title: Time-series analysis of continuously monitored blood glucose: the impacts of geographic and daily lifestyle factors.
abstract: Type 2 diabetes is known to be associated with environmental, behavioral, and lifestyle factors. However, the actual impacts of these factors on blood glucose (BG) variation throughout the day have remained relatively unexplored. Continuous blood glucose monitors combined with human activity tracking technologies afford new opportunities for exploration in a naturalistic setting. Data from a study of 40 patients with diabetes is utilized in this paper, including continuously monitored BG, food/medicine intake, and patient activity/location tracked using global positioning systems over a 4-day period. Standard linear regression and more disaggregated time-series analysis using autoregressive integrated moving average (ARIMA) are used to explore patient BG variation throughout the day and over space. The ARIMA models revealed a wide variety of BG correlating factors related to specific activity types, locations (especially those far from home), and travel modes, although the impacts were highly personal. Traditional variables related to food intake and medications were less often significant. Overall, the time-series analysis revealed considerable patient-by-patient variation in the effects of geographic and daily lifestyle factors. We would suggest that maps of BG spatial variation or an interactive messaging system could provide new tools to engage patients and highlight potential risk factors.
authors.affiliation: Department of Geography & Environmental Studies, Wilfrid Laurier University, 75 University Avenue West, Waterloo, ON, Canada N2L 3C5.
authors.forename: Sean T
authors.identifier: 0000-0002-5359-1356
authors.initials: ST
authors.lastname: Doherty
authors.affiliation: Institute of Transport and Logistics Studies, The University of Sydney Business School, University of Sydney, Sydney, NSW 2006, Australia.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Greaves
mesh_terms: D000054:Acceleration; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000379:methods*; D017028:Caregivers; D003142:Communication; D003920:Diabetes Mellitus / Q000097:blood* / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis*; D005260:Female; D005843:Geography; D006801:Humans; D008019:Life Style; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D017010:Reminder Systems; D013997:Time Factors
chemical_list: D001786:Blood Glucose