METHOD AND/OR SYSTEM FOR ASSESSING A PATIENT'S GLYCEMIC RESPONSE

• US 20130190583A1
• Filed: 12/14/2012
• Published: 07/25/2013
• Est. Priority Date: 01/19/2012
• Status: Active Grant

• Current Assignee: Medtronic Minimed Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Minimed Incorporated (Medtronic Plc)
• Inventors: Kaufman, Francine R., Roy, Anirban, Grosman, Benyamin, Keenan, Desmond Barry
• Granted Patent: US 10,694,983 B2
• Time in Patent Office: Days
• US Class Current: 600/365
• 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 5/1473 invasive, e.g. introduced into the body by a catheter A61B5/1482 takes precedence
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61B 5/4866 Evaluating metabolism A61B5/083 takes precedence
• CPC Class Codes: A61B 5/6849 in combination with a needle set
• 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 5/142 Pressure infusion, e.g. using pumps
• CPC Class Codes: G16H 20/17 delivered via infusion or injection
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

Subject matter disclosed herein relates to a method and/or system for tailoring insulin therapies to physiological characteristics of a patient. In particular, observations of a blood glucose concentration of a patient responsive to a meal profile and an insulin profile may be used for estimating one or more physiological parameters.

Claims

1. A method comprising:

determining a meal profile of a patient indicative of an ingestion of a carbohydrate;

determining an insulin profile of said patient indicative of insulin infused by said patient;

obtaining one or more observations of a blood glucose concentration of said patient responsive to said meal profile and said insulin profile; and

estimating one or more physiological parameters of said patient to model said blood glucose concentration based, at least in part, on the meal profile, the insulin profile and the one or more observations of said blood glucose concentration.

2. The method of claim 1, wherein said meal profile comprises a multi-component expression.

3. The method of claim 2, wherein said meal profile is defined, at least in part, by multiple humps.

4. The method of claim 1, wherein said insulin profile comprises an expression of subcutaneous insulin and an expression of insulin infused.

5. The method of claim 4, wherein said insulin profile is defined, at least in part, according to a pharmacokinetic model.

6. The method of claim 1, and further comprising applying at least one of said estimated parameters in determining a meal bolus or a correction bolus.

7. The method of claim 1, and further comprising applying at least one of said estimated parameters in determining limits to an amount of insulin to be specified in an insulin pump command.

8. The method of claim 1, and further comprising applying at least one of said estimated parameters to tune parameters of a controller to determine an amount of insulin to be infused to said patient on discrete command intervals.

9. The method of claim 1, wherein at least one of said one or more physiological parameters comprises a blood glucose concentration observed following a fasting period during an infusion of insulin to said patient at a constant basal rate.

10. The method of claim 1, and further comprising computing an insulin infusion basal rate for said patient based, at least in part, on at least one of said one or more physiological parameters.

11. A apparatus comprising:

a special purpose computing apparatus to;

determine a meal profile of a patient indicative of an ingestion of a carbohydrate;

determine an insulin profile of said patient indicative of insulin infused by said patient;

obtain one or more observations of a blood glucose concentration of said patient responsive to said meal profile and said insulin profile; and

estimate one or more physiological parameters of said patient to model said blood glucose concentration based, at least in part, on the meal profile, the insulin profile and the one or more observations of said blood glucose concentration.

12. The apparatus of claim 11, wherein said meal profile comprises a multi-component expression.

13. The apparatus of claim 12, wherein said meal profile is defined, at least in part, by multiple humps.

14. The apparatus of claim 11, wherein said insulin profile comprises an expression of subcutaneous insulin and an expression of insulin infused.

15. The apparatus of claim 14, wherein said insulin profile is defined, at least in part, according to a pharmacokinetic model.

16. The apparatus of claim 11, wherein said special purpose computing apparatus is further to apply at least one of said estimated parameters in determining a meal bolus or a correction bolus.

17. The apparatus of claim 11, wherein said special purpose computing apparatus is further to apply at least one of said estimated parameters in determining limits to an amount of insulin to be specified in an insulin pump command.

18. The apparatus of claim 11, wherein said special purpose computing apparatus is further to apply at least one of said estimated parameters to tune parameters of a controller to determine an amount of insulin to be infused to a patient on discrete command intervals.

19. The apparatus of claim 11, wherein at least one of said one or more physiological parameters comprises a blood glucose concentration observed following a fasting period during an infusion of insulin to said patient at a constant basal rate.

20. The apparatus of claim 11, wherein said special purpose computing apparatus is further to compute an insulin infusion basal rate for said patient based, at least in part, on at least one of said one or more physiological parameters.

21. The apparatus of claim 11, and further comprising a continuous glucose monitoring device to provide said one or more observations of said blood glucose concentration based, at least in part, on signals generated by a glucose sensor.

22. The apparatus of claim 11, and further comprising an insulin infusion pump to receive commands from said special purpose computing apparatus determined based, at least in part, on said estimated one or more physiological parameters.

23. An apparatus comprising:

means for determining a meal profile of a patient indicative of an ingestion of a carbohydrate;

means for determining an insulin profile of said patient indicative of insulin infused by said patient;

means for obtaining one or more observations of a blood glucose concentration of said patient responsive to said meal profile and said insulin profile; and

means for estimating one or more physiological parameters of said patient to model said blood glucose concentration based, at least in part, on the meal profile, the insulin profile and the one or more observations of said blood glucose concentration.