System, method, and computer readable medium for dynamic insulin sensitivity in diabetic pump users

• US 10,463,789 B2
• Filed: 09/02/2016
• Issued: 11/05/2019
• Est. Priority Date: 09/02/2015
• Status: Active Grant

• Current Assignee: University of Virginia Patent Foundation (University of Virginia)
• Original Assignee: University of Virginia Patent Foundation (University of Virginia)
• Inventors: Breton, Marc D., Jiang, Boyi, Fabris, Chiara
• Primary Examiner(s): Hayman, Imani N
• Application Number:
  US15/255,828
• Publication Number:
  US 20170056591A1
• Time in Patent Office: 1,159 Days
• CPC Class Codes: A61B 5/1451 for interstitial fluid
• 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 5/7275 Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
• CPC Class Codes: A61M 2005/14208 with a programmable infusion control system, characterised by the infusion program
• CPC Class Codes: A61M 2230/201 Glucose concentration
• 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: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 20/13 delivered from dispensers
• CPC Class Codes: G16H 20/17 delivered via infusion or injection
• CPC Class Codes: G16H 40/60 for the operation of medical equipment or devices
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

A technique for treating diabetes that recognizes patient insulin sensitivity is a time-varying physiological parameter. The described techniques for treating diabetes include measuring interstitial fluid glucose concentration, reading insulin delivery data, determining patient insulin sensitivity based on the interstitial fluid glucose concentration and insulin delivery data, and a time-varying physiological parameter, and dispensing an insulin dose from an insulin delivery device based on the determined patient insulin sensitivity.

Claims

1. A method of treating diabetes comprising:

measuring interstitial fluid glucose concentration using a glucose monitor;

receiving insulin delivery data to reconstruct historical insulin concentration of a patient;

determining patient insulin sensitivity based on the measured interstitial fluid glucose concentration, the insulin delivery data, an estimated glucose rate of appearance, and an estimated insulin concentration; and

determining a diabetes treatment regime specific to the patient at a specific time based on the determined patient insulin sensitivity, wherein the estimated glucose rate of appearance is determined from a meal compartment including a first meal absorption model, and a second meal absorption model, such that the first meal absorption model is faster than the second meal absorption model, and the first and second meal absorption models are based on an adaptation of a Kalman filtering process.

2. The method of claim 1, wherein the measured interstitial fluid glucose concentration is an approximation of patient blood glucose.

3. The method of claim 1 comprising:

determining the estimated insulin concentration from an insulin compartment, wherein the insulin compartment is based on an adaptation of a Kalman filtering process.

4. The method of claim 1 wherein the diabetes treatment regime includes dispensing an insulin dose from an insulin delivery device to the patient.

5. A method for determining an insulin dose based on patient insulin sensitivity, the method comprising:

receiving interstitial fluid glucose concentration measurements of a glucose monitor;

receiving insulin delivery data to reconstruct historical insulin concentration of a patient;

determining patient insulin sensitivity based on the received interstitial fluid glucose concentration measurements, the received insulin pump data, an estimated glucose rate of appearance, and an estimated insulin concentration; and

determining an insulin dose based on the determined patient insulin sensitivity that is specific to a patient, wherein the estimated glucose rate of appearance is determined from a meal compartment including a first meal absorption model, and a second meal absorption model, such that the first meal absorption model is faster than the second meal absorption model, and the first and second meal absorption models are based on an adaptation of a Kalman filtering process.

6. The method of claim 5, wherein the received interstitial fluid glucose concentration is an approximation of patient blood glucose.

7. The method of claim 5 comprising:

determining the estimated insulin concentration from an insulin compartment, wherein the insulin compartment is based on an adaptation of a Kalman filtering process.

8. The method of claim 5 comprising:

dispensing the insulin dose from an insulin pump to the patient.

9. The method of claim 5 comprising:

basing the determined patient insulin sensitivity on a weighted value of the measured interstitial fluid glucose concentration.

10. The method of claim 5 comprising:

compensating the determined patient insulin sensitivity for calibration and measurement noise.

11. The method of claim 5, comprising:

receiving patient physical activity information, wherein the determined patient insulin sensitivity is further based in part on the received patient physical activity information.

12. The method of claim 5, comprising:

receiving patient circadian rhythm information, wherein the determined patient insulin sensitivity is based in part on the received patient circadian rhythm information.

13. The method of claim 5, wherein the determined patient insulin sensitivity is based in part on a specified patient dietary habit.