arXiv:2601.05353cs.LGcs.IT2026-01被引 6

用语言模型解析血糖波动形态,提升长期预测精度。

GlyRAG: Context-Aware Retrieval-Augmented Framework for Blood Glucose Forecasting

  • 用大模型从血糖数据中提取语义上下文,生成描述性文本。
  • 30分钟预测RMSE降低至10.6(原13.8),60分钟降至20.2(原23.1)。
  • 无需额外传感器,适合临床长期血糖风险预警场景。

基于持续血糖监测(CGM)数据的精准血糖预测可支持糖尿病异常风险的早期预警。然而,现有神经网络模型将CGM数据视为纯数值序列,未融合信号形态中的上下文信息。大语言模型(LLMs)在时序预测中展现潜力,但其在糖尿病管理中作为智能上下文提取器的角色尚未被探索。本研究提出GlyRAG框架,利用大模型作为上下文代理,直接从时间窗口内的CGM数据生成描述性叙事。该文本嵌入后与分块血糖表征融合,并通过交叉注意力引入相似历史训练片段。在OhioT1DM和AZT1D数据集上,针对5、30、60分钟预测时长进行评估。相比强基线模型PatchTST,GPT-4-GlyRAG显著降低长期预测的均方根误差(RMSE):在OhioT1DM上,30分钟时从13.8降至10.6,60分钟时从23.1降至20.2。LLaMA 3.1也带来小幅但显著的提升,表明该上下文提取流程不依赖特定大模型。临床误差网格分析显示,约85%的预测落在临床上可接受的Clarke误差网格区域A+B内。结果表明,仅依赖CGM数据生成的语言上下文与案例检索机制,即可在不增加传感设备的前提下,有效提升长期血糖预测性能。

原文摘要 · Abstract (English)

Accurate blood glucose forecasting using continuous glucose monitoring (CGM) data can support the early prediction of dysglycemic risk. However, current neural-network-based forecasting models treat CGM data as a purely numerical sequence without integrating the contextual information contained in CGM signal morphology. Recently, large language models (LLMs) have shown promise for time-series forecasting, yet their role as agentic context extractors in diabetes care remains largely unexplored. In this study, we bridge glucose forecasting and LLM-based contextualization by developing GlyRAG, a context-aware, retrieval-augmented forecasting framework that uses an LLM as a contextualization agent to summarize glucose morphology directly from a timed CGM window. The generated CGM-only narrative is embedded and fused with patch-based glucose representations, while a retrieval module incorporates similar historical training episodes through cross-attention. We evaluate GlyRAG on the OhioT1DM and AZT1D datasets for 5-, 30-, and 60-minute forecasting horizons. Compared with strong CGM-only baselines, GPT-4 GlyRAG significantly improves long-horizon root mean square error (RMSE) over PatchTST on both datasets. For example, RMSE decreases from 13.8 to 10.6 at 30 minutes and from 23.1 to 20.2 at 60 minutes on OhioT1DM. LLaMA 3.1 produces smaller but significant long-horizon gains, suggesting that the contextualization pipeline is not limited to GPT-4. Clinical error-grid analyses further show that approximately 85 percent of predictions fall within the clinically acceptable Clarke Error Grid Zones A and B. These results suggest that CGM-derived linguistic context and case-based retrieval can improve long-horizon glucose forecasting without requiring additional sensing modalities.

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