A Spiking Neural Network for Non-Invasive Glucose Estimation on Wearable Bioimpedance Biosensors, with a Multiplication-Free Neuromorphic Path

Wearable glucose monitoring demands low-power local processing, but conventional neural networks rely on energy-intensive multiply–accumulate (MAC) operations that limit battery life. This study shows that a Spiking Neural Network (SNN), built on a regression-adapted Leaky Integrate-and-Fire (LIF) neuron, can estimate blood glucose from multi-frequency bioimpedance and auxiliary biosignals with clinically auditable accuracy at low computational and memory cost. Using data from 98 patients (717 measurements, eGluco3 device, Azambuja Hospital, Brusque, Brazil) evaluated by 5-fold walk-forward cross-validation under ISO 15197:2013, three main findings emerge. First, a new calibration method—the Patient Fingerprint, built from each patient’s first K sensor readings—outperforms conventional one-hot patient encoding (14.2 ± 2.6 mg/dL vs. 15.4 ± 3.3 mg/dL mean absolute error) and, unlike one-hot, requires only these K readings rather than the patient’s presence in the training set; a leave-patients-out analysis confirms that the fingerprint captures individual physiology and that unseen-patient accuracy improves with calibration depth but remains clinically insufficient (MAE 94.8→65.9 mg/dL from K=3 to K=5), positioning clinical-grade cross-patient generalization on a larger cohort as the primary scaling axis. Second, the direct-injection fingerprint model reaches 100% of the samples within Consensus Error Grid Zones A+B across all validation folds (the rate-coding variant reaches 98.8%, just below the 99% Criterion B threshold), without requiring any demographic or clinical metadata; sensor history alone renders such records redundant; and Criterion A, however, stays below the 95% normative threshold, so the results support clinical safety rather than formal certification. Third, replacing the analog input encoding with a multiplication-free rate-coding scheme removes all first-layer MAC operations at a cost of 2.7 mg/dL additional error; because the additional microticks raise the total operation count, this defines a design lever whose energy payoff is specific to neuromorphic hardware rather than a net saving on conventional microcontrollers. Together, these results demonstrate that SNNs offer a clinically auditable, self-calibrating, and memory-efficient path to continuous glucose estimation on embedded wearable devices.