People living with type 1 diabetes (T1D) require lifelong selfmanagement to maintain glucose levels in a safe range. Failure to do so
can lead to adverse glycemic events with short and long-term complications. Continuous glucose monitoring (CGM) is widely used in T1D
self-management for real-time glucose measurements, while smartphone
apps are adopted as basic electronic diaries, data visualization tools, and
simple decision support tools for insulin dosing. Applying a mixed effects
logistic regression analysis to the outcomes of a six-week longitudinal
study in 12 T1D adults using CGM and a clinically validated wearable
sensor wristband (NCT ID: NCT03643692), we identified several significant associations between physiological measurements and hypo- and
hyperglycemic events measured an hour later. We proceeded to develop
a new smartphone-based platform, ARISES (Adaptive, Real-time, and Intelligent System to Enhance Self-care), with an embedded deep learning algorithm utilizing multi-modal data from CGM, daily entries of meal
and bolus insulin, and the sensor wristband to predict glucose levels and
hypo- and hyperglycemia. For a 60-minute prediction horizon, the proposed algorithm achieved the average root mean square error (RMSE)
of 35.28±5.77 mg/dL with the Matthews correlation coefficients for
detecting hypoglycemia and hyperglycemia of 0.56±0.07 and 0.70±0.05,
respectively. The use of wristband data significantly reduced the RMSE
by 2.25 mg/dL (p < 0.01). The well-trained model is implemented on
the ARISES app to provide real-time decision support. These results
indicate that the ARISES has great potential to mitigate the risk of
severe complications and enhance self-management for people with T1D.