Feature-Based Machine Learning Model for Real-Time Hypoglycemia Prediction

Darpit Dave, Daniel J. DeSalvo, Balakrishna Haridas, Siripoom McKay, Akhil Shenoy, Chester J. Koh, Mark Lawley, Madhav Erraguntla

Research output: Contribution to journalArticlepeer-review

63 Scopus citations


Background: Hypoglycemia is a serious health concern in youth with type 1 diabetes (T1D). Real-time data from continuous glucose monitoring (CGM) can be used to predict hypoglycemic risk, allowing patients to take timely intervention measures. Methods: A machine learning model is developed for probabilistic prediction of hypoglycemia (<70 mg/dL) in 30- and 60-minute time horizons based on CGM datasets obtained from 112 patients over a range of 90 days consisting of over 1.6 million CGM values under normal living conditions. A comprehensive set of features relevant for hypoglycemia are developed and a parsimonious subset with most influence on predicting hypoglycemic risk is identified. Model performance is evaluated both with and without contextual information on insulin and carbohydrate intake. Results: The model predicted hypoglycemia with >91% sensitivity for 30- and 60-minute prediction horizons while maintaining specificity >90%. Inclusion of insulin and carbohydrate data yielded performance improvement for 60-minute but not for 30-minute predictions. Model performance was highest for nocturnal hypoglycemia (~95% sensitivity). Shortterm (less than one hour) and medium-term (one to four hours) features for good prediction performance are identified. Conclusions: Innovative feature identification facilitated high performance for hypoglycemia risk prediction in pediatric youth with T1D. Timely alerts of impending hypoglycemia may enable proactive measures to avoid severe hypoglycemia and achieve optimal glycemic control. The model will be deployed on a patient-facing smartphone application in an upcoming pilot study.

Original languageEnglish (US)
Pages (from-to)842-855
Number of pages14
JournalJournal of Diabetes Science and Technology
Issue number4
StatePublished - 2020


  • carbohydrate intake
  • continuous glucose monitoring
  • feature extraction
  • hypoglycemia prediction
  • insulin pump data
  • machine learning

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Bioengineering
  • Biomedical Engineering


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