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Saman Khamesian

Publications and source records attributed to Saman Khamesian.

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GlyTwin: Digital Twin for Glucose Control in Type 1 Diabetes Through Optimal Behavioral Modifications Using Patient-Centric Counterfactuals

Frequent and long-term exposure to hyperglycemia increases the risk of chronic complications, including neuropathy, nephropathy, and cardiovascular disease. Existing continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) technologies model only specific aspects of glycemic regulation, such as predicting hypoglycemia and administering small insulin boluses. Similarly, current digital twin approaches in diabetes management primarily focus on predicting glucose responses to human behavior and insulin therapy. As a result, these technologies lack the ability to provide alternative treatment scenarios that could guide proactive behavioral interventions for optimal diabetes management. To address this gap, we propose GlyTwin, a novel computational framework that enhances digital twin technologies by integrating counterfactual explanations to simulate optimal behavioral treatments for glucose control. GlyTwin generates counterfactual treatments by recommending adjustments to behavioral choices, such as carbohydrate intake and insulin dosing, to significantly reduce the occurrence and duration of hyperglycemic events. In addition, GlyTwin incorporates stakeholder preferences into its intervention-generation process, ensuring that the tool is personalized and user-centric. We evaluate GlyTwin on AZT1D, a new dataset constructed by collecting longitudinal data from 50 individuals living with type 1 diabetes (T1D) on automated insulin delivery (AID) systems, each monitored for 26 days. Results show that GlyTwin outperforms state-of-the-art methods for generating counterfactual explanations, with 85.8\% valid explanations and 87.3\% effectiveness in preventing hyperglycemia compared with historical data.

cs.LG

GUIDE: Reinforcement Learning for Behavioral Action Support in Type 1 Diabetes

Type 1 Diabetes (T1D) management requires continuous adjustment of insulin and lifestyle behaviors to maintain blood glucose within a safe target range. Although automated insulin delivery (AID) systems have improved glycemic outcomes, many patients still fail to achieve recommended clinical targets, warranting new approaches to improve glucose control in patients with T1D. While reinforcement learning (RL) has been utilized as a promising approach, current RL-based methods focus primarily on insulin-only treatment and do not provide behavioral recommendations for glucose control. To address this gap, we propose GUIDE, an RL-based decision-support framework designed to complement AID technologies by providing behavioral recommendations to prevent abnormal glucose events. GUIDE generates structured actions defined by intervention type, magnitude, and timing, including bolus insulin administration and carbohydrate intake events. GUIDE integrates a patient-specific glucose level predictor trained on real-world continuous glucose monitoring data and supports both offline and online RL algorithms within a unified environment. We evaluate both off-policy and on-policy methods across 25 individuals with T1D using standardized glycemic metrics. Among the evaluated approaches, the CQL-BC algorithm demonstrates the highest average time-in-range, reaching 85.49% while maintaining low hypoglycemia exposures. Behavioral similarity analysis further indicates that the learned CQL-BC policy preserves key structural characteristics of patient action patterns, achieving a mean cosine similarity of 0.87 $\pm$ 0.09 across subjects. These findings suggest that conservative offline RL with a structured behavioral action space can provide clinically meaningful and behaviorally plausible decision support for personalized diabetes management.

cs.LG

Glycemic-Aware and Architecture-Agnostic Training Framework for Blood Glucose Forecasting in Type 1 Diabetes

Managing Type 1 Diabetes (T1D) demands constant vigilance as individuals strive to regulate their blood glucose levels and avoid dysglycemia, including hyperglycemia and hypoglycemia. Despite advances in automated insulin delivery (AID) systems, achieving optimal glycemic control remains challenging. These systems integrate data from wearable devices such as insulin pumps and continuous glucose monitors (CGMs), helping reduce variability and improve time in range. However, they often fail to prevent dysglycemia due to limitations in prediction algorithms that cannot accurately anticipate glycemic excursions. This limitation highlights the need for more advanced glucose forecasting methods. To address this need, we introduce GLIMMER (Glucose Level Indicator Model with Modified Error Rate), a modular and architecture-agnostic training framework for glucose forecasting. GLIMMER combines structured preprocessing, a region-aware loss formulation, and genetic algorithm-based weight optimization to emphasize prediction accuracy in dysglycemic regions. We evaluate GLIMMER using two datasets: the publicly available OhioT1DM dataset and a newly collected AZT1D dataset consisting of data from 25 individuals with T1D. Our analyses demonstrate that GLIMMER consistently improves forecasting performance across baseline architectures, reducing RMSE and MAE by up to 24.6% and 29.6%, respectively. Additionally, GLIMMER achieves a recall of 98.4% and an F1-score of 86.8% for dysglycemia prediction, highlighting strong performance in clinically high-risk regions. Compared with state-of-the-art models containing millions of parameters-such as TimesNet (18.7M), BG-BERT (2.1M), and Gluformer (11.2M)-GLIMMER attains comparable accuracy while using only 10K parameters, demonstrating its efficiency as a lightweight and architecture-agnostic solution for glycemic forecasting.

cs.LG

AZT1D: A Real-World Dataset for Type 1 Diabetes

High quality real world datasets are essential for advancing data driven approaches in type 1 diabetes (T1D) management, including personalized therapy design, digital twin systems, and glucose prediction models. However, progress in this area has been limited by the scarcity of publicly available datasets that offer detailed and comprehensive patient data. To address this gap, we present AZT1D, a dataset containing data collected from 25 individuals with T1D on automated insulin delivery (AID) systems. AZT1D includes continuous glucose monitoring (CGM) data, insulin pump and insulin administration data, carbohydrate intake, and device mode (regular, sleep, and exercise) obtained over 6 to 8 weeks for each patient. Notably, the dataset provides granular details on bolus insulin delivery (i.e., total dose, bolus type, correction specific amounts) features that are rarely found in existing datasets. By offering rich, naturalistic data, AZT1D supports a wide range of artificial intelligence and machine learning applications aimed at improving clinical decision making and individualized care in T1D.

cs.LG

NutriGen: Personalized Meal Plan Generator Leveraging Large Language Models to Enhance Dietary and Nutritional Adherence

Maintaining a balanced diet is essential for overall health, yet many individuals struggle with meal planning due to nutritional complexity, time constraints, and lack of dietary knowledge. Personalized food recommendations can help address these challenges by tailoring meal plans to individual preferences, habits, and dietary restrictions. However, existing dietary recommendation systems often lack adaptability, fail to consider real-world constraints such as food ingredient availability, and require extensive user input, making them impractical for sustainable and scalable daily use. To address these limitations, we introduce NutriGen, a framework based on large language models (LLM) designed to generate personalized meal plans that align with user-defined dietary preferences and constraints. By building a personalized nutrition database and leveraging prompt engineering, our approach enables LLMs to incorporate reliable nutritional references like the USDA nutrition database while maintaining flexibility and ease-of-use. We demonstrate that LLMs have strong potential in generating accurate and user-friendly food recommendations, addressing key limitations in existing dietary recommendation systems by providing structured, practical, and scalable meal plans. Our evaluation shows that Llama 3.1 8B and GPT-3.5 Turbo achieve the lowest percentage errors of 1.55\% and 3.68\%, respectively, producing meal plans that closely align with user-defined caloric targets while minimizing deviation and improving precision. Additionally, we compared the performance of DeepSeek V3 against several established models to evaluate its potential in personalized nutrition planning.

cs.AI

Hybrid Self-Attention NEAT: A novel evolutionary approach to improve the NEAT algorithm

This article presents a "Hybrid Self-Attention NEAT" method to improve the original NeuroEvolution of Augmenting Topologies (NEAT) algorithm in high-dimensional inputs. Although the NEAT algorithm has shown a significant result in different challenging tasks, as input representations are high dimensional, it cannot create a well-tuned network. Our study addresses this limitation by using self-attention as an indirect encoding method to select the most important parts of the input. In addition, we improve its overall performance with the help of a hybrid method to evolve the final network weights. The main conclusion is that Hybrid Self- Attention NEAT can eliminate the restriction of the original NEAT. The results indicate that in comparison with evolutionary algorithms, our model can get comparable scores in Atari games with raw pixels input with a much lower number of parameters.

cs.NE