Insulin management

• US 10,255,992 B2
• Filed: 04/02/2018
• Issued: 04/09/2019
• Est. Priority Date: 01/31/2014
• Status: Active Grant

• Current Assignee: Glytec LLC (Aseko, Inc.)
• Original Assignee: Aseko, Inc.
• Inventors: Booth, Robert C., Hebblewhite, Harry
• Primary Examiner(s): Riggs, II, Larry D
• Application Number:
  US15/942,740
• Publication Number:
  US 20180226149A1
• Time in Patent Office: 372 Days
• Field of Search: None
• CPC Class Codes: A61B 5/14532 for measuring glucose, e.g. by tissue impedance measurement
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61B 5/4848 Monitoring or testing the effects of treatment, e.g. of medication
• CPC Class Codes: A61M 2005/14208 with a programmable infusion control system, characterised by the infusion program
• CPC Class Codes: A61M 2005/14296 Pharmacokinetic models
• CPC Class Codes: A61M 2005/1726 the body parameters being measured at, or proximate to, the infusion site
• CPC Class Codes: A61M 2205/18 with alarm
• CPC Class Codes: A61M 2205/3327 Measuring
• CPC Class Codes: A61M 2205/35 Communication
• CPC Class Codes: A61M 2205/3553 remote, e.g. between patient's home and doctor's office
• CPC Class Codes: A61M 2205/3584 using modem, internet or bluetooth
• CPC Class Codes: A61M 2205/3592 using telemetric means, e.g. radio or optical transmission
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2205/507 Head Mounted Displays [HMD]
• CPC Class Codes: A61M 2205/52 with memories providing a history of measured variating parameters of apparatus or patient
• CPC Class Codes: A61M 2205/581 by audible feedback
• CPC Class Codes: A61M 2230/201 Glucose concentration
• CPC Class Codes: A61M 5/14 Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
• 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: A61P 3/10 : for hyperglycaemia, e.g. antidiabetics
• CPC Class Codes: G16H 10/40 : for data related to laboratory analysis, e.g. patient specimen analysis
• CPC Class Codes: G16H 20/17 : delivered via infusion or injection
• 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 80/00 : ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring

Abstract

A method of administering insulin includes receiving blood glucose measurements of a patient at a data processing device from a glucometer. The blood glucose measurements are separated by a time interval. The method also includes receiving patient information at the data processing device and selecting a subcutaneous insulin treatment from a collection of subcutaneous insulin treatments. The selection is based on the blood glucose measurements and the patient information. The selection includes one or more of a subcutaneous standard program, a subcutaneous program without meal boluses, a meal-by-meal subcutaneous program without carbohydrate counting, a meal-by-meal subcutaneous program with carbohydrate counting, and a subcutaneous program for non-diabetic patients. The method also includes executing, using the data processing device, the selected subcutaneous insulin treatment.

Claims

1. A method comprising:

receiving, at data processing hardware, a blood glucose measurement of a patient from a glucometer;

determining, by the data processing hardware, a blood glucose type of the received blood glucose measurement;

when the determined blood glucose type comprises one of a pre-breakfast blood glucose measurement, a pre-lunch blood glucose measurement, or a pre-dinner blood glucose measurement;

determining, by the data processing hardware, whether a subsequent blood glucose measurement associated with an immediately subsequent blood glucose type has been received from the glucometer during a current day, the immediately subsequent blood glucose type comprising one of;

the pre-lunch blood glucose measurement when the determined blood glucose type comprises the pre-breakfast blood glucose measurement;

the pre-dinner blood glucose measurement when the determined blood glucose type comprises the pre-lunch blood glucose measurement;

or

a bedtime blood glucose measurement when the determined blood glucose type comprises the pre-dinner blood glucose measurement;

when the subsequent blood glucose measurement associated with the immediately subsequent blood glucose type has been received, determining, by the data processing hardware, an adjustment factor for adjusting a next day'"'"'s recommended meal bolus for the determined blood glucose type governed by the subsequent blood glucose measurement for the immediately subsequent blood glucose type;

determining, by the data processing hardware, the next day'"'"'s recommended meal bolus at the time of day associated with the determined blood glucose type by multiplying a current day'"'"'s recommended meal bolus associated with the determined blood glucose type times the adjustment factor; and

transmitting the next day'"'"'s recommended meal bolus to an administration device in communication with the data processing hardware on the next day at the time of day associated with the determined blood glucose type, the administration device comprising;

a doser; and

an administration computing device in communication with the doser, the administration computing device configured to cause the doser to administer a number of units of insulin to the patient using the next day'"'"'s recommended meal bolus.

2. The method of claim 1, wherein determining the adjustment factor comprises:

determining whether the subsequent blood glucose measurement is within one of a plurality of target ranges of values; and

when the blood glucose measurement is within one of the plurality of target ranges of values, setting the adjustment factor to a target adjustment factor associated with the corresponding target range of values that includes the subsequent blood glucose measurement.

3. The method of claim 2, wherein the plurality of target ranges of values comprises:

a first target range of values including blood glucose values less than a first configurable constant;

a second target range of values including blood glucose values greater than or equal to the first configurable constant and less than a low target blood glucose value of a target blood glucose range for the patient;

a third target range of values including blood glucose values greater than or equal to the low target blood glucose value and less than a high target blood glucose value of the target blood glucose range;

a fourth target range of values including blood glucose values greater than or equal to the high target blood glucose value and less than a second configurable constant;

a fifth target range of values including blood glucose values greater than or equal to the second configurable constant and less than a third configurable constant; and

a sixth target range of values including blood glucose values greater than or equal to the third configurable constant.

4. The method of claim 1, wherein the blood glucose type is associated with a blood glucose time associated with a time of measuring the blood glucose measurement, the blood glucose type including one of a midsleep blood glucose measurement, the pre-breakfast blood glucose measurement, the pre-lunch blood glucose measurement, the pre-dinner blood glucose measurement, and the bedtime blood glucose measurement, wherein the midsleep, pre-breakfast, pre-lunch, pre-dinner, and bedtime blood glucose measurements are scheduled in a daily repetitive rotational order.

5. The method of claim 1, further comprising, when the determined blood glucose type comprises the pre-breakfast blood glucose measurement:

determining, by the data processing hardware, whether a previous midsleep blood glucose measurement has been received from the glucometer; and

when the pre-breakfast blood glucose measurement has been received;

selecting, by the data processing hardware, a governing blood glucose value as one of the previous midsleep blood glucose measurement or the pre-breakfast blood glucose measurement;

determining, by the data processing hardware, an adjustment factor for adjusting a current day'"'"'s recommended basal dose based on the selected governing blood glucose measurement;

retrieving, by the data processing hardware, a previous day'"'"'s last recommended basal dose; and

determining, by the data processing hardware, the current day'"'"'s recommended basal dose by multiplying the adjustment factor times the previous day'"'"'s last recommended basal dose.

6. The method of claim 5, wherein the governing blood glucose value is selected as the previous midsleep blood glucose measurement when the previous midsleep blood glucose measurement is less than the pre-breakfast blood glucose measurement.

7. The method of claim 5, wherein the governing blood glucose value is selected as the pre-breakfast blood glucose measurement when the pre-breakfast blood glucose measurement is less than the previous midsleep blood glucose measurement unless the previous midsleep blood glucose measurement was accompanied by a correction insulin dose exceeding three units of insulin and an elapsed time between the correction insulin dose and the pre-breakfast blood glucose measurement is less than three hours.

8. The method of claim 5, wherein the current day'"'"'s recommended basal dose corresponds to an insulin dose of long-acting insulin to be administered to the patient at a configurable frequency of one, two, or three times per day.

9. The method of claim 5, further comprising transmitting the current day'"'"'s recommended basal dose from the data processing hardware to a display in communication with the data processing hardware, the current day'"'"'s recommended basal dose indicating a number of units of long-acting insulin to be administered to the patient.

10. The method of claim 1, further comprising:

determining, by the data processing hardware, whether the pre-breakfast blood glucose measurement has been received from the glucometer; and

when the pre-breakfast blood glucose measurement has not been received;

blocking, by the data processing hardware, a basal dose recommendation; and

transmitting a warning from the data processing hardware to a display in communication with the data processing hardware, the warning indicating the pre-breakfast blood glucose measurement has not been received and the blocked basal dose recommendation.

11. A system comprising:

a glucometer measuring blood glucose measurements separated by a time interval; and

a dosing controller in communication with the glucometer, the dosing controller including data processing hardware and memory hardware in communication with the data processing hardware, the dosing controller configured to perform operations comprising;

receiving a blood glucose measurement of a patient from a glucometer;

determining a blood glucose type of the received blood glucose measurement;

when the determined blood glucose type comprises one of a pre-breakfast blood glucose measurement, a pre-lunch blood glucose measurement, or a pre-dinner blood glucose measurement;

determining whether a subsequent blood glucose measurement associated with an immediately subsequent blood glucose type has been received from the glucometer during a current day, the immediately subsequent blood glucose type comprising one of;

the pre-lunch blood glucose measurement when the determined blood glucose type comprises the pre-breakfast blood glucose measurement;

the pre-dinner blood glucose measurement when the determined blood glucose type comprises the pre-lunch blood glucose measurement;

or

a bedtime blood glucose measurement when the determined blood glucose type comprises the pre-dinner blood glucose measurement;

when the subsequent blood glucose measurement associated with the immediately subsequent blood glucose type has been received, determining an adjustment factor for adjusting a next day'"'"'s recommended meal bolus for the determined blood glucose type governed by the subsequent blood glucose measurement for the immediately subsequent blood glucose type;

determining the next day'"'"'s recommended meal bolus at the time of day associated with the determined blood glucose type by multiplying a current day'"'"'s recommended meal bolus associated with the determined blood glucose type times the adjustment factor; and

transmitting the next day'"'"'s recommended meal bolus to an administration device in communication with the dosing controller on the next day at the time of day associated with the determined blood glucose type, the administration device comprising;

a doser; and

an administration computing device in communication with the doser, the administration computing device configured to cause the doser to administer a number of units of insulin to the patient using the next day'"'"'s recommended meal bolus.

12. The system of claim 11, wherein determining the adjustment factor comprises:

determining whether the subsequent blood glucose measurement is within one of a plurality of target ranges of values; and

when the blood glucose measurement is within one of the plurality of target ranges of values, setting the adjustment factor to a target adjustment factor associated with the corresponding target range of values that includes the subsequent blood glucose measurement.

13. The system of claim 12, wherein the plurality of target ranges of values comprises:

a first target range of values including blood glucose values less than a first configurable constant;

a second target range of values including blood glucose values greater than or equal to the first configurable constant and less than a low target blood glucose value of a target blood glucose range for the patient;

a third target range of values including blood glucose values greater than or equal to the low target blood glucose value and less than a high target blood glucose value of the target blood glucose range;

a fourth target range of values including blood glucose values greater than or equal to the high target blood glucose value and less than a second configurable constant;

a fifth target range of values including blood glucose values greater than or equal to the second configurable constant and less than a third configurable constant; and

a sixth target range of values including blood glucose values greater than or equal to the third configurable constant.

14. The system of claim 11, wherein the blood glucose type is associated with a blood glucose time associated with a time of measuring the blood glucose measurement, the blood glucose type including one of a midsleep blood glucose measurement, the pre-breakfast blood glucose measurement, the pre-lunch blood glucose measurement, the pre-dinner blood glucose measurement, and the bedtime blood glucose measurement, wherein the midsleep, pre-breakfast, pre-lunch, pre-dinner, and bedtime blood glucose measurements are scheduled in a daily repetitive rotational order.

15. The system of claim 11, wherein the operations further comprise, when the determined blood glucose type comprises the pre-breakfast blood glucose measurement:

determining whether a previous midsleep blood glucose measurement has been received from the glucometer; and

when the pre-breakfast blood glucose measurement has been received;

selecting a governing blood glucose value as one of the previous midsleep blood glucose measurement or the pre-breakfast blood glucose measurement;

determining an adjustment factor for adjusting a current day'"'"'s recommended basal dose based on the selected governing blood glucose measurement;

retrieving a previous day'"'"'s last recommended basal dose; and

determining the current day'"'"'s recommended basal dose by multiplying the adjustment factor times the previous day'"'"'s last recommended basal dose.

16. The system of claim 15, wherein the governing blood glucose value is selected as the previous midsleep blood glucose measurement when the previous midsleep blood glucose measurement is less than the pre-breakfast blood glucose measurement.

17. The system of claim 15, wherein the governing blood glucose value is selected as the pre-breakfast blood glucose measurement when the pre-breakfast blood glucose measurement is less than the previous midsleep blood glucose measurement unless the previous midsleep blood glucose measurement was accompanied by a correction insulin dose exceeding three units of insulin and an elapsed time between the correction insulin dose and the pre-breakfast blood glucose measurement is less than three hours.

18. The system of claim 15, wherein the current day'"'"'s recommended basal dose corresponds to an insulin dose of long-acting insulin to be administered to the patient at a configurable frequency of one, two, or three times per day.

19. The system of claim 15, wherein the operations further comprise transmitting the current day'"'"'s recommended basal dose from the data processing hardware to a display in communication with the dosing controller, the current day'"'"'s recommended basal dose indicating a number of units of long-acting insulin to be administered to the patient.

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

determining whether the pre-breakfast blood glucose measurement has been received from the glucometer; and

when the pre-breakfast blood glucose measurement has not been received;

blocking a basal dose recommendation; and

transmitting a warning from to a display in communication with the dosing controller, the warning indicating the pre-breakfast blood glucose measurement has not been received and the blocked basal dose recommendation.