Abstract: We utilize dynamical modes as features derived from Continuous Glucose Monitoring (CGM) data to detect meal events. By leveraging the inherent properties of underlying dynamics, these modes capture key aspects of glucose variability, enabling the identification of patterns and anomalies associated with meal consumption. This approach not only improves the accuracy of meal detection but also enhances the interpretability of the underlying glucose dynamics. By focusing on dynamical features, our method provides a robust framework for feature extraction, facilitating generalization across diverse datasets and ensuring reliable performance in real-world applications. The proposed technique offers significant advantages over traditional approaches, improving detection accuracy, detection delay, and system robustness.

While previous studies of AI in diabetes management focus on long-term risk, research on near-future glucose prediction remains limited but important as it enables timely diabetes self-management. Integrating AI with continuous glucose monitoring (CGM) holds promise for near-future glucose prediction. However, existing models have limitations in capturing patterns of blood glucose fluctuations and demonstrate poor generalizability. A robust approach is needed to leverage massive CGM data for near-future glucose prediction. We propose large sensor models (LSMs) to capture knowledge in CGM data by modeling patients as sequences of glucose. CGM-LSM is pretrained on 15.96 million glucose records from 592 diabetes patients for near-future glucose prediction. We evaluated CGM-LSM against state-of-the-art methods using the OhioT1DM dataset across various metrics, prediction horizons, and unseen patients. Additionally, we assessed its generalizability across factors like diabetes type, age, gender, and hour of day. CGM-LSM achieved exceptional performance, with an rMSE of 29.81 mg/dL for type 1 diabetes patients and 23.49 mg/dL for type 2 diabetes patients in a two-hour prediction horizon. For the OhioT1DM dataset, CGM-LSM achieved a one-hour rMSE of 15.64 mg/dL, halving the previous best of 31.97 mg/dL. Robustness analyses revealed consistent performance not only for unseen patients and future periods, but also across diabetes type, age, and gender. The model demonstrated adaptability to different hours of day, maintaining accuracy across periods of various activity intensity levels. CGM-LSM represents a transformative step in diabetes management by leveraging pretraining to uncover latent glucose generation patterns in sensor data. Our findings also underscore the broader potential of LSMs to drive innovation across domains involving complex sensor data.

Recent advances in self-supervised learning enabled novel medical AI models, known as foundation models (FMs) that offer great potential for characterizing health from diverse biomedical data. Continuous glucose monitoring (CGM) provides rich, temporal data on glycemic patterns, but its full potential for predicting broader health outcomes remains underutilized. Here, we present GluFormer, a generative foundation model on biomedical temporal data based on a transformer architecture, and trained on over 10 million CGM measurements from 10,812 non-diabetic individuals. We tokenized the CGM training data and trained GluFormer using next token prediction in a generative, autoregressive manner. We demonstrate that GluFormer generalizes effectively to 15 different external datasets, including 4936 individuals across 5 different geographical regions, 6 different CGM devices, and several metabolic disorders, including normoglycemic, prediabetic, and diabetic populations, as well as those with gestational diabetes and obesity. GluFormer produces embeddings which outperform traditional CGM analysis tools, and achieves high Pearson correlations in predicting clinical parameters such as HbA1c, liver-related parameters, blood lipids, and sleep-related indices. Notably, GluFormer can also predict onset of future health outcomes even 4 years in advance. We also show that CGM embeddings from pre-intervention periods in Randomized Clinical Trials (RCTs) outperform other methods in predicting primary and secondary outcomes. When integrating dietary data into GluFormer, we show that the enhanced model can accurately generate CGM data based only on dietary intake data, simulate outcomes of dietary interventions, and predict individual responses to specific foods. Overall, we show that GluFormer accurately predicts health outcomes which generalize across different populations metabolic conditions.

The global diabetes epidemic highlights the importance of maintaining good glycemic control. Glucose prediction is a fundamental aspect of diabetes management, facilitating real-time decision-making. Recent research has introduced models focusing on long-term glucose trend prediction, which are unsuitable for real-time decision-making and result in delayed responses. Conversely, models designed to respond to immediate glucose level changes cannot analyze glucose variability comprehensively. Moreover, contemporary research generally integrates various physiological parameters (e.g. insulin doses, food intake, etc.), which inevitably raises data privacy concerns. To bridge such a research gap, we propose TimeGlu -- an end-to-end pipeline for short-term glucose prediction solely based on CGM time series data. We implement four baseline methods to conduct a comprehensive comparative analysis of the model's performance. Through extensive experiments on two contrasting datasets (CGM Glucose and Colas dataset), TimeGlu achieves state-of-the-art performance without the need for additional personal data from patients, providing effective guidance for real-world diabetic glucose management.

Deep learning models achieve state-of-the art results in predicting blood glucose trajectories, with a wide range of architectures being proposed. However, the adaptation of such models in clinical practice is slow, largely due to the lack of uncertainty quantification of provided predictions. In this work, we propose to model the future glucose trajectory conditioned on the past as an infinite mixture of basis distributions (i.e., Gaussian, Laplace, etc.). This change allows us to learn the uncertainty and predict more accurately in the cases when the trajectory has a heterogeneous or multi-modal distribution. To estimate the parameters of the predictive distribution, we utilize the Transformer architecture. We empirically demonstrate the superiority of our method over existing state-of-the-art techniques both in terms of accuracy and uncertainty on the synthetic and benchmark glucose data sets.

The scientists looked at their glucose measurements over time and developed machine learning models to see if those values could be used to determine …

Amir Hayeri, CEO of Bio Conscious Tech, works with chronically ill patients to help them predict and ideally avoid disease complications. When you hear the word "glucose," what do you think of? For most people, the next word they think of is "diabetes." More than 10% of the U.S. population is diagnosed with diabetes; so is more than 8% of the Canadian population. An even larger population is pre-diabetic.

WIRE)--New data presented today at the 80th American Diabetes Association Scientific Sessions – A Virtual Experience unveiled a new AI algorithm from January.ai. In an in-house study of 1,022 participants, the algorithm effectively predicted individualized glycemic response to specific meals in people with type 2 diabetes and pre-diabetes. This algorithm is critical to the company's goal of developing and offering a program that provides people with highly personalized food and activity recommendations that drive positive behavior change and improved health. In the Sugar Challenge study, January.ai After a few days of data-gathering to develop an individualized model, the algorithm accurately predicted glucose response to future meals in the absence of any further CGM data, a finding that supports further exploration of the impact of AI models with intermittent CGM use.

Continuous Glucose Monitoring (CGM) has enabled important opportunities for diabetes management. This study explores the use of CGM data as input for digital decision support tools. We investigate how Recurrent Neural Networks (RNNs) can be used for Short Term Blood Glucose (STBG) prediction and compare the RNNs to conventional time-series forecasting using Autoregressive Integrated Moving Average (ARIMA). A prediction horizon up to 90 min into the future is considered. In this context, we evaluate both population-based and patient-specific RNNs and contrast them to patient-specific ARIMA models and a simple baseline predicting future observations as the last observed. We find that the population-based RNN model is the best performing model across the considered prediction horizons without the need of patient-specific data. This demonstrates the potential of RNNs for STBG prediction in diabetes patients towards detecting/mitigating severe events in the STBG, in particular hypoglycemic events. However, further studies are needed in regards to the robustness and practical use of the investigated STBG prediction models.

Blood glucose value prediction is an important task in diabetes management. While it is reported that glucose concentration is sensitive to social context such as mood, physical activity, stress, diet, alongside the influence of diabetes pathologies, we need more research on data and methodologies to incorporate and evaluate signals about such temporal context into prediction models. Person-generated data sources, such as actively contributed surveys as well as passively mined data from social media offer opportunity to capture such context, however the self-reported nature and sparsity of such data mean that such data are noisier and less specific than physiological measures such as blood glucose values themselves. Therefore, here we propose a Gaussian Process model to both address these data challenges and combine blood glucose and latent feature representations of contextual data for a novel multi-signal blood glucose prediction task. We find this approach outperforms common methods for multi-variate data, as well as using the blood glucose values in isolation. Given a robust evaluation across two blood glucose datasets with different forms of contextual information, we conclude that multi-signal Gaussian Processes can improve blood glucose prediction by using contextual information and may provide a significant shift in blood glucose prediction research and practice.