Real-time adaptive models for the personalized prediction of glycemic profile in type 1 diabetes patients

Prediction of glycemic profile is an important task for both early recognition of hypoglycemia and enhancement of the control algorithms for optimization of insulin infusion rate. Adaptive models for glucose prediction and recognition of hypoglycemia based on statistical and artificial intelligence techniques are presented.

We compared an autoregressive (AR) model using only glucose information, an AR model with external insulin input (ARX), and an artificial neural network (ANN) using both glucose and insulin information. Online adaptive models were used to account for the intra- and inter-subject variability of the population with diabetes. The evaluation of the predictive ability included prediction horizons (PHs) of 30 min and 45 min.

The AR model presented root mean square error (RMSE) values of 14.0-21.6 mg/dL and correlation coefficients (CCs) of 0.92-0.95 for PH=30 min and 23.2-35.9 mg/dL and 0.79-0.87, respectively, for PH=45 min. The respective values for the ARX models were slightly better (PH=30 min, 13.3-18.8 mg/dL and 0.94-0.96; PH=45 min, 22.8-29.4 mg/dL and 0.83-0.88). For the ANN, the RMSE values ranged from 2.8 to 6.3 mg/dL, and the CC was 0.99 for all cases and PHs. The sensitivity of hypoglycemia prediction was 78% for AR, 81% for ARX, and 96% for ANN for PH=30 min and 65%, 67%, and 95%, respectively, for PH=45 min. The corresponding specificities were 96%, 96%, and 99% for PH=30 min and 93%, 93%, and 99% for PH=45 min.

The ANN appears to be more appropriate for the prediction of glucose profile based on glucose and insulin data.