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Multimodal AI correlates of glucose spikes in people with normal glucose regulation, pre-diabetes and type 2 diabetes
Carletti, Mattia Pandit, Jay Gadaleta, Matteo Chiang, Danielle Delgado, Felipe Quartuccio, Katie Fernandez, Brianna Raygoza Garay, Juan Antonio Torkamani, Ali Miotto, Riccardo
Carletti, Mattia
Pandit, Jay
Gadaleta, Matteo
Chiang, Danielle
Delgado, Felipe
Quartuccio, Katie
Fernandez, Brianna
Raygoza Garay, Juan Antonio
Torkamani, Ali
Miotto, Riccardo
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Computational Biology
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Journal article
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2025
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English
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Abstract
Type 2 diabetes (T2D) is a multifaceted disease associated with several factors, including diet, genetics, exercise, sleep and gut microbiome. Current diagnostic and monitoring methods based on episodic assays like glycated hemoglobin (HbA1c) fail to capture its full complexity. Here, in a prospective cohort of 1,137 participants in the United States, we analyzed multimodal data from 347 deeply phenotyped individuals (174 normoglycemic, 79 prediabetic and 94 T2D). We found significant differences in the distribution of glucose spike metrics among different diabetes states, with longer expected time for spike resolution and higher values of nocturnal hypoglycemia in T2D. We identified significant correlations between mean glucose level and gut microbiome diversity, and between expected time for spike resolution and resting heart rate. Our multimodal glycemic risk profiles, validated in 1,955 normoglycemic and 114 prediabetic individuals from an independent cohort, improved risk stratification by highlighting substantial variability among individuals with the same value of HbA1c. Such a multimodal approach provides a detailed phenotype that can potentially improve T2D prevention, diagnosis and treatment, and is more informative than HbA1c.
Citation
M. Carletti et al., “Multimodal AI correlates of glucose spikes in people with normal glucose regulation, pre-diabetes and type 2 diabetes,” Nature Medicine 2025, pp. 1–7, Jul. 2025, doi: 10.1038/s41591-025-03849-7
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Nature Medicine
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Springer Nature