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We present a multitask learning approach to the problem of hypoglycemia (HG) prediction in diabetes. The approach is based on a state-of-the-art time series forecasting model, N-BEATS, and extends it by adding a classification task so that the model performs both glucose forecasting (i.e., predicting future glucose values) and HG prediction (i.e., probability of future HG events sometime within the prediction horizon). We also propose an alternative loss function that penalizes forecasting errors in the HG range. We evaluate the approach on a dataset containing over 1.6M recordings from 112 patients with type 1 diabetes who wore a continuous glucose monitor (CGM) for 90 days. Our results show that the classification branch significantly outperforms the forecasting branch on the problem of HG prediction, and that the new loss function is more effective at reducing forecasting errors in the HG range than multi-task learning. 

Background: Monitoring glucose excursions is important in diabetes management. This can be achieved using continuous glucose monitors (CGMs). However, CGMs are expensive and invasive. Thus, alternative low-cost noninvasive wearable sensors capable of predicting glycemic excursions could be a game changer to manage diabetes. Methods: In this article, we explore two noninvasive sensor modalities, electrocardiograms (ECGs) and accelerometers, collected on five healthy participants over two weeks, to predict both hypoglycemic and hyperglycemic excursions. We extract 29 features encompassing heart rate variability features from the ECG, and time- and frequency-domain features from the accelerometer. We evaluated two machine-learning approaches to predict glycemic excursions: a classification model and a regression model. Results: The best model for both hypoglycemia and hyperglycemia detection was the regression model based on ECG and accelerometer data, yielding 76% sensitivity and specificity for hypoglycemia and 79% sensitivity and specificity for hyperglycemia. This had an improvement of 5% in sensitivity and specificity for both hypoglycemia and hyperglycemia when compared with using ECG data alone. Conclusions: Electrocardiogram is a promising alternative not only to detect hypoglycemia but also to predict hyperglycemia. Supplementing ECG data with contextual information from accelerometer data can improve glucose prediction.