title: Glycemic Control Indices and Their Aggregation in the Prediction of Nocturnal Hypoglycemia From Intermittent Blood Glucose Measurements.
abstract: Despite the risk associated with nocturnal hypoglycemia (NH) there are only a few methods aiming at the prediction of such events based on intermittent blood glucose monitoring data. One of the first methods that potentially can be used for NH prediction is based on the low blood glucose index (LBGI) and suggested, for example, in Accu-Chek® Connect as a hypoglycemia risk indicator. On the other hand, nowadays there are other glucose control indices (GCI), which could be used for NH prediction in the same spirit as LBGI. In the present study we propose a general approach of combining NH predictors constructed from different GCI.
  
  
  
  The approach is based on a recently developed strategy for aggregating ranking algorithms in machine learning. NH predictors have been calibrated and tested on data extracted from clinical trials, performed in EU FP7-funded project DIAdvisor. Then, to show a portability of the method we have tested it on another dataset that was received from EU Horizon 2020-funded project AMMODIT.
  
  
  
  We exemplify the proposed approach by aggregating NH predictors that have been constructed based on 4 GCI associated with hypoglycemia. Even though these predictors have been preliminary optimized to exhibit better performance on the considered dataset, our aggregation approach allows a further performance improvement. On the dataset, where a portability of the proposed approach has been demonstrated, the aggregating predictor has exhibited the following performance: sensitivity 77%, specificity 83.4%, positive predictive value 80.2%, negative predictive value 80.6%, which is higher than conventionally considered as acceptable.
  
  
  
  The proposed approach shows potential to be used in telemedicine systems for NH prediction.
authors.affiliation: Indian Institute of Technology Delhi, New Delhi, India siva@maths.iitd.ac.in.
authors.forename: Sivananthan
authors.initials: S
authors.lastname: Sampath
authors.affiliation: Johann Radon Institute for Computational and Applied Mathematics (RICAM), Austrian Academy of Sciences, Linz, Wien, Austria.
authors.forename: Pavlo
authors.initials: P
authors.lastname: Tkachenko
authors.affiliation: Department of Endocrinology, Diabetes, Nutrition, and CIC INSERM 1411, Montpellier University Hospital, Montpellier, France.|Institute of Functional Genomics, UMR CNRS 5203/INSERM U1191, University of Montpellier, Montpellier, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Renard
authors.affiliation: Johann Radon Institute for Computational and Applied Mathematics (RICAM), Austrian Academy of Sciences, Linz, Wien, Austria.
authors.forename: Sergei V
authors.initials: SV
authors.lastname: Pereverzev
mesh_terms: D000465:Algorithms; D001786:Blood Glucose / Q000032:analysis*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D006801:Humans; D007003:Hypoglycemia / Q000097:blood*; D000069550:Machine Learning
chemical_list: D001786:Blood Glucose
keywords: aggregation; prediction from glycemic control indices; prediction of nocturnal hypoglycemia; type 1 diabetes