Clinical notes in Electronic Health Records (EHRs) capture rich temporal information on events, clinician reasoning, and lifestyle factors often missing from structured data. Leveraging them for predictive modeling can be impactful for timely identification of chronic diseases. However, they present core natural language processing (NLP) challenges: long text, irregular event distribution, complex temporal dependencies, privacy constraints, and resource limitations. We present two complementary methods for temporally and contextually grounded risk prediction from longitudinal notes. First, we introduce HiTGNN, a hierarchical temporal graph neural network that integrates intra-note temporal event structures, inter-visit dynamics, and medical knowledge to model patient trajectories with fine-grained temporal granularity. Second, we propose ReVeAL, a lightweight, test-time framework that distills the reasoning of large language models into smaller verifier models. Applied to opportunistic screening for Type 2 Diabetes (T2D) using temporally realistic cohorts curated from private and public hospital corpora, HiTGNN achieves the highest predictive accuracy, especially for near-term risk, while preserving privacy and limiting reliance on large proprietary models. ReVeAL enhances sensitivity to true T2D cases and retains explanatory reasoning. Our ablations confirm the value of temporal structure and knowledge augmentation, and fairness analysis shows HiTGNN performs more equitably across subgroups.

Objective: Create precise, structured, data-backed guidelines for type 2 diabetes treatment progression, suitable for clinical adoption. Research Design and Methods: Our training cohort was composed of patient (with type 2 diabetes) visits from Boston Medical Center (BMC) from 1998 to 2014. We divide visits into 4 groups based on the patient's treatment regimen before the visit, and further divide them into subgroups based on the recommended treatment during the visit. Since each subgroup has observational data, which has confounding bias (sicker patients are prescribed more aggressive treatments), we used machine learning and optimization to remove some datapoints so that the remaining data resembles a randomized trial. On each subgroup, we train AI-backed tree-based models to prescribe treatment changes. Once we train these tree models, we manually combine the models for every group to create an end-to-end prescription pipeline for all patients in that group. In this process, we prioritize stepping up to a more aggressive treatment before considering less aggressive options. We tested this pipeline on unseen data from BMC, and an external dataset from Hartford healthcare (type 2 diabetes patient visits from January 2020 to May 2024). Results: The median HbA1c reduction achieved by our pipelines is 0.26% more than what the doctors achieved on the unseen BMC patients. For the Hartford cohort, our pipelines were better by 0.13%. Conclusions: This precise, interpretable, and efficient AI-backed approach to treatment progression in type 2 diabetes is predicted to outperform the current practice and can be deployed to improve patient outcomes.

Diabetes is a chronic metabolic disorder characterized by persistently high blood glucose levels (BGLs), leading to severe complications such as cardiovascular disease, neuropathy, and retinopathy. Predicting BGLs enables patients to maintain glucose levels within a safe range and allows caregivers to take proactive measures through lifestyle modifications. Continuous Glucose Monitoring (CGM) systems provide real-time tracking, offering a valuable tool for monitoring BGLs. However, accurately forecasting BGLs remains challenging due to fluctuations due to physical activity, diet, and other factors. Recent deep learning models show promise in improving BGL prediction. Nonetheless, forecasting BGLs accurately from multimodal, irregularly sampled data over long prediction horizons remains a challenging research problem. In this paper, we propose AttenGluco, a multimodal Transformer-based framework for long-term blood glucose prediction. AttenGluco employs cross-attention to effectively integrate CGM and activity data, addressing challenges in fusing data with different sampling rates. Moreover, it employs multi-scale attention to capture long-term dependencies in temporal data, enhancing forecasting accuracy. To evaluate the performance of AttenGluco, we conduct forecasting experiments on the recently released AIREADI dataset, analyzing its predictive accuracy across different subject cohorts including healthy individuals, people with prediabetes, and those with type 2 diabetes. Furthermore, we investigate its performance improvements and forgetting behavior as new cohorts are introduced. Our evaluations show that AttenGluco improves all error metrics, such as root mean square error (RMSE), mean absolute error (MAE), and correlation, compared to the multimodal LSTM model. AttenGluco outperforms this baseline model by about 10% and 15% in terms of RMSE and MAE, respectively.

A shocking number of American adults don't know the signs of a heart attack. New research is emphasizing that socializing with friends and family may help protect people against heart attack, stroke, type 2 diabetes and other conditions and illnesses. The study suggests that social interactions may keep people healthy because these interactions boost the immune system and reduce the risk of disease. Cambridge University researchers, along with colleagues in China, came to these conclusions after studying protein in blood samples taken from over 42,000 adults recruited to the U.K. Biobank, news agency SWNS reported. The study team said social relationships play a key role in well-being.

Retrieval-augmented generation (RAG) has emerged as a promising approach to enhance the performance of large language models (LLMs) in knowledge-intensive tasks such as those from medical domain. However, the sensitive nature of the medical domain necessitates a completely accurate and trustworthy system. While existing RAG benchmarks primarily focus on the standard retrieve-answer setting, they overlook many practical scenarios that measure crucial aspects of a reliable medical system. This paper addresses this gap by providing a comprehensive evaluation framework for medical question-answering (QA) systems in a RAG setting for these situations, including sufficiency, integration, and robustness. We introduce Medical Retrieval-Augmented Generation Benchmark (MedRGB) that provides various supplementary elements to four medical QA datasets for testing LLMs' ability to handle these specific scenarios. Utilizing MedRGB, we conduct extensive evaluations of both state-of-the-art commercial LLMs and open-source models across multiple retrieval conditions. Our experimental results reveals current models' limited ability to handle noise and misinformation in the retrieved documents. We further analyze the LLMs' reasoning processes to provides valuable insights and future directions for developing RAG systems in this critical medical domain.

This paper proposes a knowledge-enhanced disease diagnosis method based on a prompt learning framework. The method retrieves structured knowledge from external knowledge graphs related to clinical cases, encodes it, and injects it into the prompt templates to enhance the language model's understanding and reasoning capabilities for the task.We conducted experiments on three public datasets: CHIP-CTC, IMCS-V2-NER, and KUAKE-QTR. The results show that the proposed method significantly outperforms existing models across multiple evaluation metrics, with an F1 score improvement of 2.4% on the CHIP-CTC dataset, 3.1% on the IMCS-V2-NER dataset,and 4.2% on the KUAKE-QTR dataset. Additionally,ablation studies confirmed the critical role of the knowledge injection module,as the removal of this module resulted in a significant drop in F1 score. The experimental results demonstrate that the proposed method not only effectively improves the accuracy of disease diagnosis but also enhances the interpretability of the predictions, providing more reliable support and evidence for clinical diagnosis.

Fox News medical contributor Dr. Marc Siegel joins'Fox News Live' to discuss the growing popularity of a new class of weight loss drugs actually meant to treat diabetes and the potential side effects. Getting screened for type 2 diabetes could one day be as simple as speaking into your smartphone. Currently, gauging diabetes risk requires fasting, taking a blood test and waiting days for the results. In an effort to change that, researchers from Klick Applied Sciences in Toronto, Canada, have developed an artificial intelligence model that uses a 10-second voice recording to predict diabetes risk. The AI program was shown to predict the disease with 85% accuracy, according to a study published in the peer-reviewed journal Mayo Clinic Proceedings: Digital Health last month.

Canadian medical researchers have trained a machine-learning AI to accurately predict Type 2 diabetes from just six to 10 seconds of the patient's spoken voice. This was achieved after the model identified 14 acoustic features for differences between non-diabetic and Type 2 diabetic individuals. The AI focused on a set of vocal features, including slight changes in pitch and vocal intensity that the human ears can't hear of doctors, and paired that data with basic health information, including the patient's age, sex, height, and weight. Sex proved to be decisive, the researchers found: The AI can diagnose the disease with 89 percent for women, but slightly less accurately, 86 percent for men. A Canadian firm has trained a machine-learning AI to accurately predict Type 2 diabetes from just six to 10 seconds of a patient's spoken voice.

Background: Racial and ethnic minority groups and individuals facing social disadvantages, which often stem from their social determinants of health (SDoH), bear a disproportionate burden of type 2 diabetes (T2D) and its complications. It is therefore crucial to implement effective social risk management strategies at the point of care. Objective: To develop an EHR-based machine learning (ML) analytical pipeline to identify the unmet social needs associated with hospitalization risk in patients with T2D. Methods: We identified 10,192 T2D patients from the EHR data (from 2012 to 2022) from the University of Florida Health Integrated Data Repository, including contextual SDoH (e.g., neighborhood deprivation) and individual-level SDoH (e.g., housing stability). We developed an electronic health records (EHR)-based machine learning (ML) analytic pipeline, namely individualized polysocial risk score (iPsRS), to identify high social risk associated with hospitalizations in T2D patients, along with explainable AI (XAI) techniques and fairness assessment and optimization. Results: Our iPsRS achieved a C statistic of 0.72 in predicting 1-year hospitalization after fairness optimization across racial-ethnic groups. The iPsRS showed excellent utility for capturing individuals at high hospitalization risk; the actual 1-year hospitalization rate in the top 5% of iPsRS was ~13 times as high as the bottom decile. Conclusion: Our ML pipeline iPsRS can fairly and accurately screen for patients who have increased social risk leading to hospitalization in T2D patients.

We propose a novel approach for interpreting deep embeddings in the context of patient clustering. We evaluate our approach on a dataset of participants with type 2 diabetes from the UK Biobank, and demonstrate clinically meaningful insights into disease progression patterns.