ADJUSTING INSULIN DELIVERY RATES

• US 20170203039A1
• Filed: 01/13/2017
• Published: 07/20/2017
• Est. Priority Date: 01/14/2016
• Status: Active Grant

• Current Assignee: Insulet Corporation
• Original Assignee: Bigfoot Biomedical, Inc. (Abbott Laboratories)
• Inventors: Desborough, Lane, Mazlish, Bryan
• Granted Patent: US 10,780,223 B2
• Time in Patent Office: Days
• CPC Class Codes: A61B 2562/0295 Strip shaped analyte sensors for apparatus classified in A61B5/145 or A61B5/157
• 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: A61M 2005/14208 with a programmable infusion control system, characterised by the infusion program
• CPC Class Codes: A61M 2205/3303 Using a biosensor
• CPC Class Codes: A61M 2205/3553 remote, e.g. between patient's home and doctor's office
• CPC Class Codes: A61M 2205/3561 local, e.g. within room or hospital
• CPC Class Codes: A61M 2205/3569 sublocal, e.g. between console and disposable
• CPC Class Codes: A61M 2205/3584 using modem, internet or bluetooth
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2205/52 with memories providing a history of measured variating parameters of apparatus or patient
• CPC Class Codes: A61M 2230/005 Parameter used as control input for the apparatus
• CPC Class Codes: A61M 2230/201 Glucose concentration
• CPC Class Codes: A61M 5/142 Pressure infusion, e.g. using pumps
• CPC Class Codes: A61M 5/14244 adapted to be carried by the patient, e.g. portable on the body
• CPC Class Codes: A61M 5/14248 of the skin patch type
• CPC Class Codes: A61M 5/145 using pressurised reservoirs, e.g. pressurised by means of pistons
• 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 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 20/17 delivered via infusion or injection
• CPC Class Codes: G16H 40/40 : for the management of medical equipment or devices, e.g. scheduling maintenance or upgrades
• CPC Class Codes: G16H 40/60 : for the operation of medical equipment or devices
• CPC Class Codes: G16H 40/67 : for remote operation
• CPC Class Codes: G16H 50/30 : for calculating health indices; for individual health risk assessment

Abstract

A method includes receiving up-to-date blood glucose data for a PWD, determining basal insulin dosages for the PWD based on a baseline basal rate, delivering the basal insulin dosages to the PWD, modifying a target blood glucose level based on variability of blood glucose data for the PWD, receiving a temporary override indicating a user preference to reduce the likelihood that the PWD has a hypoglycemic event or a user preference to reduce the likelihood that the PWD has a hyperglycemic event, determining a temporary target blood glucose level based on the input—greater than the modified blood glucose level if the preference is to reduce the likelihood of a hypoglycemic event—lower than the modified target blood glucose level if the preference is to reduce the likelihood that of a hyperglycemic event. The method includes delivering basal insulin for the temporary period of time based on the temporary target.

Claims

1. A method comprising:

receiving up-to-date blood glucose data for a person with diabetes (PWD);

determining basal insulin dosages for the PWD based at least in part on one or more baseline basal rates stored in memory on a controller, the received up-to-date blood glucose data, and at least one target blood glucose level stored in the memory;

delivering one or more of the determined basal insulin dosages to the PWD;

modifying the one or more target blood glucose levels stored in the memory based on a variability of blood glucose data for the PWD;

receiving an input at an electronic device of a temporary override indicating a user preference to reduce the likelihood that the PWD has a hypoglycemic event or a user preference to reduce the likelihood that the PWD has a hyperglycemic event;

determining one or more temporary target blood glucose levels based on the received input, wherein the temporary target blood glucose levels are greater than the modified one or more target blood glucose levels if the user preference is to reduce the likelihood that the PWD has a hypoglycemic event, and wherein the temporary target blood glucose levels are lower than the modified one or more target blood glucose levels if the user preference is to reduce the likelihood that the PWD has a hyperglycemic event; and

delivering one or more doses of basal insulin for a temporary period of time based on the one or more temporary target blood glucose levels.

2. The method of claim 1, wherein the basal insulin dosages for the PWD are determined by:

generating a first plurality of insulin delivery profiles, each of the first plurality of insulin delivery profiles including a first series of insulin delivery actions based on the one or more stored baseline basal insulin rates spanning a first time interval;

projecting a first plurality of future blood glucose values for each insulin delivery profile of the first plurality of insulin delivery profiles for a plurality of times spanning the first time interval, each projected future blood glucose values being projected using at least one of the received up-to-date blood glucose levels for the PWD; and

selecting a first profile of the first plurality of insulin delivery profiles based at least in part upon a comparison between the first plurality of future blood glucose values for each insulin delivery profile and the one or more target blood glucose levels.

3. The method of claim 2, wherein the first time interval is longer than the time interval for which the selected first profile is used to deliver insulin prior to the determination of a next dose of insulin using the same process.

4. The method of claim 2, wherein the generating a first plurality of insulin delivery profiles is used during the temporary period of time, and the selected profile is based on the one or more temporary target blood glucose levels during the temporary period of time.

5. The method of claim 1, wherein receiving an input comprises receiving a selection of one of a numerical target blood glucose level, a selection of an activity, or a selection of a textual description of a preferred blood glucose level.

6. The method of claim 1, wherein the one or more temporary target blood glucose levels are set at a fixed percentage increase or decrease from the one or more modified target blood glucose levels.

7. The method of claim 1, wherein the one or more temporary target blood glucose levels are set at a fixed numerical increase or decrease from the one or more modified target blood glucose levels.

8. The method of claim 1, wherein the one or more temporary target blood glucose levels are limited by a particular maximum or minimum value for target blood glucose levels.

9. The method of claim 1, wherein all target blood glucose levels are limited to values between 100 mg/dL and 160 mg/dL.

10. The method of claim 1, wherein receiving an input comprises receiving a length of time for the temporary period of time.

11. The method of claim 1, the memory stores a baseline basal rate and a target blood glucose level for a plurality of diurnal time periods.

12. The method of claim 1, wherein the one or more target blood glucose levels are modified based on a determination of a probability of the PWD having a blood glucose level below a threshold blood glucose level based on the variability of received blood glucose data over multiple days, wherein the one or more target blood glucose levels are modified to align the probability of the PWD having a blood glucose level below the threshold blood glucose level with an acceptable probability of the PWD having a blood glucose level falling below the threshold blood glucose level.

13. A system comprising:

an insulin pump configured to deliver insulin based on a message;

a glucose sensor configured to generate a plurality of glucose sensor data points;

an interface for receiving a user preference to reduce the likelihood that a person with diabetes (PWD) has a hypoglycemic event or a user preference to reduce the likelihood that the PWD has a hyperglycemic event

a controller, the controller, the interface, or a combination thereof, configured to;

receive up-to-date blood glucose data from the glucose sensor;

determine basal insulin dosages based at least in part on one or more baseline basal rates stored in memory on the controller, the received up-to-date blood glucose data, and at least one target blood glucose level stored in the memory;

generate the message to the insulin pump to deliver the determined basal insulin dosages;

modify the one or more target blood glucose levels stored in the memory based on a variability of blood glucose data from the glucose sensor;

receive the user preference;

determine one or more temporary target blood glucose levels based on the received user preference, wherein the temporary target blood glucose levels are greater than the modified one or more target blood glucose levels if the user preference is to reduce the likelihood that the PWD has a hypoglycemic event, wherein the temporary target blood glucose levels are lower than the modified one or more target blood glucose levels if the user preference is to reduce the likelihood that the PWD has a hyperglycemic event; and

generate the message to the insulin pump to deliver doses of basal insulin for a temporary period of time based on the one or more temporary target blood glucose levels.

14. The system of claim 13, wherein the controller is part of the insulin pump.

15. The system of claim 13, wherein the controller is a separate device from the insulin pump.

16. One or more non-transitory computer-readable media including instructions that, in response to being executed by one or more processors, cause a system to perform operations, the operations comprising:

receiving up-to-date blood glucose data from a glucose sensor;

determining basal insulin dosages based at least in part on one or more stored baseline basal rates, the received up-to-date blood glucose data and at least one target blood glucose level stored;

generating a first message to an insulin pump to deliver the determined basal insulin dosages;

modifying the one or more target blood glucose levels based on a variability of blood glucose data from the glucose sensor;

receiving a user preference;

determine one or more temporary target blood glucose levels based on the received user preference, wherein the temporary target blood glucose levels are greater than the modified one or more target blood glucose levels if the user preference is to reduce the likelihood that a person with diabetes (PWD) has a hypoglycemic event, wherein the temporary target blood glucose levels are lower than the modified one or more target blood glucose levels if the user preference is to reduce the likelihood that the PWD has a hyperglycemic event; and

generating a second message to the insulin pump to deliver doses of basal insulin for a temporary period of time based on the one or more temporary target blood glucose levels.

17. The computer-readable media of claim 16, wherein the one or more temporary target blood glucose levels are set at a fixed percentage increase or decrease from the one or more modified target blood glucose levels.

18. The computer-readable media of claim 16, wherein the one or more temporary target blood glucose levels are limited by a particular maximum or minimum value for target blood glucose levels.

19. The computer-readable media of claim 16, wherein the one or more temporary target blood glucose levels are set at a fixed numerical increase or decrease from the one or more modified target blood glucose levels.

20. The computer-readable media of claim 16, wherein all target blood glucose levels are limited to values between 100 mg/dL and 160 mg/dL.