Device and method for insulin dosing

• US 20070078818A1
• Filed: 06/07/2006
• Published: 04/05/2007
• 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: Jovanovic, Lois, Zivitz, Maury
• Granted Patent: US 8,251,904 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• 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 including 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;

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.

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

defining a value for a physiological condition as a normal value and defining a usual dose associated with the normal 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 normal value;

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

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

14. The method of claim 13, wherein the physiological condition is selected from the group including menstrual status, exercise level, stress level, and illness status.

15. The method of claim 14, further including the step of storing a set of alterations corresponding to each potential value of the physiological condition.

16. The method of claim 13, wherein the method is performed by a computing device.

17. The method of claim 13, wherein the doses are doses of insulin and the recommendations assist the patient in controlling diabetes.

18. The method of claim 13, further including the steps of:

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

19. The method of claim 13, wherein the value of the physiological condition of the patient is not equal to the defined normal value, and both the usual dose and the recommended second dose are displayed to the patient.

20. The method of claim 13, wherein the normal value is defined as a range of possible values.

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

providing an advising computing device;

providing the patient with a recommended dose; and

instructing the patient to either agree with the recommended dose or to disagree with the recommended dose and input the actually administered dose.

22. The method of claim 21, 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.

23. The method of claim 21, further including the step of providing a patient accessible listing of insulin dose alterations that correspond to blood glucose results outside of target ranges.

24. The method of claim 21, further including the step of receiving an input indicative of the patient'"'"'s weight.

25. The method of claim 21, further including the step of calculating maximum daily dose parameters.

26. The method of claim 25, wherein the calculation of the maximum daily dose is based upon the patient'"'"'s weight.

27. The method of claim 26, 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.

28. The method of claim 25, 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.

29. The method of claim 25, wherein upon receiving an indication that the maximum daily dose has been exceeded by the patient, a healthcare professional is notified.

30. The method of claim 25, 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.

31. The method of claim 25, 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.

32. The method of claim 31, wherein the third party is a healthcare professional.

33. The method of claim 21, 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.

34. The method of claim 33, wherein the defined range is customizable by a healthcare professional.

35. The method of claim 21, 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.

36. The method of claim 21, 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.

37. The method of claim 21, 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.

38. The method of claim 21, further including the step of setting a target blood glucose range for one hour after a meal.

39. The method of claim 21, further including the step of setting a target blood glucose range for two hours after a meal.

40. The method of claim 21, further including the step of setting a target blood glucose range for a defined time after a meal.

41. The method of claim 21, 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.

42. The method of claim 21, further comprising the step of receiving a meal dose time from the patient.

43. The method of claim 42, wherein subsequent expected meal dose times are automatically altered based upon receiving the meal dose time from the patient.

44. The method of claim 21, further comprising the step of receiving a bedtime dose time from the patient.

45. The method of claim 44, wherein an expected breakfast dose time is automatically altered based upon receiving the bedtime dose time from the patient.

46. The method of claim 21, further comprising the step of receiving an expected meal carbohydrate intake.

47. The method of claim 46, further comprising the step of issuing a warning to a patient to alter carbohydrate intake based upon the expected meal carbohydrate intake.

48. The method of claim 47, wherein the warning to the patient warns the patient to decrease the carbohydrate intake.

49. The method of claim 47, wherein the warning to the patient warns the patient to increase the carbohydrate intake

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

providing an advising computing device;

receiving a blood glucose reading; and

determining 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.

51. The method of claim 50, further comprising the step of discontinuing the providing of a recommended dose if the reading is identified as non-conforming.

52. 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; and

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.

53. The method of claim 52, wherein the indicator of the physiological condition is a blood glucose reading.

54. The method of claim 52, wherein the communications indicate instances when a patient has agreed and disagreed with provided advice.

55. A computer readable medium containing 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.

56. The computer readable medium of claim 55, wherein the third expected dose is defined as the average of the first actually administered dose and the second actually administered dose.

57. A computer readable medium containing 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 normal value and defining a usual dose associated with the normal 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 normal value;

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

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

58. 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; and

instructing the patient to either agree with the recommended dose or to disagree with the recommended dose and input the actually administered dose.