The paper examines how the representation of physiological data affects the performance of large language models (LLMs) in predicting post‑meal blood glucose events for people with type 1 diabetes. Using the OhioT1DM dataset, the authors compare zero‑shot and few‑shot prompt‑based LLMs across 30, 60, and 90‑minute horizons, varying the textual encoding of glucose readings, derived descriptors, and contextual variables such as insulin, meals, carbs, and activity. Results show that while conventional supervised models excel at hyperglycemia prediction, certain prompt‑based LLM configurations outperform them for hypoglycemia, and that the way data is presented to the model is a key determinant of success, with added context not consistently improving outcomes.
The study evaluates time‑series foundation models for continuous glucose monitoring (CGM) forecasting across eight public datasets covering Type 1, Type 2, and non‑diabetes populations. Zero‑shot foundation models did not consistently beat strong task‑specific baselines, but lightweight fine‑tuning of models like Chronos‑Bolt improved root‑mean‑square error by up to 18% in both in‑distribution and out‑of‑distribution settings. Incorporating multimodal dietary context via CGMacros and a residual‑based fusion framework further reduced overall RMSE by ~3% and postprandial RMSE by ~15%, indicating that dietary signals add clinically meaningful value beyond CGM alone.
By Bowen Zhang, Hsiu-Wen Cheng, Hongyu Yang, Evie L. Shen, Joleen Vansomphone, Yuna Li, Kerry Zhou, Zitian Qu, Suning Zhao, Xiangning Deng, Hua Zhou, Jin J. Zhou
arXiv:2609.08772v1 Announce Type: new
Abstract: Large Language Models (LLMs) are increasingly being investigated for physiological time-series prediction, yet their effectiveness may depend not only...
By Andrea Apicella, Pasquale Arpaia, Matteo Orefice, Andrea Pollastro, Roberto Prevete
arXiv:2606. 06881v1 Announce Type: new Abstract: Blood glucose forecasting models are foundational for modern diabetes management systems, as reliable short-term predictions can enable proactive interventions, support automated insulin delivery, and reduce the risk of hypo- and hyperglycemic events.
By Baiying Lu, Zhaohui Liang, Ryan Pontius, Shengpu Tang, Temiloluwa Prioleau
arXiv:2606. 18640v1 Announce Type: new Abstract: Glucose forecasting algorithms are an important aspect of glycemic control management in type 1 diabetes.
By Nathaniel Jeffries, Miriam Wolff, Sam Royston, Elizabeth Healey, Caleb Mayer, David Klonoff, Michael Snyder, Tao Wang
GlucoFM is a lightweight foundation model for continuous glucose monitoring that aligns irregular CGM data to a 24‑hour grid and splits glucose dynamics into slow‑varying trend and short‑term deviation streams. Pre‑trained on over 109,000 hours of unlabeled recordings, it outperforms existing CGM‑specific models on seven phenotype‑classification tasks, improving average PR‑AUC by 4.1 points and enabling strong cross‑dataset transfer and few‑shot adaptation. When combined with meal, nutrition, and subject context, its frozen encoder delivers the lowest two‑hour postprandial glycemic response errors for trajectory, incremental AUC, peak rise, and peak timing metrics.
By Zechen Li, Keerthana Natarajan, Weizhi Zhang, Menglian Zhou, Simon A. Lee, Yuwei Zhang, Maxwell A. Xu, Zeinab Esmaeilpour, Flora D. Salim, Mark Malhotra, Lindsey Sunden, Shwetak Patel, Yuzhe Yang, Ahmed A. Metwally