Long-acting insulin management for blood glucose prediction models.

Abstract

Currently available state-of-the-art mathematical models for blood glucose level prediction have been developed for intensive care departments, and thus they do not support long-acting or ‘basal’ insulins applied typically once a day. Our goal was to adjust the current models to support basal insulin, and thus provide a short term blood glucose prediction service applicable in outpatient care, in the form of a smartphone application. We propose a method that simulates the absorption of basal insulin as a series of smaller insulin doses according to four alternative ‘dosing profiles’, instead of using a single big dose of bolus insulin. The corrected model was tested on 18 data sets originating from a clinical trial in which 16 insulin dependent patients (7 female and 9 male) used a continuous glucose monitor device to record their blood glucose levels for six days, while their meals were recorded. The prediction errors of the corrected model were compared to the errors of the original model with the usual statistical methods and the error grid analysis. We also evaluated the night periods separately from the day-time. The proposed model correction was found to reduce the error of the prediction with respect to all investigated evaluation criteria by 0.59-1.02 mmol/l, moving the average absolute error close to the error range on the measurement devices. This reduction could bring online, continuous blood glucose prediction services closer to mass deployment in lifestyle support applications for diabetics.