Predicted time to assess and/or control a glycemic state

• US 10,850,033 B2
• Filed: 08/01/2017
• Issued: 12/01/2020
• Est. Priority Date: 12/11/2013
• Status: Active Grant

• Current Assignee: Medtronic Minimed Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Minimed Incorporated (Medtronic Plc)
• Inventors: Kovelman, Paul H.
• Primary Examiner(s): Jang, Christian
• Assistant Examiner(s): Alter, Mitchell E
• Application Number:
  US15/666,342
• Publication Number:
  US 20170326296A1
• Time in Patent Office: 1,218 Days
• Field of Search: 600365
• 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 5/6849 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 2005/14208 with a programmable infusion control system, characterised by the infusion program
• CPC Class Codes: A61M 2005/1726 the body parameters being measured at, or proximate to, the infusion site
• CPC Class Codes: A61M 2230/201 Glucose concentration
• CPC Class Codes: A61M 5/14244 adapted to be carried by the patient, e.g. portable on the body
• 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 20/17 delivered via infusion or injection

Abstract

Presented here are techniques for controlling glucose levels of a patient based on predicted time to a target glucose level. One methodology predicts a trajectory of the blood glucose level based on past observations of the blood glucose level, determines a cost expression based on the trajectory, and affects a future command to an infusion pump to affect a cost value according to the cost expression. Another methodology defines a target blood glucose concentration level for the patient, observes a current blood glucose concentration for the patient based on signals received from a blood-glucose sensor, and predicts a duration of time for the patient'"'"'s blood glucose concentration to reach the target blood glucose concentration level based on the observed current blood glucose concentration.

Claims

1. An apparatus comprising:

an insulin infusion pump to deliver insulin to a patient;

a glucose sensor to obtain observations of blood glucose concentration of the patient; and

a controller to;

assign a plurality of different threshold time periods to each of a plurality of different target blood glucose concentration levels for the patient, resulting in a plurality of different time-to-target checkpoints for the target blood glucose concentration levels, each of the plurality of different time-to-target checkpoints having a respective insulin infusion pump operation associated therewith;

predict a respective duration of time for the patient'"'"'s blood glucose concentration to reach each of the target blood glucose concentration levels using an observed current blood glucose concentration of the patient;

identify which of the target blood glucose concentration levels is predicted to be reached first in time;

compare the predicted duration of time for the identified target blood glucose concentration level against the threshold time periods of the plurality of different time-to-target checkpoints of the identified target blood glucose concentration level, to determine an operation of the insulin infusion pump based on the predicted duration of time and the plurality of different time-to-target checkpoints; and

altering a therapy applied to the patient based on the determined operation of the insulin infusion pump.

2. The apparatus of claim 1, wherein:

the controller initiates a first operation of the insulin infusion pump when the predicted duration of time is shorter than a first threshold time period; and

the controller initiates a second operation of the insulin infusion pump when the predicted duration of time is equal to or longer than the first threshold time period.

3. The apparatus of claim 2, wherein:

the controller initiates a third operation of the insulin infusion pump when the predicted duration of time is equal to or longer than a second threshold time period; and

the second threshold time period is longer than the first threshold time period.

4. The apparatus of claim 1, wherein predicting the duration of time comprises:

predicting the duration of time based, at least in part, on one or more parameters representing a sensitivity of the patient to insulin.

5. The apparatus of claim 1, wherein predicting the duration of time comprises:

predicting the duration of time based, at least in part, on an expected change in a rate of infusion of insulin.

6. The apparatus of claim 1, wherein the determined operation comprises one or more of:

changing a rate of insulin infusion; and

administering glucose to the patient.

7. The apparatus of claim 1, wherein altering the therapy comprises generating one or more insulin pump commands to control the determined operation of the insulin infusion pump.

8. An insulin infusion device to deliver insulin to a patient, comprising:

an infusion device housing; and

a controller housed in the infusion device housing, the controller configurable to;

assign a plurality of different threshold time periods to each of a plurality of different target blood glucose concentration levels for the patient, resulting in a plurality of different time-to-target checkpoints for the target blood glucose concentration levels, each of the plurality of different time-to-target checkpoints having a respective insulin infusion device operation associated therewith;

obtain, from a glucose sensor, observations of blood glucose concentration of the patient;

predict a respective duration of time for the patient'"'"'s blood glucose concentration to reach each of the target blood glucose concentration levels using an observed current blood glucose concentration of the patient;

identify which of the target blood glucose concentration levels is predicted to be reached first in time;

compare the predicted duration of time for the identified target blood glucose concentration level against the threshold time periods of the plurality of different time-to-target checkpoints of the identified target blood glucose concentration level, to determine an operation of the insulin infusion device based on the predicted duration of time and the plurality of different time-to-target checkpoints; and

altering a therapy applied to the patient based on the determined operation of the insulin infusion device.

9. The insulin infusion device of claim 8, wherein:

the controller initiates a first operation of the insulin infusion device when the predicted duration of time is shorter than a first threshold time period; and

the controller initiates a second operation of the insulin infusion device when the predicted duration of time is equal to or longer than the first threshold time period.

10. The insulin infusion device of claim 9, wherein:

the controller initiates a third operation of the insulin infusion device when the predicted duration of time is equal to or longer than a second threshold time period; and

the second threshold time period is longer than the first threshold time period.

11. The insulin infusion device of claim 8, wherein predicting the duration of time comprises:

predicting the duration of time based, at least in part, on one or more parameters representing a sensitivity of the patient to insulin.

12. The insulin infusion device of claim 8, wherein predicting the duration of time comprises:

predicting the duration of time based, at least in part, on an expected change in a rate of infusion of insulin.

13. The insulin infusion device of claim 8, wherein the determined operation comprises one or more of:

changing a rate of insulin infusion; and

administering glucose to the patient.