GARNN: An Interpretable Graph Attentive Recurrent Neural Network for Predicting Blood Glucose Levels via Multivariate Time Series

Accurate prediction of future blood glucose (BG) levels can effectively improve BG management for people living with diabetes, thereby reducing complications and improving quality of life. The state of the art of BG prediction has been achieved by leveraging advanced deep learning methods to model multi-modal data, i.e., sensor data and self-reported event data, organised as multi-variate time series (MTS). However, these methods are mostly regarded as ``black boxes'' and not entirely trusted by clinicians and patients. In this paper, we propose interpretable graph attentive recurrent neural networks (GARNNs) to model MTS, explaining variable contributions via summarizing variable importance and generating feature maps by graph attention mechanisms instead of post-hoc analysis. We evaluate GARNNs on four datasets, representing diverse clinical scenarios. Upon comparison with twelve well-established baseline methods, GARNNs not only achieve the best prediction accuracy but also provide high-quality temporal interpretability, in particular for postprandial glucose levels as a result of corresponding meal intake and insulin injection. These findings underline the potential of GARNN as a robust tool for improving diabetes care, bridging the gap between deep learning technology and real-world healthcare solutions.

Blood Glucose Level Prediction: A Graph-based Explainable Method with Federated Learning

In the UK, approximately 400,000 people with type 1 diabetes (T1D) rely on insulin delivery due to insufficient pancreatic insulin production. Managing blood glucose (BG) levels is crucial, with continuous glucose monitoring (CGM) playing a key role. CGM, tracking BG every 5 minutes, enables effective blood glucose level prediction (BGLP) by considering factors like carbohydrate intake and insulin delivery. Recent research has focused on developing sequential models for BGLP using historical BG data, incorporating additional attributes such as carbohydrate intake, insulin delivery, and time. These methods have shown notable success in BGLP, with some providing temporal explanations. However, they often lack clear correlations between attributes and their impact on BGLP. Additionally, some methods raise privacy concerns by aggregating participant data to learn population patterns. Addressing these limitations, we introduced a graph attentive memory (GAM) model, combining a graph attention network (GAT) with a gated recurrent unit (GRU). GAT applies graph attention to model attribute correlations, offering transparent, dynamic attribute relationships. Attention weights dynamically gauge attribute significance over time. To ensure privacy, we employed federated learning (FL), facilitating secure population pattern analysis. Our method was validated using the OhioT1DM'18 and OhioT1DM'20 datasets from 12 participants, focusing on 6 key attributes. We demonstrated our model's stability and effectiveness through hyperparameter impact analysis.