HDformer: A Higher-Dimensional Transformer for Detecting Diabetes Utilizing Long-Range Vascular Signals

Diabetes mellitus is a global concern, and early detection can prevent serious complications. 50% of people with diabetes live undiagnosed, disproportionately afflicting low-income groups. Non-invasive methods have emerged for timely detection; however, their limited accuracy constrains clinical usage. In this research, we present a novel Higher-Dimensional Transformer (HDformer), the first Transformer-based architecture which utilizes longrange photoplethysmography (PPG) to detect diabetes. The long-range PPG maximizes the signal contextual information when compared to the less-than 30 second signals commonly used in existing research. To increase the computational efficiency of HDformer's long-range processing, a new attention module, Time Square Attention (TSA), is invented to reduce the volume of tokens by more than 10x, while retaining the local/global dependencies. TSA converts the 1D inputs into 2D representations, grouping the adjacent points into a single 2D token. It then generates dynamic patches and feeds them into a gated mixture-ofexperts (MoE) network, optimizing the learning on different attention areas. HDformer achieves state-of-the-art results (sensitivity 98.4, accuracy 97.3, specificity 92.8, AUC 0.929) on the standard MIMIC-III dataset, surpassing existing research. Furthermore, we develop an end-to-end solution where a low-cost wearable is prototyped to connect with the HDformer in the Cloud via a mobile app. This scalable, convenient, and affordable approach provides instantaneous detection and continuous monitoring for individuals. It aids doctors in easily screening for diabetes and safeguards underprivileged communities. This minimizes treatment delays and saves lives. The enhanced versatility of HDformer allows for efficient processing and learning of long-range signals in general one-dimensional time-series sequences, particularly for all biomedical waveforms.