High quality real world datasets are essential for advancing data driven approaches in type 1 diabetes (T1D) management, including personalized therapy design, digital twin systems, and glucose prediction models. However, progress in this area has been limited by the scarcity of publicly available datasets that offer detailed and comprehensive patient data. To address this gap, we present AZT1D, a dataset containing data collected from 25 individuals with T1D on automated insulin delivery (AID) systems. AZT1D includes continuous glucose monitoring (CGM) data, insulin pump and insulin administration data, carbohydrate intake, and device mode (regular, sleep, and exercise) obtained over 6 to 8 weeks for each patient. Notably, the dataset provides granular details on bolus insulin delivery (i.e., total dose, bolus type, correction specific amounts) features that are rarely found in existing datasets. By offering rich, naturalistic data, AZT1D supports a wide range of artificial intelligence and machine learning applications aimed at improving clinical decision making and individualized care in T1D.

Modeling the dynamics of probability distributions from time-dependent data samples is a fundamental problem in many fields, including digital health. The goal is to analyze how the distribution of a biomarker, such as glucose, changes over time and how these changes may reflect the progression of chronic diseases like diabetes. We introduce a probabilistic model based on a Gaussian mixture that captures the evolution of a continuous-time stochastic process. Our approach combines a non-parametric estimate of the distribution, obtained with Maximum Mean Discrepancy (MMD), and a Neural Ordinary Differential Equation (Neural ODE) that governs the temporal evolution of the mixture weights. The model is highly interpretable, detects subtle distribution shifts, and remains computationally efficient. Simulation studies show that our method matches or surpasses the estimation accuracy of state-of-the-art, less interpretable techniques such as normalizing flows and non-parametric kernel density estimators. We further demonstrate its utility using data from a digital clinical trial, revealing how interventions affect the time-dependent distribution of glucose levels. The proposed method enables rigorous comparisons between control and treatment groups from both mathematical and clinical perspectives, offering novel longitudinal characterizations that existing approaches cannot achieve.

Type 1 Diabetes is a chronic autoimmune condition in which the immune system attacks and destroys insulin-producing beta cells in the pancreas, resulting in little to no insulin production. Insulin helps glucose in your blood enter your muscle, fat, and liver cells so they can use it for energy or store it for later use. If insulin is insufficient, it causes sugar to build up in the blood and leads to serious health problems. People with Type 1 Diabetes need synthetic insulin every day. In diabetes management, continuous glucose monitoring is an important feature that provides near real-time blood glucose data. It is useful in deciding the synthetic insulin dose. In this research work, we used machine learning tools, deep neural networks, deep reinforcement learning, and voting and stacking regressors to predict blood glucose levels at 30-min time intervals using the latest DiaTrend dataset. Predicting blood glucose levels is useful in better diabetes management systems. The trained models were compared using several evaluation metrics. Our evaluation results demonstrate the performance of various models across different glycemic conditions for blood glucose prediction. The source codes of this work can be found in: https://github.com/soon-jynn-chu/t1d_bg_prediction

A frequent problem in statistical science is how to properly handle missing data in matched paired observations. There is a large body of literature coping with the univariate case. Yet, the ongoing technological progress in measuring biological systems raises the need for addressing more complex data, e.g., graphs, strings and probability distributions, among others. In order to fill this gap, this paper proposes new estimators of the maximum mean discrepancy (MMD) to handle complex matched pairs with missing data. These estimators can detect differences in data distributions under different missingness mechanisms. The validity of this approach is proven and further studied in an extensive simulation study, and results of statistical consistency are provided. Data from continuous glucose monitoring in a longitudinal population-based diabetes study are used to illustrate the application of this approach. By employing the new distributional representations together with cluster analysis, new clinical criteria on how glucose changes vary at the distributional level over five years can be explored.

AEGIS study possesses unique information on longitudinal changes in circulating glucose through continuous glucose monitoring technology (CGM). However, as usual in longitudinal medical studies, there is a significant amount of missing data in the outcome variables. For example, 40 percent of glycosylated hemoglobin (A1C) biomarker data are missing five years ahead. With the purpose to reduce the impact of this issue, this article proposes a new data analysis framework based on learning in reproducing kernel Hilbert spaces (RKHS) with missing responses that allows to capture non-linear relations between variable studies in different supervised modeling tasks. First, we extend the Hilbert-Schmidt dependence measure to test statistical independence in this context introducing a new bootstrap procedure, for which we prove consistency. Next, we adapt or use existing models of variable selection, regression, and conformal inference to obtain new clinical findings about glucose changes five years ahead with the AEGIS data. The most relevant findings are summarized below: i) We identify new factors associated with long-term glucose evolution; ii) We show the clinical sensibility of CGM data to detect changes in glucose metabolism; iii) We can improve clinical interventions based on our algorithms' expected glucose changes according to patients' baseline characteristics.