Page 198 - EJMO-9-3

Eurasian Journal of
Medicine and Oncology Medication therapy based on HbA1c

Table 4. Cardiovascular medications used in the study groups of HbA1c during the second observation. This non-
parametric measure was selected due to the non-linear
Medication HbA1c level HbA1c level relationship between medication dosage and glycemic
≤8% (%) ≥8% (%)
ACE inhibitors 18.9 7.1 response. The model achieved strong performance,
with a correlation coefficient of 0.826 (p=2.3 × 10 ). To
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Angiotensin II receptor blockers 37.8 58.9 understand the importance of each feature used in the
Beta-blockers 90.5 92.9 model, all features were normalized before training. The
Mineralocorticoid receptor 68.9 51.8 description of the model is presented in Table 8. The root
antagonists mean square error of the model on the test set was 1.172.
Calcium channel blockers 44.6 48.2
In addition, we found that patients with higher
Thiazide diuretics 9.5 16.1 HbA1c levels (≥8%) were generally younger and had a
Loop diuretics 71.6 46.4 longer duration of diabetes and IHD. These patients also
Antiplatelet agents 100 100 required more aggressive antihyperglycemic therapy,
Statins 75.7 87.5 including higher usage of metformin and insulin. The use
Sacubitril/valsartan 28.4 10.7 of cardiovascular medications varied significantly between
Ivabradine 2.7 8.9 the groups, with higher usage of ACE inhibitors and statins
in patients with higher HbA1c levels.
Abbreviations: ACE: Angiotensin-converting enzyme; HbA1c: Glycated
hemoglobin.
4. Discussion
A B The study revealed that patients with higher HbA1c levels
(≥8%) were generally younger and were more likely to be
female. This observation is consistent with related research
indicating that younger patients with T2DM often struggle
with glycemic control due to various factors, including
lifestyle, adherence to treatment, and metabolic differences.
Gale and Gillespie discussed the impact of gender on
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diabetes management, noting that women may have a
higher risk of poor glycemic control due to hormonal
fluctuations and other physiological factors. However, we
hypothesized that the primary contributing factor is the
difference in life expectancy between men (72.1 years)
C and women (76.6 years) in Uzbekistan. The average age of
women reaching the target levels was 69.2 years, whereas
it was 65 years for men. The average age of women with
an HbA1c level ≥8% was 66.7 years, and 58.4 years for
men. Thus, the younger age in the second group is largely
attributed to men with lower life expectancy. Failure
to reach target levels poses a greater risk, with impaired
survival being a key contributing factor to this outcome.
The longer duration of diabetes and IHD in patients
with higher HbA1c levels suggests that disease duration
significantly impacts glycemic control. The Diabetes
Control and Complications Trial demonstrated that
Figure 2. Box plots illustrating changes in (A) urea, (B) creatinine, and
(C) uric acid levels in patients between two observations, depending on prolonged diabetes duration is associated with an increased
the type of prescribed diuretics. The colors are consistent. risk of complications and poorer glycemic control. This
study’s findings underscore the importance of early and
We also constructed a linear regression model to aggressive intervention to achieve and maintain target
predict HbA1c levels in patients based on their clinical data HbA1c levels. The multinomial logistic regression model
and dosages of prescribed medications. This model was revealed that the duration of T2DM has a negative impact,
trained on the training set and was tested using Spearman’s while the duration of IHD has a positive impact. Patients
correlation coefficient between predicted and actual levels with a longer history of IHD were more likely to adhere to

Volume 9 Issue 3 (2025) 190 doi: 10.36922/EJMO025160133