System, tools, devices and a program for diabetes care

• US 7,766,831 B2
• Filed: 03/07/2008
• Issued: 08/03/2010
• Est. Priority Date: 09/09/2005
• Status: Active Grant

• Current Assignee: Roche Diagnostics International AG (Roche Holding AG)
• Original Assignee: Roche Diagnostics International AG (Roche Holding AG)
• Inventors: Schoemaker, Michael, Koschinsky, Theodor, Heckermann, Sascha, La Bastide, Sebastiaan, Essenpreis, Matthias, Brandt, Derek
• Primary Examiner(s): Marmor, II; Charles A
• Assistant Examiner(s): JANG, CHRISTIAN YONGKYUN
• Application Number:
  US12/044,133
• Publication Number:
  US 20080242963A1
• Time in Patent Office: 879 Days
• Field of Search: 600345-347, 600/365
• US Class Current: 600/365
• CPC Class Codes: A61B 5/14532 for measuring glucose, e.g. by tissue impedance measurement
• 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: A61B 5/743 Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
• CPC Class Codes: A61B 5/7445 Display arrangements, e.g. multiple display units
• CPC Class Codes: G16H 20/17 delivered via infusion or injection
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

A method for diabetes care, the method (which also may be referred to as, involve or incorporate at least one of a tool, device or program) allowing for the characterization of the relevance of errors of parameters affecting glucose concentration on a postprandial glucose concentration outcome for a person with diabetes mellitusm, wherein the method involves at least one of sensing, determining, calculating, predicting, describing and communicating the effects of potential errors of parameters affecting glucose concentration on postprandial glucose concentration values within a clinically relevant glucose range.

Claims

1. A system for determining postprandial glucose concentration, said system comprising:

a processor adapted to execute computer implemented instructions to calculate postprandial glucose values based on a therapeutic action scheme and each of;

a preprandial glucose concentration measurement by self-monitoring of glucose;

an effect of carbohydrate-portion on maximum glucose increase;

an estimate of carbohydrate amount in a meal;

an effect of prandial insulin on maximum glucose decrease; and

an insulin dosage;

wherein the processor is further adapted to execute computer implemented instructions to account for a margin of error for the self-monitored preprandial glucose concentration measurement in the calculation;

wherein the processor is further adapted to execute computer implemented instructions to account for an error associated with at least one of;

the effect of carbohydrate-portion on maximum glucose concentration increase;

the estimate of carbohydrate amount in a meal;

the effect of prandial insulin on maximum glucose concentration decrease; and

the insulin dosage; and

wherein a trend of a continuous blood glucose monitoring is considered as follows;

2. The system according to claim 1, wherein the processor is further adapted to execute computer implemented instructions to determine postprandial glucose concentration for different ranges of preprandial glucose concentration values according to the therapeutic scheme.

3. The system according to claim 2, wherein the system further comprises a display operatively coupled to the processor, and wherein the processor is further adapted to execute computer implemented instructions to display postprandial blood glucose as a function of preprandial blood glucose on the display.

4. The system according to claim 3, wherein the processor is further adapted to execute computer implemented instructions to determine whether a critical point is reached by exceeding a lower limit for glucose concentration or by exceeding an upper limit for glucose concentration.

5. The system according to claim 4, wherein the therapeutic scheme includes a carbohydrate self-adjustment in relation to preprandial glucose concentration according to the relation:

6. The system according to claim 4, wherein the therapeutic scheme includes a pre-prandial insulin dose self-adjustment according to the relation:

7. A method of therapy, diagnosis or education comprising:

using a computing system having data processing logic and computer readable storage media with one or more computer programs stored thereon for calculating postprandial glucose concentrations for a range of preprandial glucose concentrations based on a therapeutic action scheme and each of;

a preprandial glucose measurement by self-monitoring of glucose concentration;

an effect of carbohydrate-portion on maximum glucose increase;

an estimate of carbohydrate amount in a meal;

an effect of prandial insulin on maximum glucose decrease; and

an insulin dosage, and

displaying a result relating to the calculated postprandial glucose concentrations only if the calculated postprandial glucose concentrations are within a predetermined range, wherein the result is displayed on a display operatively coupled to the computing system;

wherein

calculating postprandial glucose concentrations further includes taking into account a margin of error for self-monitored preprandial glucose concentration.

8. The method according to claim 7, further comprising the step of taking into account an error associated with at least one of:

the effect of carbohydrate-portion on maximum glucose increase;

the estimate of carbohydrate amount in a meal;

the effect of prandial insulin on maximum glucose decrease; and

the insulin dosage.

9. The method according to claim 7, wherein determining postprandial glucose concentration further includes determining postprandial blood glucose for different ranges of preprandial glucose concentration values according to the therapeutic scheme.

10. The method according to claim 7, further comprising the step of displaying postprandial glucose as a function of preprandial glucose.

11. The method according to claim 7, further comprising the step of determining whether a critical point is reached by exceeding a lower limit for glucose concentration or by exceeding an upper limit for glucose concentration.

12. The method according to claim 7, wherein the therapeutic scheme includes a carbohydrate self-adjustment in relation to preprandial glucose concentration according to the relation:

13. The method according to claim 7, wherein the therapeutic scheme includes a pre-prandial insulin dose self-adjustment according to the relation:

14. The method according to claim 7, wherein the trend of a continuous glucose monitoring is considered as follows:

15. The method according to claim 7, wherein said computing system is contained within or operatively associated with one of an a blood glucose meter, an insulin pump or a continuous glucose monitor.

16. The method according to claim 15, and an error grid for the evaluation of measurement errors associated with said blood glucose meter.

17. A computer accessible medium having stored thereon computer executable instructions to determine postprandial glucose concentrations, the computer executable instructions comprising:

calculating postprandial glucose values for a range of preprandial glucose concentrations based on a thereapeutic action scheme and each of;

a preprandial glucose measurement by self-monitoring of glucose;

an effect of carbohydrate-portion on maximum glucose increase;

an estimate of carbohydrate amount in a meal

an the effect of prandial insulin on maximum glucose decrease; and

an insulin dosage,

wherein a margin of error for self-monitored preprandial glucose is accounted for in calculating the postprandial glucose values, and

wherein the therapeutic scheme includes a pre-prandial insulin dose self-adjustment according to the relation;

18. The computer accessible medium according to claim 17, wherein an error associated with at least one of:

the effect of carbohydrate-portion on maximum glucose increase;

the estimate of carbohydrate amount in a meal;

the effect of prandial insulin on maximum blood glucose decrease; and

the insulin dosage;

is accounted for in calculating the postprandial glucose values.

19. The computer accessible medium according to claim 17, wherein calculating postprandial glucose values further comprises determining postprandial glucose concentration for different ranges of preprandial blood glucose values according to the therapeutic scheme.

20. The computer accessible medium according to claim 19, further comprising displaying the postprandial glucose concentration as a function of preprandial glucose concentration.

21. The computer accessible medium according to claim 17, further comprising determining whether a critical point is reached by exceeding a lower limit for glucose or by exceeding an upper limit for glucose concentration.

22. The computer accessible medium according to claim 21, wherein the therapeutic scheme includes a carbohydrate self-adjustment in relation to preprandial glucose concentration according to the relation:

23. The computer accessible medium according to claim 17, wherein the trend of a continuous blood glucose monitoring is considered as follows: