A new index to optimally design and compare continuous glucose monitoring glucose prediction algorithms.

BACKGROUND Continuous glucose monitoring (CGM) data can be exploited to prevent hypo-/hyperglycemic events in real time by forecasting future glucose levels. In the last few years, several glucose prediction algorithms have been proposed, but how to compare them (e.g., methods based on polynomial rather than autoregressive time-series models) and even how to determine the optimal parameter set for a given method (e.g., prediction horizon and forgetting) are open problems. METHODS A new index, J, is proposed to optimally design a prediction algorithm by taking into account two key components: the regularity of the predicted profile and the time gained thanks to prediction. Effectiveness of J is compared with previously proposed criteria such as the root mean square error (RMSE) and continuous glucose-error grid analysis (CG-EGA) on 20 Menarini (Florence, Italy) Glucoday® CGM data sets. RESULTS For a given prediction algorithm, the new index J is able to suggest a more consistent and better parameter set (e.g., prediction horizon and forgetting factor of choice) than RMSE and CG-EGA. In addition, the minimization of J can reliably be used as a selection criterion in comparing different prediction methods. CONCLUSIONS The new index can be used to compare different prediction strategies and to optimally design their parameters.

[1]  Giovanni Sparacino,et al.  Continuous glucose monitoring time series and hypo/hyperglycemia prevention: requirements, methods, open problems. , 2008, Current diabetes reviews.

[2]  D. Klonoff Continuous glucose monitoring: roadmap for 21st century diabetes therapy. , 2005, Diabetes care.

[3]  C. C. Palerm,et al.  Hypoglycemia prediction and detection using optimal estimation. , 2005, Diabetes technology & therapeutics.

[4]  J. Mastrototaro,et al.  Alarms based on real-time sensor glucose values alert patients to hypo- and hyperglycemia: the guardian continuous monitoring system. , 2004, Diabetes technology & therapeutics.

[5]  C. Cobelli,et al.  Artificial neural network algorithm for online glucose prediction from continuous glucose monitoring. , 2010, Diabetes technology & therapeutics.

[6]  Srinivasan Rajaraman,et al.  Predicting Subcutaneous Glucose Concentration in Humans: Data-Driven Glucose Modeling , 2009, IEEE Transactions on Biomedical Engineering.

[7]  Jay S Skyler,et al.  Continuous glucose monitoring: an overview of its development. , 2009, Diabetes technology & therapeutics.

[8]  Giovanni Sparacino,et al.  An Online Self-Tunable Method to Denoise CGM Sensor Data , 2010, IEEE Transactions on Biomedical Engineering.

[9]  W Kenneth Ward The role of new technology in the early detection of hypoglycemia. , 2004, Diabetes technology & therapeutics.

[10]  Giovanni Sparacino,et al.  Glucose Prediction Algorithms from Continuous Monitoring Data: Assessment of Accuracy via Continuous Glucose Error-Grid Analysis , 2007, Journal of diabetes science and technology.

[11]  Giovanni Sparacino,et al.  Continuous glucose monitoring and hypo/hyperglycaemia prediction , 2006 .

[12]  L. Quinn,et al.  Estimation of future glucose concentrations with subject-specific recursive linear models. , 2009, Diabetes technology & therapeutics.

[13]  Alberto Maran,et al.  Continuous subcutaneous glucose monitoring in diabetic patients: a multicenter analysis. , 2002, Diabetes care.

[14]  Bruce Buckingham Hypoglycemia detection, and better yet, prevention, in pediatric patients. , 2005, Diabetes technology & therapeutics.

[15]  Giovanni Sparacino,et al.  Glucose Concentration can be Predicted Ahead in Time From Continuous Glucose Monitoring Sensor Time-Series , 2007, IEEE Transactions on Biomedical Engineering.