Predicting Blood Glucose with an LSTM and Bi-LSTM Based Deep Neural Network

A deep learning network was used to predict future blood glucose levels, as this can permit diabetes patients to take action before imminent hyperglycaemia and hypoglycaemia. A sequential model with one long-short-term memory (LSTM) layer, one bidirectional LSTM layer and several fully connected layers was used to predict blood glucose levels for different prediction horizons. The method was trained and tested on 26 datasets from 20 real patients. The proposed network outperforms the baseline methods in terms of all evaluation criteria.Comment: 5 pages, submitted to 2018 14th Symposium on Neural Networks and Applications (NEUREL

Precision medicine and artificial intelligence : a pilot study on deep learning for hypoglycemic events detection based on ECG

Tracking the fluctuations in blood glucose levels is important for healthy subjects and crucial diabetic patients. Tight glucose monitoring reduces the risk of hypoglycemia, which can result in a series of complications, especially in diabetic patients, such as confusion, irritability, seizure and can even be fatal in specific conditions. Hypoglycemia affects the electrophysiology of the heart. However, due to strong inter-subject heterogeneity, previous studies based on a cohort of subjects failed to deploy electrocardiogram (ECG)-based hypoglycemic detection systems reliably. The current study used personalised medicine approach and Artificial Intelligence (AI) to automatically detect nocturnal hypoglycemia using a few heartbeats of raw ECG signal recorded with non-invasive, wearable devices, in healthy individuals, monitored 24 hours for 14 consecutive days. Additionally, we present a visualisation method enabling clinicians to visualise which part of the ECG signal (e.g., T-wave, ST-interval) is significantly associated with the hypoglycemic event in each subject, overcoming the intelligibility problem of deep-learning methods. These results advance the feasibility of a real-time, non-invasive hypoglycemia alarming system using short excerpts of ECG signal

Precision medicine and artificial intelligence : a pilot study on deep learning for hypoglycemic events detection based on ECG

Tracking the fluctuations in blood glucose levels is important for healthy subjects and crucial diabetic patients. Tight glucose monitoring reduces the risk of hypoglycemia, which can result in a series of complications, especially in diabetic patients, such as confusion, irritability, seizure and can even be fatal in specific conditions. Hypoglycemia affects the electrophysiology of the heart. However, due to strong inter-subject heterogeneity, previous studies based on a cohort of subjects failed to deploy electrocardiogram (ECG)-based hypoglycemic detection systems reliably. The current study used personalised medicine approach and Artificial Intelligence (AI) to automatically detect nocturnal hypoglycemia using a few heartbeats of raw ECG signal recorded with non-invasive, wearable devices, in healthy individuals, monitored 24 hours for 14 consecutive days. Additionally, we present a visualisation method enabling clinicians to visualise which part of the ECG signal (e.g., T-wave, ST-interval) is significantly associated with the hypoglycemic event in each subject, overcoming the intelligibility problem of deep-learning methods. These results advance the feasibility of a real-time, non-invasive hypoglycemia alarming system using short excerpts of ECG signal

Prediction-Coherent LSTM-based Recurrent Neural Network for Safer Glucose Predictions in Diabetic People

In the context of time-series forecasting, we propose a LSTM-based recurrent neural network architecture and loss function that enhance the stability of the predictions. In particular, the loss function penalizes the model, not only on the prediction error (mean-squared error), but also on the predicted variation error. We apply this idea to the prediction of future glucose values in diabetes, which is a delicate task as unstable predictions can leave the patient in doubt and make him/her take the wrong action, threatening his/her life. The study is conducted on type 1 and type 2 diabetic people, with a focus on predictions made 30-minutes ahead of time. First, we confirm the superiority, in the context of glucose prediction, of the LSTM model by comparing it to other state-of-the-art models (Extreme Learning Machine, Gaussian Process regressor, Support Vector Regressor). Then, we show the importance of making stable predictions by smoothing the predictions made by the models, resulting in an overall improvement of the clinical acceptability of the models at the cost in a slight loss in prediction accuracy. Finally, we show that the proposed approach, outperforms all baseline results. More precisely, it trades a loss of 4.3\% in the prediction accuracy for an improvement of the clinical acceptability of 27.1\%. When compared to the moving average post-processing method, we show that the trade-off is more efficient with our approach

Artificial neural network algorithm for online glucose prediction from continuous glucose monitoring.

Background and Aims: Continuous glucose monitoring (CGM) devices could be useful for real-time management of diabetes therapy. In particular, CGM information could be used in real time to predict future glucose levels in order to prevent hypo-/hyperglycemic events. This article proposes a new online method for predicting future glucose concentration levels from CGM data. Methods: The predictor is implemented with an artificial neural network model (NNM). The inputs of the NNM are the values provided by the CGM sensor during the preceding 20 min, while the output is the prediction of glucose concentration at the chosen prediction horizon (PH) time. The method performance is assessed using datasets from two different CGM systems (nine subjects using the Medtronic [Northridge, CA] Guardian® and six subjects using the Abbott [Abbott Park, IL] Navigator®). Three different PHs are used: 15, 30, and 45 min. The NNM accuracy has been estimated by using the root mean square error (RMSE) and prediction delay. Results: The RMSE is around 10, 18, and 27 mg/dL for 15, 30, and 45 min of PH, respectively. The prediction delay is around 4, 9, and 14 min for upward trends and 5, 15, and 26 min for downward trends, respectively. A comparison with a previously published technique, based on an autoregressive model (ARM), has been performed. The comparison shows that the proposed NNM is more accurate than the ARM, with no significant deterioration in the prediction delay

Blood Glucose Forecasting using LSTM Variants under the Context of Open Source Artificial Pancreas System

High accuracy of blood glucose prediction over the long term is essential for preventative diabetes management. The emerging closed-loop insulin delivery system such as the artificial pancreas system (APS) provides opportunities for improved glycaemic control for patients with type 1 diabetes. Existing blood glucose studies are proven effective only within 30 minutes but the accuracy deteriorates drastically when the prediction horizon increases to 45 minutes and 60 minutes. Deep learning, especially for long short term memory (LSTM) and its variants have recently been applied in various areas to achieve state-of-the-art results in tasks with complex time series data. In this study, we present deep LSTM based models that are capable of forecasting long term blood glucose levels with improved prediction and clinical accuracy. We evaluate our approach using 20 cases(878,000 glucose values) from Open Source Artificial Pancreas System (OpenAPS). On 30-minutes and 45-minutes prediction, our Stacked-LSTM achieved the best performance with Root-Mean-Square-Error (RMSE) marks 11.96 & 15.81 and Clark-Grid-ZoneA marks 0.887 & 0.784. In terms of 60-minutes prediction, our ConvLSTM has the best performance with RMSE = 19.6 and Clark-Grid-ZoneA=0.714. Our models outperform existing methods in both prediction and clinical accuracy. This research can hopefully support patients with type 1 diabetes to better manage their behavior in a more preventative way and can be used in future real APS context

Investigating the Impact of Multiple Inputs on Predicting Glucose Level in Individuals with Type-1 Diabetes through Deep Learning Technique

Type-1 Diabetes is a chronic auto-immune disorder featured by the disability of human body to produce insulin, an enzyme helps to digest carbohydrates. Insulin works with the take-up of glucose from the circulatory system into cells. Without sufficient insulin, glucose aggregates in the blood, prompting hyperglycemia. Uncontrolled hyperglycemia, whenever left untreated, can bring about dangerous intricacies, which can harm the vital organs. Managing type-1 diabetes presents huge difficulties for impacted people, as it requires a sensitive equilibrium of insulin administration, sugar consumption, active work, and cautious observing of blood glucose levels. Despite the progress made in type-I diabetes management, challenges persist. Achieving optimal blood glucose control remains elusive for many individuals. Understanding the complex interplay between these variables and their impact on blood glucose regulation is vital for emerging more effective treatment strategies. Accurate and timely prediction of glucose level plays a critical role in the effective management of diabetes. Through this paper we aim at investigating the impact of multiple inputs on forecasting of glucose level in individuals with type-1 diabetes by means of deep learning techniques.  In our paper, we use the Long-Short-Term-Memory (LSTM) network to study the forthcoming blood glucose pattern when various combinations if inputs, previous blood glucose reading, insulin administrated and carbohydrate intake are provided as inputs. We used the ShanghaiT1DM dataset for the study

Data Driven Patient-Specialized Neural Networks for Blood Glucose Prediction

Diabetes is an autoimmune disease characterized by glucose levels dysfunctions. It involves continuous monitoring combined with insulin treatment. Nowadays, continuous glucose monitoring systems (CGMs) have led to a greater availability of data. These can be effectively used by machine learning techniques to infer future values of the glycaemic concentration, allowing the early prevention of dangerous states and a better optimisation of the diabetic treatment. In this work, we investigate a patient-specialized prediction model. Thus, we designed a specialized solution based on Long Short-Term Memory (LSTM) neural network. Our solution was experimentally compared with two literature approaches, respectively based on Feed-Forward (FNN) and Recurrent (RNN) neural networks. The experimental results have highlighted that our LSTM solution obtained good performance both for short- and long-term glucose level inference (60 min.), overcoming the other methods both in terms of correlation between measured and predicted glucose signal and in terms of clinical outcome