Device and method for insulin dosing

• US 8,251,904 B2
• Filed: 06/07/2006
• Issued: 08/28/2012
• Est. Priority Date: 06/09/2005
• Status: Active Grant

• Current Assignee: Roche Diabetes Care Inc. (Roche Holding AG)
• Original Assignee: Roche Diagnostics Operations Incorporated (Roche Holding AG)
• Inventors: Zivitz, Maury, Jovanovic, Lois
• Primary Examiner(s): Natnithithadha, Navin
• Application Number:
  US11/422,639
• Publication Number:
  US 20070078818A1
• Time in Patent Office: 2,274 Days
• Field of Search: 600345-366, 600/309, 600/300, 604/890.1, 128/920, 128/921
• US Class Current: 600/365
• CPC Class Codes: A61B 5/0002 Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network A61B5/07 takes precedence; transmission systems for measured values G08C; transmission H04B; transmission of digital information H04L; wireless communication networks H04W
• CPC Class Codes: A61B 5/14532 for measuring glucose, e.g. by tissue impedance measurement
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 20/17 delivered via infusion or injection

Abstract

A device and method of providing instruction to a patient regarding the dosing of insulin is provided.

Claims

1. A method of providing instruction to a patient via an advising computing device the advising computing device performing the steps of:

receiving an indication of a first dose actually administered;

determining if the actually administered first dose differs from an expected first dose generated via an advising program of the advising computing device;

receiving an indication of a second dose actually administered; and

determining if the actually administered second dose differs from an expected second dose generated via the advising program of the advising computing device;

such that if the actually administered first dose differs from the expected first dose and the actually administered second dose differs from the expected second dose, then defining a third expected dose using the first actually administered dose and the second actually administered dose.

2. The method of claim 1, wherein the expected third dose is determined by averaging the first actually administered dose and the second actually administered dose.

3. The method of claim 1, wherein the expected first dose is zero.

4. The method of claim 1, wherein the expected second dose is zero.

5. The method of claim 1, wherein the expected first dose is equal to the expected second dose.

6. The method of claim 5, wherein if the expected first dose is equal to the actually administered first dose or if the expected second dose is equal to the actually administered second dose, then defining the third expected dose to be equal to the expected first dose.

7. The method of claim 1, wherein each of the determining steps and defining step are performed automatically by a computing device.

8. The method of claim 7, wherein a health care professional interacts with the computing device to set up a dosing regimen prescription prior to use of the computing device by the patient.

9. The method of claim 1, wherein the expected first dose is for a defined time on a first day, the expected second dose is for the defined time on a second day, and the third expected dose is for the defined time on a third day.

10. The method of claim 9, wherein the first and second days are consecutive days.

11. The method of claim 9, wherein the first and second days are days when the patient experiences similar physiological conditions.

12. The method of claim 1, wherein the doses are doses of insulin and the expected doses assist the patient in controlling diabetes.

13. The method of claim 1, wherein defining a third expected dose includes using an electronically stored prescription, further wherein changes to the prescription require input of a password.

14. A method of providing instruction from an advising computing device to a patient, the advising computing device performing the steps of:

defining a value for a physiological condition as a first value and defining a first dose associated with the first value of the physiological condition;

receiving indications of a value of the physiological condition of the patient;

determining if the value of the physiological condition of the patient is equal to the defined first value;

if the value of the physiological condition of the patient is equal to the defined first value, recommending the first dose; and

if the value of the physiological condition of the patient is not equal to the defined first value, determining a first past dose administered in the past when the value of the physiological condition was similarly not equal to the defined first value and recommending a second dose equal to the first past dose.

15. The method of claim 14, wherein the physiological condition is selected from the group including menstrual status, exercise level, stress level, and illness status.

16. The method of claim 15, further including the step of storing a set of alterations corresponding to each potential value of the physiological condition.

17. The method of claim 14, wherein the method is performed by a computing device.

18. The method of claim 14, wherein the doses are doses of insulin and the recommendations assist the patient in controlling diabetes.

19. The method of claim 14, the advising computing device further performing the steps of:

determining if the first past dose administered in the past differs from a recommended first past dose;

receiving an indication of the second dose actually administered;

determining if the actually administered second dose differs from the recommended second dose;

if the actually administered first past dose differs from the recommended first past dose and the actually administered second dose differs from the recommended second dose, then defining a third recommended dose that is the average of the actually administered first past dose and the actually administered second dose such that next time the value of the physiological condition of the patient is not equal to the defined first value then the third recommended dose is recommended to the patient.

20. The method of claim 14, wherein the value of the physiological condition of the patient is not equal to the defined first value, and both the first dose and the recommended second dose are displayed to the patient.

21. The method of claim 14, wherein the first value is defined as a range of possible values.

22. The method of claim 14, wherein the defining and determining steps are part of a prescription, further wherein changes to the prescription require input of a password.

23. A method of providing instruction to a patient including the steps of:

providing an advising computing device;

providing the patient with a recommended dose from the advising computing device;

instructing the patient to provide input to the advising computing device indicating either agreement or disagreement with the recommended dose; and

wherein if the patient provides input indicating agreement with the recommended dose, using the recommended dose as an actually administered dose, and if the patient provides input indicating disagreement with the recommended dose, instructing the patient to input the actually administered dose into the advising computing device.

24. The method of claim 23, wherein the recommended dose is provided by accessing a table of blood glucose corrections and comparing the table to a received blood glucose test reading.

25. The method of claim 23, further including the step of providing a patient accessible listing of insulin dose alterations that correspond to blood glucose results outside of target ranges.

26. The method of claim 23, further including the step of receiving an input indicative of the patient'"'"'s weight.

27. The method of claim 23, further including the step of calculating maximum daily dose parameters.

28. The method of claim 27, wherein the calculation of the maximum daily dose is based upon the patient'"'"'s weight.

29. The method of claim 28, wherein a healthcare professional inputs an insulin dose factor and the maximum daily dose is determined by multiplying the patient'"'"'s weight by the insulin dose factor.

30. The method of claim 27, wherein upon receiving an indication that an intended dose will cause the maximum daily dose to be exceeded by the patient, the device notifies the patient that the maximum daily dose will be exceeded if the intended dose is actually administered.

31. The method of claim 27, wherein upon receiving an indication that the maximum daily dose has been exceeded by the patient, a healthcare professional is notified.

32. The method of claim 27, wherein upon receiving an indication that the maximum daily dose has been exceeded by the patient, the patient is instructed to notify a healthcare professional.

33. The method of claim 27, wherein upon receiving an indication that patient'"'"'s blood glucose level is outside of a defined range, the device notifies a third party that the patient'"'"'s blood glucose is outside of the defined range.

34. The method of claim 33, wherein the third party is a healthcare professional.

35. The method of claim 23, wherein upon receiving an indication that patient'"'"'s blood glucose level is outside of a defined range, the device notifies the patient that the patient'"'"'s blood glucose is outside of the defined range.

36. The method of claim 35, wherein the defined range is customizable by a healthcare professional.

37. The method of claim 23, wherein the advising computing device permits the healthcare professional to customize parameters for readings and events that result in the computing device contacting the healthcare professional.

38. The method of claim 23, wherein the advising computing device permits the healthcare professional to customize parameters for readings and events that result in the computing device instructing the patient to contact the healthcare professional.

39. The method of claim 23, wherein the healthcare professional is instructed to input to the computing device whether the patient is pubescent or postmenopausal, the computing device utilizing the data regarding the pubescent or postmenopausal status of the patient in providing the patient with a recommended dose.

40. The method of claim 23, further including the step of setting a target blood glucose range for one hour after a meal.

41. The method of claim 23, further including the step of setting a target blood glucose range for two hours after a meal.

42. The method of claim 23, further including the step of setting a target blood glucose range for a defined time after a meal.

43. The method of claim 23, further comprising the step of presenting a user with a menu screen that allows a user to get more information regarding meal times, the prescribed regimen, blood glucose targets, the healthcare professional, blood glucose corrections, current weight, and carbohydrate calculations.

44. The method of claim 23, further comprising the step of receiving a meal dose time from the patient.

45. The method of claim 44, wherein subsequent expected meal dose times are automatically altered based upon receiving the meal dose time from the patient.

46. The method of claim 23, further comprising the step of receiving a bedtime dose time from the patient.

47. The method of claim 46, wherein an expected breakfast dose time is automatically altered based upon receiving the bedtime dose time from the patient.

48. The method of claim 23, further comprising the step of receiving an expected meal carbohydrate intake.

49. The method of claim 48, further comprising the step of issuing a warning to a patient to alter carbohydrate intake based upon the expected meal carbohydrate intake.

50. The method of claim 49, wherein the warning to the patient warns the patient to decrease the carbohydrate intake.

51. The method of claim 49, wherein the warning to the patient warns the patient to increase the carbohydrate intake.

52. The method of claim 23, wherein the step of providing the patient with a recommended dose from the advising computing device is performed according to a stored prescription, further wherein a password is required to make changes to the prescription.

53. A method of providing instruction to a patient including the steps of:

providing an advising computing device;

receiving a blood glucose reading by the advising computing device; and

determining, by the advising computing device, whether the received blood glucose reading was taken within a predetermined testing window; and

if the reading was taken within the window, accepting the reading and providing the patient with a recommended dose, and if the reading was taken outside the window, identifying the reading as non-conforming.

54. The method of claim 53, further comprising the step of discontinuing the providing of a recommended dose if the reading is identified as non-conforming.

55. The method of claim 53, wherein the predetermined testing window is defined by a prescription, further wherein a password is required to make changes to the prescription.

56. A method of providing instruction to a patient including the steps of:

providing at least one advising computing device;

receiving a plurality of communications from the at least one computing device indicating a health problem;

assembling a listing of the plurality of communications from at least one advising computing device, the communications being arranged so as to prioritize the communications based upon the severity of the health problem indicated thereby, and

displaying the arranged listing of communications by the computing device.

57. The method of claim 56, wherein the indicator of the physiological condition is a blood glucose reading.

58. The method of claim 56, wherein the communications indicate instances when a patient has agreed and disagreed with provided advice.

59. A computer readable medium containing non-transitory instructions that when executed by a computer performs steps to provide instruction to a patient, the steps comprising:

receiving an indication of a first dose actually administered;

determining if the actually administered first dose differs from an expected first dose;

receiving an indication of a second dose actually administered; and

determining if the actually administered second dose differs from an expected second dose;

such that if the actually administered first dose differs from the expected first dose and the actually administered second dose differs from the expected second dose, then defining a third expected dose using the first actually administered dose and the second actually administered dose.

60. The computer readable medium of claim 59, wherein the third expected dose is defined as the average of the first actually administered dose and the second actually administered dose.

61. The method of claim 59, wherein the determining steps are part of a prescription, further wherein changes to the prescription require input of a password.

62. A computer readable medium containing non-transitory instructions that when executed by a computer performs steps to provide instruction to a patient, the steps comprising:

defining a value for a physiological condition as a first value and defining a first dose associated with the first value of the physiological condition;

receiving indications of a value of the physiological condition of the patient;

determining if the value of the physiological condition of the patient is equal to the defined first value;

if the value of the physiological condition of the patient is equal to the defined first value, recommending the first dose; and

if the value of the physiological condition of the patient is not equal to the defined first value, determining a first past dose administered in the past when the value of the physiological condition was similarly not equal to the defined first value and recommending a second dose equal to the first past dose.

63. The method of claim 62, wherein the defining, determining, and recommending steps are part of a prescription, further wherein changes to the prescription require input of a password.

64. A computer readable medium containing instructions that when executed by a computer performs steps to provide instruction to a patient, the steps comprising:

providing the patient with a recommended dose;

instructing the patient to either agree with the recommended dose or to disagree with the recommended dose

wherein if the patient provides input indicating agreement with the recommended dose, using the recommended dose as an actually administered dose, and if the patient provides input indicating disagreement with the recommended dose, instructing the patient to input the actually administered dose.