Hybrid Digital Twin Framework for Personalized Diabetes Management Using Mathematical Modelling and Machine Learning.

Background/Objectives: Diabetes mellitus is a chronic metabolic disorder characterized by impaired regulation of blood glucose due to defects in insulin secretion, insulin action, or both. Physiological and lifestyle factors vary among individuals. General medicine is not applicable to all patients. In this scenario, personalized medicine for each individual becomes costly. Effective management of continuous glucose levels with accurate insulin dosage is challenging. To overcome this, a digital twin (DT)-based insulin dosage simulator with an individual's metabolic system is proposed in this work. Methods: Various machine learning techniques, mathematical models of physiology, and risk assessment using probability are used to predict the dynamics of patient-specific glucose-insulin. Parameters such as carbohydrate intake, sleep patterns, medications, and physical activity were incorporated into this model to capture real-world variations in daily life. For glucose-insulin interactions, the Bergman Minimal Model (BMM) is used; for time-of-day variability, a circadian insulin sensitivity model is used; and for predicting metabolic risks, Bayesian risk estimation (BRE) is used, which includes hyperglycemia risk. To enhance transparency and interpret model predictions, explainable artificial intelligence (XAI) methods are employed. Results: The simulation results showed improved glucose prediction accuracy, enhanced detection of hypoglycemia risk, and optimized insulin dosing strategies compared with traditional approaches. Conclusions: Overall, the proposed digital twin model offers a scalable solution using the latest techniques A "Prescriptive Analytical Framework" is provided using the BMM and BRE for personalized diabetes management and decision support for clinicians.