Regression-based prediction of seeking diabetes-related emergency medical assistance by regular clinic patients

  • Wasantha P. Jayawardene
  • Dayani C. Nilwala
  • Godfred O. Antwi
  • David K. Lohrmann
  • Mohammad R. Torabi
  • Stephanie L. Dickinson
Original Article


This study aims to examine diabetes-related emergency medical assistance (DREMA)-seeking factors among type-2 diabetes patients and predict likelihood of patients seeking DREMA before their next scheduled clinic visit. This case-control-designed study comprised a systematic random sampling of 228 patients who completed a structured interview (mean age = 62.6 years). DREMA prediction model was developed based on parameter estimates of a logistic regression model on DREMA (≥ 1 admission vs. 0 admissions), with variable selection from a forward stepwise selection process, considering all 24 potential independent variables. For the final DREMA prediction model, four variables were retained via forward stepwise logistic regression analysis: (1) age, (2) type of rice consumed, (3) physical activity outside of a regular job, and (4) leisure time exercise frequency. Likelihood of seeking DREMA increased with aging, regular or frequent consumption of white rice rather than brown or parboiled rice, and being physically inactive outside of occupation. Odds of seeking DREMA were directly associated with frequency of exercise during leisure time. With further validation and model updating based on local population characteristics, clinicians will be able to predict the DREMA-event likelihood for each clinic patient diagnosed with type-2 diabetes. Modifiable DREMA-seeking variables suggest possible interventions for preventing undesired DREMA events.


Type-2 diabetes Clinic patients Logistic regression Prediction Diabetes-related emergency medical assistance 



We would like to thank Dr. Ahmed YoussefAgha and Jessie He for their contributions to the first draft of the manuscript and data analysis, respectively.

Funding disclosure

The authors have no relevant financial or non-financial relationships to disclose i.e., there was no funding or support.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Ethical approval for the recruitment of human subjects and review of medical records were obtained from the Institutional Review Board, Indiana University Bloomington, USA.

Informed consent

The authors obtained informed consent from all individual participants included in the study.


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Copyright information

© Research Society for Study of Diabetes in India 2017

Authors and Affiliations

  • Wasantha P. Jayawardene
    • 1
  • Dayani C. Nilwala
    • 2
  • Godfred O. Antwi
    • 1
  • David K. Lohrmann
    • 1
  • Mohammad R. Torabi
    • 1
  • Stephanie L. Dickinson
    • 3
  1. 1.Applied Health Science, School of Public Health BloomingtonIndiana UniversityBloomingtonUSA
  2. 2.Pathology DepartmentBase Hospital HomagamaHomagamaSri Lanka
  3. 3.Epidemiology and Biostatistics, School of Public Health BloomingtonIndiana UniversityBloomingtonUSA

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