Background: Novel technologies like continuous glucose monitor (CGM) systems are improving diabetes management by means of real-time sensor glucose levels, retrospective course of glucose and trend arrows. Continuous Glucose Monitoring (CGM) offers real-time alerts for (prognostic) hypo- and hyperglycemia, fast dropping or increasing glucose, and hence improving glycaemia under unstable conditions like during meals, physical activity and exercise management. Complex CGM systems challenge people with diabetes and health care professionals in interpreting rapid changes, sensor delay (~10-minute difference between interstitial and plasma glucose), and malfunctions. Enhanced prediction models are necessary for optimal insulin dosing, daily activities, and especially for future fully closed-loop systems.
Methods: The aim of this study was to investigate the efficacy of three different predictive models for glucose responses: 1) an autoregressive integrated moving average model (ARIMA), 2) logistic regression, 3)and long short-term memory networks (LSTM), in predicting glucose levels after 15 minutes and one hour. We compared and evaluated the performance of these models in predicting hypoglycemia (<70 mg/dL), euglycemia (70-180 mg/dL), and hyperglycemia (>180 mg/dL). In more detail, by assessing metrics such as precision, recall, F1-score, and accuracy, we specifically assessed which model provided the most accurate and reliable predictions for glucose levels
Results: As expected, ARIMA showed the worst accuracy especially predicting hypoglycaemia withing 1-hour (7.3%). The accuracy of the logistic regression model, predicting hypoglycemia during the first 15 min was higher (98%), comparing to LSTM (88%). However, the LSTM model (87%) exceeded the accuracy of hypoglycemia prediction of the logistic regression (83%) during an hour prognosis. The same pattern observed in hyperglycemia - ARIMA model (60%, 1 hour), logistic regression (96%, 15 minutes) and LSTM (85%, 1 hour)
Conclusions: These findings suggest that different models may have varying strengths and weaknesses in predicting glucose levels, and the choice of model should be carefully considered based on the specific requirements and context of the clinical application. The logistic regression model was more accurate for the next 15 minutes, especially predicting hypoglycemia. However, the LSTM model exceeded logistic regression for the next one hour prediction. Future research could explore hybrid models or ensemble approaches that combine the strengths of multiple models to further improve the accuracy and reliability of glucose predictions.
Medicine and Pharmacology, Endocrinology and Metabolism
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
,
