Enhancing Blood Glucose Prediction with Meal Absorption and Physical Exercise Information

Objective: Numerous glucose prediction algorithm have been proposed to empower type 1 diabetes (T1D) management. Most of these algorithms only account for input such as glucose, insulin and carbohydrate, which limits their performance. Here, we present a novel glucose prediction algorithm which, in addition to standard inputs, accounts for meal absorption and physical exercise information to enhance prediction accuracy. Methods: a compartmental model of glucose-insulin dynamics combined with a deconvolution technique for state estimation is employed for glucose prediction. In silico data corresponding from the 10 adult subjects of UVa-Padova simulator, and clinical data from 10 adults with T1D were used. Finally, a comparison against a validated glucose prediction algorithm based on a latent variable with exogenous input (LVX) model is provided. Results: For a prediction horizon of 60 minutes, accounting for meal absorption and physical exercise improved glucose forecasting accuracy. In particular, root mean square error (mg/dL) went from 26.68 to 23.89, p<0.001 (in silico data); and from 37.02 to 35.96, p<0.001 (clinical data - only meal information). Such improvement in accuracy was translated into significant improvements on hypoglycaemia and hyperglycaemia prediction. Finally, the performance of the proposed algorithm is statistically superior to that of the LVX algorithm (26.68 vs. 32.80, p<0.001 (in silico data); 37.02 vs. 49.17, p<0.01 (clinical data). Conclusion: Taking into account meal absorption and physical exercise information improves glucose prediction accuracy.