AccScience Publishing / AIH / Online First / DOI: 10.36922/AIH026270074
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ORIGINAL RESEARCH ARTICLE

Few-shot personalized postprandial glucose prediction with model-agnostic neighbor fusion

Fatma Indriani1* Irwan Budiman1 Dwi Kartini1 Radityo Adi Nugroho1 Muhammad Zainal Muttaqin1 Mohammad Reza Faisal1
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1 Department of Computer Science, Faculty of Mathematics and Natural Sciences, Universitas Lambung Mangkurat, Banjarmasin, South Kalimantan , Indonesia
Received: 29 June 2026 | Revised: 5 July 2026 | Accepted: 13 July 2026 | Published online: 9 September 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

The postprandial glucose response varies substantially among individuals, so a model trained on a population predicts well on average yet makes consistent, person-specific errors for individual participants. Personalization can close this gap, but most methods require retraining or a personal meal history that a newly enrolled subject has not yet accumulated. This study aimed to personalize an arbitrary pre-trained glucose model at inference time, without retraining, gradient updates, or diagnosis labels. We propose Neighbor Fusion Personalization (NFP), a model-agnostic inference-time layer that combines a population-model prediction with two nearest-neighbor estimates. The global estimate uses similar meals from the training population and is available at cold start, whereas the personal estimate uses the subject’s accumulating meal history. An adaptive weight, w(n) = n/(n + λ), gradually shifts the prediction from population-level toward personal evidence as the available history increases. Across 44 subjects and 5 base architectures spanning linear, tree-ensemble, and neural models, NFP reduced normalized root mean square error for glucose 60 min after a meal at every tested checkpoint from three meals onward, reaching a mean improvement of 0.032 (about 13%, approximately 5 mg/dL) at 5 meals, significant on all 5 architectures (pfdr ≤ 0.01) with no per-model tuning. It outperformed subject-specific calibration and a mixed-effects baseline in the few-shot regime, and added about 0.11 ms and under 25 kB per prediction. On two independent cohorts spanning type 1 and type 2 diabetes, the direction of the effect was reproduced under frozen hyperparameters, with smaller gains that scaled with meal-feature fidelity. Because it is training-free and model-agnostic, NFP offers a practical personalization layer for continuous glucose monitoring, available from the first prediction. Its clinical value for dietary decision support remains to be tested prospectively.

Graphical abstract
Keywords
Continuous glucose monitoring
Postprandial glucose prediction
Personalization
Model-agnostic personalization
K-nearest neighbors
Few-shot learning
Inference-time adaptation
Funding
This work was funded by the DRTPM Research Program, Ministry of Higher Education, Science, and Technology of Indonesia (Main Contract No. 082/C3/DT.05.00/PL-MULTITAHUN LANJUTAN/2026; Derivative Contract No. 215/UN8.2/PG/2026).
Conflict of interest
The authors declare no conflicts of interest.
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Artificial Intelligence in Health, Electronic ISSN: 3029-2387 Print ISSN: 3041-0894, Published by AccScience Publishing