Biosensors (Basel). 2025 Apr 16. pii: 255. [Epub ahead of print]15(4):
Diabetes is a growing global health concern, affecting millions and leading to severe complications if not properly managed. The primary challenge in diabetes management is maintaining blood glucose levels (BGLs) within a safe range to prevent complications such as renal failure, cardiovascular disease, and neuropathy. Traditional methods, such as finger-prick testing, often result in low patient adherence due to discomfort, invasiveness, and inconvenience. Consequently, there is an increasing need for non-invasive techniques that provide accurate BGL measurements. Photoplethysmography (PPG), a photosensitive method that detects blood volume variations, has shown promise for non-invasive glucose monitoring. Deep neural networks (DNNs) applied to PPG signals can predict BGLs with high accuracy. However, training DNN models requires large and diverse datasets, which are typically distributed across multiple healthcare institutions. Privacy concerns and regulatory restrictions further limit data sharing, making conventional centralized machine learning (ML) approaches less effective. To address these challenges, this study proposes a federated learning (FL)-based solution that enables multiple healthcare organizations to collaboratively train a global model without sharing raw patient data, thereby enhancing model performance while ensuring data privacy and security. In the data preprocessing stage, continuous wavelet transform (CWT) is applied to smooth PPG signals and remove baseline drift. Adaptive cycle-based segmentation (ACBS) is then used for signal segmentation, followed by particle swarm optimization (PSO) for feature selection, optimizing classification accuracy. The proposed system was evaluated on diverse datasets, including VitalDB and MUST, under various conditions with data collected during surgery and anesthesia. The model achieved a root mean square error (RMSE) of 19.1 mg/dL, demonstrating superior predictive accuracy. Clarke error grid analysis (CEGA) confirmed the model's clinical reliability, with 99.31% of predictions falling within clinically acceptable limits. The FL-based approach outperformed conventional deep learning models, making it a promising method for non-invasive, privacy-preserving glucose monitoring.
Keywords: Clarke error grid analysis; deep neural networks (DNNs); diabetes management; federated learning (FL); healthcare; machine learning; non-invasive blood glucose monitoring; photoplethysmography (PPG)