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Evaluating Time-Series Foundation Models and Multimodal Dietary Context for CGM Forecasting

arxiv.org/abs/2609.11872

quality89

Updated 3 h ago · first seen 11 Sept 2026

paper_01M294FRJ4MX4J0AN225NFHFYY

Published
11 Sept 2026
T1 · 3 h ago
arXiv
2609.11872
T1 · 3 h ago
Category
stat.ML
T1 · 3 h ago

Abstract

Continuous glucose monitoring (CGM) provides high-frequency measurements of glucose dynamics and enables short-term glucose forecasting for diabetes management. Although time-series foundation models have shown strong general forecasting ability, their effectiveness for CGM prediction and the added value of multimodal dietary context remain unclear. We conduct a comprehensive empirical study using eight public CGM datasets spanning Type 1 diabetes, Type 2 diabetes, and non-diabetes populations. Under a unified protocol across multiple context lengths and prediction horizons, zero-shot foundation models did not consistently outperform strong task-specific baselines such as Elastic Net and PatchTST. In contrast, lightweight fine-tuning substantially improved forecasting performance. For example, fine-tuned Chronos-Bolt reduced RMSE by 6.5%-18.4% in the T1D cohort and by 8.6%-18.2% in the non-diabetes/T2D cohort, with comparable improvements in both in-distribution and out-of-distribution test settings. We further evaluate multimodal dietary context using CGMacros, which provides temporally aligned CGM signals, food images, and macronutrient records. A residual-based fusion framework reduced overall RMSE by approximately 3% and postprandial RMSE by approximately 15% relative to the CGM-only baseline. Moreover, Chronos-based CGM representations were more strongly correlated with observed postprandial glucose increments than representations from LSTM and CatBoost, even after those models incorporated additional dietary modalities, suggesting that pretrained temporal representations better preserve meal-induced excursion patterns. These findings show that foundation models require CGM-specific adaptation for reliable forecasting and that dietary context provides clinically meaningful signals beyond CGM alone, especially during postprandial periods.

Authors 12

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

Specification

Official page

Source:arXiv (Atom API + RSS)T1observed 3 h agohigh

Arxiv announce type
cross

Source:arXiv (Atom API + RSS)T1observed 3 h agohigh

arXiv id
2609.11872

Source:arXiv (Atom API + RSS)T1observed 3 h agohigh

Categories
stat.ML, cs.LG

Source:arXiv (Atom API + RSS)T1observed 3 h agohigh

PDF

Source:arXiv (Atom API + RSS)T1observed 3 h agohigh

Primary category
stat.ML

Source:arXiv (Atom API + RSS)T1observed 3 h agohigh

Published
11 Sept 2026

Source:arXiv (Atom API + RSS)T1observed 3 h agohigh

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Provenance

Attributed facts

9

Source tiers

T19

Freshest observation

3 h ago

Conflicts

None