{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:44:10Z","timestamp":1785545050807,"version":"3.56.0"},"reference-count":39,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Biomed Eng"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Continuous glucose monitoring (CGM) generates high-frequency time-series data, creating challenges for efficient storage, transmission, and analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to develop and evaluate a CGM-specific compression method that achieves high compression ratios while preserving signal fidelity and clinically relevant glycemic metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We introduce a content-based encoding approach (PN+) that represents CGM profiles using physiologically salient landmarks: glucose peaks and nadirs and a small set of optimally selected support points. Reconstruction is performed using piecewise cubic Hermite interpolation. PN+ was evaluated against peaks and nadirs only, uniform downsampling, piecewise aggregate approximation, and autoencoder-based compression. Performance was assessed across multiple compression ratios using 2 complementary datasets: 40,000 synthetic CGM profiles and real-world CGM data from a randomized crossover trial (558 days from 30 patients). Performance was evaluated using compression ratio, mean absolute error, and\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      between original and reconstructed CGM-derived clinical metrics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At a compression ratio of 13 (22 points per 24-hour profile), PN+ achieved substantially lower reconstruction error than comparator methods (mean absolute error=0.77 vs 2.75-3.45) and consistently higher\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      values across glycemic metrics. Improvements were most pronounced for excursion-sensitive measures such as mean amplitude of glycemic excursions, where PN+ reduced error by more than 4-fold compared with downsampling, piecewise aggregate approximation, and autoencoders. These performance advantages were preserved in heterogeneous real-world data. Encoding and decoding required less than 0.2 seconds per profile, supporting practical scalability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PN+ enables robust CGM data compression by explicitly preserving physiologically meaningful glucose dynamics. The method outperforms generic compression techniques in reconstructing clinically relevant metrics while maintaining low computational overhead, making it well suited for large-scale CGM storage, interoperability, and downstream analytics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/91959","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T22:11:52Z","timestamp":1784585512000},"page":"e91959-e91959","source":"Crossref","is-referenced-by-count":0,"title":["Continuous Glucose Monitoring Data Compression Using Peak-Nadir Encoding in Diabetes: Method Development and Evaluation"],"prefix":"10.2196","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4278-0397","authenticated-orcid":false,"given":"Clara","family":"Bender","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1120-8144","authenticated-orcid":false,"given":"Line","family":"Davidsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3916-3168","authenticated-orcid":false,"given":"S\u00f8ren Schou","family":"Olesen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3484-7571","authenticated-orcid":false,"given":"Simon","family":"Cichosz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2025.112111","article-title":"The use of continuous glucose monitoring in people living with obesity, intermediate hyperglycemia or type 2 diabetes","volume":"223","author":"Battelino","journal-title":"Diabetes Res Clin Pract"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2017.08.005","article-title":"Continuous glucose monitoring: a review of the technology and clinical use","volume":"133","author":"Klonoff","journal-title":"Diabetes Res Clin Pract"},{"issue":"3","key":"R3","doi-asserted-by":"publisher","first-page":"17","DOI":"10.3390\/diabetology6030017","article-title":"The history, evolution and future of continuous glucose monitoring (CGM)","volume":"6","author":"Bender","journal-title":"Diabetology"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1016\/j.artmed.2019.07.007","article-title":"Data-driven modeling and prediction of blood glucose dynamics: machine learning applications in type 1 diabetes","volume":"98","author":"Woldaregay","journal-title":"Artif Intell Med"},{"issue":"5","key":"R5","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1111\/pedi.12856","article-title":"Identification of clinically relevant dysglycemia phenotypes based on continuous glucose monitoring data from youth with type 1 diabetes and elevated hemoglobin A1c","volume":"20","author":"Kahkoska","journal-title":"Pediatr Diabetes"},{"issue":"1","key":"R6","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1177\/19322968241287773","article-title":"Artificial intelligence to diagnose complications of diabetes","volume":"19","author":"Ayers","journal-title":"J Diabetes Sci Technol"},{"issue":"1","key":"R7","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1089\/dia.2024.0226","article-title":"From stability to variability: classification of healthy individuals, prediabetes, and type 2 diabetes using glycemic variability indices from continuous glucose monitoring data","volume":"27","author":"Cichosz","journal-title":"Diabetes Technol Ther"},{"issue":"7","key":"R8","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1089\/dia.2023.0532","article-title":"Development and validation of a machine learning model to predict weekly risk of hypoglycemia in patients with type 1 diabetes based on continuous glucose monitoring","volume":"26","author":"Lebech Cichosz","journal-title":"Diabetes Technol Ther"},{"issue":"6","key":"R9","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1089\/dia.2023.0531","article-title":"Development of machine learning models for the identification of elevated ketone bodies during hyperglycemia in patients with type 1 diabetes","volume":"26","author":"Lebech Cichosz","journal-title":"Diabetes Technol Ther"},{"issue":"3","key":"R10","doi-asserted-by":"publisher","first-page":"388","DOI":"10.2337\/cd23-0051","article-title":"Patterns and trends in continuous glucose monitoring utilization among commercially insured individuals with type 1 diabetes: 2010-2013 to 2016-2019","volume":"42","author":"Lacy","journal-title":"Clin Diabetes"},{"issue":"4","key":"R11","doi-asserted-by":"publisher","DOI":"10.1177\/14604582231213846","article-title":"The role of compression in large scale data transfer and storage of typical biomedical signals at hospitals","volume":"29","author":"Jacobsson","journal-title":"Health Informatics J"},{"issue":"6","key":"R12","doi-asserted-by":"publisher","first-page":"5513","DOI":"10.1109\/JSEN.2023.3243390","article-title":"Compressed sensing approach for physiological signals: a review","volume":"23","author":"Lal","journal-title":"IEEE Sensors J"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.1016\/j.iot.2023.100806","article-title":"Data compression techniques in IoT-enabled wireless body sensor networks: a systematic literature review and research trends for QoS improvement","volume":"23","author":"Nassra","journal-title":"Internet Things"},{"issue":"2","key":"R14","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1177\/1932296818790281","article-title":"How to use blockchain for diabetes health care data and access management: an operational concept","volume":"13","author":"Lebech Cichosz","journal-title":"J Diabetes Sci Technol"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1177\/19322968251323913","article-title":"Finding optimal alphabet for encoding daily continuous glucose monitoring time series into compressed text","author":"Igbe","journal-title":"J Diabetes Sci Technol"},{"issue":"4","key":"R16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0284008","article-title":"ECG signal classification in wearable devices based on compressed domain","volume":"18","author":"Hua","journal-title":"PLoS One"},{"issue":"1","key":"R17","doi-asserted-by":"publisher","DOI":"10.1186\/s12938-025-01349-w","article-title":"Deep learning and electrocardiography: systematic review of current techniques in cardiovascular disease diagnosis and management","volume":"24","author":"Wu","journal-title":"Biomed Eng Online"},{"key":"R18","unstructured":"Chung FL Fu TC Luk WP Ng VT . Flexible time series pattern matching based on perceptually important points. Presented at: Workshop on Learning from Temporal and Spatial Data in International Joint Conference on Artificial Intelligence; Aug 6, 2001; Seattle, WA. URL: https:\/\/research.polyu.edu.hk\/en\/publications\/flexible-time-series-pattern-matching-based-on-perceptually-impor\/ [Accessed 30-06-2026]"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.1051\/ro\/2018089","article-title":"Grasp heuristic for time series compression with piecewise aggregate approximation","volume":"53","author":"Siyou Fotso","journal-title":"RAIRO Oper Res"},{"issue":"1","key":"R20","doi-asserted-by":"publisher","DOI":"10.1002\/wics.1392","article-title":"Data representation for time series data mining: time domain approaches","volume":"9","author":"Wilson","journal-title":"WIREs Comput Stat"},{"key":"R21","doi-asserted-by":"publisher","DOI":"10.1016\/j.measurement.2020.108031","article-title":"On the wavelet-based compressibility of continuous-time sampled ECG signal for e-health applications","volume":"164","author":"Maalej","journal-title":"Measurement (Lond)"},{"issue":"7","key":"R22","doi-asserted-by":"publisher","DOI":"10.3390\/bios12070524","article-title":"New ECG compression method for portable ECG monitoring system merged with binary convolutional auto-encoder and residual error compensation","volume":"12","author":"Shi","journal-title":"Biosensors (Basel)"},{"key":"R23","unstructured":"Cichosz S Xylander AA . Synthetic continuous glucose monitoring (CGM) signals. Mendeley Data. 2021. URL: https:\/\/data.mendeley.com\/datasets\/chd8hx65r4\/1 [Accessed 26-06-2026]"},{"issue":"5","key":"R24","doi-asserted-by":"publisher","first-page":"1220","DOI":"10.1177\/19322968211014255","article-title":"A conditional generative adversarial network for synthesis of continuous glucose monitoring signals","volume":"16","author":"Lebech Cichosz","journal-title":"J Diabetes Sci Technol"},{"issue":"6","key":"R25","doi-asserted-by":"publisher","first-page":"3379","DOI":"10.1111\/dom.16356","article-title":"Efficacy and safety of continuous glucose monitoring on glycaemic control in patients with chronic pancreatitis and insulin-treated diabetes: a randomised, open-label, crossover trial","volume":"27","author":"Davidsen","journal-title":"Diabetes Obes Metab"},{"key":"R26","unstructured":"Mirza M Osindero S . Conditional generative adversarial nets. arXiv. Preprint posted online on Nov 6, 2014. [doi: 10.48550\/arXiv.1411.1784]"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.1177\/19322968251356239","article-title":"Increased glycemic variability in patients with chronic pancreatitis and diabetes compared to type 2 diabetes","author":"Davidsen","journal-title":"J Diabetes Sci Technol"},{"issue":"8","key":"R28","doi-asserted-by":"publisher","DOI":"10.1111\/dme.70080","article-title":"Unravelling the heterogeneity of diabetes in chronic pancreatitis: alpha and beta cell dysfunction and association with glycaemic control","volume":"42","author":"Davidsen","journal-title":"Diabet Med"},{"issue":"3","key":"R29","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1109\/TBCAS.2024.3359994","article-title":"Efficient in vivo neural signal compression using an autoencoder-based neural network","volume":"18","author":"Valencia","journal-title":"IEEE Trans Biomed Circuits Syst"},{"issue":"5","key":"R30","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1016\/j.dt.2019.07.016","article-title":"A comparison of Piecewise Cubic Hermite Interpolating Polynomials, cubic splines and piecewise linear functions for the approximation of projectile aerodynamics","volume":"15","author":"Rabbath","journal-title":"Def Technol"},{"issue":"12","key":"R31","doi-asserted-by":"publisher","first-page":"1631","DOI":"10.2337\/dc17-1600","article-title":"International consensus on use of continuous glucose monitoring","volume":"40","author":"Danne","journal-title":"Diabetes Care"},{"issue":"1","key":"R32","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/S2213-8587(22)00319-9","article-title":"Continuous glucose monitoring and metrics for clinical trials: an international consensus statement","volume":"11","author":"Battelino","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"8","key":"R33","doi-asserted-by":"publisher","first-page":"1593","DOI":"10.2337\/dci19-0028","article-title":"Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range","volume":"42","author":"Battelino","journal-title":"Diabetes Care"},{"issue":"9","key":"R34","doi-asserted-by":"publisher","first-page":"644","DOI":"10.2337\/diab.19.9.644","article-title":"Mean amplitude of glycemic excursions, a measure of diabetic instability","volume":"19","author":"Service","journal-title":"Diabetes"},{"key":"R35","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.19501","article-title":"From data to insights: a tool for comprehensive Quantification of Continuous Glucose Monitoring (QoCGM)","volume":"13","author":"Cichosz","journal-title":"PeerJ"},{"issue":"4","key":"R36","doi-asserted-by":"publisher","first-page":"982","DOI":"10.1177\/1932296821992060","article-title":"Glycemic variability assessment with a 14-day continuous glucose monitoring system: when and how long to measure MAGE (mean amplitude of glucose excursion) for optimal reliability?","volume":"16","author":"Verg\u00e8s","journal-title":"J Diabetes Sci Technol"},{"issue":"3","key":"R37","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1089\/dia.2024.0404","article-title":"The virtual DCCT: adding continuous glucose monitoring to a landmark clinical trial for prediction of microvascular complications","volume":"27","author":"Kovatchev","journal-title":"Diabetes Technol Ther"},{"issue":"7","key":"R38","doi-asserted-by":"publisher","first-page":"558","DOI":"10.1089\/dia.2025.0033","article-title":"The association of time-in-range and time-in-tight-range with retinopathy progression in the virtual diabetes control and complications trial continuous glucose monitoring dataset","volume":"27","author":"Lobo","journal-title":"Diabetes Technol Ther"},{"issue":"1","key":"R39","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-00540-x","article-title":"Efficient ECG compression and QRS detection for e-health applications","volume":"7","author":"Elgendi","journal-title":"Sci Rep"}],"container-title":["JMIR Biomedical Engineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/biomedeng.jmir.org\/2026\/1\/e91959","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:24:02Z","timestamp":1785536642000},"score":1,"resource":{"primary":{"URL":"https:\/\/biomedeng.jmir.org\/2026\/1\/e91959"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,20]]},"references-count":39,"URL":"https:\/\/doi.org\/10.2196\/91959","relation":{},"ISSN":["2561-3278"],"issn-type":[{"value":"2561-3278","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,20]]},"article-number":"v11i3e91959"}}