Safeguarding techniques for a closed-loop insulin infusion system

• US 9,623,179 B2
• Filed: 08/13/2013
• Issued: 04/18/2017
• Est. Priority Date: 08/30/2012
• Status: Active Grant

• Current Assignee: Medtronic Minimed Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Minimed Incorporated (Medtronic Plc)
• Inventors: Mastrototaro, John J., Grosman, Benyamin, Parikh, Neha J., Roy, Anirban, Keenan, Desmond Barry
• Primary Examiner(s): Breene, John
• Assistant Examiner(s): Islam, Mohammad
• Application Number:
  US13/966,109
• Publication Number:
  US 20140066887A1
• Time in Patent Office: 1,344 Days
• CPC Class Codes: A61B 2560/0223 of calibration, e.g. protocols for calibrating sensors
• CPC Class Codes: A61B 5/14532 for measuring glucose, e.g. by tissue impedance measurement
• CPC Class Codes: A61B 5/1495 Calibrating or testing of in-vivo probes
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• 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: G16H 20/17 delivered via infusion or injection
• CPC Class Codes: G16H 40/40 for the management of medical equipment or devices, e.g. scheduling maintenance or upgrades

Abstract

Processor-implemented methods of controlling an insulin infusion device for a user are provided here. A first method obtains and analyzes calibration factors (and corresponding timestamp data) for a continuous glucose sensor, and regulates entry into a closed-loop operating mode of the infusion device based on the calibration factors and timestamp data. A second method obtains a most recent sensor glucose value and a target glucose setpoint value for the user at the outset of the closed-loop mode. The second method adjusts the closed-loop insulin infusion rate over time, in response to the sensor glucose value and the setpoint value. A third method calculates an upper insulin limit that applies to the insulin infusion rate during the closed-loop mode. The insulin limit is calculated based on a fasting blood glucose value of the user, a total daily insulin value of the user, and fasting insulin delivery data for the user.

Claims

1. A processor-implemented method of controlling an insulin infusion device having an insulin reservoir for insulin to be delivered from the insulin infusion device to a body of a user, the method comprising:

operating a processor architecture comprising at least one processor device to obtain sensor calibration data for a continuous glucose sensor that generates a sensor variable indicative of blood glucose of the user;

identifying a most recent calibration factor from the sensor calibration data, the most recent calibration factor representing a first conversion value applicable to convert a first value of the sensor variable to a first blood glucose value;

identifying a prior calibration factor from the sensor calibration data, the prior calibration factor representing a second conversion value applicable to convert a second value of the sensor variable to a second blood glucose value, and the prior calibration factor corresponding to an earlier time relative to the most recent calibration factor;

regulating entry into a closed-loop operating mode of the insulin infusion device, based on the most recent calibration factor and the prior calibration factor; and

operating the insulin infusion device in a closed-loop mode to continuously deliver insulin from the insulin reservoir to the body of the user in accordance with the most recent calibration factor and the prior calibration factor, wherein;

regulating entry into the closed-loop operating mode comprises permitting entry into the closed-loop operating mode only when t−

tRecent≦

tR≦

t;

t is a time when attempting to enter the closed-loop operating mode;

tRecent is a predetermined time period; and

tR is a time when the most recent calibration factor was obtained.

2. The method of claim 1, wherein:

the sensor calibration data comprises calibration timestamp data for the most recent calibration factor and the prior calibration factor; and

regulating entry into the closed-loop operating mode is based on the most recent calibration factor, the prior calibration factor, and the calibration timestamp data.

3. The method of claim 1, wherein:

the sensor calibration data comprises a most recent meter blood glucose value and a sensor current value obtained at the time of the most recent meter blood glucose value; and

identifying the most recent calibration factor comprises calculating the most recent calibration factor, using the most recent meter blood glucose value and the sensor current value obtained at the time of the most recent meter blood glucose value.

4. The method of claim 3, wherein:

the most recent calibration factor is calculated in accordance with the expression CFR=meterBG/(Isig−

2);

CFR is the most recent calibration factor;

meterBG is the most recent meter blood glucose value; and

Isig is the sensor current value obtained at the time of the most recent meter blood glucose value.

5. The method of claim 3, further comprising:

receiving a command to enter the closed-loop operating mode; and

in response to receiving the command, generating a request for the most recent meter blood glucose value.

6. The method of claim 1, wherein:

regulating entry into the closed-loop operating mode comprises permitting entry into the closed-loop operating mode only when CFmin≦

CFR≦

CFmax;

CFmin is a minimum acceptable calibration factor value;

CFmax is a maximum acceptable calibration factor value; and

CFR is the most recent calibration factor.

7. The method of claim 1, wherein:

regulating entry into the closed-loop operating mode comprises permitting entry into the closed-loop operating mode only when CFmin≦

CFP≦

CFmax;

CFmin is a minimum acceptable calibration factor value;

CFmax is a maximum acceptable calibration factor value; and

CFP is the prior calibration factor.

8. The method of claim 1, wherein:

regulating entry into the closed-loop operating mode comprises permitting entry into the closed-loop operating mode only when tR−

tDiffmax≦

tP≦

tR−

tDiffmin;

tR is a time when the most recent calibration factor was obtained;

tDiffmax is a maximum allowable time difference;

tDiffmin is a minimum allowable time difference; and

tP is a time when the prior calibration factor was obtained.

9. The method of claim 1, wherein:

regulating entry to the closed-loop operating mode comprises permitting entry to the closed-loop operating mode only when a change between the most recent calibration factor and the prior calibration factor is less than or equal to a threshold value.

10. The method of claim 1, further comprising identifying all intervening calibration factors obtained after the prior calibration factor was obtained and before the most recent calibration factor was obtained, wherein:

regulating entry to the closed-loop operating mode comprises permitting entry to the closed-loop operating mode only when each of the intervening calibration factors is greater than or equal to a minimum acceptable calibration factor value, and is less than or equal to a maximum acceptable calibration factor value.

11. A processor-implemented method of controlling an insulin infusion device having an insulin reservoir for insulin to be delivered from the insulin infusion device to a body of a user, the method comprising:

operating a processor architecture comprising at least one processor device to obtain sensor calibration data for a continuous glucose sensor that generates a sensor variable indicative of blood glucose of the user;

identifying a most recent calibration factor from the sensor calibration data, the most recent calibration factor representing a first conversion value applicable to convert a first value of the sensor variable to a first blood glucose value;

identifying a prior calibration factor from the sensor calibration data, the prior calibration factor representing a second conversion value applicable to convert a second value of the sensor variable to a second blood glucose value, and the prior calibration factor corresponding to an earlier time relative to the most recent calibration factor;

regulating entry into a closed-loop operating mode of the insulin infusion device, based on the most recent calibration factor and the prior calibration factor; and

operating the insulin infusion device in a closed-loop mode to continuously deliver insulin from the insulin reservoir to the body of the user in accordance with the most recent calibration factor and the prior calibration factor, wherein;

regulating entry into the closed-loop operating mode comprises permitting entry into the closed-loop operating mode only when;

t−

tRecent≦

tR≦

t;

CFmin≦

CFR≦

CFmax;

CFmin≦

CFP≦

CFmax;

tR−

tDiffmax≦

tP≦

tR−

tDiffmin; and

a difference between CFR and CFP is less than or equal to a threshold value;

CFR is the most recent calibration factor;

CFP is the prior calibration factor;

CFmin is a minimum acceptable calibration factor value;

CFmax is a maximum acceptable calibration factor value;

t is a time when attempting to enter the closed-loop operating mode;

tRecent is a predetermined time period;

tR is a time when CFR was obtained;

tP is a time when CFP was obtained;

tDiffmax is a maximum allowable time difference; and

tDiffmin is a minimum allowable time difference.

12. The method of claim 11, further comprising:

determining, based on the most recent calibration factor and the prior calibration factor, that the continuous glucose sensor is accurate for purposes of the closed-loop operating mode; and

initiating the closed-loop operating mode in response to the determining.

13. A processor-implemented method of controlling closed-loop delivery of insulin from an insulin reservoir of an insulin infusion device to the body of a user, the method comprising:

operating a processor architecture comprising at least one processor device to calculate a maximum insulin infusion rate for the user based on a fasting blood glucose value associated with the user, a total daily insulin value associated with the user, and fasting insulin delivery data that is indicative of insulin delivered to the user during a fasting period, wherein the maximum insulin infusion rate is applicable during a period of closed-loop operation of the insulin infusion device;

obtaining a first closed-loop insulin infusion rate for the user, wherein the first closed-loop insulin infusion rate is obtained for a current sampling point during the period of closed-loop operation;

providing a second closed-loop insulin infusion rate for the user when the obtained first closed-loop insulin infusion rate is greater than the calculated maximum insulin infusion rate, wherein the second closed-loop insulin infusion rate is less than the first closed-loop insulin infusion rate; and

operating the insulin infusion device in a closed-loop mode to continuously deliver insulin from the insulin reservoir to the body of the user in accordance with either the first closed-loop insulin infusion rate or the second closed-loop insulin infusion rate.

14. The method of claim 13, wherein the provided second closed-loop insulin infusion rate is equal to the calculated maximum insulin infusion rate.

15. The method of claim 13, wherein:

the first closed-loop insulin infusion rate is calculated in accordance with a proportional-integral-derivative insulin feedback (PID-IFB) control algorithm; and

the method further comprises the step of inhibiting windup of an integral component of the PID-IFB control algorithm when the obtained first closed-loop insulin infusion rate is greater than the calculated maximum insulin infusion rate.

16. The method of claim 15, wherein inhibiting windup of the integral component comprises:

freezing the integral component while permitting continued updating of a proportional component of the PID-IFB control algorithm, and while permitting continued updating of a derivative component of the PID-IFB control algorithm.

17. The method of claim 16, further comprising:

unfreezing the integral component when a third closed-loop insulin infusion rate for the user is less than or equal to the calculated maximum insulin infusion rate, wherein the third closed-loop insulin infusion rate is obtained for a subsequent sampling point during the period of closed-loop operation, the subsequent sampling point occurring after the current sampling point.

18. The method of claim 13, wherein the fasting blood glucose value remains constant during the period of closed-loop operation.

19. The method of claim 13, wherein the total daily insulin value remains constant during the period of closed-loop operation.

20. The method of claim 13, wherein the fasting insulin delivery data remains constant during the period of closed-loop operation.

21. The method of claim 13, wherein the fasting insulin delivery data is correlated to the fasting blood glucose value.

22. The method of claim 13, wherein:

the maximum insulin infusion rate is calculated in accordance with the expression

23. The method of claim 22, wherein:

24. The method of claim 23, wherein: