Diabetes is one of the top ten diseases that causes death, and it has become a major concern in many countries, with type 2 diabetes accounting for 96% of diabetes cases. The progression of type 2 diabetes to neuropathy is a complex process influenced by various factors, including glycemic control, duration of diabetes, and individual characteristics. Absorbing chains are one of the applications of Markov chains, which are used to determine how long patients remain in a transient state before they are absorbed. The study objective was to predict the mean sojourn time (average time) that type 2 diabetic patients live with the disease before they enter the absorbed state (i.e., amputation of the limbs or death). Fasting blood sugar levels and neuropathy conditions developed by type 2 diabetic patients were divided into eight states. The states were further classified into transient and absorbing states, where States 1-6 (low FBS, normal FBS, moderate FBS, high FBS, and numbness) formed transient states, and States 7 and 8 were absorbing states (amputation of limbs and death). The results revealed that the average time for patients with a low FBS state to stay with the disease before their limbs are amputated or to die is 14 years, and the average time for those with normal and moderate FBS states is 27 years each. Patients in the high and numbness states have average stay times of 26 and 23 years, respectively, to live with the disease before their limbs are amputated or they die. However, patients in the ulcer state have an average of two years to live with the disease before their limbs are amputated or die. In conclusion, patients’ condition deteriorates gradually as they transition to the complication stage, and patients are more likely to have their limbs amputated or die.
Bayeldeng et al. (Mon,) studied this question.