Artificial intelligence (AI) algorithms are a critical part of state-of-the-art digital health technology for diabetes management. Yet, access to large high-quality datasets is creating barriers that impede development of robust AI solutions. To accelerate development of transparent, reproducible, and robust AI solutions, we present Glucose-ML, a collection of 10 publicly available diabetes datasets, released within the last 7 years (i.e., 2018 - 2025). The Glucose-ML collection comprises over 300,000 days of continuous glucose monitor (CGM) data with a total of 38 million glucose samples collected from 2500+ people across 4 countries. Participants include persons living with type 1 diabetes, type 2 diabetes, prediabetes, and no diabetes. To support researchers and innovators with using this rich collection of diabetes datasets, we present a comparative analysis to guide algorithm developers with data selection. Additionally, we conduct a case study for the task of blood glucose prediction - one of the most common AI tasks within the field. Through this case study, we provide a benchmark for short-term blood glucose prediction across all 10 publicly available diabetes datasets within the Glucose-ML collection. We show that the same algorithm can have significantly different prediction results when developed/evaluated with different datasets. Findings from this study are then used to inform recommendations for developing robust AI solutions within the diabetes or broader health domain. We provide direct links to each longitudinal diabetes dataset in the Glucose-ML collection and openly provide our code.

Managing Type 1 Diabetes (T1D) demands constant vigilance as individuals strive to regulate their blood glucose levels to avert the dangers of dysglycemia (hyperglycemia or hypoglycemia). Despite the advent of sophisticated technologies such as automated insulin delivery (AID) systems, achieving optimal glycemic control remains a formidable task. AID systems integrate continuous subcutaneous insulin infusion (CSII) and continuous glucose monitors (CGM) data, offering promise in reducing variability and increasing glucose time-in-range. However, these systems often fail to prevent dysglycemia, partly due to limitations in prediction algorithms that lack the precision to avert abnormal glucose events. This gap highlights the need for proactive behavioral adjustments. We address this need with GLIMMER, Glucose Level Indicator Model with Modified Error Rate, a machine learning approach for forecasting blood glucose levels. GLIMMER categorizes glucose values into normal and abnormal ranges and devises a novel custom loss function to prioritize accuracy in dysglycemic events where patient safety is critical. To evaluate the potential of GLIMMER for T1D management, we both use a publicly available dataset and collect new data involving 25 patients with T1D. In predicting next-hour glucose values, GLIMMER achieved a root mean square error (RMSE) of 23.97 (+/-3.77) and a mean absolute error (MAE) of 15.83 (+/-2.09) mg/dL. These results reflect a 23% improvement in RMSE and a 31% improvement in MAE compared to the best-reported error rates.

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

Given their ability for advanced reasoning, extensive contextual understanding, and robust question-answering abilities, large language models have become prominent in healthcare management research. Despite adeptly handling a broad spectrum of healthcare inquiries, these models face significant challenges in delivering accurate and practical advice for chronic conditions such as diabetes. We evaluate the responses of ChatGPT versions 3.5 and 4 to diabetes patient queries, assessing their depth of medical knowledge and their capacity to deliver personalized, context-specific advice for diabetes self-management. Our findings reveal discrepancies in accuracy and embedded biases, emphasizing the models' limitations in providing tailored advice unless activated by sophisticated prompting techniques. Additionally, we observe that both models often provide advice without seeking necessary clarification, a practice that can result in potentially dangerous advice. This underscores the limited practical effectiveness of these models without human oversight in clinical settings. To address these issues, we propose a commonsense evaluation layer for prompt evaluation and incorporating disease-specific external memory using an advanced Retrieval Augmented Generation technique. This approach aims to improve information quality and reduce misinformation risks, contributing to more reliable AI applications in healthcare settings. Our findings seek to influence the future direction of AI in healthcare, enhancing both the scope and quality of its integration.

Understanding the complex relationships of biomarkers in diabetes is pivotal for advancing treatment strategies, a pressing need in diabetes research. This study applies Bayesian network structure learning to analyze the Shanghai Type 1 and Type 2 diabetes mellitus datasets, revealing complex relationships among key diabetes-related biomarkers. The constructed Bayesian network presented notable predictive accuracy, particularly for Type 2 diabetes mellitus, with root mean squared error (RMSE) of 18.23 mg/dL, as validated through leave-one-domain experiments and Clarke error grid analysis. This study not only elucidates the intricate dynamics of diabetes through a deeper understanding of biomarker interplay but also underscores the significant potential of integrating data-driven and knowledge-driven methodologies in the realm of personalized diabetes management. Such an approach paves the way for more custom and effective treatment strategies, marking a notable advancement in the field.

The escalating prevalence of diabetes globally underscores the need for diabetes management. Recent research highlights the growing focus on digital biomarkers in diabetes management, with innovations in computational frameworks and noninvasive monitoring techniques using personalized glucose metrics. However, they predominantly focus on insulin dosing and specific glucose values, or with limited attention given to overall glycemic control. This leaves a gap in expanding the scope of digital biomarkers for overall glycemic control in diabetes management. To address such a research gap, we propose GluMarker -- an end-to-end framework for modeling digital biomarkers using broader factors sources to predict glycemic control. Through the assessment and refinement of various machine learning baselines, GluMarker achieves state-of-the-art on Anderson's dataset in predicting next-day glycemic control. Moreover, our research identifies key digital biomarkers for the next day's glycemic control prediction. These identified biomarkers are instrumental in illuminating the daily factors that influence glycemic management, offering vital insights for diabetes care.

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.

Effective diabetes management is crucial for maintaining health in diabetic patients. Large Language Models (LLMs) have opened new avenues for diabetes management, facilitating their efficacy. However, current LLM-based approaches are limited by their dependence on general sources and lack of integration with domain-specific knowledge, leading to inaccurate responses. In this paper, we propose a knowledge-infused LLM-powered conversational health agent (CHA) for diabetic patients. We customize and leverage the open-source openCHA framework, enhancing our CHA with external knowledge and analytical capabilities. This integration involves two key components: 1) incorporating the American Diabetes Association dietary guidelines and the Nutritionix information and 2) deploying analytical tools that enable nutritional intake calculation and comparison with the guidelines. We compare the proposed CHA with GPT4. Our evaluation includes 100 diabetes-related questions on daily meal choices and assessing the potential risks associated with the suggested diet. Our findings show that the proposed agent demonstrates superior performance in generating responses to manage essential nutrients.

A fascinating session at the EASD 2022 conference on emerging technologies shed light on where we are with AID and telemedicine, and what leading researchers in diabetes believe is coming next in diabetes management. Healthcare is rapidly evolving, and now more than ever, robots and artificial intelligence have gone from science fiction to critical components of diabetes management. At the EASD 2022 conference in Stockholm, Sweden, researchers further explored this concept in a session titled, "A New Hope or Strange New Worlds: Submerging diabetes into emerging technologies." Dr. Moshe Phillip, head of the Institute of Endocrinology and Diabetes at Schneider Children's Medical Center of Israel, began by demonstrating how continuous glucose monitors (CGMs) represent a paradigm shift in diabetes technology. "CGM is the most important tool in the last 20 years," he said.

Medtronic's mission is to alleviate pain, restore health, and extend life through the application of biomedical engineering, explains Elaine Gee, PhD, Senior Principal Algorithm Engineer specializing in Artificial Intelligence at Medtronic. It's a mission Gee is well equipped for. With over 15 years' experience in modeling, bioinformatics, and engineering, she drives machine learning algorithm development and analytics to support next-generation medical devices for diabetes management. On behalf of AI Trends, Ben Lakin, from Cambridge Innovation Institute, sat down with Gee to discuss her most recent focus: algorithm development related to glucose sensing to improve the accuracy and performance of continuous glucose monitoring devices, also known as CGMs. Editor's Note: Gee will be giving a featured presentation on Advancing Continuous Glucose Monitoring Sensor Development with Machine Learning at Sensors Summit in San Diego, December 10-12.