Prediction of Nocturnal Hypoglycemia in Adults with Type 1 Diabetes under Multiple Daily Injections Using Continuous Glucose Monitoring and Physical Activity Monitor

Sensors (Basel). 2020 Mar 19;20(6):1705. doi: 10.3390/s20061705.

Abstract

(1) Background: nocturnal hypoglycemia (NH) is one of the most challenging side effects of multiple doses of insulin (MDI) therapy in type 1 diabetes (T1D). This work aimed to investigate the feasibility of a machine-learning-based prediction model to anticipate NH in T1D patients on MDI. (2) Methods: ten T1D adults were studied during 12 weeks. Information regarding T1D management, continuous glucose monitoring (CGM), and from a physical activity tracker were obtained under free-living conditions at home. Supervised machine-learning algorithms were applied to the data, and prediction models were created to forecast the occurrence of NH. Individualized prediction models were generated using multilayer perceptron (MLP) and a support vector machine (SVM). (3) Results: population outcomes indicated that more than 70% of the NH may be avoided with the proposed methodology. The predictions performed by the SVM achieved the best population outcomes, with a sensitivity and specificity of 78.75% and 82.15%, respectively. (4) Conclusions: our study supports the feasibility of using ML techniques to address the prediction of nocturnal hypoglycemia in the daily life of patients with T1D on MDI, using CGM and a physical activity tracker.

Keywords: artificial neural network; continuous glucose monitoring; hypoglycemia; machine learning; multiple daily injections; support vector machine; type 1 diabetes.

MeSH terms

  • Adult
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / physiopathology
  • Drug-Related Side Effects and Adverse Reactions / blood
  • Drug-Related Side Effects and Adverse Reactions / diagnosis*
  • Drug-Related Side Effects and Adverse Reactions / pathology
  • Exercise / physiology
  • Female
  • Fitness Trackers
  • Glucose / metabolism
  • Humans
  • Hypoglycemia / blood
  • Hypoglycemia / chemically induced
  • Hypoglycemia / diagnosis*
  • Hypoglycemia / pathology
  • Insulin / administration & dosage
  • Insulin / adverse effects
  • Insulin Infusion Systems / adverse effects
  • Machine Learning
  • Male
  • Monitoring, Physiologic*
  • Neural Networks, Computer
  • Support Vector Machine

Substances

  • Insulin
  • Glucose