arXiv:2510.06623cs.LG2025-10被引 1

用稀疏血糖数据精准估算糖尿病指标,让低成本监测也能有专业分析

DPA-Net: A Dual-Path Attention Neural Network for Inferring Glycemic Control Metrics from Self-Monitored Blood Glucose Data

  • 双路径注意力网络融合轨迹重建与直接预测
  • 在真实数据集上误差低、偏差小,优于现有方法
  • 适合资源有限地区医生和患者做血糖管理决策

连续葡萄糖监测(CGM)可提供密集动态的血糖曲线,用于可靠估算动态血糖图谱(AGP)指标,如血糖在目标范围时间(TIR)、低于目标范围时间(TBR)和高于目标范围时间(TAR)。然而,CGM成本高、普及难,尤其在低收入和中等收入地区。相比之下,自我血糖监测(SMBG)成本低、易获取,但数据稀疏且不规则,难以转化为临床有意义的血糖指标。本文提出双路径注意力神经网络(DPA-Net),直接从SMBG数据估计AGP指标。DPA-Net包含两个互补路径:(1) 空间-通道注意力路径,从稀疏SMBG观测值重建类CGM轨迹;(2) 多尺度ResNet路径,直接预测AGP指标。两路径间引入对齐机制以降低偏差并缓解过拟合。此外,设计主动采样点选择器,识别反映患者行为模式的真实、有信息量的采样点。在大规模真实世界数据集上的实验表明,DPA-Net具有稳健精度和低误差,系统性偏差小。据我们所知,这是首个基于监督学习从SMBG数据估算AGP指标的框架,为CGM不可及场景提供实用且临床相关的决策支持工具。

原文摘要 · Abstract (English)

Continuous glucose monitoring (CGM) provides dense and dynamic glucose profiles that enable reliable estimation of Ambulatory Glucose Profile (AGP) metrics, such as Time in Range (TIR), Time Below Range (TBR), and Time Above Range (TAR). However, the high cost and limited accessibility of CGM restrict its widespread adoption, particularly in low- and middle-income regions. In contrast, self-monitoring of blood glucose (SMBG) is inexpensive and widely available but yields sparse and irregular data that are challenging to translate into clinically meaningful glycemic metrics. In this work, we propose a Dual-Path Attention Neural Network (DPA-Net) to estimate AGP metrics directly from SMBG data. DPA-Net integrates two complementary paths: (1) a spatial-channel attention path that reconstructs a CGM-like trajectory from sparse SMBG observations, and (2) a multi-scale ResNet path that directly predicts AGP metrics. An alignment mechanism between the two paths is introduced to reduce bias and mitigate overfitting. In addition, we develop an active point selector to identify realistic and informative SMBG sampling points that reflect patient behavioral patterns. Experimental results on a large, real-world dataset demonstrate that DPA-Net achieves robust accuracy with low errors while reducing systematic bias. To the best of our knowledge, this is the first supervised machine learning framework for estimating AGP metrics from SMBG data, offering a practical and clinically relevant decision-support tool in settings where CGM is not accessible.

糖尿病管理机器学习血糖监测医疗AI

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