Insulin Management

• US 20150217054A1
• Filed: 10/27/2014
• Published: 08/06/2015
• Est. Priority Date: 01/31/2014
• Status: Active Grant

• Current Assignee: Aseko, Inc.
• Original Assignee: Aseko, Inc.
• Inventors: Booth, Robert C., Hebblewhite, Harry
• Granted Patent: US 9,898,585 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• 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 5/4848 Monitoring or testing the effects of treatment, e.g. of medication
• CPC Class Codes: A61M 2005/14208 with a programmable infusion control system, characterised by the infusion program
• CPC Class Codes: A61M 2005/14296 Pharmacokinetic models
• CPC Class Codes: A61M 2005/1726 the body parameters being measured at, or proximate to, the infusion site
• CPC Class Codes: A61M 2205/18 with alarm
• CPC Class Codes: A61M 2205/3327 Measuring
• CPC Class Codes: A61M 2205/35 Communication
• CPC Class Codes: A61M 2205/3553 remote, e.g. between patient's home and doctor's office
• CPC Class Codes: A61M 2205/3584 using modem, internet or bluetooth
• CPC Class Codes: A61M 2205/3592 using telemetric means, e.g. radio or optical transmission
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2205/507 Head Mounted Displays [HMD]
• CPC Class Codes: A61M 2205/52 with memories providing a history of measured variating parameters of apparatus or patient
• CPC Class Codes: A61M 2205/581 by audible feedback
• CPC Class Codes: A61M 2230/201 Glucose concentration
• CPC Class Codes: A61M 5/14 Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
• 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: A61P 3/10 : for hyperglycaemia, e.g. antidiabetics
• CPC Class Codes: G16H 10/40 : for data related to laboratory analysis, e.g. patient specimen analysis
• CPC Class Codes: G16H 20/17 : delivered via infusion or injection
• CPC Class Codes: G16H 20/60 : relating to nutrition control, e.g. diets
• CPC Class Codes: G16H 40/67 : for remote operation
• CPC Class Codes: G16H 80/00 : ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring

Abstract

A method of administering insulin includes receiving blood glucose measurements of a patient at a data processing device from a glucometer. Each blood glucose measurement is separated by a time interval and includes a blood glucose time associated with a time of measuring the blood glucose measurement. The method also includes receiving patient information at the data processing device and selecting a subcutaneous insulin treatment for tube-fed patients from a collection of subcutaneous insulin treatments. The selection is based on the blood glucose measurements and the patient information. The subcutaneous insulin treatment program for tube-fed patients determines recommended insulin doses based on the blood glucose times. The method also includes executing, using the data processing device, the selected subcutaneous insulin treatment.

Claims

1. A method comprising:

receiving blood glucose measurements of a patient at a data processing device from a glucometer, each blood glucose measurement separated by a time interval and comprising a blood glucose time associated with a time of measuring the blood glucose measurement;

receiving patient information at the data processing device;

selecting, using the data processing device, a subcutaneous insulin treatment program for tube-fed patients from a collection of subcutaneous insulin treatments based on the blood glucose measurements and the patient information, the subcutaneous insulin treatment program for tube-fed patients determining recommended insulin doses based on the blood glucose times; and

executing, using the data processing device, the selected subcutaneous insulin treatment program for tube-fed patients.

2. The method of claim 1, further comprising:

receiving, at the data processing device, a configurable constant;

storing the configurable constant in non-transitory memory associated with the data processing device; and

determining a correction factor using the data processing device by calculating;

CF=CFR/TDD

wherein CF is the correction factor, CFR is the configurable constant determined from a statistical correlation, and TDD is total daily dose of insulin per day; and

determining a pre-meal correction bolus using the data processing device by calculating;

CB=(BG−

BG_Target)/CF

wherein CB is pre-meal correction bolus, BG is the blood glucose measurement, and BG_Target is a target blood glucose of the patient.

3. The method of claim 1, further comprising determining, using the data processing device, a post-prandial correction bolus by calculating:

4. The method of claim 3, further comprising:

receiving, at the data processing device, a half-life value of the rapid-acting insulin; and

determining, using the data processing device, the mean lifetime of the rapid-acting insulin by calculating;

iLifeRapid=Half-life*ln(2)

wherein iLifeRapid is the mean lifetime of the rapid-acting insulin and Half-life is a half-life value of a rapid-actin insulin.

5. The method of claim 1, further comprising:

receiving, at the data processing device, a governing blood glucose value; and

determining, using the data processing device, an adjustment factor based on the received governing blood glucose value.

6. The method of claim 5, wherein determining the adjustment factor comprises:

determining when the governing blood glucose value is within a pre-configured range of values; and

setting the adjustment factor to a preconfigured adjustment factor associated with the pre-configured range of values.

7. The method of claim 5, wherein determining the adjustment factor comprises:

determining the governing blood glucose value is within one of multiple pre-configured ranges of values; and

setting the adjustment factor to a pre-configured adjustment factor associated with the pre-configured range of values that includes the governing blood glucose value.

8. The method of claim 1, further comprising determining, using the data processing device, a Carbohydrate-to-Insulin Ratio based on the adjustment factor by calculating:

CIR=(CIR_Previous)/AF;

wherein CIR is the Carbohydrate-to-Insulin Ratio, CIR_Previous is a previously determined Carbohydrate-to-Insulin Ratio, and AF is the adjustment factor.

9. The method of claim 1, wherein the subcutaneous insulin treatment program for tube-fed patients comprises:

receiving, at the data processing device, a blood glucose time associated with a time of measuring of the blood glucose measurement;

determining, using the data processing device, if the blood glucose time is within a pre-configured time interval;

setting a timer for a next blood glucose measurement based on the pre-configured time interval; and

determining, using the data processing device, a correction insulin dose based on the blood glucose time by calculating;

CB_x=(BG−

BG_Target)/CF;

wherein CB is the correction insulin dose, BG is the blood glucose measurement, and BG_Target is a target blood glucose value of a patient.

10. The method of claim 9, wherein the pre-configured time interval comprises one of:

one of six pre-configured time intervals each spaced four hours apart from the next beginning at 00;

00;

or

one of four pre-configured time intervals each spaced six hours apart from the next beginning at 00;

00.

11. The method of claim 9, further comprising, when the blood glucose time is within a first one of four pre-configured time intervals each spaced six hours apart from the next:

setting, using the data processing device, the blood glucose measurement as a governing blood glucose value;

determining, using the data processing device, an adjustment factor for adjusting a value of recommended equal-boluses based on the governing blood glucose value;

retrieving, using the data processing device, a previous day'"'"'s value of recommended equal-boluses; and

determining, using the data processing device, a new value of recommended equal-boluses by multiplying the adjustment factor times the previous day'"'"'s value of recommended equal-boluses, the new value of recommended equal-boluses corresponding to an insulin dose of rapid-acting insulin or regular insulin to be administered to the patient at scheduled blood glucose measurements.

12. The method of claim 9, further comprising, when the blood glucose time is within a second one of six pre-configured time intervals each spaced four hours apart from the next:

setting, using the data processing device, the blood glucose measurement as a governing blood glucose value;

determining, using the data processing device, an adjustment factor for adjusting a value of recommended equal-boluses based on the governing blood glucose value;

retrieving, using the data processing device, a previous day'"'"'s value of recommended equal-boluses; and

determining, using the data processing device, a new value of recommended equal-boluses by multiplying the adjustment factor times the previous day'"'"'s value of recommended equal-boluses, the new value of recommended equal-boluses corresponding to an insulin dose of rapid-acting insulin or regular insulin to be administered to the patient at scheduled blood glucose measurements.

13. The method of claim 9, further comprising, when the blood glucose time is within a second one of four pre-configured time intervals each spaced six hours apart from the next:

setting, using the data processing device, the blood glucose measurement as a governing blood glucose value;

determining, using the data processing device, an adjustment factor for adjusting a current day'"'"'s recommended basal dose based on the governing blood glucose value;

retrieving, using the data processing device, a previous day'"'"'s recommended basal dose; and

determining, using the data processing device, the current day'"'"'s recommended basal dose by multiplying the adjustment factor times the previous day'"'"'s recommended basal dose, the current day'"'"'s recommended basal dose corresponding to an insulin dose of long-acting insulin to be administered to the patient at a configurable frequency of one, two, or three times per day.

14. The method of claim 9, further comprising, when the blood glucose time is within a third one of six pre-configured time intervals each spaced four hours apart from the next:

setting, using the data processing device, the blood glucose measurement as a governing blood glucose value;

determining, using the data processing device, an adjustment factor for adjusting a current day'"'"'s recommended basal dose based on the governing blood glucose value;

retrieving, using the data processing device, a previous day'"'"'s recommended basal dose; and

determining, using the data processing device, the current day'"'"'s recommended basal dose by multiplying the adjustment factor times the previous day'"'"'s recommended basal dose, the current day'"'"'s recommended basal dose corresponding to an insulin dose of long-acting insulin to be administered to the patient at a configurable frequency of one, two, or three times per day.

15. The method of claim 1, further comprising transmitting the subcutaneous insulin treatment program for tube-fed patients to an administration device in communication with the data processing device, the administration device comprising:

a doser; and

an administration computing device in communication with the doser, the administration computing device, when executing the subcutaneous insulin treatment program for tube-fed patients, causing the doser to administer the recommended doses of insulin determined by the subcutaneous insulin treatment program for tube-fed patients.

16. A system comprising:

a glucometer measuring blood glucose measurements separated by a time interval; and

a dosing controller in communication with the glucometer, the dosing controller including a data processing device and non-transitory memory in communication with the data processing device, the dosing controller;

receiving blood glucose measurements of a patient from the glucometer, each blood glucose measurement separated by a time interval and comprising a blood glucose time associated with a time of measuring the blood glucose measurement;

receiving patient information;

selecting a subcutaneous insulin treatment program for tube-fed patients from a collection of subcutaneous insulin treatments based on the blood glucose measurements and the patient information, the subcutaneous insulin treatment program for tube-fed patients determining recommended insulin doses based on the blood glucose times; and

executing the selected subcutaneous insulin treatment program for tube-fed patients.

17. The system of claim 16, wherein the dosing controller determines a pre-meal correction bolus by calculating:

CB=(BG−

BG_Target)/CF

wherein BG is the blood glucose measurement, and BG_Target is a target blood glucose of the patient.

18. The system of claim 16, wherein the dosing controller determines a post-prandial correction bolus by calculating:

19. The system of claim 18, wherein the dosing controller:

receives a half-life value of the rapid-acting insulin; and

determines the mean lifetime of the rapid-acting insulin by calculating;

iLifeRapid=Half-life*ln(2)

wherein Half-life is a half-life value of a rapid-actin insulin.

20. The system of claim 16, wherein the dosing controller:

receives a governing blood glucose value; and

determines an adjustment factor based on the received governing blood glucose value.

21. The system of claim 20, wherein the dosing controller determines the adjustment factor by:

determining when the governing blood glucose value is within a pre-configured range of values; and

setting the adjustment factor to a preconfigured adjustment factor based on the pre-configured range of values.

22. The system of claim 20, wherein the dosing controller determines the adjustment factor by:

determining the governing blood glucose value is within one of multiple pre-configured ranges of values; and

setting the adjustment factor to a pre-configured adjustment factor associated with the pre-configured range of values that includes the governing blood glucose value.

23. The system of claim 16, wherein the dosing controller determines a Carbohydrate-to-Insulin Ratio based on the adjustment factor by calculating:

CIR=(CIR_Previous)/AF;

wherein CIR is the Carbohydrate-to-Insulin Ratio, CIR_Previous is a previously determined Carbohydrate-to-Insulin Ratio, and AF is the adjustment factor.

24. The system of claim 16, wherein during the subcutaneous insulin treatment program for tube-fed patients, the dosing controller:

receives a blood glucose time associated with a time of measuring of the blood glucose measurement;

determines if the blood glucose time is within a pre-configured time interval;

sets a timer for a next blood glucose measurement based on the pre-configured time interval; and

determines a correction insulin dose based on the blood glucose type by calculating;

CB_x=(BG−

BG_Target)/CF;

wherein CB is the correction insulin dose, BG is the blood glucose measurement, and BG_Target is a target blood glucose value of a patient.

25. The system of claim 24, wherein the pre-configured time interval comprises one of:

one of six pre-configured time intervals each spaced four hours apart from the next beginning at 00;

00;

or

one of four pre-configured time intervals each spaced six hours apart from the next beginning at 00;

00.

26. The system of claim 24, wherein the dosing controller, when the blood glucose time is within a first one of four-preconfigured time intervals each spaced six hours apart from the next:

sets the blood glucose measurement as a governing blood glucose value;

determines an adjustment factor for adjusting a value of recommended equal-boluses based on the governing blood glucose value;

retrieves a previous day'"'"'s value of recommended equal-boluses; and

determines a new value of recommended equal-boluses by multiplying the adjustment factor times the previous day'"'"'s value of recommended equal-boluses, the new value of recommended equal-boluses corresponding to an insulin dose of rapid-acting insulin or regular insulin to be administered to the patient at scheduled blood glucose measurements.

27. The system of claim 24, wherein the dosing controller, when the blood glucose time is within a second one of six-preconfigured time intervals each spaced four hours apart from the next:

sets the blood glucose measurement as a governing blood glucose value;

determines an adjustment factor for adjusting a value of recommended equal-boluses based on the governing blood glucose value;

retrieves a previous day'"'"'s value of recommended equal-boluses; and

determines a new value of recommended equal-boluses by multiplying the adjustment factor times the previous day'"'"'s value of recommended equal-boluses, the new value of recommended equal-boluses corresponding to an insulin dose of rapid-acting insulin or regular insulin to be administered to the patient at scheduled blood glucose measurements.

28. The system of claim 24, wherein the dosing controller, when the blood glucose time is within a second one of six-preconfigured time intervals each spaced four hours apart from the next:

sets the blood glucose measurement as a governing blood glucose value;

determines an adjustment factor for adjusting a current day'"'"'s recommended basal dose based on the governing blood glucose value;

retrieves a previous day'"'"'s recommended basal dose; and

determines the current day'"'"'s recommended basal dose by multiplying the adjustment factor times the previous day'"'"'s recommended basal dose, the current day'"'"'s recommended basal dose corresponding to an insulin dose of long-acting insulin to be administered to the patient at a configurable frequency of one, two, or three times per day.

29. The system of claim 24, wherein the dosing controller, when the blood glucose time is within a second one of six-preconfigured time intervals each spaced four hours apart from the next:

sets the blood glucose measurement as a governing blood glucose value;

determines an adjustment factor for adjusting a current day'"'"'s recommended basal dose based on the governing blood glucose value;

retrieves a previous day'"'"'s recommended basal dose; and

determines the current day'"'"'s recommended basal dose by multiplying the adjustment factor times the previous day'"'"'s recommended basal dose, the current day'"'"'s recommended basal dose corresponding to an insulin dose of long-acting insulin to be administered to the patient at a configurable frequency of one, two, or three times per day.

30. The system of claim 16, wherein the dosing controller transmits the subcutaneous insulin treatment program for tube-fed patients to an administration device in communication with the dosing controller, the administration device comprising:

a doser; and

an administration computing device in communication with the doser, the administration computing device, when executing the selected subcutaneous insulin treatment, causing the doser to administer the recommended doses of insulin determined by the subcutaneous insulin treatment program for tube-fed patients.