## GH-METHODS

Math-Physical Medicine

### NO. 268

The impact on human organs via energy associated with glucose during COVID-19 quarantine period (GH-Method: math-physical medicine)

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

Introduction
In this paper, the author describes his research results on the impact and damage on human organs via different levels of associated energy from glucose using the frequency domain analysis technique.  This report investigates specifically during his COVID-19 quarantine period.

Methods
He has collected his glucose data via a continuous glucose monitor (CGM) sensor device from 5/5/2018 through 6/2/2020 at ~76.5 glucose data per day.  During the 2+ year period (759 days), he has compiled a total of 58,064 glucose data.  In this particular analysis, he has specifically isolated the recent COVID-19 quarantine period of 135 days (1/19/2020 – 6/2/2020) to compare against four other sub-periods of equal length with 154 days each.

Initially, he collected and displayed his “time-domain” data result, which represents the horizontal x-axis as time (in day) and the vertical y-axis as glucose (in mg/dL) – similar to an EKG chart for the heart.  Next, he utilized a mathematical algorithm based on “Fourier Transform” technique to convert these time domain data into frequency domain data.  In the frequency domain chart, the x-axis becomes frequency, instead of time, and the y-axis becomes the amplitude scale associated with distinctive frequency, instead of glucose scale.  In one of his published paper (Reference 1), he proved that this frequency domain’s y-axis value actually indicates the “relative” energy associated with that particular glucose frequency on x-axis.  Based on this frequency domain data chart, he could then segregate the total data of frequency domain into three frequency sub-ranges of low, medium, and high.  Figure 1 depicts an example of the process flow mentioned above.

In the glucose related frequency domain diagram, we can see that its waveform (or curve) pattern is a symmetric salad bowl shape with the high edge on each rim.  Let us focus on the left half portion of the chart.  The far left side indicates the lower-frequency range, those much higher glucose energy values associated with lower frequencies of glucose components (lower happening times of glucose), while the center portion specifies the higher-frequency range, those much lower glucose energy values associated with higher frequencies of glucose components (higher happening times of glucose).

The above descriptions are directly applied from his learned knowledge of both physics and mathematics.  Now, let us discuss the biomedical side.

• He chose the commonly defined value of diabetes as >140 mg/dL for this analysis.
• The values of TAR (glucose >180), TIR (140 < glucose <180), and TBR (glucose <140); where TAR, TIR, and TBR are defined by American Diabetes Association (ADA) Guidelines (Reference 2). However, he has chosen 140 mg/dL as his lower bound and 180 mg/dL as his upper bound for this particular study.

Here, the author wants to concentrate on the glucose range above 140 mg/dL, i.e. the commonly defined value of diabetes, since he had severe type 2 diabetes (T2D) for over twenty years.  Besides, his recent glucose results indicate that his ADA defined TBR (< 70 mg/dL) is only 5%.  This means that his risk of insulin shock is extremely low, which removes this concern; therefore, he chose 140 mg/dL as his lower bound, instead of 70 mg/dL as suggested by ADA, for this TBR analysis.

In this paper, for clarity, his chosen definitions of values for TAR, TIR, and TBR are re-listed:

• TAR (time above range): >180
• TIR (time in range): >140 and <180
• TBR (time below range): <140

The frequency in time domain can be converted into frequency domain, and then further segregate them into three frequency ranges as low, medium, and high.  The actual numerical value of boundaries for each frequency range varies because it is based on the actual glucose fluctuation in each glucose waveform to meet his specific research objectives.  After integrating energy theory from mechanical engineering with wave theory from geophysics and communication engineering together, each frequency range is further associated with certain energy level.  After that, we can integrate them with biomedical concerns to discover the different levels of damage or impact on the human internal organs.

In order to accomplish the research objectives, he has to modify and enhance his software programs in order to be able to calculate the relative energy level of any user-defined frequency range which are based on glucose data he collected.

Results
Figure 1 displays certain prominent features of both time-domain and frequency-domain to explain the analysis process of this project.

###### Figure 1: From time-domain to frequency-domain

Readers can delve deeper into Figures 2 through 5, tables and bar charts, to find out more detailed hidden information.

Figure 2 shows his summarized analysis data table for four sub-periods of equal length with 154 days each (the “non COVID-19” related).

###### Figure 2: Data table for four 156-days sub-periods, the CGM period (5/5/18-1/18/20)

Figure 3 depicts his summarized analysis data table for the COVID-19 quarantine period of 135 days (1/19/2020 – 6/2/2020).

Figure 4 illustrates the bar charts of five time periods, including COVID-19 period, with TAR, TIR, and TBR % along with the average glucoses in mg/dL.

###### Figure 4: TAR/TIR/TBR Glucose % and mg/dL (5 sub-periods)

Figure 5 reveals the bar charts of five time periods, including COVID-19 period, with frequency associated energy % and relative energy amount.

The two specific observations from both Figure 4 and Figure 5 reflect the following facts:

First, looking into bars of TAR % and TBR % of Figure 4, the percentages of TAR glucose (> 180 mg/dL) where the lower number is better, while the percentages of TBR glucose (< 140 mg/dL) where the higher number is better.  COVID-19 period bars definitely demonstrate these two prominent characteristics, the lowest 2% of TAR and the highest 79% of TBR.

Second, looking into three bars of Figure 5 regarding relative energy during COVID-19 period, the relative energy of TAR (280), TIR (3132), and TBR (3960), as well as the summation of these three energy values (i.e. 280+3132+3960 = 7372) are the lowest in comparison with bars of the other four periods.  This clearly illustrates that the lowest glucose level with their lowest associated energy level would create the smallest impact on the organs.

The above two observations have proven that his COVID-19 period possesses the lowest impact on his organs in comparison with the other four non-quarantined periods.  This virus quarantine period’s peaceful and routine lifestyle has actually helped him to improve his overall health conditions.

###### Figure 5: TAR/TIR/TBR Energy % and # (5 sub-periods)

Figure 6 validates the relative energy contribution for COVID-19 period (1/19/2020 – 6/2/2020):

• Energy of TAR (> 180):  4%
• Energy of TIR (140 – 180):  42%
• Energy of TBR (< 140):  54%

The energy associated with glucoses above 180 mg/dL causes only 4% of his organ damage; however, the glucose range between 140 and 180 contributes 42% of damage.  This means that all of his glucose components above 140 mg/dL would contribute a 46% of total impact on his internal organs.  On the other hand, the reason for the energy associated with glucoses below 140 mg/dL brings in 54% of energy is due to the large size of glucoses located within this frequency range.

In order to identify how much influence with a commonly defined “pre-diabetes” glucose range between 120 mg/dL and 140 mg/dL.  As shown in Figure 8, he has pursued more analysis and discovered that the actual difference of two relative energies associated with TBR (120 mg/dL) and TBR (140 mg/dL) is 24%.  In paper No. 267 (Reference 4), he has already uncovered a 25% difference of associated energies for a much longer CGM time period from 5/5/2018 to 6/2/2020, including the COVID-19 period.  Therefore, there are only 30% (i.e. 54% – 24% = 30%) of energy associated with glucoses below 120 mg/dL.

As a comparison, Figure 7 is a combination of those four sub-periods of equal length with154 days each compiled into one energy contribution pie chart for the total CGM period of 5/5/2018 through 6/2/2020 (Reference 4):

• Energy of TAR (> 180):  13%
• Energy of TIR (140 – 180):  35%
• Energy of TBR (< 140):  52%

It should be noted that TAR 13% during these four normal CGM periods is higher than TAR 4% during the COVID-19 period which means his organs have suffered 9% less damage by those extremely high glucose components (>180 mg/dL) during COVID-19 period.

###### Figure 8: Changes of glucose frequency and associated energy for TBR cases of 120 or 140 mg/dL

Conclusions
It should be repeated here that, in Figures 2, 3, 4, and 5, TIR is within the range of 140 mg/dL and 180 mg/dL, TBR is less than 140 mg/dL, and TAR is greater than 180 mg/dL.  As a personal interest, the author wants to know what would happen and how much damage to his internal organs if and when his glucoses go beyond 140 mg/dL and 180 mg/dL, especially during this COVID-19 quarantine period.  There have been a few published medical articles to address this particular point, i.e. taking care of diabetes patients during this virus period.  The author believes that most T2D patients may have similar concerns as he does.

One conclusion from this research article is that this unusual COVID-19 quarantined period has created the lowest impact or damage on his internal organs in comparison with the other four non-quarantined related periods.  This virus quarantine period’s peaceful and routine lifestyle has actually helped improve his overall health conditions.  As a matter of fact, results from the other four non-virus periods show that his diabetes conditions have been well under control as well.

Therefore, he is not as concern about the energy associated with various glucose components causing damage to his various internal organs.  By having strong glucose management, it should remove the fundamental cause of damages to arteries such as CVD and stroke and micro-vessels such as CKD and DR.  In addition, he has been meticulous with controlling his blood pressure and lipids as well.  These combined efforts should greatly reduce his risk probabilities of having CVD, stroke, CKD, and DR, along with lowering complications for bladder, feet, and the nervous system.  This may contribute cancer prevention up to a 45% to 50% level of protection.

In general, diabetes patients who are disciplined with their lifestyle management would focus on their daily glucoses and try to maintain them at a level below 140 mg/dL. This is a good practice in managing their diabetes; however, the research results illustrate that it is the energy associated with glucoses causing all of the biomedical problems which need to be further analyzed.  This paper also demonstrates that the GH-Method: math-physical medicine is a powerful methodology that can be used more widely to discover some hidden truths regarding diseases and health matters.

References

1. Hsu, Gerald C., eclaireMD Foundation, USA. October 2019. No. 120: “The study on the damage to internal organs and the pancreatic beta cells health state due to excessive energy associated with high PPG components and distinctive waveforms using GH-Method: math-physical medicine.”
2. Hsu, Gerald C., eclaireMD Foundation, USA. March 2020. No. 238: “The influences of medication on diabetes control using TIR analysis (GH-Method: Math-physical medicine).”
3. Hsu, Gerald C., eclaireMD Foundation, USA. April 2020. No. 246: “Segmentation analysis of sensor glucoses and their associated energy (GH-Method: math-physical medicine).”
4. Hsu, Gerald C., eclaireMD Foundation, USA. June 2020. No. 267: “Investigation on the impact of different glucose ranges and the damage on human internal organs using frequency domain analyses (GH-Method: math-physical medicine).”