BLOOD GLUCOSE REGULATION THROUGH CONTROL OF BREATHING

• US 20110132370A1
• Filed: 03/05/2009
• Published: 06/09/2011
• Est. Priority Date: 03/05/2008
• Status: Active Grant

• Current Assignee: ResMed Pty Ltd. (ResMed Incorporated)
• Original Assignee: Resmed Limited (ResMed Incorporated)
• Inventors: Farrugia, Steven Paul
• Granted Patent: US 9,827,389 B2
• Time in Patent Office: Days
• US Class Current: 128/204.23
• CPC Class Codes: A61B 5/14532 for measuring glucose, e.g. by tissue impedance measurement
• CPC Class Codes: A61B 5/4035 Evaluating the autonomic nervous system
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/0033 electrical
• CPC Class Codes: A61M 2205/581 by audible feedback
• CPC Class Codes: A61M 2205/583 by visual feedback
• CPC Class Codes: A61M 2230/005 Parameter used as control input for the apparatus
• CPC Class Codes: A61M 2230/06 Heartbeat rate only
• CPC Class Codes: A61M 2230/201 Glucose concentration
• CPC Class Codes: A61M 2230/202 partial carbon oxide pressure, e.g. partial dioxide pressure (P-CO2)
• CPC Class Codes: A61M 2230/205 partial oxygen pressure (P-O2)
• CPC Class Codes: A61M 2230/50 Temperature
• CPC Class Codes: A61M 2230/65 Impedance, e.g. conductivity, capacity
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

A respiratory treatment apparatus (1) provides blood glucose monitoring and breathing control based on detected blood glucose information. In an example embodiment, a flow generator provides a flow of breathable gas at a pressure above atmospheric to a patient interface according to a pressure treatment control protocol such as a CPAP, APAP, bi-level CPAP, etc. A detector determines a blood glucose condition indicator with one or more sensors that are used to sense physiological information. In response to signals from the sensors, a controller, such as a digital signal processor, controls adjustments to the flow of breathable gas provided by the flow generator. The adjustments are determined by the controller based on the detected blood glucose indicator and/or changes thereto.

Claims

1. A device for treating sleep disordered breathing and diabetes comprising:

at least one sensor detecting a physiological signal and transmitting physiological data to a controller;

said controller to control a flow generator to provide pressurized gas to a patient at a first flow rate and wherein said controller is adapted to determine a blood glucose level from the physiological signal and then adjust the flow rate based on the determined blood glucose level.

2. The device of claim 1, wherein the controller compares the determined blood glucose level to one or more thresholds.

3. The device of claim 2 wherein the one or more thresholds comprises a minimum threshold value and a maximum threshold value.

4. The device of claim 3, wherein the minimum threshold value is within a range of about 2 to 3.5 mmol/L.

5. The device of claim 3, wherein the maximum threshold value is within a range of about 5.6 to 9 mmol/L.

6. The device of claim 3, wherein said controller activates an alarm, when blood glucose level is below the minimum or above the maximum threshold values.

7. A device for treating sleep disordered breathing:

wherein said device includes a patient interface, a flow generator operated by a controller and at least one sensor connected to controller, wherein said controller determines glucose levels from the detected breathing pattern of a patient.

8. A method in a controller of a respiratory treatment device for treating sleep disordered breathing and diabetes, the method comprising:

sensing a physiological signal;

determining blood glucose level from a physiological signal and adjusting a control parameter of a flow generator to provide pressurized gas based on the blood glucose level.

9. The method of claim 8, wherein said method further includes analyzing the determined blood glucose level with respect to a minimum and maximum threshold value.

10. A respiratory treatment apparatus comprising:

a flow generator to provide a flow of breathable gas at a pressure above atmospheric to a patient interface;

a detector to determine a blood glucose condition indicator with at least one sensor;

a controller to adjust the flow of breathable gas of the flow generator based on the detected blood glucose indicator.

11. The respiratory treatment apparatus of claim 10 wherein the blood glucose condition indicator is a respiratory-based blood glucose condition indicator.

12. The respiratory treatment apparatus of claim 10 wherein the blood glucose condition indicator is a sympathetic activation-based blood glucose condition indicator.

13. The respiratory treatment apparatus of claim 10 wherein the blood glucose condition indicator is a direct blood glucose level.

14. The respiratory treatment apparatus of claim 10 wherein a blood glucose condition indicator based adjustment by the controller to the flow of breathable gas of the flow generator comprises a pressure treatment control protocol change.

15. The respiratory treatment apparatus of claim 14 wherein the pressure treatment control protocol change of the controller comprises initiating ventilation control to satisfy a target ventilation.

16. The respiratory treatment apparatus of claim 15 wherein the controller is configured with a protocol to control the flow of breathable gas to maintain an approximately constant pressure level across a breathing cycle.

17. The respiratory treatment apparatus of claim 10 wherein the controller is configured with a protocol to control the flow of breathable gas to vary pressure during a breathing cycle.

18. The respiratory treatment apparatus of claim 10 further comprising a Kussmaul breathing pattern detector.

19. The respiratory treatment apparatus of claim 10 wherein an adjustment by the controller based on the detected blood glucose indicator comprises an increase of a ventilation control parameter.

20. The respiratory treatment apparatus of claim 10 wherein an adjustment by the controller based on the detected blood glucose indicator comprises a decrease of a ventilation control parameter.

26. The respiratory treatment apparatus of claim 14 wherein the pressure treatment control protocol change of the control means comprises initiating ventilation control to satisfy a target ventilation.

27. The respiratory treatment apparatus of claim 15 wherein the control means is configured with a protocol to control the flow of breathable gas to maintain an approximately constant pressure level across a breathing cycle.

28. The respiratory treatment apparatus of claim 10 wherein the control means is configured with a protocol to control the flow of breathable gas to vary pressure during a breathing cycle.

29. The respiratory treatment apparatus of claim 10 further comprising a Kussmaul breathing pattern detector.

30. The respiratory treatment apparatus of claim 10 wherein an adjustment by the control means based on the detected blood glucose indicator comprises an increase of a ventilation control parameter.

31. The respiratory treatment apparatus of claim 10 wherein an adjustment by the control means based on the detected blood glucose indicator comprises a decrease of a ventilation control parameter.

21. A respiratory treatment apparatus comprising:

flow generation means for providing a flow of breathable gas at a pressure above atmospheric to a patient interface;

detection means for determining a blood glucose condition indicator;

processing means for adjusting the flow of breathable gas of the flow generator based on the detected blood glucose indicator.

22. The respiratory treatment apparatus of claim 21 wherein the blood glucose condition indicator is a respiratory-based blood glucose condition indicator.

23. The respiratory treatment apparatus of claim 21 wherein the blood glucose condition indicator is a sympathetic activation-based blood glucose condition indicator.

24. The respiratory treatment apparatus of claim 21 wherein the blood glucose condition indicator is a direct blood glucose level.

25. The respiratory treatment apparatus of claim 21 wherein a blood glucose condition indicator based adjustment by the control means to the flow of breathable gas of the flow generation means comprises a pressure treatment control protocol change.

32. A positive pressure respiratory airway treatment device comprising:

a flow generator including a blower and servo, the flow generator configured to provide a flow of breathable gas at a pressure above atmospheric to a patient interface;

sensor apparatus comprising at least one of a noninvasive hyperglycemia/hypoglycemia monitor, an oximeter, a subcutaneous or semi-invasive blood glucose monitor, the sensor apparatus to generate signals at least representative of one or more physiological characteristics;

a processor to receive signals from the sensor apparatus and control the flow generator, the processor being programmed with processor control instructions, the processor control instructions comprising;

controlling determining of a blood glucose condition indicator; and

controlling adjusting a setting for the flow of breathable gas of the flow generator based on the detected blood glucose indicator.

33. The respiratory treatment apparatus of claim 32 wherein the blood glucose condition indicator is a respiratory-based blood glucose condition indicator.

34. The respiratory treatment apparatus of claim 32 wherein the blood glucose condition indicator is a sympathetic activation-based blood glucose condition indicator.

35. The respiratory treatment apparatus of claim 32 wherein the blood glucose condition indicator is a direct blood glucose level.