Managing Elderly type 2 diabetes (E-T2D) is challenging due to geriatric conditions (e.g., co-morbidity, multiple drug intake, etc.), and personalization becomes paramount for precision medicine. This paper presents a human digital twin (HDT) framework to manage E-T2D that exploits various patient-specific data and builds a suite of models exploiting the data for prediction and management to personalize diabetes treatment in E-T2D patients. These models include mathematical and deep-learning ones that capture different patient aspects. Consequently, the HDT virtualizes the patient from different viewpoints using an HDT that mimics the patient and has interfaces to update the virtual models simultaneously from measurements. Using these models the HDT obtains deeper insights about the patient. Further, an adaptive patient model fusing this information and a learning-based model predictive control (LB-MPC) algorithm are proposed. The geriatric conditions are captured as model parameters and constraints while solving the LB-MPC to personalize the insulin infusion for E-T2D management. The HDT is deployed on and illustrated with 15 patients using clinical trials and simulations. Our results show that HDT helps improve the time-in-range from 3–75% to 86–97% and reduces insulin infusion by 14–29%.

An artificial pancreases (AP) is a device for managing diabetes through automated insulin infusion. The control algorithm is the heart of the AP that computes the insulin infusion based on blood glucose measurements. In this article, we investigate the role of multimedia data to enable the advanced control techniques that could personalize AP in elderly type 2 diabetes patients. The performance is evaluated through in silico studies on a patient simulator wherein the patient model is computed based on the data collected from clinical studies.

We propose TRAINER, a TRustworthy Artificial Intelligence-based iNsulin recommendER for elderly individuals with type 2 diabetes, ensuring reliability and trust in insulin dosage recommendations. TRAINER exemplifies this trustworthiness and addresses such concerns by offering reliable insulin recommendations supported by clinical evidence.