Enhancing self-management in type 1 diabetes with wearables and deep learning

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Title: Enhancing self-management in type 1 diabetes with wearables and deep learning
Authors: Zhu, T
Uduku, C
Li, K
Herrero Vinas, P
Oliver, N
Georgiou, P
Item Type: Journal Article
Abstract: 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.
Issue Date: 27-Jun-2022
Date of Acceptance: 2-Jun-2022
URI: http://hdl.handle.net/10044/1/97609
DOI: 10.1038/s41746-022-00626-5
ISSN: 2398-6352
Publisher: Nature Research
Journal / Book Title: npj Digital Medicine
Volume: 5
Copyright Statement: © The Author(s) 2022. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons. org/licenses/by/4.0/. © The Author(s) 2022
Sponsor/Funder: Engineering & Physical Science Research Council (EPSRC)
Funder's Grant Number: EP/P00993X/1
Keywords: Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Medical Informatics
GLUCOSE-CONCENTRATION
PHYSICAL-ACTIVITY
BOLUS CALCULATOR
ALGORITHM
HYPOGLYCEMIA
PREDICTION
MODEL
Publication Status: Published
Article Number: ARTN 78
Appears in Collections:Department of Metabolism, Digestion and Reproduction
Electrical and Electronic Engineering
Faculty of Medicine
Faculty of Engineering



This item is licensed under a Creative Commons License Creative Commons