Such a task may be relevant in numerous other domains as well.

Reinforcement learning (RL)-based dynamic treatment regimes (DTRs) hold promise for automating complex clinical decision-making, yet their practical deployment remains hindered by the intensive engineering required to inject clinical knowledge and ensure patient safety. Recent advancements in large language models (LLMs) suggest a complementary approach, where implicit prior knowledge and clinical heuristics are naturally embedded through linguistic prompts without requiring environment-specific training. In this study, we rigorously evaluate open-source LLMs as dynamic insulin dosing agents in an in silico Type 1 diabetes simulator, comparing their zero-shot inference performance against small neural network-based RL agents (SRAs) explicitly trained for the task. Our results indicate that carefully designed zero-shot prompts enable smaller LLMs (e.g., Qwen2.5-7B) to achieve comparable or superior clinical performance relative to extensively trained SRAs, particularly in stable patient cohorts. However, LLMs exhibit notable limitations, such as overly aggressive insulin dosing when prompted with chain-of-thought (CoT) reasoning, highlighting critical failure modes including arithmetic hallucination, temporal misinterpretation, and inconsistent clinical logic. Incorporating explicit reasoning about latent clinical states (e.g., meals) yielded minimal performance gains, underscoring the current model's limitations in capturing complex, hidden physiological dynamics solely through textual inference. Our findings advocate for cautious yet optimistic integration of LLMs into clinical workflows, emphasising the necessity of targeted prompt engineering, careful validation, and potentially hybrid approaches that combine linguistic reasoning with structured physiological modelling to achieve safe, robust, and clinically effective decision-support systems.

Background: Type 1 diabetes (T1D) has seen a rapid evolution in management technology and forms a useful case study for the future management of other chronic conditions. Further development of this management technology requires an exploration of its real-world use and the potential of additional data streams. To facilitate this, we contribute the BrisT1D Dataset to the growing number of public T1D management datasets. The dataset was developed from a longitudinal study of 24 young adults in the UK who used a smartwatch alongside their usual T1D management. Findings: The BrisT1D dataset features both device data from the T1D management systems and smartwatches used by participants, as well as transcripts of monthly interviews and focus groups conducted during the study. The device data is provided in a processed state, for usability and more rapid analysis, and in a raw state, for in-depth exploration of novel insights captured in the study. Conclusions: This dataset has a range of potential applications. The quantitative elements can support blood glucose prediction, hypoglycaemia prediction, and closed-loop algorithm development. The qualitative elements enable the exploration of user experiences and opinions, as well as broader mixed-methods research into the role of smartwatches in T1D management.

Calculating mealtime insulin doses poses a significant challenge for individuals with Type 1 Diabetes (T1D). Doses should perfectly compensate for expected post-meal glucose excursions, requiring a profound understanding of the individual's insulin sensitivity and the meal macronutrients'. Usually, people rely on intuition and experience to develop this understanding. In this work, we demonstrate how a reinforcement learning agent, employing a self-attention encoder network, can effectively mimic and enhance this intuitive process. Trained on 80 virtual subjects from the FDA-approved UVA/Padova T1D adult cohort and tested on twenty, self-attention demonstrates superior performance compared to other network architectures. Results reveal a significant reduction in glycemic risk, from 16.5 to 9.6 in scenarios using sensor-augmented pump and from 9.1 to 6.7 in scenarios using automated insulin delivery. This new paradigm bypasses conventional therapy parameters, offering the potential to simplify treatment and promising improved quality of life and glycemic outcomes for people with T1D.

People with type 1 diabetes (T1D) struggle to calculate the optimal insulin dose at mealtime, especially when under multiple daily injections (MDI) therapy. Effectively, they will not always perform rigorous and precise calculations, but occasionally, they might rely on intuition and previous experience. Reinforcement learning (RL) has shown outstanding results in outperforming humans on tasks requiring intuition and learning from experience. In this work, we propose an RL agent that recommends the optimal meal-accompanying insulin dose corresponding to a qualitative meal (QM) strategy that does not require precise carbohydrate counting (CC) (e.g., a usual meal at noon.). The agent is trained using the soft actor-critic approach and comprises long short-term memory (LSTM) neurons. For training, eighty virtual subjects (VS) of the FDA-accepted UVA/Padova T1D adult population were simulated using MDI therapy and QM strategy. For validation, the remaining twenty VS were examined in 26-week scenarios, including intra- and inter-day variabilities in glucose. \textit{In-silico} results showed that the proposed RL approach outperforms a baseline run-to-run approach and can replace the standard CC approach. Specifically, after 26 weeks, the time-in-range ($70-180$mg/dL) and time-in-hypoglycemia ($<70$mg/dL) were $73.1\pm11.6$% and $ 2.0\pm 1.8$% using the RL-optimized QM strategy compared to $70.6\pm14.8$% and $ 1.5\pm 1.5$% using CC. Such an approach can simplify diabetes treatment, resulting in improved quality of life and glycemic outcomes.

Finding an optimal individualized treatment regimen is considered one of the most challenging precision medicine problems. Various patient characteristics influence the response to the treatment, and hence, there is no one-size-fits-all regimen. Moreover, the administration of an unsafe dose during the treatment can have adverse effects on health. Therefore, a treatment model must ensure patient \emph{safety} while \emph{efficiently} optimizing the course of therapy. We study a prevalent medical problem where the treatment aims to keep a physiological variable in a safe range and preferably close to a target level, which we refer to as \emph{leveling}. Such a task may be relevant in numerous other domains as well. We propose ESCADA, a novel and generic multi-armed bandit (MAB) algorithm tailored for the leveling task, to make safe, personalized, and context-aware dose recommendations. We derive high probability upper bounds on its cumulative regret and safety guarantees. Following ESCADA's design, we also describe its Thompson sampling-based counterpart. We discuss why the straightforward adaptations of the classical MAB algorithms such as GP-UCB may not be a good fit for the leveling task. Finally, we make \emph{in silico} experiments on the bolus-insulin dose allocation problem in type-1 diabetes mellitus disease and compare our algorithms against the famous GP-UCB algorithm, the rule-based dose calculators, and a clinician.

Artificial Intelligence has multiple applications in the healthcare domain. We have also seen many AI solutions being developed to identify symptoms of COVID-19 among patients. Here's one such case of AI-based screening of visitors at Mumbai railway stations to identify COVID-19 symptoms. Also, the application of Artificial Intelligence in adjusting insulin dose to control glucose levels among Type I Diabetes patients. Body-screening facility "FebriEye thermal cameras" have been set up at Chhatrapati Shivaji Maharaj Terminus and Lokmanya Tilak Terminus in Mumbai to scan passengers for COVID-19 symptoms.

As artificial intelligence algorithms and systems become more sophisticated and take on bigger responsibilities, it becomes more and more important to ensure that AI systems avoid dangerous, unwanted behavior. Recently a team of researchers from the University of Massachusetts Amherst and Stanford published a paper that demonstrates how specific AI behavior can be avoided, through the use of a technique that elicits precise mathematical instructions that can be used to tweak the behavior of an AI. According to TechXplore, the research was predicated on the assumption that unfair/unsafe behaviors can be defined with mathematical functions and variables. If this is true then it should be possible for researchers to train systems to avoid these specific behaviors. The research team aimed to develop a toolkit that could be employed by users of the AI to specify which behaviors they want the AI to avoid, and enable AI engineers to reliably train a system that will avoid unwanted actions when used in real-world scenarios.

Machine learning and artificial intelligence have become hot topics in enterprise, entrepreneurial and technology circles. So much so that in his founder's letter yesterday, Alphabet CEO Larry Page touched on the importance of the technology, noting that they began working on it "long before others." Late last year, Google also released Google Cloud Machine Learning, which provides modern machine learning services, with pre-trained models and a service so that developers everywhere can generate their own tailored models. There is no doubt that these developers have endless applications in endless industries for machine learning. As we mentioned in this blog, ML solutions can drastically improve the way we work.