Ewha Med J.  2025 Apr;48(2):e34. 10.12771/emj.2025.00332.

Cyclic dual latent discovery for improved blood glucose prediction through patient–provider interaction modeling: a prediction study

• Park S
• Kim S
• Rim D

• KMID: 2567586
• DOI: http://doi.org/10.12771/emj.2025.00332

Abstract

Purpose
Accurate prediction of blood glucose variability is crucial for effective diabetes management, as both hypoglycemia and hyperglycemia are associated with increased morbidity and mortality. However, conventional predictive models rely primarily on patient-specific biometric data, often neglecting the influence of patient–provider interactions, which can significantly impact outcomes. This study introduces Cyclic Dual Latent Discovery (CDLD), a deep learning framework that explicitly models patient–provider interactions to improve prediction of blood glucose levels. By leveraging a real-world intensive care unit (ICU) dataset, the model captures latent attributes of both patients and providers, thus improving forecasting accuracy.
Methods
ICU patient records were obtained from the MIMIC-IV v3.0 critical care database, including approximately 5,014 instances of patient–provider interaction. The CDLD model uses a cyclic training mechanism that alternately updates patient and provider latent representations to optimize predictive performance. During preprocessing, all numeric features were normalized, and extreme glucose values were capped at 500 mg/dL to mitigate the effect of outliers.
Results
CDLD outperformed conventional models, achieving a root mean square error of 0.0852 on the validation set and 0.0899 on the test set, which indicates improved generalization. The model effectively captured latent patient–provider interaction patterns, yielding more accurate glucose variability predictions than baseline approaches.
Conclusion
Integrating patient–provider interaction modeling into predictive frameworks can increase blood glucose prediction accuracy. The CDLD model offers a novel approach to diabetes management, potentially paving the way for artificial intelligence-driven personalized treatment strategies.

Keyword

Blood glucose; Biometry; Deep learning; Diabetes mellitus; Hyperglycemia; United States