1
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Ahmed BM, Ali ME, Masud MM, Azad MR, Naznin M. After-meal blood glucose level prediction for type-2 diabetic patients. Heliyon 2024; 10:e28855. [PMID: 38617952 PMCID: PMC11015419 DOI: 10.1016/j.heliyon.2024.e28855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 03/16/2024] [Accepted: 03/26/2024] [Indexed: 04/16/2024] Open
Abstract
Type 2 Diabetes, a metabolic disorder disease, is becoming a fast growing health crisis worldwide. It reduces the quality of life, and increases mortality and health care costs unless managed well. After-meal blood glucose level measure is considered as one of the most fundamental and well-recognized steps in managing Type 2 diabetes as it guides a user to make better plans of their diet and thus control the diabetes well. In this paper, we propose a data-driven approach to predict the 2 h after meal blood glucose level from the previous discrete blood glucose readings, meal, exercise, medication, & profile information of Type 2 diabetes patients. To the best of our knowledge, this is the first attempt to use discrete blood glucose readings for 2 h after meal blood glucose level prediction using data-driven models. In this study, we have collected data from five prediabetic and diabetic patients in free living conditions for six months. We have presented comparative experimental study using different popular machine learning models including support vector regression, random forest, and extreme gradient boosting, and two deep layer techniques: multilayer perceptron, and convolutional neural network. We present also the impact of different features in blood glucose level prediction, where we observe that meal has some modest and medication has a good influence on blood glucose level.
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Affiliation(s)
- Benzir Md Ahmed
- Department of Computer Science and Engineering, Bangladesh University of Engineering and Technology, Dhaka, 1000, Bangladesh
- Department of Computer Science and Engineering, United International University, Dhaka, 1212, Bangladesh
| | - Mohammed Eunus Ali
- Department of Computer Science and Engineering, Bangladesh University of Engineering and Technology, Dhaka, 1000, Bangladesh
| | | | | | - Mahmuda Naznin
- Department of Computer Science and Engineering, Bangladesh University of Engineering and Technology, Dhaka, 1000, Bangladesh
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2
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Mujahid O, Contreras I, Beneyto A, Vehi J. Generative deep learning for the development of a type 1 diabetes simulator. Commun Med (Lond) 2024; 4:51. [PMID: 38493243 PMCID: PMC10944502 DOI: 10.1038/s43856-024-00476-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 03/05/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Type 1 diabetes (T1D) simulators, crucial for advancing diabetes treatments, often fall short of capturing the entire complexity of the glucose-insulin system due to the imprecise approximation of the physiological models. This study introduces a simulation approach employing a conditional deep generative model. The aim is to overcome the limitations of existing T1D simulators by synthesizing virtual patients that more accurately represent the entire glucose-insulin system physiology. METHODS Our methodology utilizes a sequence-to-sequence generative adversarial network to simulate virtual T1D patients causally. Causality is embedded in the model by introducing shifted input-output pairs during training, with a 90-min shift capturing the impact of input insulin and carbohydrates on blood glucose. To validate our approach, we train and evaluate the model using three distinct datasets, each consisting of 27, 12, and 10 T1D patients, respectively. In addition, we subject the trained model to further validation for closed-loop therapy, employing a state-of-the-art controller. RESULTS The generated patients display statistical similarity to real patients when evaluated on the time-in-range results for each of the standard blood glucose ranges in T1D management along with means and variability outcomes. When tested for causality, authentic causal links are identified between the insulin, carbohydrates, and blood glucose levels of the virtual patients. The trained generative model demonstrates behaviours that are closer to reality compared to conventional T1D simulators when subjected to closed-loop insulin therapy using a state-of-the-art controller. CONCLUSIONS These results highlight our approach's capability to accurately capture physiological dynamics and establish genuine causal relationships, holding promise for enhancing the development and evaluation of therapies in diabetes.
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Affiliation(s)
- Omer Mujahid
- Modelling, Identification and Control Engineering Laboratory, Institut d'Informatica i Aplicacions, Universitat de Girona, Girona, 17003, Girona, Spain
| | - Ivan Contreras
- Modelling, Identification and Control Engineering Laboratory, Institut d'Informatica i Aplicacions, Universitat de Girona, Girona, 17003, Girona, Spain
| | - Aleix Beneyto
- Modelling, Identification and Control Engineering Laboratory, Institut d'Informatica i Aplicacions, Universitat de Girona, Girona, 17003, Girona, Spain
| | - Josep Vehi
- Modelling, Identification and Control Engineering Laboratory, Institut d'Informatica i Aplicacions, Universitat de Girona, Girona, 17003, Girona, Spain.
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Girona, Spain.
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3
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Yang G, Liu S, Li Y, He L. Short-term prediction method of blood glucose based on temporal multi-head attention mechanism for diabetic patients. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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4
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Afsaneh E, Sharifdini A, Ghazzaghi H, Ghobadi MZ. Recent applications of machine learning and deep learning models in the prediction, diagnosis, and management of diabetes: a comprehensive review. Diabetol Metab Syndr 2022; 14:196. [PMID: 36572938 PMCID: PMC9793536 DOI: 10.1186/s13098-022-00969-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 12/16/2022] [Indexed: 12/28/2022] Open
Abstract
Diabetes as a metabolic illness can be characterized by increased amounts of blood glucose. This abnormal increase can lead to critical detriment to the other organs such as the kidneys, eyes, heart, nerves, and blood vessels. Therefore, its prediction, prognosis, and management are essential to prevent harmful effects and also recommend more useful treatments. For these goals, machine learning algorithms have found considerable attention and have been developed successfully. This review surveys the recently proposed machine learning (ML) and deep learning (DL) models for the objectives mentioned earlier. The reported results disclose that the ML and DL algorithms are promising approaches for controlling blood glucose and diabetes. However, they should be improved and employed in large datasets to affirm their applicability.
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5
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Lin L, Liu K, Feng H, Li J, Chen H, Zhang T, Xue B, Si J. Glucose trajectory prediction by deep learning for personal home care of type 2 diabetes mellitus: modelling and applying. Math Biosci Eng 2022; 19:10096-10107. [PMID: 36031985 DOI: 10.3934/mbe.2022472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Glucose management for people with type 2 diabetes mellitus is essential but challenging due to the multi-factored and chronic disease nature of diabetes. To control glucose levels in a safe range and lessen abnormal glucose variability efficiently and economically, an intelligent prediction of glucose is demanding. A glucose trajectory prediction system based on subcutaneous interstitial continuous glucose monitoring data and deep learning models for ensuing glucose trajectory was constructed, followed by the application of personalised prediction models on one participant with type 2 diabetes in a community. The predictive accuracy was then assessed by RMSE (root mean square error) using blood glucose data. Changes in glycaemic parameters of the participant before and after model intervention were also compared to examine the efficacy of this intelligence-aided health care. Individual Recurrent Neural Network model was developed on glucose data, with an average daily RMSE of 1.59 mmol/L in the application segment. In terms of the glucose variation, the mean glucose decreased by 0.66 mmol/L, and HBGI dropped from 12.99 × 102 to 9.17 × 102. However, the participant also had increased stress, especially in eating and social support. Our research presented a personalised care system for people with diabetes based on deep learning. The intelligence-aided health management system is promising to enhance the outcome of diabetic patients, but further research is also necessary to decrease stress in the intelligence-aided health management and investigate the stress impacts on diabetic patients.
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Affiliation(s)
- Lingmin Lin
- School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
- School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, China
| | - Kailai Liu
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Huan Feng
- School of Medical Humanities, Tianjin Medical University, Tianjin, China
| | - Jing Li
- NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin 300134, China
| | - Hengle Chen
- School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Tao Zhang
- School of Biomedical Engineering and Technology, Tianjin Medical University, Tianjin, China
| | - Boyun Xue
- School of Biomedical Engineering and Technology, Tianjin Medical University, Tianjin, China
| | - Jiarui Si
- School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
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6
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Xu NY, Nguyen KT, DuBord AY, Pickup J, Sherr JL, Teymourian H, Cengiz E, Ginsberg BH, Cobelli C, Ahn D, Bellazzi R, Bequette BW, Gandrud Pickett L, Parks L, Spanakis EK, Masharani U, Akturk HK, Melish JS, Kim S, Kang GE, Klonoff DC. Diabetes Technology Meeting 2021. J Diabetes Sci Technol 2022; 16:1016-1056. [PMID: 35499170 PMCID: PMC9264449 DOI: 10.1177/19322968221090279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Diabetes Technology Society hosted its annual Diabetes Technology Meeting on November 4 to November 6, 2021. This meeting brought together speakers to discuss various developments within the field of diabetes technology. Meeting topics included blood glucose monitoring, continuous glucose monitoring, novel sensors, direct-to-consumer telehealth, metrics for glycemia, software for diabetes, regulation of diabetes technology, diabetes data science, artificial pancreas, novel insulins, insulin delivery, skin trauma, metabesity, precision diabetes, diversity in diabetes technology, use of diabetes technology in pregnancy, and green diabetes. A live demonstration on a mobile app to monitor diabetic foot wounds was presented.
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Affiliation(s)
- Nicole Y. Xu
- Diabetes Technology Society,
Burlingame, CA, USA
| | | | | | | | | | | | - Eda Cengiz
- University of California, San
Francisco, San Francisco, CA, USA
| | | | | | - David Ahn
- Mary & Dick Allen Diabetes Center
at Hoag, Newport Beach, CA, USA
| | | | | | | | - Linda Parks
- University of California, San
Francisco, San Francisco, CA, USA
| | - Elias K. Spanakis
- Baltimore VA Medical Center,
Baltimore, MD, USA
- University of Maryland, Baltimore,
MD, USA
| | - Umesh Masharani
- University of California, San
Francisco, San Francisco, CA, USA
| | - Halis K. Akturk
- Barbara Davis Center for Diabetes,
University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Sarah Kim
- University of California, San
Francisco, San Francisco, CA, USA
| | - Gu Eon Kang
- The University of Texas at Dallas,
Richardson, TX, USA
| | - David C. Klonoff
- Diabetes Research Institute,
Mills-Peninsula Medical Center, San Mateo, CA, USA
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7
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Katsarou DN, Georga EI, Christou M, Tigas S, Papaloukas C, Fotiadis DI. Short Term Glucose Prediction in Patients with Type 1 Diabetes Mellitus. Annu Int Conf IEEE Eng Med Biol Soc 2022; 2022:329-332. [PMID: 36085667 DOI: 10.1109/embc48229.2022.9870889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Glucose prediction is used in diabetes self-management as it allows to take suitable actions for proper glycemic regulation of the patient. The aim of this work is the short-term personalized glucose prediction in patients with Type 1 diabetes mellitus (T1DM). In this scope, we compared two different models, an autoregressive moving average (ARMA) model and a long short-term memory (LSTM) model for different prediction horizons. The comparison of two models was performed using the evaluation metrics of root mean square error (RMSE) and mean absolute error (MAE). The models were trained and tested in 29 real patients. The results shown that the LSTM model had better performance than ARMA with RMSE 3.13, 6.41 and 8.81 mg/dL and MAE 1.98, 5.06 and 6.47 mg/dL for 5-, 15- and 30-minutes prediction horizon.
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8
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Yu X, Yang T, Lu J, Shen Y, Lu W, Zhu W, Bao Y, Li H, Zhou J. Deep transfer learning: a novel glucose prediction framework for new subjects with type 2 diabetes. COMPLEX INTELL SYST 2022; 8:1875-87. [DOI: 10.1007/s40747-021-00360-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AbstractBlood glucose (BG) prediction is an effective approach to avoid hyper- and hypoglycemia, and achieve intelligent glucose management for patients with type 1 or serious type 2 diabetes. Recent studies have tended to adopt deep learning networks to obtain improved prediction models and more accurate prediction results, which have often required significant quantities of historical continuous glucose-monitoring (CGM) data. However, for new patients with limited historical dataset, it becomes difficult to establish an acceptable deep learning network for glucose prediction. Consequently, the goal of this study was to design a novel prediction framework with instance-based and network-based deep transfer learning for cross-subject glucose prediction based on segmented CGM time series. Taking the effects of biodiversity into consideration, dynamic time warping (DTW) was applied to determine the proper source domain dataset that shared the greatest degree of similarity for new subjects. After that, a network-based deep transfer learning method was designed with cross-domain dataset to obtain a personalized model combined with improved generalization capability. In a case study, the clinical dataset demonstrated that, with additional segmented dataset from other subjects, the proposed deep transfer learning framework achieved more accurate glucose predictions for new subjects with type 2 diabetes.
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9
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Tsichlaki S, Koumakis L, Tsiknakis M. A Systematic Review of T1D Hypoglycemia Prediction Algorithms (Preprint). JMIR Diabetes 2021; 7:e34699. [PMID: 35862181 PMCID: PMC9353679 DOI: 10.2196/34699] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 04/02/2022] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Stella Tsichlaki
- Department of Electrical & Computer Engineering, Hellenic Mediterranean University, Heraklion, Greece
| | - Lefteris Koumakis
- Institute of Computer Science, Foundation for Research and Technology-Hellas, Heraklion, Greece
| | - Manolis Tsiknakis
- Department of Electrical & Computer Engineering, Hellenic Mediterranean University, Heraklion, Greece
- Institute of Computer Science, Foundation for Research and Technology-Hellas, Heraklion, Greece
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10
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Tena F, Garnica O, Lanchares J, Hidalgo JI. Ensemble Models of Cutting-Edge Deep Neural Networks for Blood Glucose Prediction in Patients with Diabetes. Sensors (Basel) 2021; 21:7090. [PMID: 34770397 PMCID: PMC8588394 DOI: 10.3390/s21217090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/15/2021] [Accepted: 10/20/2021] [Indexed: 12/21/2022]
Abstract
This article proposes two ensemble neural network-based models for blood glucose prediction at three different prediction horizons-30, 60, and 120 min-and compares their performance with ten recently proposed neural networks. The twelve models' performances are evaluated under the same OhioT1DM Dataset, preprocessing workflow, and tools at the three prediction horizons using the most common metrics in blood glucose prediction, and we rank the best-performing ones using three methods devised for the statistical comparison of the performance of multiple algorithms: scmamp, model confidence set, and superior predictive ability. Our analysis provides a comparison of the state-of-the-art neural networks for blood glucose prediction, estimating the model's error, highlighting those with the highest probability of being the best predictors, and providing a guide for their use in clinical practice.
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Affiliation(s)
- Félix Tena
- Department of Computer Architecture, Facultad de Informática, Universidad Complutense de Madrid, 28040 Madrid, Spain; (F.T.); (O.G.); (J.L.)
| | - Oscar Garnica
- Department of Computer Architecture, Facultad de Informática, Universidad Complutense de Madrid, 28040 Madrid, Spain; (F.T.); (O.G.); (J.L.)
| | - Juan Lanchares
- Department of Computer Architecture, Facultad de Informática, Universidad Complutense de Madrid, 28040 Madrid, Spain; (F.T.); (O.G.); (J.L.)
| | - Jose Ignacio Hidalgo
- Department of Computer Architecture, Facultad de Informática, Universidad Complutense de Madrid, 28040 Madrid, Spain; (F.T.); (O.G.); (J.L.)
- Instituto de Tecnología del Conocimiento, Universidad Complutense de Madrid, 28040 Madrid, Spain
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11
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Li L, Xie X, Yang J. A predictive model incorporating the change detection and Winsorization methods for alerting hypoglycemia and hyperglycemia. Med Biol Eng Comput 2021; 59:2311-24. [PMID: 34591245 DOI: 10.1007/s11517-021-02433-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 08/18/2021] [Indexed: 10/20/2022]
Abstract
This paper focuses on establishing an effective predictive model to quickly and accurately alert hypoglycemia and hyperglycemia for helping control blood glucose levels of people with diabetes. In general, a good predictive model is established on the features of data. Inspired by this, we first analyze the characteristics of continuous glucose monitoring (CGM) data by the equality of variances test and outlier detection, which show time-varying fluctuations and jump points in CGM data. Therefore, we incorporate the change detection method and the Winsorization method into the predictive model based on the autoregressive moving average (ARMA) model and the recursive least squares (RLS) method to fit the above characteristics. To the best of our knowledge, the proposed method is the first attempt to give a solution for matching the time-varying fluctuations and jump points of CGM data simultaneously. A case study using CGM data is given to validate the effectiveness of the proposed method under 30-min-ahead prediction. The results show that the proposed method can improve the true alarm ratio of hypoglycemia and hyperglycemia from 0.7983 to 0.8783, and lengthen the average advance detection time of hypoglycemia and hyperglycemia from 19.77 to 22.64 min.
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12
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R A, R N. Diabetes Mellitus Prediction and Severity Level Estimation Using OWDANN Algorithm. Comput Intell Neurosci 2021; 2021:5573179. [PMID: 34462631 PMCID: PMC8403056 DOI: 10.1155/2021/5573179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 08/10/2021] [Indexed: 11/19/2022]
Abstract
Today, diabetes is one of the most prevalent, chronic, and deadly diseases in the world owing to some complications. If accurate early diagnosis is feasible, the risk factor and incidence of diabetes may be greatly decreased. Diabetes prediction is stable and reliable, since there are only minimal labelling evidence and outliers found in the datasets of diabetes. Numerous works coped with diabetes disease prediction and provided the solution. But the existing methods proffered low accuracy detection and consumed more training time. So, this paper proposed an OWDANN algorithm for diabetes mellitus disease prediction and severity level estimation. The proposed system mainly consists of two phases, namely, disease prediction and severity level estimation phase. In the disease prediction phase, the preprocessing is performed for the Pima dataset. Then, the features are extracted from the preprocessed data, and finally, the classification step is performed by using OWDANN. In the severity level estimation phase, the diabetes positive dataset is preprocessed first. Then, the features are extracted, and lastly, the severity level is predicted using GDHC. The extensive experimental results showed that the proposed system outperforms with 98.97% accuracy, 94.98% sensitivity, 95.62% specificity, 97.02% precision, 93.84% recall, 9404% f-measure, 0.094% FDR, and 0.023% FPR compared with the state-of-the-art methods.
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Affiliation(s)
- Annamalai R
- Department of Information Technology, Jeppiaar Institute of Technology, Kanchipuram 631604, India
| | - Nedunchelian R
- Department of Computer Science and Engineering, Excel Engineering College, Namakkal 637303, India
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13
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Martínez-Delgado L, Munoz-Organero M, Queipo-Alvarez P. Using Absorption Models for Insulin and Carbohydrates and Deep Leaning to Improve Glucose Level Predictions. Sensors (Basel) 2021; 21:5273. [PMID: 34450712 DOI: 10.3390/s21165273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/28/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022]
Abstract
Diabetes is a chronic disease caused by the inability of the pancreas to produce insulin or problems in the body to use it efficiently. It is one of the fastest growing health challenges affecting more than 400 million people worldwide, according to the World Health Organization. Intensive research is being carried out on artificial intelligence methods to help people with diabetes to optimize the way in which they use insulin, carbohydrate intakes, or physical activity. By predicting upcoming levels of blood glucose concentrations, preventive actions can be taken. Previous research studies using machine learning methods for blood glucose level predictions have mainly focused on the machine learning model used. Little attention has been given to the pre-processing of insulin and carbohydrate signals in order to mimic the human absorption processes. In this manuscript, a recurrent neural network (RNN) based model for predicting upcoming blood glucose levels in people with type 1 diabetes is combined with several carbohydrate and insulin absorption curves in order to optimize the prediction results. The proposed method is applied to data from real patients suffering type 1 diabetes mellitus (T1DM). The achieved results are encouraging, obtaining accuracy levels around 0.510 mmol/L (9.2 mg/dl) in the best scenario.
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14
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Muñoz-Organero M, Queipo-Álvarez P, García Gutiérrez B. Learning Carbohydrate Digestion and Insulin Absorption Curves Using Blood Glucose Level Prediction and Deep Learning Models. Sensors (Basel) 2021; 21:4926. [PMID: 34300672 PMCID: PMC8309907 DOI: 10.3390/s21144926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/14/2021] [Accepted: 07/17/2021] [Indexed: 11/16/2022]
Abstract
Type 1 diabetes is a chronic disease caused by the inability of the pancreas to produce insulin. Patients suffering type 1 diabetes depend on the appropriate estimation of the units of insulin they have to use in order to keep blood glucose levels in range (considering the calories taken and the physical exercise carried out). In recent years, machine learning models have been developed in order to help type 1 diabetes patients with their blood glucose control. These models tend to receive the insulin units used and the carbohydrate taken as inputs and generate optimal estimations for future blood glucose levels over a prediction horizon. The body glucose kinetics is a complex user-dependent process, and learning patient-specific blood glucose patterns from insulin units and carbohydrate content is a difficult task even for deep learning-based models. This paper proposes a novel mechanism to increase the accuracy of blood glucose predictions from deep learning models based on the estimation of carbohydrate digestion and insulin absorption curves for a particular patient. This manuscript proposes a method to estimate absorption curves by using a simplified model with two parameters which are fitted to each patient by using a genetic algorithm. Using simulated data, the results show the ability of the proposed model to estimate absorption curves with mean absolute errors below 0.1 for normalized fast insulin curves having a maximum value of 1 unit.
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Affiliation(s)
- Mario Muñoz-Organero
- Department of Telematic Engineering, Universidad Carlos III de Madrid, Leganés, 28911 Madrid, Spain; (P.Q.-Á.); (B.G.G.)
- UC3M-BS Institute of Financial Big Data, Universidad Carlos III de Madrid, Leganés, 28911 Madrid, Spain
| | - Paula Queipo-Álvarez
- Department of Telematic Engineering, Universidad Carlos III de Madrid, Leganés, 28911 Madrid, Spain; (P.Q.-Á.); (B.G.G.)
| | - Boni García Gutiérrez
- Department of Telematic Engineering, Universidad Carlos III de Madrid, Leganés, 28911 Madrid, Spain; (P.Q.-Á.); (B.G.G.)
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15
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Dave D, Erraguntla M, Lawley M, DeSalvo D, Haridas B, McKay S, Koh C. Improved Low-Glucose Predictive Alerts Based on Sustained Hypoglycemia: Model Development and Validation Study. JMIR Diabetes 2021; 6:e26909. [PMID: 33913816 PMCID: PMC8120423 DOI: 10.2196/26909] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 03/09/2021] [Accepted: 03/17/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Predictive alerts for impending hypoglycemic events enable persons with type 1 diabetes to take preventive actions and avoid serious consequences. OBJECTIVE This study aimed to develop a prediction model for hypoglycemic events with a low false alert rate, high sensitivity and specificity, and good generalizability to new patients and time periods. METHODS Performance improvement by focusing on sustained hypoglycemic events, defined as glucose values less than 70 mg/dL for at least 15 minutes, was explored. Two different modeling approaches were considered: (1) a classification-based method to directly predict sustained hypoglycemic events, and (2) a regression-based prediction of glucose at multiple time points in the prediction horizon and subsequent inference of sustained hypoglycemia. To address the generalizability and robustness of the model, two different validation mechanisms were considered: (1) patient-based validation (model performance was evaluated on new patients), and (2) time-based validation (model performance was evaluated on new time periods). RESULTS This study utilized data from 110 patients over 30-90 days comprising 1.6 million continuous glucose monitoring values under normal living conditions. The model accurately predicted sustained events with >97% sensitivity and specificity for both 30- and 60-minute prediction horizons. The false alert rate was kept to <25%. The results were consistent across patient- and time-based validation strategies. CONCLUSIONS Providing alerts focused on sustained events instead of all hypoglycemic events reduces the false alert rate and improves sensitivity and specificity. It also results in models that have better generalizability to new patients and time periods.
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Affiliation(s)
- Darpit Dave
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
| | - Madhav Erraguntla
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
| | - Mark Lawley
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
| | - Daniel DeSalvo
- Department of Pediatrics, Baylor College of Medicine / Texas Children's Hospital, Houston, TX, United States
| | - Balakrishna Haridas
- Department of Biomedical Engineering, Texas A&M University, College Station, TX, United States
| | - Siripoom McKay
- Department of Pediatrics, Baylor College of Medicine / Texas Children's Hospital, Houston, TX, United States
| | - Chester Koh
- Division of Pediatric Urology, Texas Children's Hospital, Houston, TX, United States
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, United States
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