A novel fuzzy neural network estimator for predicting hypoglycaemia in insulin-induced subjects

Predicting the onset of hypoglycaemia can avoid major health complications in Type I insulin-dependent-diabetes-mellitus (IDDM) patients. This paper describes the design of a novel fuzzy neural network estimator algorithm (FNNE) for predicting the glycaemia profile and onset of hypoglycaemia in insulin-induced subjects, by modelling the changes in heart rate and skin impedance parameters. Hypoglycaemia was induced briefly in 12 volunteers (group A: 6 non-diabetic subjects and group B: 6 Type 1 IDDM patients) using insulin infusion. Their skin impedances, heart rates and actual blood glucose levels (BGL) were monitored at regular intervals. The FNNE algorithm was trained using all subjects from group A and validated/tested on the remaining subjects from group B. The mean error of estimation of BGL profile for the training data set (group A) was 0.107 (p < 0.05) and for the validation/test data set (group B) was 0.139 (p < 0.05). Furthermore, the FNNE algorithm was able to predict the onset of hypoglycaemia episodes in group A and group B with a mean error of 0.071 (p < 0.03) and 0. 176 (p < 0.05) respectively.

[1]  P. Cryer,et al.  Hypoglycemia in IDDM , 1989, Diabetes.

[2]  N. Ghevondian,et al.  Low power portable monitoring system of parameters for hypoglycaemic patients , 1997, Proceedings of the 19th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. 'Magnificent Milestones and Emerging Opportunities in Medical Engineering' (Cat. No.97CH36136).

[3]  Michio Sugeno,et al.  Fuzzy identification of systems and its applications to modeling and control , 1985, IEEE Transactions on Systems, Man, and Cybernetics.

[4]  S R Heller,et al.  Physiological disturbances in hypoglycaemia: effect on subjective awareness. , 1991, Clinical science.

[5]  M. Sugeno,et al.  Structure identification of fuzzy model , 1988 .

[6]  E. B. French,et al.  Cholinergic manifestations of the acute autonomic reaction to hypoglycaemia in man. , 1983, Clinical science.

[7]  W. Tamborlane,et al.  Defective glucose counterregulation after strict glycemic control of insulin-dependent diabetes mellitus. , 1987, The New England journal of medicine.

[8]  Jacek M. Zurada,et al.  Introduction to artificial neural systems , 1992 .

[9]  H. Uno,et al.  Sympathetic innervation of the sweat glands and piloarrector muscles of macaques and human beings. , 1977, The Journal of investigative dermatology.

[10]  T Bennett,et al.  The physiological effects of insulin-induced hypoglycaemia in man: responses at differing levels of blood glucose. , 1983, Clinical science.

[11]  S. Genuth,et al.  The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. , 1993, The New England journal of medicine.

[12]  N D Harris,et al.  A portable system for monitoring physiological responses to hypoglycaemia. , 1996, Journal of medical engineering & technology.