title: Evaluation of the utility of a glycemic pattern identification system.
abstract: BACKGROUND
  With the increasing prevalence of systems allowing automated, real-time transmission of blood glucose data there is a need for pattern recognition techniques that can inform of deleterious patterns in glycemic control when people test. We evaluated the utility of pattern identification with a novel pattern identification system named Vigilant™ and compared it to standard pattern identification methods in diabetes.
  
  
  METHODS
  To characterize the importance of an identified pattern we evaluated the relative risk of future hypoglycemic and hyperglycemic events in diurnal periods following identification of a pattern in a data set of 536 patients with diabetes. We evaluated events 2 days, 7 days, 30 days, and 61-90 days from pattern identification, across diabetes types and cohorts of glycemic control, and also compared the system to 6 pattern identification methods consisting of deleterious event counts and percentages over 5-, 14-, and 30-day windows.
  
  
  RESULTS
  Episodes of hypoglycemia, hyperglycemia, severe hypoglycemia, and severe hyperglycemia were 120%, 46%, 123%, and 76% more likely after pattern identification, respectively, compared to periods when no pattern was identified. The system was also significantly more predictive of deleterious events than other pattern identification methods evaluated, and was persistently predictive up to 3 months after pattern identification.
  
  
  CONCLUSIONS
  The system identified patterns that are significantly predictive of deleterious glycemic events, and more so relative to many pattern identification methods used in diabetes management today. Further study will inform how improved pattern identification can lead to improved glycemic control.
authors.affiliation: InSpark Technologies, Inc, Charlottesville, VA, USA eotto@insparktech.com.
authors.forename: Erik A
authors.initials: EA
authors.lastname: Otto
authors.affiliation: Taan Consulting LLC, Charlottesville, VA, USA.
authors.forename: Vinay
authors.initials: V
authors.lastname: Tannan
mesh_terms: D019540:Area Under Curve; D019985:Benchmarking; D001786:Blood Glucose / Q000032:analysis*; D002940:Circadian Rhythm / Q000502:physiology; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy; D006801:Humans; D006943:Hyperglycemia / Q000097:blood; D007003:Hypoglycemia / Q000097:blood; D010363:Pattern Recognition, Automated; D011237:Predictive Value of Tests; D018570:Risk Assessment
chemical_list: D001786:Blood Glucose
keywords: analysis; blood; diabetes; glucose; identification; pattern