Glucose Prediction Data Analytics for Diabetic

Patients Monitoring
Geshwaree Huzooree Kavi Kumar Khedo Noorjehan Joonas
Department of IT Department of Computer Science Ministry of Health & Quality of Life
Charles Telfair Institute University of Mauritius Victoria Hospital
Moka, Mauritius Reduit, Mauritius Candos, Mauritius
geshwaree.huzooree@telfair.ac.mu k.khedo@uom.ac.mu njoonas@intnet.mu

Abstract— Diabetes Mellitus (DM) is one of the leading health
complication around the world causing national economic burden
and low quality of life. This increases the need to focus on
prevention and early detection to improve the management and
treatment of diabetes. The aim of this paper is to present a
comprehensive critical review focusing on recent glucose
prediction models and a best fit model is proposed based on the
evaluation to perform data analytics in a wireless body area
network system. The proposed glucose prediction algorithm is
based on autoregressive (ARX) model which consider exogenous
inputs such as CGM data, blood pressure (BP), total cholesterol
(TC), low-density lipoprotein cholesterol (LDL), high density
lipoproteins (HDL). A dataset of 442 diabetic patients is used to
evaluate the performance of the algorithm through mean absolute
error (MAE), root-mean-square error (RMSE), and coefficient of
determination (R2). The experimental results demonstrate that
the proposed prediction algorithm can improve the prediction
accuracy of glucose. Potential research work and challenges are
pointed out for further development of glucose prediction models.
Keywords— Diabetes; glucose prediction; type 1 diabetes; type 2
diabetes; autoregressive exogenous algorithm;
I. INTRODUCTION
Continuous glucose monitoring (CGM) devices are
becoming the new state-of-the-art method, providing a tidal
wave of real-time information due to glucose reading every five
minutes. Consequently, both patients and physicians have to
process around 9000 readings [1] and interpret the huge amount
of data to adjust the insulin doses and to keep the blood glucose
level (BGL) as close to normal as possible [2]. This exponential
increase in data highlights a high need to mine the data and to
predict the patients’ BGL for effective monitoring. A recent
review on datamining technologies for diabetes [3] pointed out
that mined data will bring value in (i) interpreting and predicting
the long-term glycemic status of the patients and (ii) identifying
important predictors of glucose control and diabetic
complications and (iii) generating alerts whenever these hypo
and hyperglycemic events are forecasted [4]. Moreover, the
patients can also use these data to change or improve their daily
lifestyles [5].
Deviating from the defined range of BGL can lead to short
term (for example, nausea, fever and coma) and long term
effects (for example, heart attack, kidney failure, blindness and
stroke) on the body [6] [7] [2]. The ability to predict impending
hypo and hyperglycemic events before they occur would (i)
enable preventive intervention through self-disease management
such as healthy nutrition and physical activity, (ii) highly
improve overall BGL control through monitoring of BGL and
(iii) be a key step in improving health outcomes and quality of
life of patients [2] [7].
Big data or huge volume of data processing technologies
includes machine learning algorithms, natural language
processing algorithms, predictive modeling and other artificial
based techniques [8]. Within this context, the use of data-driven
modeling techniques along with different combinations of data
acquired from various sources can be used to provide clinically
meaningful output [9].
Glucose prediction models can be classified in different
ways such as Compartmental Models (CMs) and Data-Driven
Models [10]. Recently, data-driven models have gained
popularity due to their simpler structure, ability to process
significant amount of data in real time, and ease of
personalization [11] [12]. The majority of proposed methods
have been based on auto regressive (AR) [13], [14], [15], [16]
or AR moving average (ARMA) models of various orders [15]
and more recently, on artificial neural networks (ANNs). ARMA
models compute current values as a linear combination of past
values and past prediction errors. Several versions [17], [18]
exist where additional inputs can also be taken into account (AR
model with external insulin input [ARX]). Although AR and
ARMA models are linear, they are used for glucose prediction
because of their simple structure and relatively comprehensive
behavior. ANNs, on the other hand, are nonlinear models that
have been successfully applied in complex, nonlinear problems.
Depending on their architecture, ANNs are mainly classified
into feed-forward and feedback or recurrent. Other techniques of
ANN have been used such as multilayer perceptron (MLP) [19]
[20] , Neural Networks (NN) [21], Radial Basis Function (RBF)
NN (RBF) [22], wavelet NN [23] and neurofuzzy techniques
[12] have been successfully applied for the simulation of glucose
dynamics. Furthermore, glucose prediction models based on
Gaussian processes [2] [24] and support vector regression (SVR)
[2], [6] have been developed. Moreover, hybrid models based on
the combined use of CM and data-driven modelling techniques
such as AR [11], cARX [4] , SVR [25], and Self-Organizing
Map (SOM) [9] have derived promising results.
An accurate glucose prediction model that warned people up
to an hour in advance of imminent changes in their blood glucose
levels would allow plenty of time for them to take preventive

978-1-5386-3831-6/17/$31.00 ©2017 IEEE

action. Several glucose predicting model have been developed
in the past and comparing them is quite challenging due to
prominent differences concerning the adopted CGM sensors,
sampling time, preprocessing algorithms possibly used to
denoise the data, and size of the datasets.
Consequently, this paper conduct a literature survey on the
recent glucose prediction models and evaluate them to select the
most suitable one for the proposed diabetic patient monitoring
system.
II. RELATED WORK
In order to prevent, detect, and manage diabetes, many
models have been developed. Real time algorithms have been
developed for calibration, filtering of noisy signals and glucose
predictions for hypoglycemic and hyperglycemic alarms [26].
Risk prediction models and early diagnosis models are
developed for the management of T2DM. Similarly, glucose
prediction models and closed loop glucose controllers are
developed for the management of T1DM. Models for risk
predictions of long term complications are developed to manage
both T1DM and T2DM. An exhaustive review to evaluate all the
models is outside the scope of this paper and, in the remaining
section, the focus will be restricted only to new technologies to
monitor glucose in pervasive system for diabetics rather than
traditional glucose monitoring. Thus, glucose prediction models
that will be useful to propose the data analytics algorithm for the
proposed WBAN system are reviewed which will later be
described in Section VI.
A. Autoregressive Models
Sparacino et al., [13] predicted glucose levels ahead of time
using continuous monitoring data. The first algorithm was based
on first-order polynomial and the other one on autoregressive
(AR) models with time-varying parameters. In a more recent
study, Zanderigo et al., [27] evaluated the models using
continuous glucose error grid analysis (CG-EGA), showing that
their performance is similar, yet the AR model appeared to be
better at hypoglycemia prevention prediction.
Reifman et al., [14] proposed a predictor based on the data-
driven AR (10) model, with time-invariant and subject-invariant
parameters identified by regularized least-squares. The CGM
measurement rate was one sample per minute. The results
demonstrated that the predictions for a PH of 30 minutes were
quite accurate.
Finan et al., [17] have proposed ARX models using
information on past glucose, insulin, and carbohydrates (CHOs)
consumed. Batch and recursive methods of identification were
examined, and the models were assessed under normal
conditions and conditions of reduced insulin sensitivity.
Eren-Oruklu et al., [15] proposed prediction algorithms
based on AR(3) and on auto-regressive with moving average
(ARMA(3,1)) models exploiting past CGM readings solely,
with time-varying parameters identified by recursive least
squares, using a forgetting factor which could be changed
according to the glucose trend. The model resulted in average
relative absolute deviation (RAD) values of 2.6% and 3.7% for
healthy and diabetes patients and a prediction horizon (PH) of
30 min. As a continuation of this work, Eren-Oruklu et al, [28]
tested the ability of this method to provide early hypoglycemic
alarms, reduce false alarms, and, thus achieving increased
specificity.
Gani et al., [16] developed AR(30) models using three
approaches: (1) raw data and ordinary least squares; (2)
smoothed data and ordinary least squares; and (3) smoothed data
and regularized least squares with time-invariant parameters
identified. The model is used to make short-term, 30-min ahead
of BGL predictions. As a continuation of this work [5], a
universal glucose model that allows for clinical use of predictive
algorithms and CGM devices for proactive therapy of diabetic
patients is proved to be feasible. In a more recent study, Lu et
al., [29] presented a real-time implementation of the previously
developed [16] offline data-driven algorithm. The
implementation consisted of a Kalman filter for real-time
filtering of CGM data and a data-driven AR model for BGL
prediction.
Fanmao and Youqing [18] developed an expectation
maximization (EM) algorithm based on ARX model to identify
the diabetic model of two inpatients with T1DM whereby the
delay of insulin absorption can be varying at every sample.
B. Artificial Neural Network (ANN) Models
A time-lagged feedforward ANN trained with
backpropagation was proposed by Pappada et al., [30]. Despite
efficient prediction of euglycemia and hyperglycemia,
hypoglycemia tended to be overestimated. Eskaf et al., [31]
conducted a pilot study on a limited dataset consisting of only
one patient using the feedforward ANN model by modeling the
glycemic level as a dynamic system. Another feedforward ANN
trained with the back propagation Levenberg–Marquardt
algorithm was presented by Pérez-Gandía et al., [32] for the
online prediction of future glucose concentration levels from
CGM data for T1DM patients. Its performance when compared
with another algorithm based on an AR model proved to be more
accurate. Zarkogianni et al., [12] presented a personalized
glucose prediction model based on neuro-fuzzy techniques.
Moreover, wavelets are applied as activation functions to
enhance the prediction performance and avoid local minimum
during training stage. The model was able to capture the
metabolic behavior of a patient and handle intra- and inter-
patient variability.
C. Support Vector Regression (SVR) and Gaussian Models
Bunescu et al., [2] described a SVR model to predict the
blood glucose level using a generic physiological models. These
models required up to seven specific input features to make
reliable predictions. Reymann et al., [6] presented an algorithm
for mobile platforms to predict the BGL of a patient with a CGM
device. The algorithm can easily be integrated into existing
CGM readers or process the data transmitted by a CGM sensor.
The algorithm was designed with data of an online simulation
tool, followed by an evaluation with real patient data on a mobile
platform. Efendic et al., [24] used Gaussian Mixture Models
(GMM) to make short-term prediction of BGL.
 TABLE I. CLASSIFICATION PERFORMANCE OF GLUCOSE PREDICTING MODELS

Author Models Input Parameters Patients (Period) Evaluation [PH/RMSE;TL]

Autoregressive Models
Sparacino et al., AR (1) models with time 28 T1DM [30/18.78; TL of 3.79 min],
CGM data
(2007) varying parameters [13] (2 days) [45/34.64]
Zanderigo et al. AR (1) models with time 28 T1DM
CGM data [30/18.78; TL of 3.79 min]
(2007) varying parameters [27] (2 days)
Reifman et al. 9 T1DM [30/22.3] , [60/35.0],
AR (10) model [14] CGM data
(2007) (5 days) [120/53.8]
Both approaches resulted in
Autoregressive exogenous CGM data, Insulin, 9 T1DM
Finan et al. (2009) RMSEs:
input (ARX) models [17] CHO ingested (2 to 8 days)
[30/26], [45/45], [60/60]
Eren-Oruklu et al. AR(3) and (ARMA(3,1)) 14 T2DM
CGM data 30/3.83a
(2009) models [15] (2 days)
[30/1.8; TL of 0.2 min],
9 T2DM
Gani et al., (2009) AR (3) models [16] CGM data [60/14.4; TL of 12.3 min],
(5 days)
[90/28.8; TL of 38.4 min]
27 T1DM, 7 T2DM
Gani et al., (2011) AR (3) models [5] CGM data [30/3.6; TL of 0.3 min]
(4000 min)

27 T1DM, 7 T2DM [10/8.97; TL of 2.5 min],

Lu et al., (2011) AR (6) model [29] CGM data
(4000 min) [20/16.06 TL of 9.26 min]

Fanmao and CGM data, Insulin, 2 T1DM

ARX model [18] RSME : 0.02
Youqing (2016) meal (2 days)
Artificial Neural Network (ANN) Models
Feed-forward ANN model CGM data, food intake, 1 T1DM RSME : ranges from 3.6 to
Eskaf et al, (2008)
[31] daily activities (7 days) 22.284
15 T1DM [15/10; TL of 4 min] ,
Pérez-Gandía et al., Feed-forward ANN model
CGM data (72 hrs/week over 4 [30/18; TL of 12 min] ,
(2010) [32]
weeks) [45/27; TL of 20 min]
CGM data, Insulin,
Pappada et al., Feed-forward ANN model Nutrition,
10 T1DM [75/43.9]
(2011) [30] Lifestyle/Emotional
states, Time
blood pressure, gender
MLP (RSME) : 0.24
Behara et al., (2014) MLP and BN [20] ,alcohol consumption, 1825 patients
BN (RSME): 0.37
and fasting glucose

Neurofuzzy(applying
Zarkogianni et al, CGM data, Energy 6 T1DM [15/14.42], [30/20.20],
wavelets as activation
(2014) expenditure (7 to 15 days) [45/24.79], [60/28.49]
functions) [12]

Support Vector Regression (SVR) Models

Bunescu et al., CGM data, Insulin,
SVR [2] 10
(2013) Meals
Reymann et al., CGM data, CHO 5 T1DM
SVR [6] Error rate : 30/19%
(2016) intakes, Insulin (25 days)
Hybrid and Fusion Models
[5 / 4.6] ; [15 / 11.1] ; [30 /
Georga et al. (2016) QKLMS-FB [33] CGM data 15 T1DM
18.7] ; [45 / 24.7] ; [60 / 30.0]
Moukiakou et al., Hybrid model based on CM Insulin, Food intake, 9 T1DM
[30/18.34]
(2008) and RNN CGM data (10 days)

Daskalaki et al., Real-time adaptive models 23 T1DM

CGM data and Insulin [15/11.9], [30/18.9], [45/26.1]
(2012) (fusion of RNN and AR) [11] (8 days)
CGM data, Insulin,
Hybrid model based on CM 27 T1DM [15/5.21], [30/6.03], [60/7.14],
Georga et al., (2013) CHO, Exercise Data,
and SVR [25] (5 to 22 days) [120/7.62]
Time
Hybrid glucose-insulin
Zarkogianni et al., CHO ingested, Insulin , 12 T1DM
metabolism model based on [30/14.10], [60/23.19]
(2013) CGM data (10 days)
CM and SOM [9]
Botwey et al., (2014) cARX and RNN [4] CGM data 23 T1DM [30/26.5; TL of 20 min]
PH: Prediction Horizon (min), RMSE: Root mean square error (mg/dl), TL: Time Lags, a: mean absolute percentage error

D. Hybrid and Fusion Models
Mougiakakou et al., [34] presented a hybrid model based on
the combined use of CMs and RNN. In [11], Daskalaki et al.,
presented the fusion of real-time adaptive models of recurrent
neural networks (RNN) and AR models. Botwey et al., [4]
developed a multi-model data fusion to improve an early
warning system for hypo-/hyperglycemic events. The study
shows that compared to the cARX and RNN models, and a linear
fusion of the two, the proposed fusion schemes represents a
significant improvement.
Georga et al., [25] presented a hybrid model based on the
combined use of CMs and SVR for the multivariate prediction
of the subcutaneous glucose concentration in patients with
T1DM. The study points out that the availability of multivariable
data and their effective combination can significantly increase
the accuracy of both short-term and long-term predictions.
Zarkogianni et al. [9], presented a personalized hybrid
glucose-insulin metabolism model based on the combined use of
CMs and a SOM. The model demonstrated the ability to capture
the patients’ metabolic behavior and to handle intra- and inter-
patient variability.
III. EVALUATION OF DATA ANALYTICS ALGORITHMS FOR
THE WBAN SYSTEM
Table I summarizes the classification performance of the
glucose prediction models discussed in Section II. For each
model, their methods, along with their input parameters, types
of diabetic patients and monitoring period are presented.
Common input parameters include CGM data, insulin infusion
rates, insulin dosages, and lifestyle/ emotional states such as
carbohydrate (CHO) ingested, nutritional intake, exercise type
and duration. Moreover, the evaluated results present the
performance results of each model in terms of root mean square
error (RMSE) and any possible time lags (TL).
Despite the comparison of the glucose predictive algorithms’
performance is not feasible due to the different models applied,
input parameters, dataset and evaluation methodology used,
several prominent conclusions can be still drawn in order to
select the most appropriate one for the proposed WBAN.
As shown in Table 1, most of glucose prediction models
developed are aimed at T1DM patients and very few glucose
prediction models have been developed and evaluated for
T2DM patients. Therefore, there is a high need of applying more
sophisticated techniques to capture the metabolic behavior of a
patient with both T1DM and T2DM, and ultimately predict their
glucose levels.
Moreover, it can be observed that almost all the algorithms’
predictive performance or accuracy declines (higher RSME) as
the prediction horizon (PH) increases proving that most models
have yet to be improved in order to make long-term predictions.
Many models have been developed based on the AR, ARMA
and ARX techniques. However, the AR models can not reflect
the relationship between glucose and input for example
carbohydrate and insulin, therefore ARX models [18], [35], [11],
[17] have further been developed and evaluated.
It can be observed that the raw CGM data are filtered to
remove high-frequency noise spikes. Moreover, despite the
adaptive nature of the model, the lags between predicted and
measured values were quite significant and the study do not
report if further lags are introduced due to the Butterworth filter.
Furthermore, the model uses an AR model of order one which is
inadequate to capture the temporal variations of the time-series
glucose signals. Even though the model can produce clinically
acceptable predictions, it is individual specific and needs to be
adapted to every individual and thus, decreasing its practicality
[13]. Even though raw CGM time-series data were used in the
AR(10) model with fixed coefficients, the time lags were
relatively large, further reducing their practical applicability and
clinical benefits [14]. The application of a more informative
input parameters such as quantitative measures of lifestyle data
for exercise and stress levels could result in better predictive
performance [17]. Gani et al., [16] [5] attempted to predict
glucose levels with acceptable time lags as compared to the
model [14]. However, their entire time series have been
previously smoothed which is never the case in a real-time.
Glucose prediction models based on ANNs presented so far
did not outperform the simpler strategies based on time-series
modeling. For the same dataset, the results in [32] are relatively
the same as of [13]. Moreover, the results in [30] indicate that
the NN described therein does not outperform the NN in [32].
Additionally, the performance of Multilayer MLP model with
23 hidden layers was found to be better than that of BN [20].
For 30-min predictions, [16] and [5] outperforms all the
other methods proposed in terms of lowest RSME and barely no
time lags. However, both methods are based only on CGM data
segments and are described by a stationary process. Thus, more
comprehensive input parameters could results into better
predictive performance. The accuracy of the prediction models
could be further optimized by improving the accuracy on larger
dataset. Moreover, besides evaluating the RSME, it is also
important to compute the mean absolute percentage error to
compare its accuracy with other related models. The other model
that achieved the lowest RMSE values than the other glucose
predicting models in terms of performance and accuracy is the
hybrid model based on CM and SVR [25], which demonstrates
the need of applying advanced data analytics and modeling
approaches based on hybrid models.
Almost all the models based on SVR [2], [25] and [36]
requires a physiological model for glucose prediction, do not
include an unobtrusive mobile application and do not trigger any
alarms to the user whenever a threshold is exceeded as compared
to the algorithm developed in [6].
For this research, an ARX model seems to be more suitable
for the proposed WBAN system [37]. The ARX model reflects
the relationship between glucose and exogenous inputs by
including inputs signals into the model structures such as BP,
TC, HDL and LDL. The data analytic algorithm is based on the
ARX model time series prediction process to predict the glucose
concentration of the patient and also to perform continuous
monitoring.
 IV. DOMAIN ANALYSIS
According to the International Diabetes Federation (IDF), in
2015, 418 million people had Diabetes Mellitus (DM) in the
world and 78 million people in the SEA Region were suffering
from DM, while it was estimated that by 2040 this number will
rise to 642 million. There were 220,000 cases of DM in
Mauritius in 2015 and the undiagnosed cases reached up to 113
million. In 2015, 2,932 deaths were attributed to DM, while the
associated cost per person with diabetes was estimated at USD
500 dollars [38]. The IDF estimated that Mauritius had a
prevalence rate of DM of 24.3%, in 2015. The recent NCD
survey report highlighted that the rapid increase in DM in
Mauritius indicated an austere future in terms of health
complications, associated disorders, and the rising costs of
health care. Hence, urgent measures and research are required
both for prevention and treatment of DM to shift the emphasis
from the disease to wellness [39].
The exponential rise in medical data results into complex,
and time consuming data processing and interpretation for both
patients and physicians. DM prevention, diagnosis, risk
reduction, decision making and timely intervention are not
trivial tasks since it is very challenging to process the acquired
data and information into useful knowledge. Recent
advancements in body area networks coupled with data analytics
have led to many promising development of personalized,
predictive, preventive, and participatory healthcare approaches
[10] [40]. Recent glucose monitoring technologies combined
with the smart data analytics can allow patients to continuously
monitor their BGL and ultimately optimize self DM
management, ensure better health monitoring, reduce further
risk complications and consequently, enhance the quality of
healthcare in Mauritius. The development of glucose prediction
models can eventually process the patients’ data and information
into clinically useful advanced knowledge to facilitate the
appropriate patient reaction in crucial situations.
V. DESIGN ARCHITECTURE
The design architecture of the system is based on the
Wireless Body Area Network (WBAN) proposed by Huzooree
et al., [37].
Fig.1. High-level WBAN architecture.
As shown in Fig 1, both invasive and non-invasive sensors are
used to sense the vital signs, represent the data (pre-processing,
compression and filtering), and transfer the sensed data over
short-range wireless communication to the patient’s android
smartphone. The smartphone then aggregates and stores the
sensed data, processes the energy consumption, provides the
healthcare monitoring interface to the patients for logging and
also sends the physiological data to the medical server at a
specified time interval whereby the physicians can directly have
access for further analysis, diagnosis and intervention.
VI. PROPOSED GLUCOSE PREDICTION MODEL FOR DATA
ANALYTICS FOR THE WBAN SYSTEM
Based on the evaluation of the models in section III, the ARX
model seems more appropriate for the proposed WBAN system
since it can accommodate exogenous inputs as compared to the
AR model, which are necessary inputs to a practical application
for glucose control. A high level glucose prediction model for
data analytics is depicted in Fig 2.
Fig.2. High-level glucose prediction model for data analytics.
At the sensor tier, the sensor devices collect the patients’
physiological parameters (such as blood glucose, blood pressure
and blood oxygen saturation) and transmit them via Bluetooth to
the mobile computing tier. In this tier, the sensed data from the
sensors, and other input data from the patients are processed as
a dataset (as shown in Table II) and are then transmitted to the
remote server tier via Internet. At the remote server, data
selection, cleaning, filtering and transformation are the main
steps of data pre-processing prior to perform data analytics.
During the data analytics process, the data are trained initially
and then the model is tested using the trained data. After the
model is validated, it can be hosted on the remote server to
predict real time glucose analytics and trigger alarms to the
physicians or patients whenever the threshold is exceeded. This
paper will focus only on the glucose prediction model in the data
analytics process.
Present glucose values can be estimated as linear
combinations of past glucose measurements using the ARX
model expression. The general form of the ARX model can be
described as eq (1)
(1)
 Equation (1) can be adapted to accommodate for the represented by and is the number of BG measurements
exogenous inputs such as BP, TC, LDL and HDL. The glucose taken.
prediction model to perform data analytics for this research is
described below as MAE ∑ | | (3)
⋯ γ (2) RMSE measures the standard deviation of the differences in
the predicted BG level ( ) and the actual BG level (a).
In (2), the glucose concentration is denoted at sampling
interval . to denote the independent variables from which ∑
the glucose measurement is to be predicted. The value of the (4)
exogenous inputs in period t is denoted by . For example,
could be BP, TC, LDL and HDL. γ is a constant disturbance, Furthermore, measures the proportion of the variance of
the white Gaussian noise is denoted by and is the discrete- the BG level, which is the dependent variable that can be
time sampling instant, i.e., = 1,2,.. predicted from the independent variables.

The coefficients for glucose concentration, carbohydrate 1 (5)

intake, insulin dosage are to respectively and are identified
using the least square ARX method. The dataset was divided into 2 sets whereby the first set
consisted of 330 records to train the model and the remaining
VII. DATA ANALYSIS AND EVALUATION 112 records were used to evaluate if the model was able to
predict the glucose measurements. Fig 3 shows the actual and
The data used in this research is from the diabetes dataset fitted graph and demonstrates clear correlation between the
used by Efron et al., [41]. This dataset includes 442 sets of data actual and predicted glucose levels. Moreover, the Residual Q-
recorded on diabetes patients. Table II is a representation of the Q Plot in Fig 4 demonstrates that the model is fit for glucose
dataset used in this research. prediction. Finally, the performance metrics MAE resulted in
7.44, RMSE in 9.28 and R2 in 0.342, which confirm that the
TABLE II. DATASET CHARACTERISTICS model can be used for glucose prediction.
Input
Values Input Parameters Values
Parameters
Patient Baseline Descriptive Statistics of the Glucose
Characteristics Dataset
235F /
Gender Total Cholesterol (TC) 189±34.6
207M
Low-density lipoprotein
Agea 48.5±13a 115±30.4
Cholesterol (LDL)
High Density
BMI 26.4±4.4 49.8±12.9
Lipoproteins (HDL)
Blood
94.6±13.8 Ratio (TC/HDL) 4.0±1.29
Pressure
Glucose 91.2±11.5
a.
Data are mean±standard deviation value
Moreover, an ideal TC is < 200 mg/dl. A borderline high TC
ranges 200-239 mg/dl. A high TC is >= 240 mg/dl. An ideal
LDL is < 100mg/dl, a close to ideal LDL ranges 100-129 mg/dl, Fig.3. Actual vs Fitted Graph
a borderline high LDL ranges 130-159 mg/dl, a high LDL ranges
160-189 mg/dl, and a very high LDL is >=190 mg/dl. A low
HDL is <40 mg/dl, a normal HDL ranges 40-59 mg/dl and a best
HDL is >=60 mg/dl. A glucose concentration value ≤70 mg/dl
is defined as hypoglycemic and a glucose concentration value
≥180 mg/dl is defined as hyperglycemic. If ever the threshold
set is reached, an alarm is triggered whereby the patient will
receive a warning message on his mobile phone and similarly
the physician will receive a warning message on the remote
server.
To evaluate the prediction performance of the model, the
metrics mean absolute error (MAE), root-mean-square error
(RMSE), and coefficient of determination (R2) are applied.
The MAE is the average error between the predicted BG
level and the actual BG level. In (3), the predicted BG
concentration is denoted by g, the actual BG concentration is
Fig.4. Q-Q Plot
 The second set of experiment was used to predict the glucose
measurements. Fig 5 shows that all the forecasted values falls
within the 95% interval of confidence therefore demonstrating
that the model is reliable.
Fig.5. Glucose Prediction Graph
The proposed model can be beneficial for diabetic patient
management since the patients can easily predict their glucose
level based on different exogenous inputs and will consequently
allow them to self-manage their conditions thereby decreasing
hospital expenses and increasing their quality of life.
VIII. FUTURE RESEARCH DIRECTIONS AND CHALLENGES
Despite all the recent advancements towards the
development of several glucose prediction models for diabetes
management, they are still not yet widely accepted due to several
reasons. There are still many future works and challenges to be
tackled to achieve a perfect compromise in terms of performance
and accuracy when developing the glucose prediction model.
Error Grid analysis can be used to analyze the performance of
several prediction algorithms to most effective modeling
approach. Most models' performance decline as the prediction
horizon increases thereby increasing the need for optimized
algorithms. Many models consider only CGM data for glucose
prediction and exclude other exogenous inputs which
consequently result into inaccurate data analysis and unreliable
decision making. Advanced powerful data analytics and
modeling approaches are needed to detect correlation from the
diverse range of raw data to extract clinically meaningful
knowledge and to be widely accepted for clinical practice.
Moreover, there is limited research conducted on glucose
prediction models applicable to patient suffering from both Type
1 and Type 2 diabetes.
IX. CONCLUSION
Self-monitoring and remote monitoring of patients generate
big data representing a wide range of patients’ data which
consist of medical, lifestyle and social information. There is a
high need to exploit these data effectively to better detect,
prevent, diagnose, predict and treat diabetes. Based on the
evaluation of the various recent glucose prediction models using
autoregressive, ANN, SVR, Gaussian, hybrid and fusion model,
this paper proposes a glucose prediction model using ARx to
perform data analytics for a wireless body area network system.
The proposed prediction model have been evaluated by
simulation experiments and the results demonstrate that the
proposed model improves the prediction accuracy. This model
will allow preventive intervention through self-disease
management and improve glucose control. As future work, this
work can be extended to analyze and further optimize the
performance of the glucose prediction algorithm by using bigger
prediction horizon.
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