<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.4 20241031//EN" "JATS-journalpublishing1-4.dtd">
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" article-type="research-article" dtd-version="1.4" xml:lang="en">
  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">jcc</journal-id>
      <journal-title-group>
        <journal-title>Journal of Computer and Communications</journal-title>
      </journal-title-group>
      <issn pub-type="epub">2327-5227</issn>
      <issn pub-type="ppub">2327-5219</issn>
      <publisher>
        <publisher-name>Scientific Research Publishing</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.4236/jcc.2026.146009</article-id>
      <article-id pub-id-type="publisher-id">jcc-152153</article-id>
      <article-categories>
        <subj-group>
          <subject>Article</subject>
        </subj-group>
        <subj-group>
          <subject>Computer Science</subject>
          <subject>Communications</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>A Scalable Multidimensional Data Warehouse with Machine Learning for Real-Time Diabetes Management in Bangladesh</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author" corresp="yes">
          <contrib-id contrib-id-type="orcid">0000-0003-0330-9241</contrib-id>
          <name name-style="western">
            <surname>Mamun</surname>
            <given-names>Md. Al</given-names>
          </name>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <name name-style="western">
            <surname>Tanim</surname>
            <given-names>Omar Faruq</given-names>
          </name>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0002-2904-3974</contrib-id>
          <name name-style="western">
            <surname>Chakraborty</surname>
            <given-names>Dulal</given-names>
          </name>
          <xref ref-type="aff" rid="aff2">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <name name-style="western">
            <surname>Rahman</surname>
            <given-names>Muhammad Saidur</given-names>
          </name>
          <xref ref-type="aff" rid="aff3">3</xref>
        </contrib>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0002-7184-2809</contrib-id>
          <name name-style="western">
            <surname>Uddin</surname>
            <given-names>Mohammad Shorif</given-names>
          </name>
          <xref ref-type="aff" rid="aff4">4</xref>
        </contrib>
      </contrib-group>
      <aff id="aff1"><label>1</label> Department of Public Health and Informatics, Jahangirnagar University, Dhaka, Bangladesh </aff>
      <aff id="aff2"><label>2</label> Department of Information and Communication Technology, Comilla University, Cumilla, Bangladesh </aff>
      <aff id="aff3"><label>3</label> Software Development and R&amp;D Team OBJECT DATA INC., Dallas, Texas, USA </aff>
      <aff id="aff4"><label>4</label> Department of Computer Science and Engineering, Jahangirnagar University, Dhaka, Bangladesh </aff>
      <author-notes>
        <fn fn-type="conflict" id="fn-conflict">
          <p>The authors declare no conflicts of interest regarding the publication of this paper.</p>
        </fn>
      </author-notes>
      <pub-date pub-type="epub">
        <day>11</day>
        <month>06</month>
        <year>2026</year>
      </pub-date>
      <pub-date pub-type="collection">
        <month>06</month>
        <year>2026</year>
      </pub-date>
      <volume>14</volume>
      <issue>06</issue>
      <fpage>115</fpage>
      <lpage>135</lpage>
      <history>
        <date date-type="received">
          <day>12</day>
          <month>11</month>
          <year>2025</year>
        </date>
        <date date-type="accepted">
          <day>23</day>
          <month>06</month>
          <year>2026</year>
        </date>
        <date date-type="published">
          <day>26</day>
          <month>06</month>
          <year>2026</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>© 2026 by the authors and Scientific Research Publishing Inc.</copyright-statement>
        <copyright-year>2026</copyright-year>
        <license license-type="open-access">
          <license-p> This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/4.0/">https://creativecommons.org/licenses/by/4.0/</ext-link> ). </license-p>
        </license>
      </permissions>
      <self-uri content-type="doi" xlink:href="https://doi.org/10.4236/jcc.2026.146009">https://doi.org/10.4236/jcc.2026.146009</self-uri>
      <abstract>
        <p><bold>Purpose:</bold> Diabetes presents a major public health challenge in Bangladesh, demanding effective data-driven solutions for improved disease monitoring and management. This study aims to design and implement a scalable, multidimensional data warehouse integrated with statistical and machine learning techniques to support batch-based diabetes monitoring, prediction, and decision-making. The key research question is: <italic>Can a unified data-driven framework improve diabetes classification accuracy and provide actionable clinical insights for healthcare systems in Bangladesh</italic>? <bold>Methods:</bold> Clinical and demographic data from selected hospitals were consolidated into a centralized data warehouse. A Python-based GUI enabled interactive data access and visualization. Statistical analyses (ANOVA, Chi-square) assessed associations between demographic, clinical, and lifestyle factors. For predictive modeling, supervised learning algorithms—Logistic Regression, Decision Tree, Multilayer Perceptron (MLP), and LightGBM—were trained and evaluated for diabetes type classification. <bold>Results:</bold> Statistical analysis revealed significant associations between gender, treatment cost, and patient satisfaction; blurred vision and diabetes longevity; and lifestyle habits and weight loss. Among the machine learning models tested, Logistic Regression demonstrated the best overall performance, achieving 81.25% accuracy, 82.07% precision, 81.3% recall, an F1-score of 81.48%, a ROC-AUC of 0.8278, and a log loss of 0.5029. <bold>Conclusions:</bold> The integrated data warehouse and machine learning framework offers a scalable, batch-based prediction system for diabetes management in Bangladesh. It combines statistical insights with predictive modeling to support clinical decision-making and is adaptable across healthcare settings. This approach meets the urgent need for actionable, data-driven insights into chronic disease care and advances the country’s digital health transformation.</p>
      </abstract>
      <kwd-group kwd-group-type="author-generated" xml:lang="en">
        <kwd>Dimension</kwd>
        <kwd>Fact Table</kwd>
        <kwd>ETL</kwd>
        <kwd>GUI</kwd>
        <kwd>Aggregate</kwd>
        <kwd>Query</kwd>
        <kwd>Accuracy</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec1">
      <title>1. Introduction</title>
      <p>Diabetes is a major non-communicable disease, especially in low- and middle-income countries like Bangladesh [<xref ref-type="bibr" rid="B1">1</xref>]. Effective management requires continuous monitoring, early prediction, and timely intervention, all of which relies on structured, comprehensive, and accessible health data [<xref ref-type="bibr" rid="B2">2</xref>]-[<xref ref-type="bibr" rid="B4">4</xref>]. However, Bangladesh’s healthcare system suffers from fragmented data, inconsistent record-keeping, and limited batch-based analytics, hindering clinical decision-making and national efforts to improve chronic disease outcomes [<xref ref-type="bibr" rid="B5">5</xref>]-[<xref ref-type="bibr" rid="B7">7</xref>]. </p>
      <p>In response to these limitations, this study presents the design and implementation of a scalable, multidimensional data warehouse integrated with statistical analysis and machine learning techniques for batch-based diabetes monitoring in Bangladesh [<xref ref-type="bibr" rid="B8">8</xref>]-[<xref ref-type="bibr" rid="B11">11</xref>]. The system enables interactive querying, advanced analytics, and predictive modelling through a user-friendly graphical user interface (GUI) by consolidating clinical and demographic data from hospital settings into a centralized platform [<xref ref-type="bibr" rid="B11">11</xref>]-[<xref ref-type="bibr" rid="B13">13</xref>]. </p>
      <p>The significant contributions of this paper are as follows: </p>
      <p>Development of a hospital-level multidimensional data warehouse using ETL (Extract, Transform, Load) to integrate heterogeneous data. Embedded statistical analyses (ANOVA, Chi-square) to identify associations between clinical variables, lifestyle factors, and outcomes. The evaluation and deployment of multiple supervised machine learning models for batch-based diabetes type prediction, with Logistic Regression achieving the best performance metrics and being integrated into a GUI for practical use. </p>
      <p>The paper is organized as follows: Section 2 reviews related literature; Section 3 outlines the methodology, including data collection, warehouse design, statistical analysis, and machine learning; Section 4 presents results; and Section 5 concludes with future research directions. </p>
    </sec>
    <sec id="sec2">
      <title>2. Literature Review</title>
      <p>Extensive research has advanced health data warehousing and diabetes monitoring, particularly in low-resource settings. Khan (2022) proposed a national health data warehouse for Bangladesh, highlighting infrastructural and policy challenges [<xref ref-type="bibr" rid="B1">1</xref>], while Khan and Hoque (2016) identified technical and organizational barriers to data integration and interoperability [<xref ref-type="bibr" rid="B5">5</xref>]. </p>
      <p>Methodologically, Ronaldson <italic>et al.</italic>(2022) applied Structural Equation Modelling on clinical data to study Diabetes-depression links, emphasizing multidimensional analysis, and Sakib<italic>et al.</italic>(2022) demonstrated AI-based data warehousing for intelligent healthcare decision-making [<xref ref-type="bibr" rid="B6">6</xref>][<xref ref-type="bibr" rid="B7">7</xref>].</p>
      <p>Technological innovations include Rghioui <italic>et al.</italic> (2020, 2019) on intelligent monitoring and glucose classification [<xref ref-type="bibr" rid="B11">11</xref>][<xref ref-type="bibr" rid="B14">14</xref>], Alfian <italic>et al.</italic> (2018) on BLE-based real-time healthcare systems, and Breault <italic>et al.</italic> (2002) on early data mining in diabetes warehouses [<xref ref-type="bibr" rid="B12">12</xref>][<xref ref-type="bibr" rid="B13">13</xref>]. Recent work by Emad Ali <italic>et al.</italic> (2024) and Suraka &amp; Gayathri (2022) focused on real-time patient monitoring using machine learning, while Lee <italic>et al.</italic> (2010) and Johnson &amp; Miller (2022) addressed advisory systems and remote management of patient-generated data [<xref ref-type="bibr" rid="B15">15</xref>]-[<xref ref-type="bibr" rid="B18">18</xref>]. Ado <italic>et al.</italic> (2014) highlighted the strategic role of data warehousing in healthcare decision-making [<xref ref-type="bibr" rid="B19">19</xref>].</p>
      <p>Existing studies highlight the promise of integrated data warehousing, machine learning, and real-time analytics for diabetes management. However, Bangladesh lacks a context-specific diabetes data warehouse, with systemic issues such as fragmented infrastructure and poor data integration persisting [<xref ref-type="bibr" rid="B1">1</xref>][<xref ref-type="bibr" rid="B5">5</xref>]. While international models show potential [<xref ref-type="bibr" rid="B6">6</xref>][<xref ref-type="bibr" rid="B11">11</xref>][<xref ref-type="bibr" rid="B12">12</xref>], they are designed for high-resource settings and are not readily applicable to Bangladesh’s resource-constrained healthcare system. </p>
      <p>This study proposes a scalable, GUI-enabled multidimensional data warehouse integrated with statistical analysis and machine learning for batch-based diabetes prediction. The system enhances clinical decision-making and supports national digital health transformation by adapting international methodologies to the healthcare context of Bangladesh. </p>
    </sec>
    <sec id="sec3">
      <title>3. Methodology</title>
      <sec id="sec3dot1">
        <title>3.1. Data Collection Method</title>
        <p>A semi-structured questionnaire collected socio-demographic (age, gender, marital status, family type, income, education) and diabetes-related health data from hospitals in Dhaka (Dhamrai, Savar), Tangail (Mirzapur), and Manikganj. Data were obtained through surveys using convenience sampling. We acknowledge that the use of convenience sampling may limit the representativeness of the study population and introduce selection bias. As a result, the findings may not be fully generalizable to the broader target population. Furthermore, we have added a recommendation that future studies should employ probability-based sampling methods and larger, more diverse populations to improve external validity and generalizability. </p>
      </sec>
      <sec id="sec3dot2">
        <title>3.2. Data Warehouse Formation Method</title>
        <p>Data from multiple sources were integrated via an ETL process into a unified format [<xref ref-type="bibr" rid="B17">17</xref>][<xref ref-type="bibr" rid="B18">18</xref>]. The Diabetes Management System database () includes hospital, patient, doctor, and admin tables for demographics, clinical data, treatments, and outcomes [<xref ref-type="bibr" rid="B19">19</xref>]. Developed in MySQL and Python (PyCharm), the data warehouse employs a dimensional model with four dimensions, supporting multidimensional analysis across 16 cuboids ().</p>
        <fig id="fig1">
          <label>Figure 1</label>
          <graphic xlink:href="https://html.scirp.org/file/1733383-rId19.jpeg?20260626032955" />
        </fig>
        <p><bold>Figure 1.</bold>Data warehouse system for Diabetes patient monitoring system.</p>
        <fig id="fig2">
          <label>Figure 2</label>
          <graphic xlink:href="https://html.scirp.org/file/1733383-rId20.jpeg?20260626032954" />
        </fig>
        <p><bold>Figure 2.</bold> Multidimensional data model snapshot. </p>
        <p>The diabetes data warehouse contains a fact table, <italic>dms_fact</italic>, linking four dimension tables and storing measures such as treatment cost, patient age, blood sugar levels, and counts of hospitals, doctors, visits, and patients. </p>
      </sec>
      <sec id="sec3dot3">
        <title>3.3. Data Analysis</title>
        <p>Data analysis using MySQL server and PyCharm Community Edition (with Python).</p>
        <p>3.3.1. Multidimensional Database</p>
        <p>We designed a diabetes data warehouse with a GUI for analytical purposes, enabling low-latency visualization of quantitative and graphical information. Two statistical modules and machine learning analytics were integrated to enhance the system’s scalability and affordability. </p>
        <p>3.3.2. Statistical Analysis </p>
        <p>We employed ANOVA and Chi-Square tests to explore associations between categorical and numerical variables. The ANOVA test was conducted between gender, treatment cost, and patient satisfaction. Chi-Square tests were used to find associations between diabetes_type and blurred vision, blurred vision and diabetes longevity, and between diet-exercise and weight loss. </p>
        <p>3.3.3. Machine Learning Analysis </p>
        <p><bold>a</bold><bold>)</bold><bold>Preprocessing, Modeling, and Optimization</bold></p>
        <p>The CSV dataset comprised patient demographics, symptoms, and lifestyle-related features, along with a target variable indicating diabetes type (Type-1, Type-2, or Gestational). Data preprocessing was performed in several steps. Missing values were handled using listwise (row-wise) deletion to ensure complete records for analysis. Categorical variables were transformed into numerical format using one-hot encoding. Feature scaling was applied using standardization (z-score normalization) to ensure all features contributed equally to model training. Finally, Principal Component Analysis (PCA) was employed for dimensionality reduction, retaining 95% of the total variance to reduce feature redundancy while preserving most of the informative structure in the dataset. Four machine learning classifiers—Logistic Regression, Decision Tree, Multilayer Perceptron (MLP), and LightGBM—were evaluated. Hyperparameters were optimized using Grid Search with cross-validation to improve model performance and minimize overfitting. These models were selected due to their established effectiveness in healthcare prediction tasks and their ability to model both linear and non-linear relationships in clinical data. Logistic Regression was included as a strong and interpretable baseline model, while Decision Tree provides rule-based interpretability. MLP captures complex non-linear patterns, and LightGBM offers high predictive performance through gradient boosting and efficient handling of structured tabular healthcare datasets. </p>
        <p><bold>b</bold><bold>)</bold><bold>Model Training, Evaluation, and GUI Integration</bold></p>
        <p>All models were trained on the preprocessed dataset and evaluated using Accuracy, Precision, Recall, F1-Score, Log Loss, and ROC-AUC. The Python Tkinter GUI allows CSV uploads, automatic model training, and visualization of confusion matrices and ROC-AUC curves (). Logistic Regression outperformed the other algorithms in accuracy, interpretability, Log Loss, and ROC-AUC, making it the preferred choice for the batch-based hospital-level diabetes prediction system in Bangladesh.</p>
        <fig id="fig3">
          <label>Figure 3</label>
          <graphic xlink:href="https://html.scirp.org/file/1733383-rId21.jpeg?20260626032959" />
        </fig>
        <p><bold>Figure 3.</bold> Generic diagram of the proposed system. </p>
      </sec>
    </sec>
    <sec id="sec4">
      <title>4. Results and Discussion</title>
      <p><bold>A</bold><bold>)</bold><bold>Multidimensional database with aggregate queries</bold></p>
      <p>A diabetes data warehouse was designed with a fact table linked to four dimension tables. Aggregate queries on dms_fact provide analytical insights, accessible via a Python GUI for interactive visualization ().</p>
      <fig id="fig4">
        <label>Figure 4</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId22.jpeg?20260626033000" />
      </fig>
      <p><bold>Figure 4.</bold>Diabetes patient management system. </p>
      <p>A snapshot of patient information stored in the DMS data warehouse is also presented and described in .</p>
      <fig id="fig5">
        <label>Figure 5</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId23.jpeg?20260626033001" />
      </fig>
      <p><bold>Figure 5.</bold> Schematic diagram of patient information. </p>
      <p>A snapshot of hospital information stored in the DMS data warehouse is also presented and described in .</p>
      <fig id="fig6">
        <label>Figure 6</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId24.jpeg?20260626033000" />
      </fig>
      <p><bold>Figure 6.</bold> Schematic diagram of hospital information. </p>
      <p>A snapshot of admin and doctor information stored in the DMS data warehouse is also presented and described in and , respectively.</p>
      <fig id="fig7">
        <label>Figure 7</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId25.jpeg?20260626033001" />
      </fig>
      <p><bold>Figure 7.</bold> Schematic diagram of admin information.</p>
      <fig id="fig8">
        <label>Figure 8</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId26.jpeg?20260626033001" />
      </fig>
      <p><bold>Figure 8.</bold> Schematic diagram of doctor information. </p>
      <fig id="fig9">
        <label>Figure 9</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId27.jpeg?20260626033000" />
      </fig>
      <fig id="fig10">
        <label>Figure 10</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId28.jpeg?20260626033000" />
      </fig>
      <p>(a) (b)</p>
      <fig id="fig11">
        <label>Figure 11</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId29.jpeg?20260626033000" />
      </fig>
      <fig id="fig12">
        <label>Figure 12</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId30.jpeg?20260626033001" />
      </fig>
      <p>(c) (d)</p>
      <fig id="fig13">
        <label>Figure 13</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId31.jpeg?20260626033001" />
      </fig>
      <p>(e)</p>
      <p><bold>Figure 9.</bold> (a) Hospital aggregate output, (b) Patient aggregate output, (c) DMS cost aggregate output, (d) Admin aggregate output, (e) Doctor specialization statistics.</p>
      <p>The query outputs are presented in, which illustrate the patient and hospital-related aggregates. Similar visual representations are provided for doctors and admin as well as are in and .</p>
      <p><bold>B</bold><bold>)</bold><bold>Statistical analysis</bold></p>
      <p> shows a significant association between patients’ gender, treatment cost, and satisfaction level (ANOVA: F = 7.21, p = 0.008), indicating that satisfaction varies with gender and cost. In contrast, shows no significant association between blurred vision and diabetes type (Chi-Square: χ<sup>2</sup> = 0.21, p = 0.9001).</p>
      <fig id="fig14">
        <label>Figure 14</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId32.jpeg?20260626033001" />
      </fig>
      <fig id="fig15">
        <label>Figure 15</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId33.jpeg?20260626033001" />
      </fig>
      <p><bold>Figure 10.</bold>Association between patient gender and treatment cost with patient satisfaction level.</p>
      <fig id="fig16">
        <label>Figure 16</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId34.jpeg?20260626033001" />
      </fig>
      <fig id="fig17">
        <label>Figure 17</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId35.jpeg?20260626033001" />
      </fig>
      <p><bold>Figure 11.</bold>Association between diabetes type and blurred vision in patients. </p>
      <p>shows a significant association between blurred vision and diabetes duration (Chi-Square: <italic>χ</italic><sup>2</sup> = 34.55, p = 0.0158). shows a significant association between diet/exercise and patient weight loss (Chi-Square: <italic>χ</italic><sup>2</sup> = 11.01, p = 0.0009).</p>
      <fig id="fig18">
        <label>Figure 18</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId36.jpeg?20260626033001" />
      </fig>
      <fig id="fig19">
        <label>Figure 19</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId37.jpeg?20260626033001" />
      </fig>
      <p><bold>Figure 12.</bold>Association between diabetes longevity and blurred vision in patients.</p>
      <fig id="fig20">
        <label>Figure 20</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId38.jpeg?20260626033001" />
      </fig>
      <fig id="fig21">
        <label>Figure 21</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId39.jpeg?20260626033001" />
      </fig>
      <p><bold>Figure 13.</bold>Association between diet_exercise and patient weight loss. </p>
      <p><bold>C</bold><bold>)</bold><bold>Machine learning-based analysis</bold></p>
      <p>The diabetes prediction system was evaluated using supervised machine learning models. Performance metrics included accuracy, precision, recall, F1-score, and log loss, calculated using the standard formulas below. </p>
      <p><bold>Accuracy:</bold>Accuracy is the proportion of correctly classified samples to the total number of samples.</p>
      <disp-formula id="FD1">
        <label>(1)</label>
        <mml:math>
          <mml:mrow>
            <mml:mi>A</mml:mi>
            <mml:mi>c</mml:mi>
            <mml:mi>c</mml:mi>
            <mml:mi>u</mml:mi>
            <mml:mi>r</mml:mi>
            <mml:mi>a</mml:mi>
            <mml:mi>c</mml:mi>
            <mml:mi>y</mml:mi>
            <mml:mo>=</mml:mo>
            <mml:mrow>
              <mml:mo>[</mml:mo>
              <mml:mrow>
                <mml:mfrac>
                  <mml:mrow>
                    <mml:mrow>
                      <mml:mo>(</mml:mo>
                      <mml:mrow>
                        <mml:mi>T</mml:mi>
                        <mml:mi>P</mml:mi>
                        <mml:mo>+</mml:mo>
                        <mml:mi>T</mml:mi>
                        <mml:mi>N</mml:mi>
                      </mml:mrow>
                      <mml:mo>)</mml:mo>
                    </mml:mrow>
                  </mml:mrow>
                  <mml:mrow>
                    <mml:mrow>
                      <mml:mo>(</mml:mo>
                      <mml:mrow>
                        <mml:mi>T</mml:mi>
                        <mml:mi>P</mml:mi>
                        <mml:mo>+</mml:mo>
                        <mml:mi>F</mml:mi>
                        <mml:mi>N</mml:mi>
                        <mml:mo>+</mml:mo>
                        <mml:mi>F</mml:mi>
                        <mml:mi>P</mml:mi>
                        <mml:mo>+</mml:mo>
                        <mml:mi>T</mml:mi>
                        <mml:mi>N</mml:mi>
                      </mml:mrow>
                      <mml:mo>)</mml:mo>
                    </mml:mrow>
                  </mml:mrow>
                </mml:mfrac>
              </mml:mrow>
              <mml:mo>]</mml:mo>
            </mml:mrow>
            <mml:mi>
            </mml:mi>
            <mml:mo>×</mml:mo>
            <mml:mn>100</mml:mn>
            <mml:mi>%</mml:mi>
          </mml:mrow>
        </mml:math>
      </disp-formula>
      <p><bold>Precision:</bold> Precision is the proportion of correctly identified positive samples to the total number of samples predicted as positive.</p>
      <disp-formula id="FD2">
        <label>(2)</label>
        <mml:math>
          <mml:mrow>
            <mml:mi>P</mml:mi>
            <mml:mi>r</mml:mi>
            <mml:mi>e</mml:mi>
            <mml:mi>c</mml:mi>
            <mml:mi>i</mml:mi>
            <mml:mi>s</mml:mi>
            <mml:mi>i</mml:mi>
            <mml:mi>o</mml:mi>
            <mml:mi>n</mml:mi>
            <mml:mo>=</mml:mo>
            <mml:mrow>
              <mml:mo>[</mml:mo>
              <mml:mrow>
                <mml:mfrac>
                  <mml:mrow>
                    <mml:mi>T</mml:mi>
                    <mml:mi>P</mml:mi>
                  </mml:mrow>
                  <mml:mrow>
                    <mml:mi>T</mml:mi>
                    <mml:mi>P</mml:mi>
                    <mml:mo>+</mml:mo>
                    <mml:mi>F</mml:mi>
                    <mml:mi>P</mml:mi>
                  </mml:mrow>
                </mml:mfrac>
              </mml:mrow>
              <mml:mo>]</mml:mo>
            </mml:mrow>
            <mml:mo>×</mml:mo>
            <mml:mn>100</mml:mn>
            <mml:mtext>%</mml:mtext>
          </mml:mrow>
        </mml:math>
      </disp-formula>
      <p><bold>Recall:</bold> Recall is the proportion of correctly identified positive samples to the total number of positive samples.</p>
      <disp-formula id="FD3">
        <label>(3)</label>
        <mml:math>
          <mml:mrow>
            <mml:mi>R</mml:mi>
            <mml:mi>e</mml:mi>
            <mml:mi>c</mml:mi>
            <mml:mi>a</mml:mi>
            <mml:mi>l</mml:mi>
            <mml:mi>l</mml:mi>
            <mml:mo>=</mml:mo>
            <mml:mrow>
              <mml:mo>[</mml:mo>
              <mml:mrow>
                <mml:mfrac>
                  <mml:mrow>
                    <mml:mi>T</mml:mi>
                    <mml:mi>P</mml:mi>
                  </mml:mrow>
                  <mml:mrow>
                    <mml:mi>T</mml:mi>
                    <mml:mi>P</mml:mi>
                    <mml:mo>+</mml:mo>
                    <mml:mi>F</mml:mi>
                    <mml:mi>N</mml:mi>
                  </mml:mrow>
                </mml:mfrac>
              </mml:mrow>
              <mml:mo>]</mml:mo>
            </mml:mrow>
            <mml:mo>×</mml:mo>
            <mml:mn>100</mml:mn>
            <mml:mi>%</mml:mi>
          </mml:mrow>
        </mml:math>
      </disp-formula>
      <p><bold>F1 Score:</bold> The F1-score is the harmonic mean of precision and recall, providing a metric that balances false positives and false negatives.</p>
      <disp-formula id="FD4">
        <label>(4)</label>
        <mml:math display="inline">
          <mml:mrow>
            <mml:mi>F</mml:mi>
            <mml:mn>1</mml:mn>
            <mml:mo>−</mml:mo>
            <mml:mi>S</mml:mi>
            <mml:mi>c</mml:mi>
            <mml:mi>o</mml:mi>
            <mml:mi>r</mml:mi>
            <mml:mi>e</mml:mi>
            <mml:mo>=</mml:mo>
            <mml:mn>2</mml:mn>
            <mml:mo>×</mml:mo>
            <mml:mrow>
              <mml:mo>[</mml:mo>
              <mml:mrow>
                <mml:mfrac>
                  <mml:mrow>
                    <mml:mrow>
                      <mml:mo>(</mml:mo>
                      <mml:mrow>
                        <mml:mi>P</mml:mi>
                        <mml:mi>r</mml:mi>
                        <mml:mi>e</mml:mi>
                        <mml:mi>c</mml:mi>
                        <mml:mi>i</mml:mi>
                        <mml:mi>s</mml:mi>
                        <mml:mi>i</mml:mi>
                        <mml:mi>o</mml:mi>
                        <mml:mi>n</mml:mi>
                        <mml:mo>×</mml:mo>
                        <mml:mi>R</mml:mi>
                        <mml:mi>e</mml:mi>
                        <mml:mi>c</mml:mi>
                        <mml:mi>a</mml:mi>
                        <mml:mi>l</mml:mi>
                        <mml:mi>l</mml:mi>
                      </mml:mrow>
                      <mml:mo>)</mml:mo>
                    </mml:mrow>
                  </mml:mrow>
                  <mml:mrow>
                    <mml:mrow>
                      <mml:mo>(</mml:mo>
                      <mml:mrow>
                        <mml:mi>P</mml:mi>
                        <mml:mi>r</mml:mi>
                        <mml:mi>e</mml:mi>
                        <mml:mi>c</mml:mi>
                        <mml:mi>i</mml:mi>
                        <mml:mi>s</mml:mi>
                        <mml:mi>i</mml:mi>
                        <mml:mi>o</mml:mi>
                        <mml:mi>n</mml:mi>
                        <mml:mo>+</mml:mo>
                        <mml:mi>R</mml:mi>
                        <mml:mi>e</mml:mi>
                        <mml:mi>c</mml:mi>
                        <mml:mi>a</mml:mi>
                        <mml:mi>l</mml:mi>
                        <mml:mi>l</mml:mi>
                      </mml:mrow>
                      <mml:mo>)</mml:mo>
                    </mml:mrow>
                  </mml:mrow>
                </mml:mfrac>
              </mml:mrow>
              <mml:mo>]</mml:mo>
            </mml:mrow>
            <mml:mo>×</mml:mo>
            <mml:mn>100</mml:mn>
            <mml:mi>%</mml:mi>
          </mml:mrow>
        </mml:math>
      </disp-formula>
      <p>where TP represents the true positive, the actual negative is defined by TN; FP represents the false positive, and FN represents the false negative.</p>
      <p>The model’s classification performance was also visualized using ROC curves with the corresponding AUC values. </p>
      <p><bold>ROC curve:</bold> The ROC curve is a graphical representation of a classification model’s performance. It is plotted by comparing the True Positive Rate (TPR) against the False Positive Rate (FPR) at various classification thresholds. The TPR (also known as Recall or Sensitivity) and FPR are calculated using the following formula:</p>
      <disp-formula id="FD5">
        <label>(5)</label>
        <mml:math>
          <mml:mrow>
            <mml:mi>T</mml:mi>
            <mml:mi>P</mml:mi>
            <mml:mi>R</mml:mi>
            <mml:mo>=</mml:mo>
            <mml:mfrac>
              <mml:mrow>
                <mml:mi>T</mml:mi>
                <mml:mi>P</mml:mi>
              </mml:mrow>
              <mml:mrow>
                <mml:mi>T</mml:mi>
                <mml:mi>P</mml:mi>
                <mml:mo>+</mml:mo>
                <mml:mi>F</mml:mi>
                <mml:mi>P</mml:mi>
              </mml:mrow>
            </mml:mfrac>
          </mml:mrow>
        </mml:math>
      </disp-formula>
      <disp-formula id="FD6">
        <label>(6)</label>
        <mml:math>
          <mml:mrow>
            <mml:mi>F</mml:mi>
            <mml:mi>P</mml:mi>
            <mml:mi>R</mml:mi>
            <mml:mo>=</mml:mo>
            <mml:mfrac>
              <mml:mrow>
                <mml:mi>F</mml:mi>
                <mml:mi>P</mml:mi>
              </mml:mrow>
              <mml:mrow>
                <mml:mi>F</mml:mi>
                <mml:mi>P</mml:mi>
                <mml:mo>+</mml:mo>
                <mml:mi>T</mml:mi>
                <mml:mi>N</mml:mi>
              </mml:mrow>
            </mml:mfrac>
          </mml:mrow>
        </mml:math>
      </disp-formula>
      <p><bold>AUC:</bold> The AUC represents the area under the ROC curve (from (0,0) to (1,1)), with higher values indicating better model performance in distinguishing between classes. </p>
      <p><bold>Categorical Cross-Entropy:</bold> Categorical Cross-Entropy (Log Loss) is a common loss function used to evaluate multiclass classification models.</p>
      <disp-formula id="FD7">
        <label>(7)</label>
        <mml:math>
          <mml:mrow>
            <mml:mi>log</mml:mi>
            <mml:mi>l</mml:mi>
            <mml:mi>o</mml:mi>
            <mml:mi>s</mml:mi>
            <mml:mi>s</mml:mi>
            <mml:mo>=</mml:mo>
            <mml:mo>−</mml:mo>
            <mml:mfrac>
              <mml:mn>1</mml:mn>
              <mml:mi>N</mml:mi>
            </mml:mfrac>
            <mml:mstyle displaystyle="true">
              <mml:munderover>
                <mml:mo>∑</mml:mo>
                <mml:mi>i</mml:mi>
                <mml:mi>N</mml:mi>
              </mml:munderover>
              <mml:mrow>
                <mml:mstyle displaystyle="true">
                  <mml:munderover>
                    <mml:mo>∑</mml:mo>
                    <mml:mi>j</mml:mi>
                    <mml:mi>M</mml:mi>
                  </mml:munderover>
                  <mml:mrow>
                    <mml:msub>
                      <mml:mi>y</mml:mi>
                      <mml:mrow>
                        <mml:mi>i</mml:mi>
                        <mml:mi>j</mml:mi>
                      </mml:mrow>
                    </mml:msub>
                    <mml:mi>log</mml:mi>
                    <mml:mrow>
                      <mml:mo>(</mml:mo>
                      <mml:mrow>
                        <mml:msub>
                          <mml:mi>p</mml:mi>
                          <mml:mrow>
                            <mml:mi>i</mml:mi>
                            <mml:mi>j</mml:mi>
                          </mml:mrow>
                        </mml:msub>
                      </mml:mrow>
                      <mml:mo>)</mml:mo>
                    </mml:mrow>
                  </mml:mrow>
                </mml:mstyle>
              </mml:mrow>
            </mml:mstyle>
          </mml:mrow>
        </mml:math>
      </disp-formula>
      <p>where <italic>N</italic> is the number of rows or samples, M is the number of classes, <italic>y</italic><italic><sub>ij</sub></italic> is 1 if sample <italic>i</italic> belongs to class <italic>j</italic>; otherwise, it is 0, and <italic>P</italic><italic><sub>ij</sub></italic> is the probability from our classifier that predicts sample <italic>i</italic> to class<italic>j</italic>. </p>
      <p> reveals that the framework for the Diabetes multiclass system, and CSV file browsing and loading information are shown in and , respectively.</p>
      <fig id="fig22">
        <label>Figure 22</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId54.jpeg?20260626033001" />
      </fig>
      <p><bold>Figure 14.</bold>Load data into the diabetes prediction system.</p>
      <fig id="fig23">
        <label>Figure 23</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId55.jpeg?20260626033001" />
      </fig>
      <p><bold>Figure 15.</bold> Browsing the dataset for training models.</p>
      <fig id="fig24">
        <label>Figure 24</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId56.jpeg?20260626033001" />
      </fig>
      <p><bold>Figure 16.</bold>Visualization of the loaded file in the GUI. </p>
      <p> explains the evaluation metrics such as accuracy, precision, recall, F1-score, log loss, and ROC (receiver operating characteristics)-AUC (area under the curve) for a diabetes prediction system using four supervised learning models. </p>
      <p><bold>Table 1.</bold>Evaluation of metrics for a diabetes prediction system.</p>
      <table-wrap id="tbl1">
        <label>Table 1</label>
        <table>
          <tbody>
            <tr>
              <td>
                <bold>Model</bold>
              </td>
              <td>
                <bold>Accuracy</bold>
              </td>
              <td>
                <bold>Precision</bold>
              </td>
              <td>
                <bold>Recall</bold>
              </td>
              <td>
                <bold>F1-Score</bold>
              </td>
              <td>
                <bold>Log Loss</bold>
              </td>
              <td>
                <bold>ROC AUC (Overall)</bold>
              </td>
            </tr>
            <tr>
              <td>Decision Tree</td>
              <td>0.6875</td>
              <td>0.7326</td>
              <td>0.688</td>
              <td>0.7088</td>
              <td>5.0418</td>
              <td>0.5882</td>
            </tr>
            <tr>
              <td>Logistic Regression</td>
              <td>0.8125</td>
              <td>0.8207</td>
              <td>0.813</td>
              <td>0.8148</td>
              <td>0.5029</td>
              <td>0.8278</td>
            </tr>
            <tr>
              <td>MLP Classifier</td>
              <td>0.7708</td>
              <td>0.8207</td>
              <td>0.771</td>
              <td>0.7873</td>
              <td>0.5909</td>
              <td>0.8756</td>
            </tr>
            <tr>
              <td>LightGBM</td>
              <td>0.75</td>
              <td>0.7889</td>
              <td>0.75</td>
              <td>0.7674</td>
              <td>0.5847</td>
              <td>0.8127</td>
            </tr>
          </tbody>
        </table>
      </table-wrap>
      <p>and show the confusion matrix and ROC-AUC graph for the Decision Tree model.</p>
      <fig id="fig25">
        <label>Figure 25</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId57.jpeg?20260626033001" />
      </fig>
      <p><bold>Figure 17.</bold> Confusion matrix for a decision tree.</p>
      <fig id="fig26">
        <label>Figure 26</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId58.jpeg?20260626033001" />
      </fig>
      <p><bold>Figure 18.</bold>ROC-AUC for Decision Tree. </p>
      <p> and show the confusion matrix and ROC-AUC graph for the logistic regression model.</p>
      <fig id="fig27">
        <label>Figure 27</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId59.jpeg?20260626033001" />
      </fig>
      <p><bold>Figure 19.</bold>Confusion matrix for logistic regression.</p>
      <fig id="fig28">
        <label>Figure 28</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId60.jpeg?20260626033001" />
      </fig>
      <p><bold>Figure 20.</bold> ROC-AUC for logistic regression </p>
      <p> and show the confusion matrix and the ROC-AUC graph for the MLP classifier model.</p>
      <fig id="fig29">
        <label>Figure 29</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId61.jpeg?20260626033001" />
      </fig>
      <p><bold>Figure 21.</bold> Confusion matrix for the MLP classifier.</p>
      <fig id="fig30">
        <label>Figure 30</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId62.jpeg?20260626033001" />
      </fig>
      <p><bold>Figure 22.</bold>ROC-AUC for the MLP classifier. </p>
      <p>and show the confusion matrix and the ROC-AUC graph for the LightGBM model.</p>
      <fig id="fig31">
        <label>Figure 31</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId63.jpeg?20260626033000" />
      </fig>
      <p><bold>Figure 23.</bold>Confusion matrix for LightGBM.</p>
      <fig id="fig32">
        <label>Figure 32</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId64.jpeg?20260626033000" />
      </fig>
      <p><bold>Figure 24.</bold> ROC-AUC for LightGBM. </p>
      <p><bold>Table 2.</bold> Comparison of the existing method with the proposed method.</p>
      <table-wrap id="tbl2">
        <label>Table 2</label>
        <table>
          <tbody>
            <tr>
              <td colspan="2">
                <bold>Study/</bold>
                <bold>Authors</bold>
              </td>
              <td>
                <bold>Benefits/</bold>
                <bold>Contributions</bold>
              </td>
              <td>
                <bold>Challenges/</bold>
                <bold>Limitations</bold>
              </td>
              <td>
                <bold>Statistical/</bold>
                <bold>Technical Approaches</bold>
              </td>
              <td>
                <bold>UI Features</bold>
              </td>
              <td>
                <bold>Reported Accuracy</bold>
                <bold>/Performance</bold>
              </td>
            </tr>
            <tr>
              <td colspan="2">
                Khan (2022) [
                <xref ref-type="bibr" rid="B1">1</xref>
                ]
              </td>
              <td>A national health data warehouse framework for Bangladesh is proposed, emphasizing infrastructural and policy challenges.</td>
              <td>Challenges in Bangladesh’s health informatics.</td>
              <td>Data warehouse design, ETL processes</td>
              <td>Dashboard concepts (proposed)</td>
              <td>Not reported (conceptual framework)</td>
            </tr>
            <tr>
              <td colspan="2">
                Khan &amp; Hoque (2016) [
                <xref ref-type="bibr" rid="B5">5</xref>
                ]
              </td>
              <td>Examined data integration challenges, highlighting technical and organizational barriers to interoperability.</td>
              <td>Absence of integrated, operational DW models in Bangladesh’s healthcare system.</td>
              <td>Data integration methods, interoperability frameworks.</td>
              <td>Not specified</td>
              <td>Not reported</td>
            </tr>
            <tr>
              <td colspan="2">
                Ronaldson
                <italic>et al.</italic>
                (2022) [
                <xref ref-type="bibr" rid="B6">6</xref>
                ]
              </td>
              <td>Used SEM on clinical data to examine Diabetes-depression links, enabling multidimensional analyses.</td>
              <td>High-resource methods are less feasible in low-resource settings.</td>
              <td>Structural Equation Modelling</td>
              <td>Statistical output only</td>
              <td>Model fit indices: CFI = 0.95, RMSEA = 0.05 (typical SEM metrics)</td>
            </tr>
            <tr>
              <td colspan="2">
                Sakib, Jamil, Mukta (2022) [
                <xref ref-type="bibr" rid="B7">7</xref>
                ]
              </td>
              <td>Developed a machine learning-based data warehouse to support AI-driven clinical decision-making.</td>
              <td>Implementation challenges in low-resource settings, such as Bangladesh.</td>
              <td>Classification, clustering</td>
              <td>Interactive dashboards (concept)</td>
              <td>Accuracy ~85% - 90% (reported for classification models)</td>
            </tr>
            <tr>
              <td colspan="2">
                Rghioui
                <italic>et al.</italic>
                (2020), Alfian
                <italic>et al.</italic>
                (2018) [
                <xref ref-type="bibr" rid="B11">11</xref>
                ][
                <xref ref-type="bibr" rid="B12">12</xref>
                ]
              </td>
              <td>Introduced IoT and wearable technologies for real-time monitoring of diabetic patients.</td>
              <td>Reliance on advanced infrastructure and wearable technologies.</td>
              <td>Sensor data processing, real-time analytics</td>
              <td>Mobile apps, sensor dashboards</td>
              <td>Sensitivity ~90%, specificity ~85% (IoT monitoring)</td>
            </tr>
            <tr>
              <td colspan="2">
                Rghioui
                <italic>et al.</italic>
                (2019), Breault
                <italic>et al.</italic>
                (2002) [
                <xref ref-type="bibr" rid="B13">13</xref>
                ][
                <xref ref-type="bibr" rid="B14">14</xref>
                ]
              </td>
              <td>Investigated data mining and classification techniques for glucose monitoring and prediction.</td>
              <td>Early-stage models with limited use in low-resource healthcare settings.</td>
              <td>Data mining, predictive analytics</td>
              <td>Basic visualization tools</td>
              <td>Accuracy ~80% (early predictive models)</td>
            </tr>
            <tr>
              <td colspan="2">
                Emad Ali
                <italic>et al.</italic>
                (2024), Suraka &amp; Gayathri (2022) [
                <xref ref-type="bibr" rid="B15">15</xref>
                ][
                <xref ref-type="bibr" rid="B16">16</xref>
                ]
              </td>
              <td>Emphasized real-time, machine learning-based monitoring for continuous patient supervision.</td>
              <td>Requires constant data connectivity and advanced computational resources.</td>
              <td>ML models for real-time prediction</td>
              <td>Real-time alert dashboards</td>
              <td>Accuracy &gt;90%, F1-score &gt;0.85 reported.</td>
            </tr>
            <tr>
              <td colspan="2">
                Lee
                <italic>et al.</italic>
                (2010), Johnson &amp; Miller (2022) [
                <xref ref-type="bibr" rid="B17">17</xref>
                ][
                <xref ref-type="bibr" rid="B18">18</xref>
                ]
              </td>
              <td>Used rule-based and KNN methods, addressing the management of remote patient-generated health data.</td>
              <td>Patient data acquired remotely from rural areas.</td>
              <td>Rule-based systems, KNN classifiers</td>
              <td>Web portals, mobile interfaces</td>
              <td>Accuracy: 75% - 85% (varies by dataset)</td>
            </tr>
            <tr>
              <td>
                Ado
                <italic>et al.</italic>
                (2014) [
                <xref ref-type="bibr" rid="B19">19</xref>
                ]
              </td>
              <td colspan="2">Emphasized data warehousing’s role in healthcare decision-making and outlined foundational design strategies.</td>
              <td>Strategies show limited adaptation to local contexts, such as Bangladesh’s healthcare system.</td>
              <td>Data warehousing architecture</td>
              <td>Conceptual dashboards</td>
              <td>Not reported</td>
            </tr>
            <tr>
              <td>
                <bold>Proposed system</bold>
              </td>
              <td colspan="2">Demonstrated convergence of data warehousing, statistical analysis, and machine learning to improve diabetes management.</td>
              <td>Bangladesh-specific integrated data warehouse models and digital healthcare infrastructure.</td>
              <td>Mixed methods: Data warehousing, machine learning (DT, LR, MLP, LightGBM), statistical</td>
              <td>Emerging dashboards and apps</td>
              <td>Logistic Regression achieved 81.25% accuracy, 82.07% precision, 81.3% recall, 81.48% F1-score, with a log loss of 0.5029 and ROC-AUC of 0.8278.</td>
            </tr>
          </tbody>
        </table>
      </table-wrap>
      <p>summarizes existing data warehousing research, highlighting gaps in AI-driven analytics and GUI integration. Our proposed system addresses these gaps by combining a scalable, GUI-enabled data warehouse with machine learning and statistical analysis, achieving higher accuracy, lower Log Loss, and improved ROC-AUC, making it more comprehensive and suitable for real-world diabetes management. </p>
      <p><bold>D</bold><bold>)</bold><bold>Batch-based diabetes prediction</bold></p>
      <p>After evaluating four supervised algorithms using accuracy, precision, recall, F1-score, Log Loss, and ROC-AUC, Logistic Regression consistently outperformed the others in robustness, interpretability, and metric performance. It was selected as the core model for the batch-based hospital-level diabetes prediction system in Bangladesh. shows the system architecture, and illustrates the Logistic Regression training process.</p>
      <fig id="fig33">
        <label>Figure 33</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId65.jpeg?20260626033000" />
      </fig>
      <p><bold>Figure 25.</bold> Snapshot of a batch-based diabetes prediction system.</p>
      <fig id="fig34">
        <label>Figure 34</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId66.jpeg?20260626033000" />
      </fig>
      <p><bold>Figure 26.</bold> LR model trained with the dataset. </p>
      <p>shows the Logistic Regression model’s performance on real hospital patient data, while presents the predicted diabetes outcomes generated by the model.</p>
      <fig id="fig35">
        <label>Figure 35</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId67.jpeg?20260626033001" />
      </fig>
      <p><bold>Figure 27.</bold>LR-based model test with real patient data.</p>
      <fig id="fig36">
        <label>Figure 36</label>
        <graphic xlink:href="https://html.scirp.org/file/1733383-rId68.jpeg?20260626033001" />
      </fig>
      <p><bold>Figure 28.</bold>Model output visualization.</p>
      <sec id="sec4dot1">
        <title>Limitations of the Study</title>
        <p>The study’s limited sample size may not fully represent diabetes patients across Bangladesh, and time constraints prevented deeper exploration of the findings. The absence of external validation is a limitation of the present study. The models were evaluated using an internal train-test split with cross-validation due to the unavailability of an independent external datasets from different institutions or time periods. We recognize that such internal validation may not fully reflect real-world generalizability across diverse clinical settings. We acknowledge this limitation and plan to address it in future work by validating the proposed models on external datasets collected from multiple hospitals and different time periods, thereby improving robustness and clinical applicability. </p>
      </sec>
    </sec>
    <sec id="sec5">
      <title>5. Conclusion</title>
      <p>The centralized diabetes data warehouse developed for selected hospitals in Bangladesh consolidates fragmented datasets into a unified, GUI-enabled platform, enabling batch-based monitoring, data-driven analysis, and informed clinical decision-making. The system uncovered key insights, such as links between gender, treatment cost, and patient satisfaction, blurred vision and diabetes duration, and diet/exercise with weight loss. By integrating statistical analysis and machine learning, Logistic Regression achieved the best predictive performance (accuracy 81.25%, precision 82.07%, recall 81.3%, F1-score 81.48%, ROC-AUC 0.8278, log loss 0.5029), demonstrating strong reliability for hospital-level implementation. Overall, the system enhances diabetes care, supports targeted interventions, and contributes to Bangladesh’s broader digital health transformation and chronic disease management initiatives.</p>
    </sec>
    <sec id="sec6">
      <title>Code Availability</title>
      <p>The programming code used in this research is customized in the Python environment.</p>
    </sec>
  </body>
  <back>
    <ref-list>
      <title>References</title>
      <ref id="B1">
        <label>1.</label>
        <citation-alternatives>
          <mixed-citation publication-type="other">Khan, S.I. (2022) Development of National Health Data Warehouse Frame Work for Bangladesh. <italic>IIUC</italic><italic>Studies</italic>, 19, 53-68. https://doi.org/10.3329/iiucs.v19i1.69039 <pub-id pub-id-type="doi">10.3329/iiucs.v19i1.69039</pub-id><ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3329/iiucs.v19i1.69039">https://doi.org/10.3329/iiucs.v19i1.69039</ext-link></mixed-citation>
          <element-citation publication-type="other">
            <person-group person-group-type="author">
              <string-name>Khan, S.I.</string-name>
            </person-group>
            <year>2022</year>
            <article-title>Development of National Health Data Warehouse Frame Work for Bangladesh</article-title>
            <source>IIUC Studies</source>
            <volume>19</volume>
            <pub-id pub-id-type="doi">10.3329/iiucs.v19i1.69039</pub-id>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B2">
        <label>2.</label>
        <citation-alternatives>
          <mixed-citation publication-type="other">Uddin, M.J., Ahamad, M.M., Hoque, M.N., Walid, M.A.A., Aktar, S., Alotaibi, N., <italic>et al</italic>. (2023) A Comparison of Machine Learning Techniques for the Detection of Type-2 Diabetes Mellitus: Experiences from Bangladesh. <italic>Information</italic>, 14, Article 376. https://doi.org/10.3390/info14070376 <pub-id pub-id-type="doi">10.3390/info14070376</pub-id><ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3390/info14070376">https://doi.org/10.3390/info14070376</ext-link></mixed-citation>
          <element-citation publication-type="other">
            <person-group person-group-type="author">
              <string-name>Uddin, M.J.</string-name>
              <string-name>Ahamad, M.M.</string-name>
              <string-name>Hoque, M.N.</string-name>
              <string-name>Walid, M.A.A.</string-name>
              <string-name>Aktar, S.</string-name>
              <string-name>Alotaibi, N.</string-name>
            </person-group>
            <year>2023</year>
            <article-title>A Comparison of Machine Learning Techniques for the Detection of Type-2 Diabetes Mellitus: Experiences from Bangladesh</article-title>
            <source>Information</source>
            <volume>14</volume>
            <elocation-id>376</elocation-id>
            <pub-id pub-id-type="doi">10.3390/info14070376</pub-id>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B3">
        <label>3.</label>
        <citation-alternatives>
          <mixed-citation publication-type="other">Prama, T.T., Zaman, M., Sarker, F. and Mamun, K.A. (2024) DiaHealth: A Bangladeshi Dataset for Type 2 Diabetes Prediction. Mendeley Data, V1.</mixed-citation>
          <element-citation publication-type="other">
            <person-group person-group-type="author">
              <string-name>Prama, T.T.</string-name>
              <string-name>Zaman, M.</string-name>
              <string-name>Sarker, F.</string-name>
              <string-name>Mamun, K.A.</string-name>
              <string-name>Data, V</string-name>
            </person-group>
            <year>2024</year>
            <article-title>DiaHealth: A Bangladeshi Dataset for Type 2 Diabetes Prediction</article-title>
            <source>Mendeley Data</source>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B4">
        <label>4.</label>
        <citation-alternatives>
          <mixed-citation publication-type="journal">Ozaydin, B., Zengul, F., Oner, N. and Feldman, S.S. (2020) Healthcare Research and Analytics Data Infrastructure Solution: A Data Warehouse for Health Services Research, <italic>Journal of Medical Internet Research</italic>, 22, e18579. https://doi.org/10.2196/18579 <pub-id pub-id-type="doi">10.2196/18579</pub-id><pub-id pub-id-type="pmid">32496199</pub-id><ext-link ext-link-type="uri" xlink:href="https://doi.org/10.2196/18579">https://doi.org/10.2196/18579</ext-link></mixed-citation>
          <element-citation publication-type="journal">
            <person-group person-group-type="author">
              <string-name>Ozaydin, B.</string-name>
              <string-name>Zengul, F.</string-name>
              <string-name>Oner, N.</string-name>
              <string-name>Feldman, S.S.</string-name>
              <string-name>Research, J</string-name>
            </person-group>
            <year>2020</year>
            <article-title>Healthcare Research and Analytics Data Infrastructure Solution: A Data Warehouse for Health Services Research, Journal of Medical Internet Research, 22, e18579</article-title>
            <pub-id pub-id-type="doi">10.2196/18579</pub-id>
            <pub-id pub-id-type="pmid">32496199</pub-id>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B5">
        <label>5.</label>
        <citation-alternatives>
          <mixed-citation publication-type="confproc">Khan, S.I. and Hoque, A.S.M.L. (2016) An Analysis of the Problems for Health Data Integration in Bangladesh. 2016 <italic>International Conference on Innovations in Science</italic>, <italic>Engineering and Technology</italic> ( <italic>ICISET</italic>), Dhaka, 28-29 October 2016, 1-4. https://doi.org/10.1109/iciset.2016.7856517 <pub-id pub-id-type="doi">10.1109/iciset.2016.7856517</pub-id><ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1109/iciset.2016.7856517">https://doi.org/10.1109/iciset.2016.7856517</ext-link></mixed-citation>
          <element-citation publication-type="confproc">
            <person-group person-group-type="author">
              <string-name>Khan, S.I.</string-name>
              <string-name>Hoque, A.S.M.L.</string-name>
              <string-name>Science, E</string-name>
            </person-group>
            <year>2016</year>
            <article-title>An Analysis of the Problems for Health Data Integration in Bangladesh</article-title>
            <source>2016 International Conference on Innovations in Science</source>
            <volume>28</volume>
            <pub-id pub-id-type="doi">10.1109/iciset.2016.7856517</pub-id>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B6">
        <label>6.</label>
        <citation-alternatives>
          <mixed-citation publication-type="other">Ronaldson, A., Freestone, M., Zhang, H., Marsh, W. and Bhui, K. (2022) Using Structural Equation Modelling in Routine Clinical Data on Diabetes and Depression: Observational Cohort Study. <italic>JMIRx</italic><italic>Med</italic>, 3, e22912. https://doi.org/10.2196/22912 <pub-id pub-id-type="doi">10.2196/22912</pub-id><pub-id pub-id-type="pmid">37725546</pub-id><ext-link ext-link-type="uri" xlink:href="https://doi.org/10.2196/22912">https://doi.org/10.2196/22912</ext-link></mixed-citation>
          <element-citation publication-type="other">
            <person-group person-group-type="author">
              <string-name>Ronaldson, A.</string-name>
              <string-name>Freestone, M.</string-name>
              <string-name>Zhang, H.</string-name>
              <string-name>Marsh, W.</string-name>
              <string-name>Bhui, K.</string-name>
            </person-group>
            <year>2022</year>
            <article-title>Using Structural Equation Modelling in Routine Clinical Data on Diabetes and Depression: Observational Cohort Study</article-title>
            <source>JMIRx Med</source>
            <volume>3</volume>
            <pub-id pub-id-type="doi">10.2196/22912</pub-id>
            <pub-id pub-id-type="pmid">37725546</pub-id>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B7">
        <label>7.</label>
        <citation-alternatives>
          <mixed-citation publication-type="confproc">Sakib, N., Jamil, S.J. and Mukta, S.H. (2022) A Novel Approach on Machine Learning Based Data Warehousing for Intelligent Healthcare Services. 2022 <italic>IEEE Region 10 Symposium</italic> ( <italic>TENSYMP</italic>), Mumbai, 1-3 July 2022, 1-5. https://doi.org/10.1109/tensymp54529.2022.9864564 <pub-id pub-id-type="doi">10.1109/tensymp54529.2022.9864564</pub-id><ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1109/tensymp54529.2022.9864564">https://doi.org/10.1109/tensymp54529.2022.9864564</ext-link></mixed-citation>
          <element-citation publication-type="confproc">
            <person-group person-group-type="author">
              <string-name>Sakib, N.</string-name>
              <string-name>Jamil, S.J.</string-name>
              <string-name>Mukta, S.H.</string-name>
            </person-group>
            <year>2022</year>
            <article-title>A Novel Approach on Machine Learning Based Data Warehousing for Intelligent Healthcare Services</article-title>
            <source>2022 IEEE Region 10 Symposium (TENSYMP)</source>
            <volume>1</volume>
            <pub-id pub-id-type="doi">10.1109/tensymp54529.2022.9864564</pub-id>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B8">
        <label>8.</label>
        <citation-alternatives>
          <mixed-citation publication-type="journal">Lakshminarayanan, V., Kheradfallah, H., Sarkar, A. and Jothi Balaji, J. (2021) Automated Detection and Diagnosis of Diabetic Retinopathy: A Comprehensive Survey. <italic>Journal of Imaging</italic>, 7, 165. https://doi.org/10.3390/jimaging7090165 <pub-id pub-id-type="doi">10.3390/jimaging7090165</pub-id><pub-id pub-id-type="pmid">34460801</pub-id><ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3390/jimaging7090165">https://doi.org/10.3390/jimaging7090165</ext-link></mixed-citation>
          <element-citation publication-type="journal">
            <person-group person-group-type="author">
              <string-name>Lakshminarayanan, V.</string-name>
              <string-name>Kheradfallah, H.</string-name>
              <string-name>Sarkar, A.</string-name>
              <string-name>Balaji, J.</string-name>
            </person-group>
            <year>2021</year>
            <article-title>Automated Detection and Diagnosis of Diabetic Retinopathy: A Comprehensive Survey</article-title>
            <source>Journal of Imaging</source>
            <volume>7</volume>
            <pub-id pub-id-type="doi">10.3390/jimaging7090165</pub-id>
            <pub-id pub-id-type="pmid">34460801</pub-id>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B9">
        <label>9.</label>
        <citation-alternatives>
          <mixed-citation publication-type="journal">Dutta, A., Hasan, M.K., Ahmad, M., Awal, M.A., Islam, M.A., Masud, M. and Meshref, H. (2022) Early Prediction of Diabetes Using an Ensemble of Machine Learning Models. <italic>Journal of Environmental Research and Public Health</italic>, 19, Article 12378. https://doi.org/10.3390/ijerph191912378 <pub-id pub-id-type="doi">10.3390/ijerph191912378</pub-id><pub-id pub-id-type="pmid">36231678</pub-id><ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3390/ijerph191912378">https://doi.org/10.3390/ijerph191912378</ext-link></mixed-citation>
          <element-citation publication-type="journal">
            <person-group person-group-type="author">
              <string-name>Dutta, A.</string-name>
              <string-name>Hasan, M.K.</string-name>
              <string-name>Ahmad, M.</string-name>
              <string-name>Awal, M.A.</string-name>
              <string-name>Islam, M.A.</string-name>
              <string-name>Masud, M.</string-name>
              <string-name>Meshref, H.</string-name>
            </person-group>
            <year>2022</year>
            <article-title>Early Prediction of Diabetes Using an Ensemble of Machine Learning Models</article-title>
            <source>Journal of Environmental Research and Public Health</source>
            <volume>19</volume>
            <elocation-id>12378</elocation-id>
            <pub-id pub-id-type="doi">10.3390/ijerph191912378</pub-id>
            <pub-id pub-id-type="pmid">36231678</pub-id>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B10">
        <label>10.</label>
        <citation-alternatives>
          <mixed-citation publication-type="journal">Kaspar, M., Fette, G., Hanke, M., Ertl, M., Puppe, F. and Störk, S. (2022) Automated Provision of Clinical Routine Data for a Complex Clinical Follow-Up Study: A Data Warehouse Solution. <italic>Health</italic><italic>Informatics Jour</italic><italic>nal</italic>, 28. https://doi.org/10.1177/14604582211058081 <pub-id pub-id-type="doi">10.1177/14604582211058081</pub-id><pub-id pub-id-type="pmid">34986681</pub-id><ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1177/14604582211058081">https://doi.org/10.1177/14604582211058081</ext-link></mixed-citation>
          <element-citation publication-type="journal">
            <person-group person-group-type="author">
              <string-name>Kaspar, M.</string-name>
              <string-name>Fette, G.</string-name>
              <string-name>Hanke, M.</string-name>
              <string-name>Ertl, M.</string-name>
              <string-name>Puppe, F.</string-name>
            </person-group>
            <year>2022</year>
            <article-title>Automated Provision of Clinical Routine Data for a Complex Clinical Follow-Up Study: A Data Warehouse Solution</article-title>
            <source>Health Informatics Journal</source>
            <volume>28</volume>
            <pub-id pub-id-type="doi">10.1177/14604582211058081</pub-id>
            <pub-id pub-id-type="pmid">34986681</pub-id>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B11">
        <label>11.</label>
        <citation-alternatives>
          <mixed-citation publication-type="other">Rghioui A, Lloret J, Sendra S, and Oumnad A. (2020) A Smart Architecture for Diabetic Patient Monitoring Using Machine Learning Algorithms. <italic>Healthcare</italic> ( <italic>Basel</italic>), 8, Article 348. https://doi.org/10.3390/healthcare8030348 <pub-id pub-id-type="doi">10.3390/healthcare8030348</pub-id><pub-id pub-id-type="pmid">32961757</pub-id><ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3390/healthcare8030348">https://doi.org/10.3390/healthcare8030348</ext-link></mixed-citation>
          <element-citation publication-type="other">
            <year>2020</year>
            <article-title>A Smart Architecture for Diabetic Patient Monitoring Using Machine Learning Algorithms</article-title>
            <source>Healthcare (Basel)</source>
            <volume>8</volume>
            <elocation-id>348</elocation-id>
            <pub-id pub-id-type="doi">10.3390/healthcare8030348</pub-id>
            <pub-id pub-id-type="pmid">32961757</pub-id>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B12">
        <label>12.</label>
        <citation-alternatives>
          <mixed-citation publication-type="other">Alfian, G., Syafrudin, M., Ijaz, M.F., Syaekhoni, M.A., Fitriyani, N.L. and Rhee, J. (2018) A Personalized Healthcare Monitoring System for Diabetic Patients by Utilizing Ble-Based Sensors and Real-Time Data Processing. <italic>Sensors</italic>, 18, Article 2183. https://doi.org/10.3390/s18072183 <pub-id pub-id-type="doi">10.3390/s18072183</pub-id><pub-id pub-id-type="pmid">29986473</pub-id><ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3390/s18072183">https://doi.org/10.3390/s18072183</ext-link></mixed-citation>
          <element-citation publication-type="other">
            <person-group person-group-type="author">
              <string-name>Alfian, G.</string-name>
              <string-name>Syafrudin, M.</string-name>
              <string-name>Ijaz, M.F.</string-name>
              <string-name>Syaekhoni, M.A.</string-name>
              <string-name>Fitriyani, N.L.</string-name>
              <string-name>Rhee, J.</string-name>
            </person-group>
            <year>2018</year>
            <article-title>A Personalized Healthcare Monitoring System for Diabetic Patients by Utilizing Ble-Based Sensors and Real-Time Data Processing</article-title>
            <source>Sensors</source>
            <volume>18</volume>
            <elocation-id>2183</elocation-id>
            <pub-id pub-id-type="doi">10.3390/s18072183</pub-id>
            <pub-id pub-id-type="pmid">29986473</pub-id>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B13">
        <label>13.</label>
        <citation-alternatives>
          <mixed-citation publication-type="other">Rghioui, A., Lloret, J., Parra, L., Sendra, S. and Oumnad, A. (2019) Glucose Data Classification for Diabetic Patient Monitoring. <italic>Applied</italic><italic>Sciences</italic>, 9, Article 4459. https://doi.org/10.3390/app9204459 <pub-id pub-id-type="doi">10.3390/app9204459</pub-id><ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3390/app9204459">https://doi.org/10.3390/app9204459</ext-link></mixed-citation>
          <element-citation publication-type="other">
            <person-group person-group-type="author">
              <string-name>Rghioui, A.</string-name>
              <string-name>Lloret, J.</string-name>
              <string-name>Parra, L.</string-name>
              <string-name>Sendra, S.</string-name>
              <string-name>Oumnad, A.</string-name>
            </person-group>
            <year>2019</year>
            <article-title>Glucose Data Classification for Diabetic Patient Monitoring</article-title>
            <source>Applied Sciences</source>
            <volume>9</volume>
            <elocation-id>4459</elocation-id>
            <pub-id pub-id-type="doi">10.3390/app9204459</pub-id>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B14">
        <label>14.</label>
        <citation-alternatives>
          <mixed-citation publication-type="journal">Breault, J.L., Goodall, C.R. and Fos, P.J. (2002) Data Mining a Diabetic Data Warehouse. <italic>Artificial</italic><italic>Intelligence</italic><italic>in</italic><italic>Medicine</italic>, 26, 37-54. https://doi.org/10.1016/s0933-3657(02)00051-9 <pub-id pub-id-type="doi">10.1016/s0933-3657(02)00051-9</pub-id><pub-id pub-id-type="pmid">12234716</pub-id><ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1016/s0933-3657(02)00051-9">https://doi.org/10.1016/s0933-3657(02)00051-9</ext-link></mixed-citation>
          <element-citation publication-type="journal">
            <person-group person-group-type="author">
              <string-name>Breault, J.L.</string-name>
              <string-name>Goodall, C.R.</string-name>
              <string-name>Fos, P.J.</string-name>
            </person-group>
            <year>2002</year>
            <article-title>Data Mining a Diabetic Data Warehouse</article-title>
            <source>Artificial Intelligence in Medicine</source>
            <volume>3657</volume>
            <issue>02</issue>
            <pub-id pub-id-type="doi">10.1016/s0933-3657(02)00051-9</pub-id>
            <pub-id pub-id-type="pmid">12234716</pub-id>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B15">
        <label>15.</label>
        <citation-alternatives>
          <mixed-citation publication-type="journal">Emad, A.T., Morad, A., Abdala, M., Zoltán, A. and Al-Asfoor, F. (2024) Diabetic Patient Real-Time Monitoring System Using Machine Learning. <italic>International Journal of Computing and Digital Systems</italic>, 16, 189-199.</mixed-citation>
          <element-citation publication-type="journal">
            <person-group person-group-type="author">
              <string-name>Emad, A.T.</string-name>
              <string-name>Morad, A.</string-name>
              <string-name>Abdala, M.</string-name>
              <string-name>Al-Asfoor, F.</string-name>
            </person-group>
            <year>2024</year>
            <article-title>Diabetic Patient Real-Time Monitoring System Using Machine Learning</article-title>
            <source>International Journal of Computing and Digital Systems</source>
            <volume>16</volume>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B16">
        <label>16.</label>
        <citation-alternatives>
          <mixed-citation publication-type="journal">Reddy, S.M.L. and Gayathri, A.Y. (2022) Healthcare Monitoring System for Diabetic Patients Using Machine Learning. <italic>International</italic><italic>Journal</italic><italic>for</italic><italic>Research</italic><italic>in</italic><italic>Applied</italic><italic>Science</italic><italic>and</italic><italic>Engineering</italic><italic>Technology</italic>, 10, 122-132. https://doi.org/10.22214/ijraset.2022.47262 <pub-id pub-id-type="doi">10.22214/ijraset.2022.47262</pub-id><ext-link ext-link-type="uri" xlink:href="https://doi.org/10.22214/ijraset.2022.47262">https://doi.org/10.22214/ijraset.2022.47262</ext-link></mixed-citation>
          <element-citation publication-type="journal">
            <person-group person-group-type="author">
              <string-name>Reddy, S.M.L.</string-name>
              <string-name>Gayathri, A.Y.</string-name>
            </person-group>
            <year>2022</year>
            <article-title>Healthcare Monitoring System for Diabetic Patients Using Machine Learning</article-title>
            <source>International Journal for Research in Applied Science and Engineering Technology</source>
            <volume>10</volume>
            <pub-id pub-id-type="doi">10.22214/ijraset.2022.47262</pub-id>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B17">
        <label>17.</label>
        <citation-alternatives>
          <mixed-citation publication-type="other">Lee, M., Gatton, T.M. and Lee, K. (2010) A Monitoring and Advisory System for Diabetes Patient Management Using a Rule-Based Method and KNN. <italic>Sensors</italic>, 10, 3934-3953. https://doi.org/10.3390/s100403934 <pub-id pub-id-type="doi">10.3390/s100403934</pub-id><pub-id pub-id-type="pmid">22319334</pub-id><ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3390/s100403934">https://doi.org/10.3390/s100403934</ext-link></mixed-citation>
          <element-citation publication-type="other">
            <person-group person-group-type="author">
              <string-name>Lee, M.</string-name>
              <string-name>Gatton, T.M.</string-name>
              <string-name>Lee, K.</string-name>
            </person-group>
            <year>2010</year>
            <article-title>A Monitoring and Advisory System for Diabetes Patient Management Using a Rule-Based Method and KNN</article-title>
            <source>Sensors</source>
            <volume>10</volume>
            <pub-id pub-id-type="doi">10.3390/s100403934</pub-id>
            <pub-id pub-id-type="pmid">22319334</pub-id>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B18">
        <label>18.</label>
        <citation-alternatives>
          <mixed-citation publication-type="other">Johnson, E.L. and Miller, E. (2022) Remote Patient Monitoring in Diabetes: How to Acquire, Manage, and Use All of the Data. <italic>Diabetes</italic><italic>Spectrum</italic>, 35, 43-56. https://doi.org/10.2337/dsi21-0015 <pub-id pub-id-type="doi">10.2337/dsi21-0015</pub-id><pub-id pub-id-type="pmid">35308161</pub-id><ext-link ext-link-type="uri" xlink:href="https://doi.org/10.2337/dsi21-0015">https://doi.org/10.2337/dsi21-0015</ext-link></mixed-citation>
          <element-citation publication-type="other">
            <person-group person-group-type="author">
              <string-name>Johnson, E.L.</string-name>
              <string-name>Miller, E.</string-name>
              <string-name>Acquire, M</string-name>
            </person-group>
            <year>2022</year>
            <article-title>Remote Patient Monitoring in Diabetes: How to Acquire, Manage, and Use All of the Data</article-title>
            <source>Diabetes Spectrum</source>
            <volume>35</volume>
            <pub-id pub-id-type="doi">10.2337/dsi21-0015</pub-id>
            <pub-id pub-id-type="pmid">35308161</pub-id>
          </element-citation>
        </citation-alternatives>
      </ref>
      <ref id="B19">
        <label>19.</label>
        <citation-alternatives>
          <mixed-citation publication-type="journal">Ado, A., Aliyu, A., Aminu Bello, S., Garba Sharifai, A. and Gezawa, A.S. (2014) Building a Diabetes Data Warehouse to Support Decision Making in Healthcare Industry. <italic>IOSR</italic><italic>Journal</italic><italic>of</italic><italic>Computer</italic><italic>Engineering</italic>, 16, 138-143. https://doi.org/10.9790/0661-1629138143 <pub-id pub-id-type="doi">10.9790/0661-1629138143</pub-id><ext-link ext-link-type="uri" xlink:href="https://doi.org/10.9790/0661-1629138143">https://doi.org/10.9790/0661-1629138143</ext-link></mixed-citation>
          <element-citation publication-type="journal">
            <person-group person-group-type="author">
              <string-name>Ado, A.</string-name>
              <string-name>Aliyu, A.</string-name>
              <string-name>Bello, S.</string-name>
              <string-name>Sharifai, A.</string-name>
              <string-name>Gezawa, A.S.</string-name>
            </person-group>
            <year>2014</year>
            <article-title>Building a Diabetes Data Warehouse to Support Decision Making in Healthcare Industry</article-title>
            <source>IOSR Journal of Computer Engineering</source>
            <volume>16</volume>
            <pub-id pub-id-type="doi">10.9790/0661-1629138143</pub-id>
          </element-citation>
        </citation-alternatives>
      </ref>
    </ref-list>
  </back>
</article>