METHOD FOR THE DETERMINATION OF AT LEAST ONE CHARACTERISTIC FIGURE RELATING TO A PATIENT'S GLUCOSE METABOLISM, AND APPARATUS THEREFOR

• US 20100298751A1
• Filed: 11/11/2008
• Published: 11/25/2010
• Est. Priority Date: 11/12/2007
• Status: Active Grant

• Current Assignee: Fresenius Medical Care Deutschland GmbH (Fresenius Medical Care AG)
• Original Assignee: Fresenius Medical Care Deutschland Medical Care de
• Inventors: Schulte, Elke, Müller, Carsten
• Granted Patent: US 10,226,562 B2
• Time in Patent Office: Days
• US Class Current: 604/4.01
• CPC Class Codes: A61B 5/14532 for measuring glucose, e.g. by tissue impedance measurement
• CPC Class Codes: A61M 1/1609 after use, i.e. downstream of dialyser
• CPC Class Codes: A61M 1/34 Filtering material out of the blood by passing it through a membrane, i.e. hemofiltration or diafiltration
• CPC Class Codes: A61M 1/342 Adding solutions to the blood, e.g. substitution solutions for preventing coagulation A61M1/3672
• CPC Class Codes: A61M 1/3434 with pre-dilution and post-dilution
• CPC Class Codes: A61M 1/3437 downstream of the filter, e.g. post-dilution with filtrate
• CPC Class Codes: A61M 1/3458 having electrolytes not present in the dialysate
• 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: B01D 61/32 Controlling or regulating
• CPC Class Codes: C12Q 1/54 involving glucose or galactose

Abstract

The present invention relates to a method for detecting at least one characteristic relating to a patient'"'"'s glucose metabolism, having steps to be performed during an extracorporeal treatment of the patient'"'"'s blood, particularly during a dialysis treatment, of the extracorporeal addition of glucose and/or insulin and extracorporeal measurement of a glucose concentration and/or an insulin concentration. The invention further proposes a corresponding device. In addition, the invention proposes a method for determining the composition of the dialysate for the extracorporeal treatment of a patient'"'"'s blood having the steps of determining a glucose level in the patient'"'"'s blood during the dialysis session and adapting the amount of glucose added to the dialysate or blood based on the glucose level determined. To this end, the invention proposes a corresponding device. The invention further proposes a blood treatment device.

Claims

1-19. -19. (canceled)

20. A method for the determination of at least one characteristic figure relating to the glucose metabolism of a patient, comprising:

extracorporeally adding at least one of a) glucose and b) insulin during an extracorporeal treatment of the blood of the patient; and

extracorporeally measuring at least one of a) a glucose concentration and b) an insulin concentration during the extracorporeal treatment.

21. The method according to claim 20, wherein the extracorporeal treatment is a dialysis treatment.

22. The method according to claim 20, further comprising:

changing a dialysate glucose concentration while monitoring the measured glucose concentration.

23. The method according to claim 22, wherein:

the change in the dialysate glucose concentration is reflected in the determination of the at least one characteristic figure.

24. The method according to claim 20, further comprising:

determining a glucose shift across a dialysis filter after extracorporeal addition of glucose, wherein the glucose shift across the dialysis filter is reflected in the determination of the at least one characteristic figure.

25. The method according to claim 20, wherein the extracorporeal addition of at least one of a) glucose and b) insulin includes an addition on the dialysate side and/or on the substituate side.

26. The method according to claim 20, wherein:

at least one of a) the addition of glucose and/or insulin and b) the measuring of the glucose concentration and/or the insulin concentration is automated.

27. The method according to claim 20, further comprising:

at least one of a) outputting and b) storing at least one determined characteristic figure.

28. A method for the determination of at least one characteristic figure relating to the glucose metabolism of a patient during an extracorporeal dialysis treatment of the patient with the aid of a dialysis apparatus having at least one of a) a substituate side and b) a dialysate side, comprising:

extracorporeally measuring a concentration of at least one substance comprised of at least one of a) glucose and b) insulin; and

extracorporeally adding at least one of a) glucose and b) insulin on the dialysate side and/or on the substituate side for the purpose of examining the glucose metabolism.

29. The method according to claim 28, further comprising:

changing a dialysate glucose concentration while monitoring the measured concentration.

30. The method according to claim 29, wherein:

the change in the dialysate glucose concentration is reflected in the determination of the at least one characteristic figure.

31. The method according to claim 29, further comprising:

determining a glucose shift across a dialysis filter after extracorporeal addition of glucose, wherein the glucose shift across the dialysis filter is reflected in the determination of the at least one characteristic figure.

32. The method according to claim 28, wherein:

at least one of a) the addition of glucose and/or insulin and b) the measuring of the glucose concentration and/or the insulin concentration is automated.

33. The method according to claim 28, further comprising:

at least one of a) outputting and b) storing at least one determined characteristic figure.

34. An apparatus for the determination of at least one characteristic figure relating to the glucose metabolism of a patient, comprising:

a measurement instrument configured to extracorporeally measure the glucose concentration and/or insulin concentration during an extracorporeal treatment of the blood of the patient, particularly during a dialysis treatment,

an input line configured to extracorporeally add glucose and/or insulin during the extracorporeal treatment.

35. The apparatus according to claim 34, wherein the extracorporeal treatment is a dialysis treatment.

36. The apparatus according to claim 34, further comprising:

a means for changing the dialysate glucose concentration while monitoring the measured glucose concentration.

37. The apparatus according to claim 36, further comprising:

a means for the calculatory reflection of the change in the determination of the at least one characteristic figure.

38. The apparatus according to claim 34, further comprising:

a means for the determination of a glucose shift across a dialysis filter after the extracorporeal addition of glucose; and

a means for the calculatorily reflecting the glucose shift across the dialysis filter in the determination of the at least one characteristic figure.

39. The apparatus according to claim 34, wherein:

the input line is configured to extracorporeally add glucose and/or insulin on the dialysate side and/or substituate side.

40. The apparatus according to claim 34, wherein:

the apparatus is automated to at least one of a) add glucose and/or insulin and b) measure the glucose concentration and/or the insulin concentration.

41. The apparatus according to claim 34, further comprising:

a means for outputting and/or storing at least one determined characteristic figure.

42. The apparatus according to claim 34, wherein the apparatus is a blood treatment apparatus.

43. An apparatus for the determination of at least one characteristic figure relating to the glucose metabolism of a patient during an extracorporeal dialysis treatment of the patient with the aid of a dialysis apparatus comprising a substituate side and/or a dialysate side, including

a measurement instrument configured to measure a concentration of at least one substance comprised of at least one of a) glucose and b) insulin;

an input line configured to extracorporeally add at least one substance comprised of at least one of a) glucose and b) insulin on the dialysate side and/or on the substituate side for the purpose of examining the glucose metabolism.

44. The apparatus according to claim 43, further comprising:

a means for changing the dialysate glucose concentration while monitoring the measured glucose concentration.

45. The apparatus according to claim 44, further comprising:

a means for the calculatorily reflecting the change in the determination of the at least one characteristic figure.

46. The apparatus according to claim 43, further comprising:

a means for the determination of a glucose shift across a dialysis filter after the extracorporeal addition of glucose; and

a means for the calculatory reflection of the glucose shift across the dialysis filter in the determination of the at least one characteristic figure.

47. The apparatus according to claim 43, wherein:

the apparatus is automated to at least one of a) add glucose and/or insulin and b) measure the glucose concentration and/or the insulin concentration.

48. The apparatus according to claim 43, further comprising:

a means for outputting and/or storing at least one determined characteristic figure.

49. The apparatus according to claim 43, wherein the apparatus is a blood treatment apparatus.

50. A method for defining the composition of the dialysate for the extracorporeal blood treatment of a patient, comprising:

determining a glucose level in the blood of the patient during the dialysis session; and

adapting the glucose quantity to be added to the dialysate based on the determined glucose level.

51. An apparatus for defining the composition of the dialysate for the extracorporeal dialysis of a patient, comprising:

a means for determining a glucose level in the blood of the patient during the dialysis session;

a means for adapting a glucose quantity to be added to the dialysate based on the determined glucose level.

52. The apparatus according to claim 51, wherein the apparatus is a blood treatment apparatus.