title: A glucose model based on support vector regression for the prediction of hypoglycemic events under free-living conditions.
abstract: BACKGROUND
  The prevention of hypoglycemic events is of paramount importance in the daily management of insulin-treated diabetes. The use of short-term prediction algorithms of the subcutaneous (s.c.) glucose concentration may contribute significantly toward this direction. The literature suggests that, although the recent glucose profile is a prominent predictor of hypoglycemia, the overall patient's context greatly impacts its accurate estimation. The objective of this study is to evaluate the performance of a support vector for regression (SVR) s.c. glucose method on hypoglycemia prediction.
  
  
  METHODS
  We extend our SVR model to predict separately the nocturnal events during sleep and the non-nocturnal (i.e., diurnal) ones over 30-min and 60-min horizons using information on recent glucose profile, meals, insulin intake, and physical activities for a hypoglycemic threshold of 70 mg/dL. We also introduce herein additional variables accounting for recurrent nocturnal hypoglycemia due to antecedent hypoglycemia, exercise, and sleep. SVR predictions are compared with those from two other machine learning techniques.
  
  
  RESULTS
  The method is assessed on a dataset of 15 patients with type 1 diabetes under free-living conditions. Nocturnal hypoglycemic events are predicted with 94% sensitivity for both horizons and with time lags of 5.43 min and 4.57 min, respectively. As concerns the diurnal events, when physical activities are not considered, the sensitivity is 92% and 96% for a 30-min and 60-min horizon, respectively, with both time lags being less than 5 min. However, when such information is introduced, the diurnal sensitivity decreases by 8% and 3%, respectively. Both nocturnal and diurnal predictions show a high (>90%) precision.
  
  
  CONCLUSIONS
  Results suggest that hypoglycemia prediction using SVR can be accurate and performs better in most diurnal and nocturnal cases compared with other techniques. It is advised that the problem of hypoglycemia prediction should be handled differently for nocturnal and diurnal periods as regards input variables and interpretation of results.
authors.affiliation: Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece.
authors.forename: Eleni I
authors.initials: EI
authors.lastname: Georga
authors.forename: Vasilios C
authors.initials: VC
authors.lastname: Protopappas
authors.forename: Diego
authors.initials: D
authors.lastname: Ardigò
authors.forename: Demosthenes
authors.initials: D
authors.lastname: Polyzos
authors.forename: Dimitrios I
authors.initials: DI
authors.lastname: Fotiadis
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000465:Algorithms; D002940:Circadian Rhythm; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000378:metabolism; D005060:Europe / Q000453:epidemiology; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000517:prevention & control; D007003:Hypoglycemia / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D015994:Incidence; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D018670:Monitoring, Ambulatory; D011237:Predictive Value of Tests; D012890:Sleep; D040521:Subcutaneous Tissue / Q000187:drug effects / Q000378:metabolism*; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D005947:Glucose