The Institute of Endocrinology, Metabolism and Hypertension, Tel-Aviv Sourasky Medical Centre, Tel Aviv, Israel.
The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Diabetes Metab Res Rev. 2020 Nov;36(8):e3348. doi: 10.1002/dmrr.3348. Epub 2020 Jun 14.
This study was designed to improve blood glucose level predictability and future hypoglycemic and hyperglycemic event alerts through a novel patient-specific supervised-machine-learning (SML) analysis of glucose level based on a continuous-glucose-monitoring system (CGM) that needs no human intervention, and minimises false-positive alerts. The CGM data over 7 to 50 non-consecutive days from 11 type-1 diabetic patients aged 18 to 39 with a mean HbA1C of 7.5% ± 1.2% were analysed using four SML models. The algorithm was constructed to choose the best-fit model for each patient. Several statistical parameters were calculated to aggregate the magnitudes of the prediction errors. The personalised solutions provided by the algorithm were effective in predicting glucose levels 30 minutes after the last measurement. The average root-mean-square-error was 20.48 mg/dL and the average absolute-mean-error was 15.36 mg/dL when the best-fit model was selected for each patient. Using the best-fit-model, the true-positive-hypoglycemia-prediction-rate was 64%, whereas the false-positive- rate was 4.0%, and the false-negative-rate was 0.015%. Similar results were found even when only CGM samples below 70 were considered. The true-positive-hyperglycemia-prediction-rate was 61%. State-of-the-art SML tools are effective in predicting the glucose level values of patients with type-1diabetes and notifying these patients of future hypoglycemic and hyperglycemic events, thus improving glycemic control. The algorithm can be used to improve the calculation of the basal insulin rate and bolus insulin, and suitable for a closed loop "artificial pancreas" system. The algorithm provides a personalised medical solution that can successfully identify the best-fit method for each patient.
这项研究旨在通过基于连续血糖监测系统(CGM)的新型患者特定的监督机器学习(SML)分析来提高血糖水平的可预测性,并对未来的低血糖和高血糖事件发出警报,该系统无需人为干预,并且最大限度地减少假阳性警报。对 11 名年龄在 18 至 39 岁、糖化血红蛋白平均值为 7.5%±1.2%的 1 型糖尿病患者的 CGM 数据进行了 7 至 50 天的非连续分析,这些数据来自 4 个 SML 模型。该算法旨在为每位患者选择最佳拟合模型。计算了多个统计参数来综合预测误差的大小。该算法提供的个性化解决方案在最后一次测量后 30 分钟内预测血糖水平的效果非常好。当为每位患者选择最佳拟合模型时,平均均方根误差为 20.48mg/dL,平均绝对平均误差为 15.36mg/dL。使用最佳拟合模型,低血糖的真阳性预测率为 64%,而假阳性率为 4.0%,假阴性率为 0.015%。即使仅考虑 CGM 样本低于 70 的情况,也得到了相似的结果。高血糖的真阳性预测率为 61%。最先进的 SML 工具可有效预测 1 型糖尿病患者的血糖值,并通知这些患者未来的低血糖和高血糖事件,从而改善血糖控制。该算法可用于改善基础胰岛素率和胰岛素推注的计算,适用于闭环“人工胰腺”系统。该算法提供了一种个性化的医疗解决方案,可以成功识别每位患者的最佳拟合方法。