Personalized wireless-based interactive diabetes treatment

• US 8,812,244 B2
• Filed: 05/31/2012
• Issued: 08/19/2014
• Est. Priority Date: 01/26/2009
• Status: Expired due to Fees

• Current Assignee: Teladoc Health, Inc.
• Original Assignee: EOS Health Incorporated
• Inventors: Angelides, Kimon
• Primary Examiner(s): Riggs, II, Larry D
• Application Number:
  US13/485,849
• Publication Number:
  US 20120231431A1
• Time in Patent Office: 810 Days
• Field of Search: None
• US Class Current: 702/19
• 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: G10L 15/26 Speech to text systems G10L15/08 takes precedence
• CPC Class Codes: G16H 20/17 delivered via infusion or injection
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 20/60 relating to nutrition control, e.g. diets
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 70/00 ICT specially adapted for the handling or processing of medical references

Abstract

This is a system for integrating a system of education, monitoring and advising on glucose testing, diet, exercise and drug administration, by a wireless link, or GPRS system, using a device which is lightweight and portable (and easily carried by the patient) and which is capable of:

• glucose testing and recording the results;
• providing some feedback and advice from internal programs based on the results and on patient preferences; and
• transmitting the glucose testing results for external recording (e.g., on a server) and external analysis, feedback and advice from the server, and for feedback and advice from an appropriately knowledgeable and health care experienced party.

Claims

1. A method of diabetes management through a portable device carried with the patient and linked through a wireless connection to a server, wherein the patient is queried to provide blood glucose levels and other health information and the patient is periodically advised of needed actions as well as provided reminders, related advice and education, comprising:

providing the patient with a portable device with a wireless link to the server, and wherein the server is capable of sending queries for information and advice and information to the patient and is capable of receiving information from the patient and analyzing the received information to provide advice, queries and information, and wherein the portable device also incorporates a glucometer which can send the patient'"'"'s blood glucose level results to the server on the wireless link, and wherein the patient enters preferences and exclusions in the server or in the portable device for types of exercise and for foods, and the patient updates said preferences and exclusions over time;

sending the patient, periodically, queries to check blood glucose level, and repeating the queries until the glucometer sends blood glucose level results to the server, which follows from the patient providing a blood sample for blood glucose level testing to the glucometer;

querying for information from the patient including time from last food intake and insulin or drug administration, and glucose-response related feelings;

advising the patient to determine ketone levels if the patient'"'"'s blood glucose is above a threshold or other patient information indicates it is prudent to do so, and where the ketone level results are transmitted by the portable device to the server;

advising the patient, from the server, to either;

(i) cease exertion or (ii) begin a preferred type of exercising based on;

(i) patient exercise preferences and exclusions, said preferred type of exercising having similar exertion levels to patient exercise preferences, and (ii) blood glucose level, time from last food intake, insulin and drug administration, and glucose-response related feelings;

advising the patient, from the server, to eat food, and advising on food choices to eat based on;

(i) patient food preferences and exclusions, wherein said food choices are also based on the time of day the advice to eat is provided and patient preferences include patient preferences for certain foods at certain times of day, and further including in said food choices foods with similar textures to said patient food preferences, and (ii) blood glucose level, time from last food intake, insulin and drug administration, and glucose-response related feelings; and

wherein the advice from the server is triggered to provide the following message if the patient'"'"'s blood glucose level is less than 70 mg/dl or if the patient is experiencing known symptoms of hypoglycemia and reports those symptoms to the server;

(i) Treat with 15 gm of fast acting glucose or equivalent;

(ii) Wait 15 minutes and rest and re-test;

(iii) If your blood glucose level is still less than 70 mg/dl or if you still have hypoglycemic symptoms REPEAT steps (i) and (ii);

(iv) If you feel better, you still NEED to eat the next scheduled snack or meal, but if your next meal or snack is not scheduled for 30-60 minutes, eat a snack now that contains 15 grams of carbohydrate;

or, if your next meal is more than 60 minutes away, eat 15 gm of carbohydrates and 1 ounce of protein now;

(v) If you are unable to correct hypoglycemia after the REPEAT of steps (i) and (ii) above, you need to seek IMMEDIATE medical attention;

DO NOT DRIVE YOURSELF;

DO NOT RECEIVE FLUIDS IF YOU ARE UNCONSCIOUS OR UNABLE TO SWALLOW; and

providing education to the patient, from the server, regarding medications, diet, exercise, blood glucose and ketone levels, and risks involved with each, based on patient food and exercise preferences and exclusions, blood glucose level, time from last food intake, insulin and drug administration, and glucose-response related feelings.

2. The method of claim 1 wherein the patient provides information including feelings, reactions to medications, exercise level, time from last food intake, time from last drug administration in response to queries.

3. The method of claim 1 wherein the blood glucose level, ketone level or other patient status indicator can trigger health care worker intervention and advice from the health care worker.

4. The method of claim 1 wherein the educational materials provided to the patient include materials relevant to blood glucose and ketone levels which expand on the dangers and solutions.

5. The method of claim 1 wherein the patient indicates that the advice and educational materials were reviewed.

6. The method of claim 1 wherein the portable device is linked to or includes a pedometer or a heart rate monitor which is also carried by the patient.

7. The method of claim 1 wherein the advice on diet and exercise includes, eat carbohydrates with a low glycemic index, or increase or decrease exertion level.

8. The method of claim 1 wherein the educational materials provided to the patient specify the risks and adverse events associated with particular medications.

9. The method of claim 1 wherein the educational materials provided to the patient include information on diseases and conditions related to diabetes, including ketoacidosis, peripheral neuropathy, atherosclerosis, depression, foot wounds, and cataracts.

10. The method of claim 1 wherein the patient preferences are updated by the patient from the portable device, and after said updating, the server provides advice to the patient on foods, exercise, and education, based on the updated preferences.

11. The method of claim 1 wherein the patient also tests for LDL and cholesterol.

12. The method of claim 1 wherein the queries and advice are in the form of text messages.

13. The method of claim 1 wherein the advice to the patient on food includes similar foods or foods with the same or similar characteristics to those the patient indicates are preferences.