Toward Detection of Nocturnal Hypoglycemia in People With Diabetes Using Consumer-Grade Smartwatches and a Machine Learning Approach.

IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM
Camilo Mendez, Ceren Asli Kaykayoglu, Thiemo Bähler, Juri Künzler, Aritz Lizoain, Martina Rothenbühler, Markus H Schmidt, Markus Laimer, Lilian Witthauer
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Abstract

Background: Nocturnal hypoglycemia poses significant risks to individuals with insulin-treated diabetes, impacting health and quality of life. Although continuous glucose monitoring (CGM) systems reduce these risks, their poor accuracy at low glucose levels, high cost, and availability limit their use. This study examined physiological biomarkers associated with nocturnal hypoglycemia and evaluated the use of machine learning (ML) to detect hypoglycemia during nighttime sleep using data from consumer-grade smartwatches.

Methods: This study analyzed 351 nights of 36 adults with insulin-treated diabetes. Participants wore two smartwatches alongside CGM systems. Linear mixed-effects models compared sleep and vital signs between nights with and without hypoglycemia during early and late sleep. A ML model was trained to detect hypoglycemia solely using smartwatch data.

Results: Sixty-six nights with spontaneous hypoglycemia were recorded. Hypoglycemic nights showed increased wake periods, heart rate, stress levels, and activity during early sleep, with weaker effects during late sleep. In nights when hypoglycemia occurred during early sleep, the ML model performed comparable or better than prior studies with an area under the receiver operator curve of 0.78 for level 1 and 0.83 for level 2 hypoglycemia, with sensitivity of 0.78 and 0.89, specificity of 0.64 for both, negative predictive value of 0.94 and 0.99, and positive predictive value of 0.25 and 0.13 for level 1 and level 2 hypoglycemia, respectively.

Conclusions: Consumer-grade smartwatches demonstrate promise for detecting nocturnal hypoglycemia, particularly during early sleep. Refining models to reduce false alarms could enhance their clinical utility as low-cost, accessible tools to complement CGM.

利用消费级智能手表和机器学习方法检测糖尿病患者的夜间低血糖症。
背景:夜间低血糖对胰岛素治疗的糖尿病患者具有显著的风险,影响健康和生活质量。尽管连续血糖监测(CGM)系统降低了这些风险,但它们在低血糖水平下的准确性差、成本高和可用性限制了它们的使用。本研究检查了与夜间低血糖相关的生理生物标志物,并利用消费级智能手表的数据评估了机器学习(ML)在夜间睡眠期间检测低血糖的应用。方法:本研究分析了36例胰岛素治疗糖尿病患者的351个夜晚。参与者佩戴了两个智能手表和CGM系统。线性混合效应模型比较了有低血糖和没有低血糖的夜间早睡和晚睡之间的睡眠和生命体征。训练ML模型,仅使用智能手表数据检测低血糖。结果:共66例自发性低血糖患者。低血糖夜表明,早睡时醒来时间、心率、压力水平和活动增加,晚睡时影响较弱。在早期睡眠时发生低血糖的夜晚,ML模型的受试者操作曲线下面积与先前研究相当或更好,1级低血糖为0.78,2级低血糖为0.83,敏感性为0.78和0.89,特异性为0.64,1级和2级低血糖的阴性预测值分别为0.94和0.99,阳性预测值分别为0.25和0.13。结论:消费级智能手表有望检测夜间低血糖,尤其是在早期睡眠时。改进模型以减少误报可以提高其作为低成本、可获得的工具补充CGM的临床效用。
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来源期刊
Journal of Diabetes Science and Technology
Journal of Diabetes Science and Technology Medicine-Internal Medicine
CiteScore
7.50
自引率
12.00%
发文量
148
期刊介绍: The Journal of Diabetes Science and Technology (JDST) is a bi-monthly, peer-reviewed scientific journal published by the Diabetes Technology Society. JDST covers scientific and clinical aspects of diabetes technology including glucose monitoring, insulin and metabolic peptide delivery, the artificial pancreas, digital health, precision medicine, social media, cybersecurity, software for modeling, physiologic monitoring, technology for managing obesity, and diagnostic tests of glycation. The journal also covers the development and use of mobile applications and wireless communication, as well as bioengineered tools such as MEMS, new biomaterials, and nanotechnology to develop new sensors. Articles in JDST cover both basic research and clinical applications of technologies being developed to help people with diabetes.
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