Deep learning for blood glucose level prediction: How well do models generalize across different data sets?

Deep learning-based models for predicting blood glucose levels in diabetic patients can facilitate proactive measures to prevent critical events and are essential for closed-loop control therapy systems. However, selecting appropriate models from the literature may not always yield conclusive results, as the choice could be influenced by biases or misleading evaluations stemming from different methodologies, datasets, and preprocessing techniques. This study aims to compare and comprehensively analyze the performance of various deep learning models across diverse datasets to assess their applicability and generalizability across a broader spectrum of scenarios. Commonly used deep learning models for blood glucose level forecasting, such as feed-forward neural network, convolutional neural network, long short-term memory network (LSTM), temporal convolutional neural network, and self-attention network (SAN), are considered in this study. To evaluate the generalization capabilities of each model, four datasets of varying sizes, encompassing samples from different age groups and conditions, are utilized. Performance metrics include Root Mean Square Error (RMSE), Mean Absolute Difference (MAD), and Coefficient of Determination (CoD) for analytical asssessment, Clarke Error Grid (CEG) for clinical assessments, Kolmogorov-Smirnov (KS) test for statistical analysis, and generalization ability evaluations to obtain both coarse and granular insights. The experimental findings indicate that the LSTM model demonstrates superior performance with the lowest root mean square error and highest generalization capability among all other models, closely followed by SAN. The ability of LSTM and SAN to capture long-term dependencies in blood glucose data and their correlations with various influencing factors and events contribute to their enhanced performance. Despite the lower predictive performance, the FFN was able to capture patterns and trends in the data, suggesting its applicability in forecasting future direction. Moreover, this study helps in identifying the optimal model based on specific objectives, whether prioritizing generalization or accuracy.