Medical Informatics Research & Development Centre, University of Pannonia, Egyetem u. 10, 8200 Veszprém, Hungary.
Department of Medical Rehabilitation and Physical Medicine, University of Szeged, Dugonics tér 13, 6720 Szeged, Hungary.
J Healthc Eng. 2019 Jan 10;2019:8605206. doi: 10.1155/2019/8605206. eCollection 2019.
According to recent surveys, the current ways of diabetics trying to estimate their insulin need based on experience and conjecture are sometimes inefficient in practice. This paper proposes a prediction algorithm and presents the validation of the model in outpatient care. The algorithm consists of two state-of-the-art models that calculate nutrition absorption and glycaemia including insulin evolution. The combined model is extended with personalized parameter training including genetic algorithm and Nelder-Mead method, and a more realistic, diurnal parameter profile as a representation of the natural biorhythm. This method implemented in a user-friendly application can help diabetics calculate their insulin need. The tests were performed on a data set including a clinical trial involving more than 20 diabetic patients. We experienced 55% improvement in the results due to model training compared to the tests based on literature parameters. In the best case, 92.5% of the predicted blood glucose level values were in the range of clinically acceptable errors, which means around 2.8 mmol/l root mean square error. The results of the validation based on outpatient data are promising compared to others found in the literature. Handling other important factors such as physical activity and stress remains a challenge for future research.
根据最近的调查,目前糖尿病患者根据经验和猜测来估计胰岛素需求的方法在实践中有时效率不高。本文提出了一种预测算法,并在门诊护理中验证了该模型。该算法由两个最先进的模型组成,包括计算营养吸收和血糖的模型,包括胰岛素的演变。将联合模型扩展为包括遗传算法和Nelder-Mead 方法的个性化参数训练,以及更真实的、日常的参数谱,以代表自然生物节律。这种方法在用户友好的应用程序中实现,可以帮助糖尿病患者计算他们的胰岛素需求。测试是在一个包含 20 多名糖尿病患者的临床试验数据集上进行的。与基于文献参数的测试相比,由于模型训练,结果提高了 55%。在最好的情况下,92.5%的预测血糖值在临床可接受的误差范围内,这意味着大约 2.8mmol/l 的均方根误差。与文献中发现的结果相比,基于门诊数据的验证结果很有希望。处理其他重要因素,如体力活动和压力,仍然是未来研究的挑战。