DOI: 10.25934/pr00009007
title: Prediction of hypoglycemia during and after exercise

description: Project context:
Diabetes mellitus is a group of metabolic disorders characterized by chronic hyperglycemia (high blood sugar) resulting from defects in insulin production, insulin action, or both. Prolonged high blood sugar levels can lead to damage and dysfunction in various organs and systems, affecting metabolic processes and causing a range of complications. Severe complications may include diabetic retinopathy (leading to blindness), nephropathy (kidney failure), cardiovascular disease (heart attack and stroke), neuropathy (nerve damage), and lower limb amputation.
According to the latest data released by the International Diabetes Federation in 2021, it is estimated that approximately 537 million people worldwide are living with diabetes. This chronic condition requires lifelong management, including medication, dietary adjustments, regular physical activity, and monitoring of blood sugar levels.
Hypoglycemia, or low blood sugar, is a common concern for individuals with diabetes. It can occur as a result of excessive insulin or other glucose-lowering medications, insufficient food intake, or increased physical activity. Symptoms of hypoglycemia vary in severity and can include shakiness, dizziness, confusion, sweating, weakness, hunger, and irritability. In severe cases, loss of consciousness or seizures can occur.
Regular exercise is beneficial for individuals with diabetes as it improves insulin sensitivity, promotes better blood sugar control, enhances cardiorespiratory fitness, reduces the risk of cardiovascular complications, and improves psychological well-being. However, some individuals with diabetes may have concerns about engaging in physical activity due to the fear of experiencing hypoglycemia. Continuous glucose monitoring and early warning systems for hypoglycemia can help alleviate this fear, enabling individuals to participate in regular exercise and improve their overall health. These systems also provide early alerts for hypoglycemia in daily life, helping individuals avoid potential dangers.
In summary, diabetes mellitus is characterized by chronic high blood sugar levels, leading to various complications and significantly impacting individuals' quality of life. Hypoglycemia is a potential concern, but with appropriate management and monitoring, individuals with diabetes can engage in regular exercise and improve their overall health outcomes.

Necessity of research:
This study is available to all.  Exercise is one of the causes of hypoglycemia, regardless of whether people have diabetes or not. This study can predict the diabetic blood sugar level and the probability of hypoglycemia during and after exercise, and give early warning of hypoglycemia in advance to prevent the occurrence of danger.  As of 2021, the number of adults with diabetes worldwide will reach 537 million, with approximately one in 10 adults worldwide suffering from the condition, and the trend is growing rapidly.  Therefore, the audience and social benefits of this project are huge. 

Plan:
Firstly, mixed effects random Forest (MERF) was used to analyze the correlation between all features and post-exercise hypoglycemia.  Secondly, odds ratio and partial dependence analysis were used to determine the risk factors associated with hypoglycemia as characteristic parameters.  Then the data set was cut in a window of 15min, and the time series prediction method was used to model the hourly blood glucose change after exercise.  Finally, the time point where the blood sugar value is continuously lower than 70 mg/dL is used as the hypoglycemic warning point, and the hypoglycemic alarm is made 30min in advance.