GH-METHODS

Math-Physical Medicine

NO. 070

Using GH-Method: Math-Physical Medicine to Conduct Segmentation Analysis to Investigate the Impact of Different Intensity of Exercise on Postprandial Plasma Glucose

Corresponding Author: Gerald C. Hsu, eclaireMD Foundation, USA.

Introduction
This paper is based on big data collected from 4,347 post-meal exercise (walking steps per meal) and measured postprandial plasma glucose or PPG (mg/dL) during a period of 1,449 days, from 5/1/2015 to 4/19/2019.  This dataset is provided by a long-term type-2 diabetes patient who is under a lifestyle management program.

Method
At the beginning of this analysis period, the author provided two definitions for his post-meal walking exercise:

  1. 1,000 to 2,000 steps as his minimum requirement
  2. Above 4,000 steps as his optimal target

He further separated his data into the following five levels of walking intensity:

  • 0 – 1,000 steps
  • 1,000 – 2,000 steps
  • 2,000 – 3,000 steps
  • 3,000 – 4,000 steps
  • 4,000 – 10,000 steps

Results

  1. Inactivity (0-2,000 steps)
    Contribution: 10%
    Average PPG: 133 mg/dL
  2. Weak-intensity (2000-3,000 steps)
    Contribution: 16%
    Average PPG: 124 mg/dL
  3. Low-intensity (3,000-4,000 steps)
    Contribution: 27%
    Average PPG: 121 mg/dL
  4. Medium-intensity (4,000-10,000 steps)
    Contribution: 76%
    Average PPG: 116 mg/dL
  5. Overall Average Results
    Contribution:  100%
    Average walking: 4,214 steps
    Average PPG: 118 mg/dL
Figure 1: Finger PPG, Sensor PPG, Candlestick PPG

There were three reasons for the 428 episodes of inactivity in Level 1:

  1. 117 airline meals in confined environments restricting post-meal walking.
  2. Lack of understanding on the importance of “post-meal” exercise at the early stage of the period.
  3. The patient’s plantar fasciitis condition in the last four months prevented him from having sufficient walking steps.

PPG has a complicated and nonlinear inter-relationship with its 19 influential factors.  Among them, the combined contribution from both carbs/sugar intake and exercise is ~80%: carbs/sugar ~39% and post-meal walking ~41%.

Conclusion
By using the GH-Method: math-physical medicine, the author conducted a segmentation analysis to investigate the impact on PPG from four different walking intensity levels.  Through this quantitative analysis, it is obvious that the higher intensity of walking offers better results for the PPG values.  The data also showed a “pseudo-linear” mathematical relationship existing between walking steps and PPG values.  Based on this analysis, it seems that every block of thousand steps of post-meal walking reduces ~5 mg/dL of the PPG value; therefore, 4,000 steps could decrease ~20 mg/dL of the PPG value.

In addition, this analysis revealed the patient’s personality and psychological behavior.  He is a strong-willed person, who persistently follows his exercise regimen in order to control his diabetes conditions.