email protected]

c 2019 The Author(s). Published by KKG Publications. This is an Open Access article distributed under a Creative Commons Attribution- NonCommercial-NoDerivatives 4.0 International License. 9 Mukasheva A. et al. / International Journal of Health and Medical Sciences 5, 2019 identifying factors influencing awareness, including the and diabetes remain different problems - not all obese presence of diabetes. Analyzing the situation, it can be people develop diabetes, and not all diabetics have weight safely assumed that not informing the public about the problems - they are so closely interrelated that researchers hidden threats of this disease are of great harm to health often mix them. The authors of the study [21] explain and cause material harm. As noted by researchers [8], that the opening of international trade markets, accompa- educating patients about the disease and assuming respon- nied by economic growth, takes into account the influx of sibility for day-to-day control of the situation is the key cheap processed foods. Carbonated drinks and products to success in recovery. The situation in Kazakhstan is that use large amounts of sugar imported from abroad also disappointing; only according to WHO [9] the preva- offer a cheap substitute for a traditional diet and put the lence of diabetes in men is 11.3%, and in women it is population at risk for diabetes. However, correlation stud- 11.7% with a total population of 17 million people. Ac- ies suggest only trends and the relationship between dia- cording to medical specialists [10] the number of people betes and diet, and population data cannot scientifically with diabetes in Kazakhstan will increase to a million prove that sugar causes diabetes. by 2030, which is a huge problem for the country, and It can be assumed that improving living standards this is the main reason for active research in this area. and urbanization may not cause diabetes; the economy To improve the situation with diabetes, researchers be- demonstrates the impact on the country of refined sugar gan to pay attention to the use of forecasting methods in and processed foods. It seems that with a lot of money, medicine, because forecasting demonstrates the serious- people started buying processed foods that they could ness of the disease and the need to take drastic measures not afford before, but this is a by-product of economic for its non-proliferation. According to the authors [11] growth. According to the data, the growing share of the studies from 91 countries were used to calculate the preva- average human diet from sugar is associated not with lence of diabetes by age and sex to determine national Gross Domestic Product, but with an increase in food diabetes prevalence rates in all 216 countries for 2010 imports [21]. and 2030. The possibility of using information systems According to this study [22], the prevalence of dia- in diagnosing diabetes is demonstrated in these studies betes in China over the past three decades has increased [12, 13, 14, 15, 16, 17], where the possibilities of using dramatically. Diabetes has become a major public health big data technology as a tool were considered. problem in China. The estimated prevalence of predia- Many chronic diseases spread rapidly and are at later betes in 2013 was 35.7%, which was much higher than stages in South Asia than in other regions. In South the estimate of 15.5% in the 2008 survey. Similarly, the Asians, type 2 diabetes develops at a younger middle age prevalence of prediabetes was higher among older people, and progresses faster than in other ethnic groups [18]. men, and overweight and obese people. In addition, the To date, mortality from infectious diseases such as prevalence of diabetes in young people is relatively high malaria and tuberculosis has declined sharply, and chronic and increasing. The prevalence of diabetes in the age diseases such as cancer and diabetes are increasing. This group of 20 to 39 years was 3.2%. model is associated with economic improvement and an As noted above, the prevention of diabetes in the lo- increase in the number of people living longer, but it cal population in China has an important role. It is better forces governments in developing countries to fight for to prevent a disease than to treat its irreversible conse- new and often more costly treatments for diseases that quences. Especially with a population showing growth lead to additional costs [19]. rates in the economy, all of these conditions are conducive According to official statistics from the International to the spread of diabetes, and preventive measures must Diabetes Federation (MDF), in 2015, in seven countries, be taken at the state level. there were more than ten million people with diabetes: China, India, the United States of America, Brazil, Rus- A. Forecasting in Medicine sian Federation, Mexico, and Indonesia. Today, about 422 Prediction can be obtained by substituting variables million people aged 20 to 79 have it, while 47 percent of into the regression equation. Having determined the con- diabetes-related deaths occur before the age of 60. By fidence intervals, you can apply them in the prediction. 2040, one in ten - 642 million people - according to MDF Regression analysis is widely used, which is an important forecasts, will have this condition [20]. statistical method for analyzing medical data. The main Combined with increased life expectancy and in- purpose of the statistical evaluation of medical data is to comes that enable people to buy more food, it can lead describe the relationship between two variables [23]. to an increase in obesity worldwide. Although obesity This article applies a new methodological framework Mukasheva A. et al. / International Journal of Health and Medical Sciences 5, 2019 10 where two models are defined based on linear regres- life of patients with colorectal cancer [28]. sion, as rising health care costs motivate the search for ways to improve the effectiveness of care [24]. The re- II. STATISTICAL ANALYSIS sults of the following study [25] demonstrate regression Today, it can be seen as a high interest in statisti- methods that are appropriate for analyzing health care cal models that are used in many studies in the field of costs, after which these methods were applied under ex- economics and health policy [29]. As a result of direct perimental conditions in the treatment of cardiovascular interaction with specialists working in this field with re- diseases and under conditions of monitoring the treatment searchers, the result is increased to obtain reliable infor- of diabetes patients. Differences were shown between mation. This opportunity was provided by the authors of methods giving different results depending on the degree the research article [30]. Because of the joint interest in of consistency between the basic assumptions of each predicting and applying the necessary measures to influ- method and the specific characteristics of the health prob- ence the reduction in the growth of the incidence, it is lem. The flexibility of regression makes it particularly possible to obtain optimistic results for taking decisive applicable in certain conditions when other statistical measures. In the following research paper, the statistics of methods inadequately address. Regression is a powerful patients with diabetes from 2004 to 2018 in Kazakhstan and widely used statistical method that allows researchers were applied. Because of the provided statistical informa- to quantify mathematical relationships for purposes of tion, it became possible to make a forecast for 2019 on description, hypothesis testing, or prediction [26]. In this the number of diabetics in the Republic of Kazakhstan. paper [27], the problem of forecasting costs in health care The data of the register of patients with diabetes was pro- was considered using a two-component model with sparse vided by the Public Foundation “Kazakhstan Society for regularization. The relevance of the analysis of the cost the Study of Diabetes” [30], which is located in Almaty, of health care in the following work allowed us to study Kazakhstan. The main concern of this research is to iden- the differences in costs and patterns of resource use for tify the most accurate experimental method for predicting different demographic configurations in the last year of diabetes in the Republic of Kazakhstan. TABLE 1 DATA FROM THE REGISTER OF PATIENTS WITH DIABETES OVER THE PAST 15 YEARS

No. Region 2004 2005 2006 2007 2008 2009 2010 2011

1 Akmola 6062 6272 6600 14283 7696 8318 9261 10068 2 3743 4046 4534 4926 5563 6229 6868 7443 3 Almaty 9196 8079 9041 10238 10943 12547 14361 15967 4 1930 2066 2254 2412 2687 3040 3379 3897 5 East-Kazakhstan 2567 2650 2771 2996 3327 3677 4004 4601 6 Jambyl 6684 5848 7533 8170 8397 7832 8309 9343 7 12718 13333 14259 15103 16322 17293 18820 20133 8 9055 9343 10114 10653 10970 11274 11960 12655 9 2151 1399 1680 2974 3401 3600 4087 4545 10 Mangistau 1561 1671 1923 2268 2502 2931 3232 3473 11 South Kazakhstan 13172 14997 16611 18025 20178 21567 23394 25172 12 7151 7375 7879 8773 9427 9799 10824 11657 13 North-Kazakhstan 6413 6486 6960 7739 8319 8792 9603 10432 14 West-Kazakhstan 14966 14968 15788 17840 19120 19879 21251 22650 15 Astana city 3370 4026 4549 4830 4931 5761 6903 7538 16 Almaty city 13616 15004 15543 16487 17553 19473 19429 21108 17 The Republic of Kazakhstan 114355 117563 128039 147717 151336 162012 175685 190682 11 Mukasheva A. et al. / International Journal of Health and Medical Sciences 5, 2019

TABLE 1 CONTINUE

No. Region 2012 2013 2014 2015 2016 2017 2018

1 Akmola 10858 11570 13004 13919 14572 15058 15736 2 Aktobe 8100 9011 9811 11503 12431 13164 13862 3 Almaty 18064 20610 23852 25781 26607 28431 30121 4 Atyrau 4474 5154 6587 7256 7656 8308 8674 5 East-Kazakhstan 5158 5751 7154 7506 8127 8806 9518 6 Jambyl 9878 10800 13089 14448 15618 16674 17458 7 Karaganda 22020 23198 26426 27577 28367 26837 30622 8 Kostanay 13216 14287 17821 19179 20407 21853 22568 9 Kyzylorda 5023 5562 7166 7931 8964 9825 10560 10 Mangistau 3983 4928 6812 8451 8533 10444 7013 11 South Kazakhstan 27466 28822 32699 30294 33448 35225 37883 12 Pavlodar 12560 13385 14581 13650 16196 17880 18965 13 North-Kazakhstan 11286 12575 14270 14908 15399 16055 16681 14 West-Kazakhstan 23551 25328 27867 29203 31613 32947 33845 15 Astana city 8522 9859 11086 11986 12851 14001 15220 16 Almaty city 23776 25362 29228 29037 32382 34604 37720 17 The Republic of Kazakhstan 207935 226202 261453 272629 293171 310114 326449

III. EXPERIMENTAL METHODS regression: If there is a linear relationship between two variables, y = a + bx then regression analysis methods to build predictive mod- where used to predict from x to y. The regression els can be applied. In this study, three regression analysis equation had such a mathematical expression in the case models were applied: of linear regression: 1. The most common method is the use of linear y = 15915x + 78368, where R2 = 0.9804 TABLE 2 THE POSSIBLE NUMBER OF PATIENTS FOR THE 2019 YEAR USING LINEAR REGRESSION METHODS

No. Region 2019

1 Akmola 16110 2 Aktobe 14107 3 Almaty 31222 4 Atyrau 8882 5 East-Kazakhstan 9446 6 Jambyl 17172 7 Karaganda 31500 8 Kostanay 22444 9 Kyzylorda 10453 10 Mangistau 9399 11 South Kazakhstan 39085 12 Pavlodar 18612 13 North-Kazakhstan 17554 14 West-Kazakhstan 34932 15 Astana city 15254 16 Almaty city 36837 17 The Republic of Kazakhstan 333010 Mukasheva A. et al. / International Journal of Health and Medical Sciences 5, 2019 12

For each value of x, the equation gives the best pre- of the country. After obtaining these data, a graph was dictive value of y, and all values of y form a regression constructed, where the criterion of the accuracy of the line that equals the regression line [31]. As a result of approximation, i.e., R2 was above 0.9. the application of the statistical data described in Table 1, According to linear regression, the possible number projected data for 2019 were obtained for each region of patients for 2019 year equals to 333010 patients.

Fig. 1. Linear regression graph and forecast results for 2019

2. Forecasting by the use of polynomial regression matical expression in the case of polynomial regression analysis: [32, 33]: y = ax3 + bx2 + cx + d, y = − 38,378x3 + 1487,6x2 + 780,81x + 113349, where the regression equation had such a mathe- where R2 = 0.9964 TABLE 3 THE POSSIBLE NUMBER OF PATIENTS FOR 2019 YEAR USING POLYNOMIAL REGRESSION METHODS

No. Region 2019

1 Akmola 16187 2 Aktobe 15189 3 Almaty 30867 4 Atyrau 9419 5 East-Kazakhstan 10225 6 Jambyl 19725 7 Karaganda 31569 8 Kostanay 25198 9 Kyzylorda 11852 10 Mangistau 10609 11 South Kazakhstan 38867 12 Pavlodar 20445 13 North-Kazakhstan 17137 14 West-Kazakhstan 35993 15 Astana city 16240 16 Almaty city 40552 17 The Republic of Kazakhstan 350074 13 Mukasheva A. et al. / International Journal of Health and Medical Sciences 5, 2019

According to the polynomial regression method, this number for 2019 equals 350074 patients.

Fig. 2. Polynomial regression graph and forecast results for 2019

3. Forecasting by the use of exponential regression where the regression equations had such a mathemat- analysis: ical expression in the case of exponential regression [34]: y = a∗mx = a∗(eln(m))x = a∗e(x∗ln(m)) = a∗ebx, y = 102666e0.0796x, where b = ln(m) where R2 = 0,995 TABLE 4 THE POSSIBLE NUMBER OF PATIENTS FOR THE 2019 YEAR USING EXPONENTIAL REGRESSION METHODS

No. Region 2019

1 Akmola 17956.62 2 Aktobe 16150.32 3 Almaty 36074.25 4 Atyrau 10580 5 East-Kazakhstan 10817 6 Jambyl 18472 7 Karaganda 33915 8 Kostanay 23805 9 Kyzylorda 13304 10 Mangistau 11624 11 South Kazakhstan 42957 12 Pavlodar 20082 13 North-Kazakhstan 19236 14 West-Kazakhstan 37296 15 Astana city 17976 16 Almaty city 39702 17 The Republic of Kazakhstan 369945.3

Finally, according to the exponential regression patients. method, this number for 2019 year equals to 369945 Mukasheva A. et al. / International Journal of Health and Medical Sciences 5, 2019 14

Fig. 3. Exponential regression graph and forecast results for 2019

The three types of regression methods had a high certificate, and about 10% to 15% indicated it as the main criterion for the accuracy of the approximation. The cause of death [35]. polynomial regression showed the highest coefficient of determination. It should be noted that the polynomial V. CONCLUSION experiment showed high accuracy. After processing the obtained statistical data and af- ter conducting experimental studies, it can be concluded IV. DISCUSSION that the prevalence of diabetes in RK is increasing. Once If possible, the population should undergo various again, they were convinced that to perform prediction screenings and examinations in order to detect this dis- tasks in medicine, the use of regression analysis shows ease or learn about a person’s predisposition. When di- a high-reliability criterion. Also, based on the results agnosing this ailment in a patient, it will be necessary obtained, it can be concluded that early detection of the to inform how to live correctly with this diagnosis, that disease and preventive measures to increase risk aware- is, proper nutrition and a healthy lifestyle. The longer ness and complications of diabetes in the population is a person lives with undetected diabetes, the worse their an important vector in preventing diabetes. This study health consequences can be. There should be open access in this area will have a continuation, or rather the study to initial diagnostics, such as blood glucose testing, and of the possibilities of developing and introducing the lat- should be available at primary health care facilities. The est information technologies in the early diagnosis and authors suggest that early diagnosis is the key to victory treatment of diabetes as this work is part of a project to over this disease. Diabetes mellitus needs to be investi- diagnose and study diabetes using BigData technology. gated and studied as a global social problem that carries hidden threats to future generations. Late diagnosis and REFERENCES inadequate treatment will lead to various complications [1] World Health Organization. (2018) Diabetes. of the whole organism, and this will lead to a decrease in [Online]. Available: https://bit.ly/36tvQMf the quality of life and its duration. [2] World Health Organization. (2016) Global re- Genetic inheritance, ethnicity, overweight, and a port on diabetes. [Online]. Available: https: sedentary lifestyle have a huge impact on the appear- //bit.ly/2RMZNCT ance of this disease in people. The probability of getting diabetes is very high if the population does not treat their [3] International Diabetes Federation. (n.d.) Epi- health properly. demiology and research. [Online]. Available: Many do not assess diabetes as the cause of death, https://bit.ly/2t6Chq3 although it does great harm to the entire body. Studies [4] T. Sungkhapong, P. Prommete, N. Martkoksoong, have shown that only about 35-40% of people with dia- and B. Kittichottipanich, “The health behaviors’ betes who died had diabetes listed elsewhere on the death modification for controlling and prevention of dia- betes mellitus by using promise model at premruthai 15 Mukasheva A. et al. / International Journal of Health and Medical Sciences 5, 2019

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