Deep learning framework for detection of hypoglycemic episodes in children with type 1 diabetes

© 2016 IEEE. Most Type 1 diabetes mellitus (T1DM) patients have hypoglycemia problem. Low blood glucose, also known as hypoglycemia, can be a dangerous and can result in unconsciousness, seizures and even death. In recent studies, heart rate (HR) and correct QT interval (QTc) of the electrocardiogram (ECG) signal are found as the most common physiological parameters to be effected from hypoglycemic reaction. In this paper, a state-of-the-art intelligent technology namely deep belief network (DBN) is developed as an intelligent diagnostics system to recognize the onset of hypoglycemia. The proposed DBN provides a superior classification performance with feature transformation on either processed or un-processed data. To illustrate the effectiveness of the proposed hypoglycemia detection system, 15 children with Type 1 diabetes were volunteered overnight. Comparing with several existing methodologies, the experimental results showed that the proposed DBN outperformed and achieved better classification performance

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

EDMON - Electronic Disease Surveillance and Monitoring Network: A Personalized Health Model-based Digital Infectious Disease Detection Mechanism using Self-Recorded Data from People with Type 1 Diabetes

Through time, we as a society have been tested with infectious disease outbreaks of different magnitude, which often pose major public health challenges. To mitigate the challenges, research endeavors have been focused on early detection mechanisms through identifying potential data sources, mode of data collection and transmission, case and outbreak detection methods. Driven by the ubiquitous nature of smartphones and wearables, the current endeavor is targeted towards individualizing the surveillance effort through a personalized health model, where the case detection is realized by exploiting self-collected physiological data from wearables and smartphones. This dissertation aims to demonstrate the concept of a personalized health model as a case detector for outbreak detection by utilizing self-recorded data from people with type 1 diabetes. The results have shown that infection onset triggers substantial deviations, i.e. prolonged hyperglycemia regardless of higher insulin injections and fewer carbohydrate consumptions. Per the findings, key parameters such as blood glucose level, insulin, carbohydrate, and insulin-to-carbohydrate ratio are found to carry high discriminative power. A personalized health model devised based on a one-class classifier and unsupervised method using selected parameters achieved promising detection performance. Experimental results show the superior performance of the one-class classifier and, models such as one-class support vector machine, k-nearest neighbor and, k-means achieved better performance. Further, the result also revealed the effect of input parameters, data granularity, and sample sizes on model performances. The presented results have practical significance for understanding the effect of infection episodes amongst people with type 1 diabetes, and the potential of a personalized health model in outbreak detection settings. The added benefit of the personalized health model concept introduced in this dissertation lies in its usefulness beyond the surveillance purpose, i.e. to devise decision support tools and learning platforms for the patient to manage infection-induced crises

INDEPENDENT HEROES: Supporting Type 1 Diabetic Young Adults’ Transition to Independent Living

This Master of Design Thesis project focuses on the condition of severe hypoglycemia (low blood sugar) in young adults living with type 1 diabetes by carefully understanding the unique challenges they face in transitioning to adult care. This research surfaces the needs that often get blurred in the transition process and offers a design for an appropriate solution to support the identified issues. Canadian young adults living with type 1 diabetes often find themselves at the risk of hypoglycemia during emerging adulthood. The concept of emerging adulthood has not been considered extensively in managing chronic illness and transition from pediatric to adult care. Yet, this is a critical time when a person may first assume full responsibility for their diabetes self-care while simultaneously facing all the usual challenges young adults face. Additionally, the fear of hypoglycemia is strongest in this group. A review of the literature informs us about previous work done in this field. However, most current interventions are in the form of bulky printed materials. Another critical issue with the development of most recent tools is the absence of user involvement in the creative process leading to unmet user needs. In this project, participatory design methodologies were introduced in a human-centered approach, collaborating with young adults to understand and address the transition process gap. It included actively listening to user narratives and co-creating the solution. The synthesis of primary and secondary research resulted in the designed outcome of a smart wearable device that will work in conjunction with the Continuous glucose monitor (CGM) and alerts the bystander and emergency contacts by turning them into potential lifesavers. It will inform them of a diabetic emergency and guide them through the life-saving instructions. Additionally, it will alert the medical emergency services for prompt assistance if needed. The solution attempts to provide early intervention during emergency and could also alleviate the fear of hypoglycemia in young adults. This in turn will reduce the load on the already burdened healthcare system

Disease diagnosis in smart healthcare: Innovation, technologies and applications

To promote sustainable development, the smart city implies a global vision that merges artificial intelligence, big data, decision making, information and communication technology (ICT), and the internet-of-things (IoT). The ageing issue is an aspect that researchers, companies and government should devote efforts in developing smart healthcare innovative technology and applications. In this paper, the topic of disease diagnosis in smart healthcare is reviewed. Typical emerging optimization algorithms and machine learning algorithms are summarized. Evolutionary optimization, stochastic optimization and combinatorial optimization are covered. Owning to the fact that there are plenty of applications in healthcare, four applications in the field of diseases diagnosis (which also list in the top 10 causes of global death in 2015), namely cardiovascular diseases, diabetes mellitus, Alzheimer’s disease and other forms of dementia, and tuberculosis, are considered. In addition, challenges in the deployment of disease diagnosis in healthcare have been discussed

Wearable continuous glucose monitoring sensors: A revolution in diabetes treatment

Worldwide, the number of people affected by diabetes is rapidly increasing due to aging populations and sedentary lifestyles, with the prospect of exceeding 500 million cases in 2030, resulting in one of the most challenging socio-health emergencies of the third millennium. Daily management of diabetes by patients relies on the capability of correctly measuring glucose concentration levels in the blood by using suitable sensors. In recent years, glucose monitoring has been revolutionized by the development of Continuous Glucose Monitoring (CGM) sensors, wearable non/minimally-invasive devices that measure glucose concentration by exploiting different physical principles, e.g., glucose-oxidase, fluorescence, or skin dielectric properties, and provide real-time measurements every 1–5 min. CGM opened new challenges in different disciplines, e.g., medicine, physics, electronics, chemistry, ergonomics, data/signal processing, and software development to mention but a few. This paper first makes an overview of wearable CGM sensor technologies, covering both commercial devices and research prototypes. Then, the role of CGM in the actual evolution of decision support systems for diabetes therapy is discussed. Finally, the paper presents new possible horizons for wearable CGM sensor applications and perspectives in terms of big data analytics for personalized and proactive medicine

The Quality Application of Deep Learning in Clinical Outcome Predictions Using Electronic Health Record Data: A Systematic Review

Introduction: Electronic Health Record (EHR) is a significant source of medical data that can be used to develop predictive modelling with therapeutically useful outcomes. Predictive modelling using EHR data has been increasingly utilized in healthcare, achieving outstanding performance and improving healthcare outcomes. Objectives: The main goal of this review study is to examine different deep learning approaches and techniques used to EHR data processing. Methods: To find possibly pertinent articles that have used deep learning on EHR data, the PubMed database was searched. Using EHR data, we assessed and summarized deep learning performance in a number of clinical applications that focus on making specific predictions about clinical outcomes, and we compared the outcomes with those of conventional machine learning models. Results: For this study, a total of 57 papers were chosen. There have been five identified clinical outcome predictions: illness (n=33), intervention (n=6), mortality (n=5), Hospital readmission (n=7), and duration of stay (n=1). The majority of research (39 out of 57) used structured EHR data. RNNs were used as deep learning models the most frequently (LSTM: 17 studies, GRU: 6 research). The analysis shows that deep learning models have excelled when applied to a variety of clinical outcome predictions. While deep learning's application to EHR data has advanced rapidly, it's crucial that these models remain reliable, offering critical insights to assist clinicians in making informed decision. Conclusions: The findings demonstrate that deep learning can outperform classic machine learning techniques since it has the advantage of utilizing extensive and sophisticated datasets, such as longitudinal data seen in EHR. We think that deep learning will keep expanding because it has been quite successful in enhancing healthcare outcomes utilizing EHR data

MyDi application: Towards automatic activity annotation of young patients with Type 1 diabetes

Type I diabetes mellitus (T1DM) is a widespread metabolic disorder characterized by pancreatic insufficiency. People with T1DM require: a lifelong insulin injection, to constantly monitor glycemia and to take note of their activities. This continuous follow-up, especially at a very young age, may be challenging. Adolescents with T1DM may develop anxiety symptoms and depression which can lead to the loss of glycemic control. An assistive technology that automatizes the activity monitoring process could support these young patient in managing T1DM. The aim of this work is to present the MyDi framework which integrates a smart glycemic diary (for Android users), to automatically record and store patient's activity via pictures and a deep-learning (DL)-based technology able to classify the activity performed by the patients (i.e., meal and sport) via picture analysis. The proposed approach was tested on two different datasets, the Insta-Dataset with 3498 pictures (also used for training and validating the DL model) and the MyDi-Dataset with 126 pictures, achieving very encouraging results in both cases (Preci= 1.0, Reci= 1.0, f1i= 1.0 with i E C:[meal, sport]) prompting the possibility of translating this application in the T1DM monitoring process

Multi-modal Predictive Models of Diabetes Progression

With the increasing availability of wearable devices, continuous monitoring of individuals' physiological and behavioral patterns has become significantly more accessible. Access to these continuous patterns about individuals' statuses offers an unprecedented opportunity for studying complex diseases and health conditions such as type 2 diabetes (T2D). T2D is a widely common chronic disease that its roots and progression patterns are not fully understood. Predicting the progression of T2D can inform timely and more effective interventions to prevent or manage the disease. In this study, we have used a dataset related to 63 patients with T2D that includes the data from two different types of wearable devices worn by the patients: continuous glucose monitoring (CGM) devices and activity trackers (ActiGraphs). Using this dataset, we created a model for predicting the levels of four major biomarkers related to T2D after a one-year period. We developed a wide and deep neural network and used the data from the demographic information, lab tests, and wearable sensors to create the model. The deep part of our method was developed based on the long short-term memory (LSTM) structure to process the time-series dataset collected by the wearables. In predicting the patterns of the four biomarkers, we have obtained a root mean square error of 1.67% for HBA1c, 6.22 mg/dl for HDL cholesterol, 10.46 mg/dl for LDL cholesterol, and 18.38 mg/dl for Triglyceride. Compared to existing models for studying T2D, our model offers a more comprehensive tool for combining a large variety of factors that contribute to the disease