Means and method for improved glycemic control for diabetic patients

• US 10,102,922 B2
• Filed: 04/03/2018
• Issued: 10/16/2018
• Est. Priority Date: 09/11/2012
• Status: Active Grant

• Current Assignee: Aseko, Inc.
• Original Assignee: Aseko, Inc.
• Inventors: Booth, Robert C., Fischell, Robert E.
• Primary Examiner(s): Kanaan, Maroun P
• Application Number:
  US15/943,900
• Publication Number:
  US 20180226140A1
• Time in Patent Office: 196 Days
• CPC Class Codes: A61B 2562/0295 Strip shaped analyte sensors for apparatus classified in A61B5/145 or A61B5/157 disposable multilayered or laminated electrodes G01N27/307; details of handling chemical test elements G01N33/4875
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/14532 for measuring glucose, e.g. by tissue impedance measurement
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: G06F 3/04847 Interaction techniques to control parameter settings, e.g. interaction with sliders or dials
• CPC Class Codes: G16H 10/40 for data related to laboratory analysis, e.g. patient specimen analysis
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 20/17 delivered via infusion or injection
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 20/60 relating to nutrition control, e.g. diets
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: G16H 80/00 ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

A glycemic control system includes a physician processor, remote processor, and a portable telephone having a data input mechanism, a display, and an internal processor for bi-directional communication with the physician'"'"'s processor and the remote processor. A patient inputs data to the internal processor responsive to input from the physician'"'"'s processor and then transmits the information to the remote processor where an optimized number of units to be administered is sent back and displayed on the portable telephone.

Claims

1. A method comprising:

receiving, at data processing hardware, a current blood glucose measurement of a patient and a time period of the current blood glucose measurement from a user device controlled by the patient and in communication with the data processing hardware, wherein the user device;

receives the current blood glucose measurement and the time period of the current blood glucose measurement from a blood glucose meter in communication with the user device; and

transmits the current blood glucose measurement of the patient and the time period of the current blood glucose measurement to the data processing hardware;

determining, by the data processing hardware, whether the time period of the current blood glucose measurement is a pre-meal time and a meal type associated with the pre-meal time is one of breakfast, lunch, dinner, or snack;

when the time period of the current blood glucose measurement is the pre-meal time and the meal type associated with the pre-meal time is breakfast;

obtaining, by the data processing hardware, a previous basal dose administered by the patient, a previous mid-sleep blood glucose measurement of the patient, and a previous breakfast blood glucose measurement of the patient from memory hardware in communication with the data processing hardware;

determining, by the data processing hardware, an adjustment factor based on one of the previous mid-sleep blood glucose measurement or the previous breakfast blood glucose measurement; and

multiplying, by the data processing hardware, the previous basal dose times the adjustment factor to determine a new basal dose of insulin for the patient to administer;

transmitting the new basal dose from the data processing hardware to the user device, the new basal dose of insulin, when received by the user device, causing a user interface executing on the user device to display the new basal dose of insulin;

obtaining, by the data processing hardware, an insulin sensitivity factor for the patient and a target blood glucose range defined by upper and lower blood glucose limits for the patient from the memory hardware, the insulin sensitivity factor and the target blood glucose range inputted to the memory hardware by a medical professional computing device associated with an authorized medical professional;

determining, by the data processing hardware, whether the current blood glucose measurement exceeds the midpoint of the target blood glucose range for the patient; and

when the current blood glucose measurement exceeds the midpoint of the target blood glucose range for the patient;

determining, by the data processing hardware, a correction dose based on a function of the current blood glucose measurement, the mid-point of the target blood glucose range and the insulin sensitivity factor; and

transmitting the correction dose from the data processing hardware to the user device, the correction dose, when received by the user device, causing the user interface executing on the user device to display the correction dose.

2. The method of claim 1, wherein determining the adjustment factor comprises determining whether the previous breakfast blood glucose measurement is greater than the previous mid-sleep blood glucose measurement, and one of:

when the previous breakfast blood glucose measurement is greater than the previous mid-sleep blood glucose measurement, determining the adjustment factor based on the previous mid-sleep blood glucose measurement;

or

when the previous breakfast blood glucose measurement is less than the previous mid-sleep blood glucose measurement, determining the adjustment factor based on the previous breakfast blood glucose measurement.

3. The method of claim 1, wherein the user interface executing on the user device is configured to display the new basal dose of insulin during the time period of the current blood glucose measurement.

4. The method of claim 1, further comprising:

receiving, at the data processing hardware, a number of carbohydrates consumed by the patient during a pre-meal time associated with a meal type corresponding to one of breakfast, lunch, or dinner;

obtaining, by the data processing hardware, a carbohydrate-to-insulin ratio for the patient from the memory hardware, the carbohydrate-to-insulin ratio input to the memory hardware by the medical professional computing device associated with the authorized medical professional;

dividing, by the data processing hardware, the number of carbohydrates consumed by the patient by the carbohydrate-to-insulin ratio to determine a recommended meal bolus; and

transmitting the recommended meal bolus from the data processing hardware to the user device, the recommended meal bolus, when received by the user device, causing the user interface executing on the user device to display the recommended meal bolus.

5. The method of claim 4, wherein the carbohydrate-to-insulin ratio is calculated as follows:

CIR=450×

TDD

wherein CIR is the carbohydrate-to-insulin ratio and TDD is a total prescribed daily dose of insulin for the patient based on a weight of the patient.

6. The method of claim 4, wherein the user device is configured to:

receive, in the user interface, an input from the patient indicating the number of carbohydrates consumed by the patient; and

transmit the number of carbohydrates consumed by the patient to the data processing hardware.

7. The method of claim 4, wherein after transmitting the recommended meal bolus to the user device, the user device is configured to:

receive, in the user interface, an input from the patient indicating a number of units of insulin administered by the patient during the pre-meal time associated with the meal type corresponding to one of breakfast, lunch, or dinner associated with the recommended meal bolus, the number of units of insulin associated with the recommended meal bolus; and

transmit the number of units of insulin administered by the patient to the data processing hardware.

8. The method of claim 1, wherein the correction dose is calculated as follows:

9. The method of claim 1, further comprising:

in response to receiving the current blood glucose measurement from the user device, obtaining, by the data processing hardware, a hypoglycemia blood glucose limit for the patient from the memory hardware, the hypoglycemia blood glucose limit inputted to the memory hardware by the medical professional computing device associated with the authorized medical professional;

determining, by the data processing hardware, whether the current blood glucose measurement is less than the hypoglycemia blood glucose limit; and

when the current blood glucose measurement is less than the hypoglycemia blood glucose limit;

transmitting an out-of-range blood glucose alert from the data processing hardware to the medical professional computing device;

receiving, at the data processing hardware, hypoglycemia patient instructions when the current blood glucose measurement is less than the hypoglycemia blood glucose limit from the medical professional computing device; and

transmitting the received one of the hypoglycemia patient instructions from the data processing hardware to the user device, the hypoglycemia patient instructions, when received by the user device, causing the user interface executing on the user device to display the hypoglycemia patient instructions.

10. The method of claim 1, wherein after transmitting the new basal to the user device, the user device is configured to:

receive, in the user interface, an input from the patient indicating a number of units of insulin associated with the new basal dose administered by the patient; and

transmit the number of units of insulin associated with the new basal dose administered by the patient to the data processing hardware.

11. A system comprising:

a blood glucose meter configured to measure blood glucose measurements of a patient;

a user device having a screen and in communication with the blood glucose meter, the user device configured to;

receive a current blood glucose measurement of the patient and a time period of the current blood glucose measurement from the blood glucose meter; and

display a user interface on the screen; and

data processing hardware in communication with the user device, the data processing hardware configured to perform operations comprising;

determining whether the time period of the current blood glucose measurement is a pre-meal time and a meal type associated with the pre-meal time is one of breakfast, lunch, dinner, or snack;

when the time period of the current blood glucose measurement is the pre-meal time and the meal type associated with the pre-meal time is breakfast;

obtaining a previous basal dose administered by the patient, a previous mid-sleep blood glucose measurement of the patient, and a previous breakfast blood glucose measurement of the patient from memory hardware in communication with the data processing hardware;

determining an adjustment factor based on one of the previous mid-sleep blood glucose measurement or the previous breakfast blood glucose measurement; and

multiplying the previous basal dose times the adjustment factor to determine a new basal dose of insulin for the patient to administer;

transmitting the new basal dose to the user device, the user device configured to display the new basal dose of insulin in the user interface;

obtaining an insulin sensitivity factor for the patient and a target blood glucose range defined by upper and lower blood glucose limits for the patient from the memory hardware, the insulin sensitivity factor and the target blood glucose range inputted to the memory hardware by a medical professional computing device associated with an authorized medical professional;

determining whether the current blood glucose measurement exceeds the midpoint of the target blood glucose range for the patient; and

when the current blood glucose measurement exceeds the midpoint of the target blood glucose range for the patient;

determining a correction dose based on a function of the current blood glucose measurement, the mid-point of the target blood glucose range and the insulin sensitivity factor; and

transmitting the correction dose to the user device, the user device configured to display the correction dose in the user interface.

12. The system of claim 11, wherein determining the adjustment factor comprises determining whether the previous breakfast blood glucose measurement is greater than the previous mid-sleep blood glucose measurement, and one of:

when the previous breakfast blood glucose measurement is greater than the previous mid-sleep blood glucose measurement, determining the adjustment factor based on the previous mid-sleep blood glucose measurement;

or

when the previous breakfast blood glucose measurement is less than the previous mid-sleep blood glucose measurement, determining the adjustment factor based on the previous breakfast blood glucose measurement.

13. The system of claim 11, wherein the user device is configured to display the new basal dose of insulin in the user interface during the time period of the current blood glucose measurement.

14. The system of claim 11, wherein the operations further comprise:

receiving a number of carbohydrates consumed by the patient during a pre-meal time associated with a meal type corresponding to one of breakfast, lunch, or dinner;

obtaining a carbohydrate-to-insulin ratio for the patient from the memory hardware, the carbohydrate-to-insulin ratio input to the memory hardware by the medical professional computing device associated with the authorized medical professional;

dividing the number of carbohydrates consumed by the patient by the carbohydrate-to-insulin ratio to determine a recommended meal bolus; and

transmitting the recommended meal bolus to the user device, the user device configured to display the recommended meal bolus in the user interface.

15. The system of claim 14, wherein the carbohydrate-to-insulin ratio is calculated as follows:

CIR=450×

TDD

wherein CIR is the carbohydrate-to-insulin ratio and TDD is a total prescribed daily dose of insulin for the patient based on a weight of the patient.

16. The system of claim 14, wherein the user device is configured to:

receive, in the user interface, an input from the patient indicating the number of carbohydrates consumed by the patient; and

transmit the number of carbohydrates consumed by the patient to the data processing hardware.

17. The system of claim 14, wherein after transmitting the recommended meal bolus to the user device, the user device is configured to:

receive, in the user interface, an input from the patient indicating a number of units of insulin administered by the patient during the pre-meal time associated with the meal type corresponding to one of breakfast, lunch, or dinner associated with the recommended meal bolus, the number of units of insulin associated with the recommended meal bolus; and

transmit the number of units of insulin administered by the patient to the data processing hardware.

18. The system of claim 11, wherein the correction dose is calculated as follows:

19. The system of claim 11, wherein the operations further comprise:

in response to receiving the current blood glucose measurement from the user device, obtaining a hypoglycemia blood glucose limit for the patient from the memory hardware, the hypoglycemia blood glucose limit inputted to the memory hardware by the medical professional computing device associated with the authorized medical professional;

determining whether the current blood glucose measurement is less than the hypoglycemia blood glucose limit; and

when the current blood glucose measurement is less than the hypoglycemia blood glucose limit;

transmitting an out-of-range blood glucose alert to the medical professional computing device;

receiving hypoglycemia patient instructions when the current blood glucose measurement is less than the hypoglycemia blood glucose limit from the medical professional computing device; and

transmitting the received one of the hypoglycemia patient instructions from the data processing hardware to the user device, the user device configured to display the hypoglycemia patient instructions in the user interface.

20. The system of claim 11, wherein after transmitting the new basal to the user device, the user device is configured to:

receive, in the user interface, an input from the patient indicating a number of units of insulin associated with the new basal dose administered by the patient; and

transmit the number of units of insulin associated with the new basal dose administered by the patient to the data processing hardware.