Chronobiologically-informed features from CGM data provide unique information for XGBoost prediction of longer-term glycemic dysregulation in 8,000 individuals with type-2 diabetes

Type 2 Diabetes causes dysregulation of blood glucose, which leads to long-term, multi-tissue damage. Continuous glucose monitoring devices are commercially available and used to track glucose at high temporal resolution so that individuals can make informed decisions about their metabolic health. Algorithms processing these continuous data have also been developed that can predict glycemic excursion in the near future. These data might also support prediction of glycemic stability over longer time horizons. In this work, we leverage longitudinal Dexcom continuous glucose monitoring data to test the hypothesis that additional information about glycemic stability comes from chronobiologically-informed features. We develop a computationally efficient multi-timescale complexity index, and find that inclusion of time-of-day complexity features increases the performance of an out-of-the-box XGBoost model in predicting the change in glucose across days. These findings support the use of chronobiologically-inspired and explainable features to improve glucose prediction algorithms with relatively long time-horizons.