US20090099438A1 - System for managing glucose levels in patients with diabetes or hyperglycemia - Google Patents
System for managing glucose levels in patients with diabetes or hyperglycemia Download PDFInfo
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- US20090099438A1 US20090099438A1 US12/337,157 US33715708A US2009099438A1 US 20090099438 A1 US20090099438 A1 US 20090099438A1 US 33715708 A US33715708 A US 33715708A US 2009099438 A1 US2009099438 A1 US 2009099438A1
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- blood glucose
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
- A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
- A61M5/168—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body
- A61M5/172—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body electrical or electronic
- A61M5/1723—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body electrical or electronic using feedback of body parameters, e.g. blood-sugar, pressure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/145—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue
- A61B5/14532—Measuring characteristics of blood in vivo, e.g. gas concentration, pH value; Measuring characteristics of body fluids or tissues, e.g. interstitial fluid, cerebral tissue for measuring glucose, e.g. by tissue impedance measurement
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/48—Other medical applications
- A61B5/4836—Diagnosis combined with treatment in closed-loop systems or methods
- A61B5/4839—Diagnosis combined with treatment in closed-loop systems or methods combined with drug delivery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
- A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
- A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
- A61M5/142—Pressure infusion, e.g. using pumps
- A61M5/14212—Pumping with an aspiration and an expulsion action
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
- G16H10/40—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for data related to laboratory analysis, e.g. patient specimen analysis
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
- G16H20/10—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients
- G16H20/17—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients delivered via infusion or injection
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
- A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
- A61M5/142—Pressure infusion, e.g. using pumps
- A61M2005/14208—Pressure infusion, e.g. using pumps with a programmable infusion control system, characterised by the infusion program
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/18—General characteristics of the apparatus with alarm
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/50—General characteristics of the apparatus with microprocessors or computers
- A61M2205/502—User interfaces, e.g. screens or keyboards
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/50—General characteristics of the apparatus with microprocessors or computers
- A61M2205/52—General characteristics of the apparatus with microprocessors or computers with memories providing a history of measured variating parameters of apparatus or patient
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/58—Means for facilitating use, e.g. by people with impaired vision
- A61M2205/581—Means for facilitating use, e.g. by people with impaired vision by audible feedback
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2205/00—General characteristics of the apparatus
- A61M2205/58—Means for facilitating use, e.g. by people with impaired vision
- A61M2205/583—Means for facilitating use, e.g. by people with impaired vision by visual feedback
Definitions
- This invention relates to maintenance of proper glucose levels in hyperglycemic individuals, and in particular, to a system that aids in the correct administration of insulin through the use of computerized insulin dosage calculations that are made with the use of individual-specific information.
- BG blood glucose
- Maintaining proper blood sugar, i.e., glucose, levels is important for hyperglycemic individuals, e.g., diabetics, in order to prevent long term problems such as nerve damage, blindness, and kidney disease.
- the need to control blood glucose (often referred to as BG) levels is even more important with hyperglycemic patients in critical care situations, such as in hospital intensive care units following surgical procedures, as those patients are more likely to suffer adverse physical effects, e.g., infections, from improperly maintained BG levels.
- Compounding this problem is the fact that BG levels in such patients may be unstable, necessitating frequent measurements and adjustments of administered insulin dosage. At times the degree of insulin dosage adjustment may be significant, or the calculated dosage amount may be high, so that it is difficult to determine whether the calculated insulin dose is correct or if an error in blood sugar measurement or an equipment malfunction has occurred.
- FIG. 1 is a diagrammatic view of a blood glucose management system in accordance with one embodiment of the present invention.
- FIG. 2 is a flowchart illustrating the operation of a blood glucose management system in accordance with an aspect of the present invention.
- FIG. 3 is a diagrammatic view of a blood glucose management system in accordance with another embodiment of the present invention.
- FIGS. 4 through 27 are representative computer screen images illustrating aspects of the operation of a blood glucose management system in accordance with an embodiment of the present invention.
- BG blood glucose
- BG blood glucose
- IV intravenous
- nurse 16 tests the blood sugar or glucose level of patient 12 by a known, available means including, but not limited to, a traditional finger stick using known, commercially available products. Nurse 16 then enters the measured BG level of patient 12 into data handling device 24 .
- Device 24 is illustratively shown as having a display 26 and an input 28 .
- Display 26 may be of any conventional or available display type, such as, for example, a CRT or LCD screen, while input 26 may be a computer keyboard, for example.
- the entered information is sent via communications channel 30 to computer or data processor 32 which may be located at a central location, such as a nurses' station or hospital-wide patient monitor center.
- Communications channel 30 may be of the form of a hardwired connection, a local area network, or an internet-based wide area network, to cite a few non-limiting examples.
- Network access may advantageously provide access to patient data from other hospitals or in-patient facilities, and it can allow patent 12 to be moved within a networked facility or between network-linked facilities, while still maintaining active monitoring of the patient's condition and providing access to historical patient data.
- Data processor 32 illustratively comprises a central processing unit (CPU) 34 and memory 36 , which may be of any known or available form, such as, for example, ROM, PROM, RAM, EPROM or EEPROM. Also shown as being connected or associated with data processor 32 are display 38 (such as, for example, a CRT or LCD screen) and input device 40 , such as a keyboard, for example.
- display 38 such as, for example, a CRT or LCD screen
- input device 40 such as a keyboard, for example.
- Data processor 32 evaluates the BG level of patient 12 to determine if the glucose level is high or low. If it is low, data processor 32 calculates an appropriate dosage of glucose, typically administered as dextrose (such as that identified as D-50), that is needed to bring the BG level of patient 12 back within a predetermined “normal” range. If the BG level is high, data processor 32 calculates a proper insulin drip level that required to restore the BG level of patient 12 to the “normal” range. If the BG level is within the “normal” range for patient 12 , data processor 32 calculates a proper insulin drip level sufficient to maintain the BG level of patient 12 within the “normal” range. The information is sent back to device 24 via communications channel 30 where it appears on display 26 .
- dextrose such as that identified as D-50
- Nurse or caregiver 16 then administers dextrose, if needed, or makes any necessary adjustments to drip regulator 20 so that the proper amount of insulin 18 is delivered to patient 12 .
- the calculation used by CPU 34 of data processor 32 illustratively utilizes a known algorithm identified as the Protocol of Bode et al., and described in an article entitled “Intravenous Insulin Infusion Therapy: Indications, Methods, and Transition to Subcutaneous Insulin Therapy,” Endocrine Practice, Vol. 10 (Suppl. 2), March/April 2004, but a proprietary algorithm or some other proven calculation could be developed or adapted to be suitable as well.
- FIG. 2 illustrates a flowchart which shows a BG management process 41 in accordance with an embodiment of the present invention, which will be used to illustrate the manner in which BG management system 10 of FIG. 1 operates.
- a particular patient is selected for BG monitoring or management by system 10 .
- the process of step 42 selects critical care patient 12 .
- Step 44 determines from information provided by step 42 whether patient 12 requires a new insulin drip to be established, or whether a previously established insulin drip is to be restarted.
- step 48 information concerning the previous insulin drip for patient 12 is retrieved from database 46 and used in step 48 to set initial insulin administration, e.g., drip rate, multiplier and “normal” BG level, data for patient 12 .
- initial insulin administration e.g., drip rate, multiplier and “normal” BG level
- BG level e.g., BG level 1
- Having access to known information specific to patient 12 greatly aids in establishing an initial insulin drip rate that will be more accurate, and hence lead to a quicker stabilization of the BG level for patient 12 than would be possible if a drip rate were started from a nominal average value. Access to this information allows patient 12 to be temporarily discontinued from a drip without requiring a “break-in” period when the drip is resumed.
- Process 41 then proceeds to step 50 , which measures the BG level of patient 12 .
- the BG level of patient 12 is measured manually by nurse 14 , and entered into data handling device 24 , which communicates that information to data processor 32 .
- Process 41 including step 50 , need not be performed manually by a nurse or caregiver, but could be performed automatically without human intervention.
- the measured BG level is then evaluated at step 52 to determine if the BG level falls below, within, or above the “normal” range previously established for patient 12 .
- step 54 calculates the appropriate amount of glucose (e.g., D-50 dextrose) needed by patient 12 .
- This information is used by process 41 at step 56 to administer the dextrose dose to patient 12 .
- Process 41 sets an appropriate recheck interval at step 58 , e.g., 15 minutes, at which time alarm 60 either provides an audible or visible alert to nurse 16 that it is time to recheck the BG level of patient 12 .
- alarm 60 could initiate a new BG check via step 50 directly.
- the information determined at step 58 is also stored in database 46 to provide historical data that can be used to generate a complete report about patient 12 , re-establish a drip, or more accurately predict the course of treatment needed to control BG levels in patient 12 .
- process 41 calculates the proper insulin drip rate for patient 12 at step 62 .
- This insulin dosage is then administered at step 64 , which permits adjustment of the insulin drip rate and volume being given to patient 12 based on the information determined at step 62 .
- process 41 determines an appropriate BG level recheck interval (that is also stored in database 46 ) for patient 12 .
- alarm 68 provides an alert to a nurse or caregiver that it is time to recheck the BG level of patient 12 or, in an automated system or environment, directly initiates a BG level measurement via step 50 .
- Process 41 may incorporate additional alerts that require additional evaluations or determinations in order to proceed, so that improper measurements or data entry, or an equipment malfunction, may be discovered before an incorrect treatment is administered to a patient.
- Such alerts may, for example, be associated with step 50 if the BG level measured at a given time is significantly different than that measured previously, or if the previous measurement was done only a short time before.
- Alerts could also be associated with steps 54 or 62 if the calculated dextrose or insulin dosage amount appears to be abnormally high or low.
- Other alert mechanisms may also be included as desired and the actions needed, e.g., doctor or nurse sign-off, BG level recheck, may be specified in order for the process to proceed.
- Process 41 can use the information stored in database 46 , which creates a permanent archived record for each patient, to create individual patient reports or to determine trends and predictions from statistically analyzing a large amount of data from a number of patients.
- system 10 may be performed by electronic circuitry and/or with computer software, including but not limited to the steps of determining whether measured or calculated amounts are within normal ranges, issuing alert messages, and setting patient glucose level recheck intervals.
- Such automation is clearly much more important in an out-patient environment (e.g., diabetics utilizing insulin pumps) than with an in-patient situation where continuous or frequent nursing or other medical care is provided.
- FIG. 3 shows a BG management system 70 that is adapted to handle multiple or even large numbers of patients, and that automatically performs certain functions that were done manually or with human intervention in system 10 of FIG. 1 . It is understood, however, that the number of patients and the degree of automation are shown and described for illustrative purposes only, and the aspects and advantages of the present invention are not dependent upon any particular number of patients or the manner in which the operating steps are performed.
- System 70 operates similarly to system 10 of FIG. 1 in that an illustrative patient 72 , located on bed or other device 74 in a hospital or other in-patient facility, is administered an insulin drip via IV tube 76 from insulin reservoir 78 , with the rate and amount of that drip being set by drip controller 80 .
- the BG level of patient 72 is measured automatically by measurement device 82 , rather than manually as was done as by nurse 16 in system 10 shown in FIG. 1 .
- the above-described elements associated with patient 72 can be considered to make up an overall patient unit 84 a.
- FIG. 3 illustratively shows additional patient units 84 b , 84 c , and 84 d , although it is understood that any number of patient units may be provided.
- the automatically measured BG levels from each of patient units 84 a - d is applied to controller 86 which coordinates data from the various patient units.
- the data is provided to data processor 88 in a manner that enables data processor 88 to identify the patient unit that is the source of each piece of information. It is understood that the functionality of controller 86 may be incorporated in some other component such that an identifiable discrete element may not be present.
- Data processor 88 illustratively incorporates a central processing unit (CPU) 90 and a memory unit 92 , which may be of any known or otherwise appropriate type.
- CPU central processing unit
- I/O devices 94 a - d are input/output devices 94 a - d, which illustratively correspond to patient units 84 a - d respectively. It is of course possible that a single or limited number of I/O devices may be provided so that multiple patient units can be accommodated by one I/O device in a multiplexed fashion. Insulin drip rate information is provided to the corresponding drip controllers in each of patient units 84 a - d via output lines 96 a - d.
- Alert signals may be evaluated by automatic failsafe or double checking circuitry, or a human intervener, such as the equivalent of nurse 16 , may be called upon to verify the accuracy of measurements or calculations if they do not appear to fall within “normal” or previously measured limits.
- FIGS. 4 through 26 will now be described as illustrative examples of representative display screens for a computer software program that performs certain of the functions described in connection with system 10 and/or system 70 .
- system 10 For the sake of efficiency and readability in describing FIGS. 4 through 26 , reference will be made solely to system 10 , although it is understood that references to the operation of system 10 are also applicable to system 70 whenever such described function is performed by system 70 .
- FIG. 4 illustrates one example of an initial system status screen 100 that identifies all patients that are under the control of blood glucose management system 10 (in this case only John Doe), with each patient's identification number as well as other data. It is understood that the information provided on screen 100 is shown for illustrative purposes, and other types of information, such as the ages of the patients, their room number, and medication list, for example, could also be shown. Screen 100 further provides a list of possible actions that may be taken with respect to a given patient, including the action of resuming a previous, e.g., temporarily discontinued, drip, or starting a new drip.
- FIG. 5 shows a display screen 102 that displays an alert message 104 in response to a selection of the function Change Drip Setup. The alert message requires a response as to whether previously entered insulin drip setup parameters are to be changed.
- FIG. 6 illustrates a screen 106 that illustratively appears in response to a decision to change drip setup parameters for a selected patient, i.e., John Doe.
- FIGS. 7 through 20 illustrate a series of screens that requests specific information that system 10 will use to determine insulin drip rates for patient John Doe.
- FIG. 7 shows a screen 108 that requires the entry of a number 110 representing the selected patient's (John Doe's) insulin sensitivity factor.
- FIG. 8 shows a screen 112 requesting an entry 114 of the BG level that is desired to be the lower limit of John Doe's target “normal” glucose level range (in this case 80 mg/dl), while
- FIG. 9 shows a screen 116 requesting an entry 118 of the BG level that is desired to be the upper limit of John Doe's target glucose level range (in this case 110 mg/dl).
- FIG. 10 illustrates a screen 120 in which an entry 122 specifies the time in minutes between BG level measurements, i.e., normal recheck interval, when the glucose measurements fall within the target range.
- FIG. 11 shows a screen 124 in which an entry 126 specifies the time in minutes for a modified recheck interval when a BG reading falls below the target range.
- FIG. 12 shows a representative screen 128 that calls for an entry 130 that defines the number of initial BG measurements that must be completed before the initial recheck interval reverts to the normal recheck interval.
- FIG. 13 illustrates a screen 132 that sets a particular initial recheck interval through an entry 134 for a “break-in” period of time when a new insulin drip is established for a patient.
- FIG. 14 illustrates a data entry 136 on screen 138 that specifies the number of minutes, over which the patient's BG measurement has been stable, necessary to allow system 10 to increase the recheck interval time.
- FIG. 15 thus shows in screen 140 via entry 142 the number of minutes that constitute the increased recheck interval.
- FIG. 16 shows a screen 144 in which a data entry 146 is requested to specify a low BG measurement that will cause an alert to be generated and/or displayed indicating that the patient should be treated for hypoglycemia, and calculating the amount of glucose (e.g., D-50 dextrose) solution needed to be administered to the patient.
- glucose e.g., D-50 dextrose
- the alert may be caused to be displayed at the patient's bedside and/or at a central monitoring station, and be of a visual and/or auditory nature, so that nurse 16 is appropriately notified to administer the glucose or dextrose solution to address the patient's hypoglycemia.
- the alert may also cause the necessary amount of the proper solution to be administered directly to the patient without any human intervention.
- FIG. 17 shows a screen 148 that allows an entry 150 of the number of minutes for a “snooze” interval that allows a nurse or caregiver to silence an audible alert or alarm for a limited time if it is not possible to immediately address the underlying condition that caused the alert.
- the alert is generated via a software program that causes the program to determine the proper treatment and automatically administer the necessary drugs or solutions to the patient.
- Additional information may also be entered and used by system 10 , such as a time interval (in minutes) that will issue an alert or warning if a BG measurement has already been done during this interval.
- a time interval in minutes
- a warning screen would typically be displayed if a BG level were entered for a patient before this interval had passed or elapsed.
- FIG. 19 requests an entry 156 , via screen 158 , of a maximum drip rate that is allowed before an independent check or confirmation, such as by the patient's doctor, is needed to proceed.
- FIG. 20 illustrates a screen 160 that requires an entry 162 specifying the number of minutes over which a patient's measured BG level remains stable (e.g., within the normal range) before data relating to weaning the patient from an IV insulin drip to a subcutaneous insulin treatment can be determined or calculated.
- the screen 164 in FIG. 21 signifies via a message 166 that the insulin drip setup program has been completed, and that the patient's current BG measurement can now be entered.
- FIG. 22 shows a screen 168 in which an entry 170 indicates a BG level of 295 mg/dl for patient John Doe.
- a comment field 172 is also provided to enable a doctor, nurse, or other caregiver to record a comment or piece of information that may be useful to other caregivers during a following shift, for example. Comment field 172 is shown as indicating “This sugar is high.”
- FIG. 23 further illustrates an alert message 174 which appears on screen 168 when the previously described BG level of 295 mg/dl is entered, thereby allowing a careful verification of the accuracy of the glucose measurement or, if the measurement accuracy cannot be positively established, a second blood measurement can be taken.
- FIG. 24 shows a status screen 176 that appears once an IV insulin drip is established with patient or individual John Doe.
- Status screen 176 provides a summary of current BG measurement and treatment information concerning John Doe, such as insulin infusion drip rate, last BG reading, and the recheck interval.
- FIG. 25 shows a screen 178 that illustrates a historical summary chart for patient John Doe.
- FIG. 26 shows a screen 180 that provides information needed to wean patient John Doe from an IV insulin drip treatment to the administration of insulin subcutaneously. The information may include, as non-limiting examples, the time over which the current insulin drip rate has been able to maintain John Doe's BG at a stable level, the amount of insulin needed to cover a particular amount of dietary carbohydrate, and the effect on BG level of a particular dose of insulin.
- FIG. 27 shows a screen 182 that is displayed when the action requesting a printed report is selected, in order to verify that the selected action is what was intended to be selected.
- Changes in set-up or default settings can also be made to accommodate patients who encounter wide swings in their BG measurements (e.g., brittle diabetics), or those changes could be made in response to, or in anticipation of, specific events, such as when a hyperglycemic individual intends to engage in an activity that would otherwise cause BG levels to vary beyond normal level, e.g., running a marathon.
- BG measurements e.g., brittle diabetics
Abstract
A blood glucose maintenance system for use by hyperglycemic individuals measures their blood glucose level and calculates an appropriate glucose or insulin dosage based on the measurement. Recheck intervals responsive to dosage history are determined. Warning or alert messages or signals are produced if certain measurements or calculations fall outside established normal ranges. It is particularly useful for patients in a hospital or in-patient environment.
Description
- This invention relates to maintenance of proper glucose levels in hyperglycemic individuals, and in particular, to a system that aids in the correct administration of insulin through the use of computerized insulin dosage calculations that are made with the use of individual-specific information.
- Maintaining proper blood sugar, i.e., glucose, levels is important for hyperglycemic individuals, e.g., diabetics, in order to prevent long term problems such as nerve damage, blindness, and kidney disease. The need to control blood glucose (often referred to as BG) levels is even more important with hyperglycemic patients in critical care situations, such as in hospital intensive care units following surgical procedures, as those patients are more likely to suffer adverse physical effects, e.g., infections, from improperly maintained BG levels. Compounding this problem is the fact that BG levels in such patients may be unstable, necessitating frequent measurements and adjustments of administered insulin dosage. At times the degree of insulin dosage adjustment may be significant, or the calculated dosage amount may be high, so that it is difficult to determine whether the calculated insulin dose is correct or if an error in blood sugar measurement or an equipment malfunction has occurred.
- It is therefore an object of one embodiment of the present invention to provide a system for monitoring patients' blood glucose levels, calculating proper insulin dosages, and providing relevant feedback information and messages to the individual, or when used in a hospital or other in-patient setting, to the patient's physician, nurse, or other caregiver. Variations of BG levels outside a predetermined range results in more frequent BG measurements, while calculated insulin doses that fall outside normally expected levels (either high or low) generate feedback messages and warnings that require additional measurement or caregiver intervention to insure the correct treatment is administered.
-
FIG. 1 is a diagrammatic view of a blood glucose management system in accordance with one embodiment of the present invention. -
FIG. 2 is a flowchart illustrating the operation of a blood glucose management system in accordance with an aspect of the present invention. -
FIG. 3 is a diagrammatic view of a blood glucose management system in accordance with another embodiment of the present invention. -
FIGS. 4 through 27 are representative computer screen images illustrating aspects of the operation of a blood glucose management system in accordance with an embodiment of the present invention. - For the purposes of promoting understanding of the principles of the invention, reference will now be made to the embodiments illustrated in the drawings and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the invention is hereby intended and alterations and modifications in the devices, systems and representations illustrated in the Figures of the drawing, and further applications of the principles of the present invention as illustrated herein being contemplated as would normally occur to one skilled in the art to which the invention relates.
- Referring to
FIG. 1 , there is shown a blood glucose (BG)management system 10 for ahyperglycemic patient 12 who is illustratively being cared for in a hospital critical care setting, e.g., within an intensive care unit following heart surgery, although other patient settings are of course possible. The condition ofpatient 12 onbed 14 is shown as being illustratively monitored directly by a nurse orcaregiver 16, but at least some functions that are performed bynurse 16 could be performed by automatic monitoring (pulse, blood pressure), data entry, and/or intravenous medication delivery equipment (not shown), to name only a few possible examples. For purposes of explaining an embodiment of the present invention,patient 12 is shown as receiving a continuous drip of insulin fromreservoir 18 that is controlled bydrip regulator 20 through an intravenous (IV)line 22. - In operation, nurse 16 tests the blood sugar or glucose level of
patient 12 by a known, available means including, but not limited to, a traditional finger stick using known, commercially available products.Nurse 16 then enters the measured BG level ofpatient 12 intodata handling device 24.Device 24 is illustratively shown as having adisplay 26 and aninput 28.Display 26 may be of any conventional or available display type, such as, for example, a CRT or LCD screen, whileinput 26 may be a computer keyboard, for example. When the patient's measured glucose level has been entered intodevice 24, the entered information is sent viacommunications channel 30 to computer ordata processor 32 which may be located at a central location, such as a nurses' station or hospital-wide patient monitor center.Communications channel 30 may be of the form of a hardwired connection, a local area network, or an internet-based wide area network, to cite a few non-limiting examples. Network access may advantageously provide access to patient data from other hospitals or in-patient facilities, and it can allowpatent 12 to be moved within a networked facility or between network-linked facilities, while still maintaining active monitoring of the patient's condition and providing access to historical patient data.Data processor 32 illustratively comprises a central processing unit (CPU) 34 andmemory 36, which may be of any known or available form, such as, for example, ROM, PROM, RAM, EPROM or EEPROM. Also shown as being connected or associated withdata processor 32 are display 38 (such as, for example, a CRT or LCD screen) andinput device 40, such as a keyboard, for example. -
Data processor 32 evaluates the BG level ofpatient 12 to determine if the glucose level is high or low. If it is low,data processor 32 calculates an appropriate dosage of glucose, typically administered as dextrose (such as that identified as D-50), that is needed to bring the BG level ofpatient 12 back within a predetermined “normal” range. If the BG level is high,data processor 32 calculates a proper insulin drip level that required to restore the BG level ofpatient 12 to the “normal” range. If the BG level is within the “normal” range forpatient 12,data processor 32 calculates a proper insulin drip level sufficient to maintain the BG level ofpatient 12 within the “normal” range. The information is sent back todevice 24 viacommunications channel 30 where it appears ondisplay 26. Nurse orcaregiver 16 then administers dextrose, if needed, or makes any necessary adjustments to dripregulator 20 so that the proper amount ofinsulin 18 is delivered topatient 12. The calculation used byCPU 34 ofdata processor 32 illustratively utilizes a known algorithm identified as the Protocol of Bode et al., and described in an article entitled “Intravenous Insulin Infusion Therapy: Indications, Methods, and Transition to Subcutaneous Insulin Therapy,” Endocrine Practice, Vol. 10 (Suppl. 2), March/April 2004, but a proprietary algorithm or some other proven calculation could be developed or adapted to be suitable as well. -
FIG. 2 illustrates a flowchart which shows aBG management process 41 in accordance with an embodiment of the present invention, which will be used to illustrate the manner in whichBG management system 10 ofFIG. 1 operates. Beginning atstep 42 ofprocess 41, a particular patient is selected for BG monitoring or management bysystem 10. For illustrative purposes, the process ofstep 42 selectscritical care patient 12.Step 44 determines from information provided bystep 42 whetherpatient 12 requires a new insulin drip to be established, or whether a previously established insulin drip is to be restarted. If the drip is to be restarted, information concerning the previous insulin drip forpatient 12 is retrieved fromdatabase 46 and used instep 48 to set initial insulin administration, e.g., drip rate, multiplier and “normal” BG level, data forpatient 12. Having access to known information specific topatient 12 greatly aids in establishing an initial insulin drip rate that will be more accurate, and hence lead to a quicker stabilization of the BG level forpatient 12 than would be possible if a drip rate were started from a nominal average value. Access to this information allowspatient 12 to be temporarily discontinued from a drip without requiring a “break-in” period when the drip is resumed. Ifpatient 12 is a new patient, or if information related to a previous drip is no longer valid, certain initial parameters, such as high and low target BG levels that establish a “normal” range forpatient 12, are set and stored indatabase 46.Process 41 then proceeds tostep 50, which measures the BG level ofpatient 12. InFIG. 1 , the BG level ofpatient 12 is measured manually bynurse 14, and entered intodata handling device 24, which communicates that information todata processor 32.Process 41, includingstep 50, need not be performed manually by a nurse or caregiver, but could be performed automatically without human intervention. The measured BG level is then evaluated atstep 52 to determine if the BG level falls below, within, or above the “normal” range previously established forpatient 12. - If the measured BG level is low (i.e., below the lower limit of the desired BG range),
step 54 calculates the appropriate amount of glucose (e.g., D-50 dextrose) needed bypatient 12. This information is used byprocess 41 atstep 56 to administer the dextrose dose topatient 12.Process 41 then sets an appropriate recheck interval atstep 58, e.g., 15 minutes, at whichtime alarm 60 either provides an audible or visible alert to nurse 16 that it is time to recheck the BG level ofpatient 12. In an automated arrangement,alarm 60 could initiate a new BG check viastep 50 directly. The information determined atstep 58 is also stored indatabase 46 to provide historical data that can be used to generate a complete report aboutpatient 12, re-establish a drip, or more accurately predict the course of treatment needed to control BG levels inpatient 12. - If the evaluation at
step 52 determines that the BG level is high (i.e., above the upper limit of the desired BG range),process 41 calculates the proper insulin drip rate forpatient 12 atstep 62. This insulin dosage is then administered atstep 64, which permits adjustment of the insulin drip rate and volume being given topatient 12 based on the information determined atstep 62. Atstep 66,process 41 then determines an appropriate BG level recheck interval (that is also stored in database 46) forpatient 12. At the end of such interval,alarm 68 provides an alert to a nurse or caregiver that it is time to recheck the BG level ofpatient 12 or, in an automated system or environment, directly initiates a BG level measurement viastep 50. -
Process 41 may incorporate additional alerts that require additional evaluations or determinations in order to proceed, so that improper measurements or data entry, or an equipment malfunction, may be discovered before an incorrect treatment is administered to a patient. Such alerts may, for example, be associated withstep 50 if the BG level measured at a given time is significantly different than that measured previously, or if the previous measurement was done only a short time before. Alerts could also be associated withsteps Process 41 can use the information stored indatabase 46, which creates a permanent archived record for each patient, to create individual patient reports or to determine trends and predictions from statistically analyzing a large amount of data from a number of patients. - Many of the functions of
system 10 that have been described with reference toFIG. 2 may be performed by electronic circuitry and/or with computer software, including but not limited to the steps of determining whether measured or calculated amounts are within normal ranges, issuing alert messages, and setting patient glucose level recheck intervals. Such automation is clearly much more important in an out-patient environment (e.g., diabetics utilizing insulin pumps) than with an in-patient situation where continuous or frequent nursing or other medical care is provided. -
FIG. 3 shows aBG management system 70 that is adapted to handle multiple or even large numbers of patients, and that automatically performs certain functions that were done manually or with human intervention insystem 10 ofFIG. 1 . It is understood, however, that the number of patients and the degree of automation are shown and described for illustrative purposes only, and the aspects and advantages of the present invention are not dependent upon any particular number of patients or the manner in which the operating steps are performed. -
System 70 operates similarly tosystem 10 ofFIG. 1 in that anillustrative patient 72, located on bed orother device 74 in a hospital or other in-patient facility, is administered an insulin drip viaIV tube 76 frominsulin reservoir 78, with the rate and amount of that drip being set bydrip controller 80. The BG level ofpatient 72, however, is measured automatically bymeasurement device 82, rather than manually as was done as bynurse 16 insystem 10 shown inFIG. 1 . For the sake of a more simplified explanation ofsystem 70, the above-described elements associated withpatient 72 can be considered to make up anoverall patient unit 84 a. -
FIG. 3 illustratively shows additionalpatient units controller 86 which coordinates data from the various patient units. The data is provided todata processor 88 in a manner that enablesdata processor 88 to identify the patient unit that is the source of each piece of information. It is understood that the functionality ofcontroller 86 may be incorporated in some other component such that an identifiable discrete element may not be present.Data processor 88 illustratively incorporates a central processing unit (CPU) 90 and amemory unit 92, which may be of any known or otherwise appropriate type. Also shown as being associated withdata processor 88 are input/output (I/O) devices 94 a-d, which illustratively correspond to patient units 84 a-d respectively. It is of course possible that a single or limited number of I/O devices may be provided so that multiple patient units can be accommodated by one I/O device in a multiplexed fashion. Insulin drip rate information is provided to the corresponding drip controllers in each of patient units 84 a-d via output lines 96 a-d. - The operation of
system 70 inFIG. 3 may also be represented by the process that is shown and described in connection withFIG. 2 . Alert signals may be evaluated by automatic failsafe or double checking circuitry, or a human intervener, such as the equivalent ofnurse 16, may be called upon to verify the accuracy of measurements or calculations if they do not appear to fall within “normal” or previously measured limits. -
FIGS. 4 through 26 will now be described as illustrative examples of representative display screens for a computer software program that performs certain of the functions described in connection withsystem 10 and/orsystem 70. For the sake of efficiency and readability in describingFIGS. 4 through 26 , reference will be made solely tosystem 10, although it is understood that references to the operation ofsystem 10 are also applicable tosystem 70 whenever such described function is performed bysystem 70. -
FIG. 4 illustrates one example of an initialsystem status screen 100 that identifies all patients that are under the control of blood glucose management system 10 (in this case only John Doe), with each patient's identification number as well as other data. It is understood that the information provided onscreen 100 is shown for illustrative purposes, and other types of information, such as the ages of the patients, their room number, and medication list, for example, could also be shown.Screen 100 further provides a list of possible actions that may be taken with respect to a given patient, including the action of resuming a previous, e.g., temporarily discontinued, drip, or starting a new drip. If the action to resume a prior drip is selected, for example, a screen (not shown) might then be displayed to verify that the action of resuming a prior drip was intended to be selected.FIG. 5 shows adisplay screen 102 that displays analert message 104 in response to a selection of the function Change Drip Setup. The alert message requires a response as to whether previously entered insulin drip setup parameters are to be changed.FIG. 6 illustrates ascreen 106 that illustratively appears in response to a decision to change drip setup parameters for a selected patient, i.e., John Doe.FIGS. 7 through 20 illustrate a series of screens that requests specific information thatsystem 10 will use to determine insulin drip rates for patient John Doe. The information provided for John Doe would therefore be expected to be different than corresponding information for other patients. By way of example,FIG. 7 shows ascreen 108 that requires the entry of anumber 110 representing the selected patient's (John Doe's) insulin sensitivity factor.FIG. 8 shows ascreen 112 requesting anentry 114 of the BG level that is desired to be the lower limit of John Doe's target “normal” glucose level range (in thiscase 80 mg/dl), whileFIG. 9 shows ascreen 116 requesting anentry 118 of the BG level that is desired to be the upper limit of John Doe's target glucose level range (in thiscase 110 mg/dl). -
FIG. 10 illustrates ascreen 120 in which anentry 122 specifies the time in minutes between BG level measurements, i.e., normal recheck interval, when the glucose measurements fall within the target range.FIG. 11 shows ascreen 124 in which anentry 126 specifies the time in minutes for a modified recheck interval when a BG reading falls below the target range.FIG. 12 shows arepresentative screen 128 that calls for anentry 130 that defines the number of initial BG measurements that must be completed before the initial recheck interval reverts to the normal recheck interval.FIG. 13 illustrates ascreen 132 that sets a particular initial recheck interval through anentry 134 for a “break-in” period of time when a new insulin drip is established for a patient. -
FIG. 14 illustrates adata entry 136 onscreen 138 that specifies the number of minutes, over which the patient's BG measurement has been stable, necessary to allowsystem 10 to increase the recheck interval time.FIG. 15 thus shows inscreen 140 viaentry 142 the number of minutes that constitute the increased recheck interval.FIG. 16 shows a screen 144 in which adata entry 146 is requested to specify a low BG measurement that will cause an alert to be generated and/or displayed indicating that the patient should be treated for hypoglycemia, and calculating the amount of glucose (e.g., D-50 dextrose) solution needed to be administered to the patient. The alert, with the calculated glucose dosage, may be caused to be displayed at the patient's bedside and/or at a central monitoring station, and be of a visual and/or auditory nature, so thatnurse 16 is appropriately notified to administer the glucose or dextrose solution to address the patient's hypoglycemia. The alert may also cause the necessary amount of the proper solution to be administered directly to the patient without any human intervention.FIG. 17 shows ascreen 148 that allows anentry 150 of the number of minutes for a “snooze” interval that allows a nurse or caregiver to silence an audible alert or alarm for a limited time if it is not possible to immediately address the underlying condition that caused the alert. It is of course possible that in an automated system, such assystem 70, for example, the alert is generated via a software program that causes the program to determine the proper treatment and automatically administer the necessary drugs or solutions to the patient. - Additional information may also be entered and used by
system 10, such as a time interval (in minutes) that will issue an alert or warning if a BG measurement has already been done during this interval. This is shown byentry 152 onscreen 154 inFIG. 18 which is designed to protect against an inadvertent duplicate or incorrect patient data entry. A warning screen (not shown) would typically be displayed if a BG level were entered for a patient before this interval had passed or elapsed.FIG. 19 requests anentry 156, viascreen 158, of a maximum drip rate that is allowed before an independent check or confirmation, such as by the patient's doctor, is needed to proceed.FIG. 20 illustrates ascreen 160 that requires anentry 162 specifying the number of minutes over which a patient's measured BG level remains stable (e.g., within the normal range) before data relating to weaning the patient from an IV insulin drip to a subcutaneous insulin treatment can be determined or calculated. Thescreen 164 inFIG. 21 signifies via amessage 166 that the insulin drip setup program has been completed, and that the patient's current BG measurement can now be entered. -
FIG. 22 shows ascreen 168 in which anentry 170 indicates a BG level of 295 mg/dl for patient John Doe. Acomment field 172 is also provided to enable a doctor, nurse, or other caregiver to record a comment or piece of information that may be useful to other caregivers during a following shift, for example.Comment field 172 is shown as indicating “This sugar is high.”FIG. 23 further illustrates analert message 174 which appears onscreen 168 when the previously described BG level of 295 mg/dl is entered, thereby allowing a careful verification of the accuracy of the glucose measurement or, if the measurement accuracy cannot be positively established, a second blood measurement can be taken.FIG. 24 shows astatus screen 176 that appears once an IV insulin drip is established with patient or individual John Doe.Status screen 176 provides a summary of current BG measurement and treatment information concerning John Doe, such as insulin infusion drip rate, last BG reading, and the recheck interval.FIG. 25 shows ascreen 178 that illustrates a historical summary chart for patient John Doe.FIG. 26 shows ascreen 180 that provides information needed to wean patient John Doe from an IV insulin drip treatment to the administration of insulin subcutaneously. The information may include, as non-limiting examples, the time over which the current insulin drip rate has been able to maintain John Doe's BG at a stable level, the amount of insulin needed to cover a particular amount of dietary carbohydrate, and the effect on BG level of a particular dose of insulin. Lastly,FIG. 27 shows ascreen 182 that is displayed when the action requesting a printed report is selected, in order to verify that the selected action is what was intended to be selected. - The previous description has been made based on treatment of hyperglycemic patients in an in-patient medical/surgical setting, such as a hospital or nursing home, as the novel features of the invention lend themselves particularly well to a critical or intensive care setting. The scope of the invention, however, is not limited to an in-patient environment. Significant advantages can also be realized by ambulatory or otherwise healthy individuals with diabetes through the use of, for example, periodic or continuous blood glucose measurement devices and an insulin pump. The manner in which such as system, incorporating one or more embodiments of the present invention, could provide automatic blood glucose measurement and administration of proper insulin amounts while still maintaining sufficient safeguards to protect against an inadvertent application of an incorrect insulin dose due to an equipment malfunction or some incident of human error. Changes in set-up or default settings can also be made to accommodate patients who encounter wide swings in their BG measurements (e.g., brittle diabetics), or those changes could be made in response to, or in anticipation of, specific events, such as when a hyperglycemic individual intends to engage in an activity that would otherwise cause BG levels to vary beyond normal level, e.g., running a marathon.
- While the invention has been illustrated and described in detail in the drawing and foregoing description, the same is to be considered as illustrative and not restrictive in character, it being understood that only the preferred embodiment has been shown and described and that all changes, modifications and equivalents that come within the spirit of the inventions disclosed are desired to be protected. The articles “a”, “an”, “said” and “the” are not limited to a singular element, and include one or more such elements.
Claims (33)
1. A system for maintaining a blood glucose level in an individual comprising:
setup means for establishing a desired range of blood glucose levels for said individual;
measuring means for determining a blood glucose level for said individual;
calculating means responsive to said blood glucose level for determining a proper glucose dosage amount for said individual when said blood glucose level is below said desired range and for determining a proper insulin dosage amount for said individual when said blood glucose level is above said desired range;
delivery means for administering at least one of said glucose dosage amount or said insulin dosage amount to said individual;
evaluation means responsive to said blood glucose level for determining a time interval for said individual after which said individual's blood glucose level is to be re-measured; and
timing means for generating a signal when said time interval has elapsed.
2. The system described in claim 1 , wherein said measuring means operates on a periodic basis.
3. The system described in claim 1 , wherein said measuring means operates on a continuous basis.
4. The system described in claim 1 , wherein said calculating means is further responsive to at least one criteria associated with said individual.
5. The system described in claim 1 , wherein said criteria comprises previously measured blood glucose levels for said individual.
6. The system described in claim 1 , wherein said criteria comprises previously administered insulin delivery dosages for said individual.
7. The system described in claim 1 , wherein said criteria comprises information regarding food previously consumed by said individual.
8. The system described in claim 1 , wherein said individual is a patient in a hospital.
9. The system described in claim 1 , wherein said individual is a resident of a nursing home facility.
10. The system described in claim 1 , wherein said individual is in an out-patient setting.
11.-13. (canceled)
14. The system described in claim 11, wherein said alert signal is visual.
15. The system described in claim 1 , wherein said timing means signal is auditory.
16. The system described in claim 1 , wherein said timing means signal is visual.
17. The system described in claim 1 , wherein said timing means signal is applied to said measurement means for causing said measurement means to measure a blood glucose level for said individual.
18. The system described in claim 1 , wherein said delivery means comprises an insulin pump.
19. A system for maintaining blood glucose levels in a plurality of individuals comprising:
setup means for establishing a desired range of blood glucose levels for each one of said individuals of said plurality of individuals;
measuring means for determining a blood glucose level for each one of said individuals;
calculating means responsive to said blood glucose level for each one of said individuals for determining a proper glucose dosage amount for each one of said individuals whose blood glucose level is below said desired range for said individual and for determining a proper insulin dosage amount for each one of said individuals whose blood glucose level is above said desired range for said individual;
delivery means for administering at least one of said proper glucose dosage amount or said proper insulin dosage amount to each one of said individuals;
evaluation means responsive to said blood glucose level of each one of said individuals for determining a time interval for each one of said individuals after which said individual's blood glucose level is to be re-measured; and
timing means for generating a signal when said time interval for each of one of said individuals has elapsed; and
data storage means for maintaining information from at least one of said setup means, said measuring means, said calculating means, said delivery means, said evaluation means, or said timing means for each one of said individuals.
20. The system described in claim 19 , wherein said calculating means is further responsive to at least one criteria associated with each one of said individuals.
21. The system described in claim 19 , further comprising reporting means coupled to said data storage means for generating time-based reports for each one of said individuals.
22. The system described in claim 19 , further comprising reporting means coupled to said data storage means for generating dosage-based reports for said plurality of individuals.
23. A method for maintaining blood glucose level in an individual comprising the steps of:
establishing a desired range of blood glucose levels for said individual;
measuring a blood glucose level for said individual;
calculating in response to said blood glucose level a proper glucose dosage amount for said individual when said blood glucose level is below said desired range and for calculating a proper insulin dosage amount for said individual when said blood glucose level is above said desired range;
administering at least one of said glucose dosage amount or said insulin dosage amount to said individual;
determining in response to said blood glucose level a time interval for said individual after which said individual's blood glucose level is to be re-measured; and
generating a signal when said time interval has elapsed.
24. The method described in claim 23 , wherein the performance of said steps of measuring a blood glucose level and administering at least one of said dosage amounts require human intervention.
25. The method described in claim 23 , wherein each of said steps is performed without human intervention.
26. The method described in claim 23 , wherein said generated signal causes said blood glucose level of said individual to be re-measured.
27. The method described in claim 23 , wherein said time interval is determined in response to at least one criteria associated with said individual.
28. The method described in claim 27 , wherein said criteria comprises previously measured blood glucose levels for said individual.
29. The method described in claim 27 , wherein said criteria comprises previously administered insulin delivery dosages for said individual.
30. The method described in claim 27 , wherein said criteria comprises information regarding food previously consumed by said individual.
31. The method described in claim 23 , wherein each of said individuals is a patient in a hospital.
32. The method described in claim 23 , wherein each of said individuals is a resident of a nursing home facility.
33. The method described in claim 23 , wherein each of said individuals is in an out-patient setting.
34. The method described in claim 23 , wherein said step of administering said dosage amount is performed by an insulin pump.
35. A method for maintaining blood glucose level in a plurality of individuals comprising the steps of:
establishing a desired range of blood glucose levels for each one of said individuals of said plurality of individuals;
measuring a blood glucose level for each one of said individuals;
calculating in response to said blood glucose level for each one of said individuals a proper glucose dosage amount for one each of said individuals whose blood glucose level is below said desired range for said individual and for calculating a proper insulin dosage amount for each one of said individuals whose blood glucose level is above said desired range for said individual;
administering at least one of said proper glucose dosage amount or said proper insulin dosage amount to each one of said individuals;
determining in response to said blood glucose level for each one of said individuals a time interval for each one of said individuals after which said individual's blood glucose level is re-measured;
generating a signal when said time interval for each one of said individuals has elapsed; and
maintaining information derived from at least one of said steps of establishing, measuring, calculating, administering, determining, or generating.
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Cited By (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9171343B1 (en) | 2012-09-11 | 2015-10-27 | Aseko, Inc. | Means and method for improved glycemic control for diabetic patients |
US9233204B2 (en) | 2014-01-31 | 2016-01-12 | Aseko, Inc. | Insulin management |
US20160088428A1 (en) * | 2011-04-08 | 2016-03-24 | Dexcom, Inc. | Systems and methods for processing and transmitting sensor data |
US9486580B2 (en) | 2014-01-31 | 2016-11-08 | Aseko, Inc. | Insulin management |
US9861745B2 (en) | 2010-03-05 | 2018-01-09 | B. Braun Melsungen Ag | System and method for monitoring time intervals during blood parameter monitoring |
US9886556B2 (en) | 2015-08-20 | 2018-02-06 | Aseko, Inc. | Diabetes management therapy advisor |
US9892234B2 (en) | 2014-10-27 | 2018-02-13 | Aseko, Inc. | Subcutaneous outpatient management |
US9897565B1 (en) | 2012-09-11 | 2018-02-20 | Aseko, Inc. | System and method for optimizing insulin dosages for diabetic subjects |
US11081226B2 (en) | 2014-10-27 | 2021-08-03 | Aseko, Inc. | Method and controller for administering recommended insulin dosages to a patient |
Families Citing this family (136)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6852104B2 (en) | 2002-02-28 | 2005-02-08 | Smiths Medical Md, Inc. | Programmable insulin pump |
US9123077B2 (en) | 2003-10-07 | 2015-09-01 | Hospira, Inc. | Medication management system |
US8065161B2 (en) | 2003-11-13 | 2011-11-22 | Hospira, Inc. | System for maintaining drug information and communicating with medication delivery devices |
US8956291B2 (en) * | 2005-02-22 | 2015-02-17 | Admetsys Corporation | Balanced physiological monitoring and treatment system |
US8323194B2 (en) | 2009-12-18 | 2012-12-04 | Inlight Solutions, Inc. | Detection of bubbles during hemodynamic monitoring when performing automated measurement of blood constituents |
WO2007059476A2 (en) * | 2005-11-15 | 2007-05-24 | Luminous Medical, Inc. | Blood analyte determinations |
US7509156B2 (en) * | 2005-05-18 | 2009-03-24 | Clarian Health Partners, Inc. | System for managing glucose levels in patients with diabetes or hyperglycemia |
US20070078314A1 (en) * | 2005-09-30 | 2007-04-05 | Grounsell Richard L | System and method for measuring and predicting insulin dosing rates |
JP2010507176A (en) | 2006-10-16 | 2010-03-04 | ホスピラ・インコーポレイテツド | System and method for comparing and utilizing dynamic information and configuration information from multiple device management systems |
US20080306353A1 (en) * | 2006-11-03 | 2008-12-11 | Douglas Joel S | Calculation device for metabolic control of critically ill and/or diabetic patients |
WO2008067245A2 (en) * | 2006-11-29 | 2008-06-05 | University Of Maryland, Baltimore | Determining insulin pump rate for tight glycemic control |
US20080154513A1 (en) * | 2006-12-21 | 2008-06-26 | University Of Virginia Patent Foundation | Systems, Methods and Computer Program Codes for Recognition of Patterns of Hyperglycemia and Hypoglycemia, Increased Glucose Variability, and Ineffective Self-Monitoring in Diabetes |
US7734323B2 (en) | 2007-01-24 | 2010-06-08 | Smiths Medical Asd, Inc. | Correction factor testing using frequent blood glucose input |
US20080206799A1 (en) * | 2007-02-27 | 2008-08-28 | Michael Blomquist | Carbohydrate ratio testing using frequent blood glucose input |
US20080228056A1 (en) | 2007-03-13 | 2008-09-18 | Michael Blomquist | Basal rate testing using frequent blood glucose input |
US8758245B2 (en) * | 2007-03-20 | 2014-06-24 | Lifescan, Inc. | Systems and methods for pattern recognition in diabetes management |
US20080234943A1 (en) * | 2007-03-20 | 2008-09-25 | Pinaki Ray | Computer program for diabetes management |
US20080235053A1 (en) * | 2007-03-20 | 2008-09-25 | Pinaki Ray | Communication medium for diabetes management |
US8417311B2 (en) | 2008-09-12 | 2013-04-09 | Optiscan Biomedical Corporation | Fluid component analysis system and method for glucose monitoring and control |
US7751907B2 (en) | 2007-05-24 | 2010-07-06 | Smiths Medical Asd, Inc. | Expert system for insulin pump therapy |
US8221345B2 (en) | 2007-05-30 | 2012-07-17 | Smiths Medical Asd, Inc. | Insulin pump based expert system |
EP2008577A1 (en) * | 2007-06-28 | 2008-12-31 | F.Hoffmann-La Roche Ag | Assembly with infusion pump and measuring device |
CA3105353A1 (en) | 2007-10-10 | 2009-04-16 | Optiscan Biomedical Corporation | Fluid component analysis system and method for glucose monitoring and control |
US9026370B2 (en) | 2007-12-18 | 2015-05-05 | Hospira, Inc. | User interface improvements for medical devices |
US20090177147A1 (en) | 2008-01-07 | 2009-07-09 | Michael Blomquist | Insulin pump with insulin therapy coaching |
US20090177142A1 (en) | 2008-01-09 | 2009-07-09 | Smiths Medical Md, Inc | Insulin pump with add-on modules |
US10624577B2 (en) | 2008-04-04 | 2020-04-21 | Hygieia, Inc. | Systems, devices, and methods for alleviating glucotoxicity and restoring pancreatic beta-cell function in advanced diabetes mellitus |
US9220456B2 (en) | 2008-04-04 | 2015-12-29 | Hygieia, Inc. | Systems, methods and devices for achieving glycemic balance |
CN103400028B (en) * | 2008-04-04 | 2017-04-12 | 海吉雅有限公司 | Device for optimizing patient's insulin dosage regimen |
US20110137208A1 (en) * | 2008-07-24 | 2011-06-09 | Admetsys Corporation | Device and method for automatically sampling and measuring blood analytes |
US7959598B2 (en) | 2008-08-20 | 2011-06-14 | Asante Solutions, Inc. | Infusion pump systems and methods |
WO2010056718A2 (en) | 2008-11-11 | 2010-05-20 | Hygieia, Inc. | Apparatus and system for diabetes management |
US10437962B2 (en) | 2008-12-23 | 2019-10-08 | Roche Diabetes Care Inc | Status reporting of a structured collection procedure |
US8849458B2 (en) | 2008-12-23 | 2014-09-30 | Roche Diagnostics Operations, Inc. | Collection device with selective display of test results, method and computer program product thereof |
US9117015B2 (en) | 2008-12-23 | 2015-08-25 | Roche Diagnostics Operations, Inc. | Management method and system for implementation, execution, data collection, and data analysis of a structured collection procedure which runs on a collection device |
US20120011125A1 (en) | 2008-12-23 | 2012-01-12 | Roche Diagnostics Operations, Inc. | Management method and system for implementation, execution, data collection, and data analysis of a structured collection procedure which runs on a collection device |
US10456036B2 (en) | 2008-12-23 | 2019-10-29 | Roche Diabetes Care, Inc. | Structured tailoring |
US9918635B2 (en) | 2008-12-23 | 2018-03-20 | Roche Diabetes Care, Inc. | Systems and methods for optimizing insulin dosage |
KR101285520B1 (en) | 2008-12-23 | 2013-07-17 | 에프. 호프만-라 로슈 아게 | Structured testing method for diagnostic or therapy support of a patient with a chronic disease and devices thereof |
US8271106B2 (en) | 2009-04-17 | 2012-09-18 | Hospira, Inc. | System and method for configuring a rule set for medical event management and responses |
CN102483775A (en) * | 2009-06-30 | 2012-05-30 | 生命扫描有限公司 | Analyte testing method and system |
CA2766944C (en) * | 2009-06-30 | 2019-10-29 | Lifescan, Inc. | Analyte testing methods and device for calculating basal insulin therapy |
JP5871797B2 (en) * | 2009-06-30 | 2016-03-01 | ライフスキャン・スコットランド・リミテッド | Diabetes management system and method |
EP4276848A3 (en) * | 2009-09-08 | 2024-01-17 | Abbott Diabetes Care, Inc. | Methods and articles of manufacture for hosting a safety critical application on an uncontrolled data processing device |
US20110071464A1 (en) * | 2009-09-23 | 2011-03-24 | Medtronic Minimed, Inc. | Semi-closed loop insulin delivery |
PL2482870T3 (en) | 2009-09-29 | 2018-05-30 | Admetsys Corporation | System and method for differentiating containers in medication delivery |
CA2957595C (en) * | 2009-09-29 | 2020-06-02 | Lifescan Scotland Limited | Analyte testing method and device for diabetes management |
US8882701B2 (en) | 2009-12-04 | 2014-11-11 | Smiths Medical Asd, Inc. | Advanced step therapy delivery for an ambulatory infusion pump and system |
US8771251B2 (en) | 2009-12-17 | 2014-07-08 | Hospira, Inc. | Systems and methods for managing and delivering patient therapy through electronic drug delivery systems |
US9563743B2 (en) * | 2010-02-25 | 2017-02-07 | Lifescan Scotland Limited | Analyte testing method and system with high and low blood glucose trends notification |
US8532933B2 (en) | 2010-06-18 | 2013-09-10 | Roche Diagnostics Operations, Inc. | Insulin optimization systems and testing methods with adjusted exit criterion accounting for system noise associated with biomarkers |
US10561785B2 (en) | 2010-06-22 | 2020-02-18 | Medtronic Minimed, Inc. | Method and/or system for closed-loop control of glucose to a treatment range |
US20120173151A1 (en) | 2010-12-29 | 2012-07-05 | Roche Diagnostics Operations, Inc. | Methods of assessing diabetes treatment protocols based on protocol complexity levels and patient proficiency levels |
US8755938B2 (en) | 2011-05-13 | 2014-06-17 | Roche Diagnostics Operations, Inc. | Systems and methods for handling unacceptable values in structured collection protocols |
US8766803B2 (en) | 2011-05-13 | 2014-07-01 | Roche Diagnostics Operations, Inc. | Dynamic data collection |
WO2013028497A1 (en) | 2011-08-19 | 2013-02-28 | Hospira, Inc. | Systems and methods for a graphical interface including a graphical representation of medical data |
JP6033874B2 (en) | 2011-10-21 | 2016-11-30 | ホスピーラ インコーポレイテッド | Medical device update system |
WO2013090709A1 (en) | 2011-12-16 | 2013-06-20 | Hospira, Inc. | System for monitoring and delivering medication to a patient and method of using the same to minimize the risks associated with automated therapy |
TW201333870A (en) * | 2011-12-21 | 2013-08-16 | 艾登工具股份有限公司 | Systems and methods for determining insulin therapy for a patient |
ES2741725T3 (en) | 2012-03-30 | 2020-02-12 | Icu Medical Inc | Air detection system and method to detect air in a pump of an infusion system |
US9238100B2 (en) | 2012-06-07 | 2016-01-19 | Tandem Diabetes Care, Inc. | Device and method for training users of ambulatory medical devices |
US10463788B2 (en) | 2012-07-31 | 2019-11-05 | Icu Medical, Inc. | Patient care system for critical medications |
US20140060145A1 (en) * | 2012-08-30 | 2014-03-06 | Abbot Diabetes Care Inc. | Analyte Monitoring Methods, Devices and Systems for Recommending Confirmation Tests |
US9504412B2 (en) | 2012-09-17 | 2016-11-29 | Lifescan, Inc. | Method and system to derive glycemic patterns from clustering of glucose data |
US9119529B2 (en) * | 2012-10-30 | 2015-09-01 | Dexcom, Inc. | Systems and methods for dynamically and intelligently monitoring a host's glycemic condition after an alert is triggered |
US9351670B2 (en) | 2012-12-31 | 2016-05-31 | Abbott Diabetes Care Inc. | Glycemic risk determination based on variability of glucose levels |
US10383580B2 (en) | 2012-12-31 | 2019-08-20 | Abbott Diabetes Care Inc. | Analysis of glucose median, variability, and hypoglycemia risk for therapy guidance |
ES2908320T3 (en) | 2013-03-06 | 2022-04-28 | Icu Medical Inc | Medical device communication method |
US10357606B2 (en) | 2013-03-13 | 2019-07-23 | Tandem Diabetes Care, Inc. | System and method for integration of insulin pumps and continuous glucose monitoring |
US10016561B2 (en) | 2013-03-15 | 2018-07-10 | Tandem Diabetes Care, Inc. | Clinical variable determination |
AU2014233094B2 (en) | 2013-03-15 | 2020-07-02 | Abbott Diabetes Care Inc. | System and method to manage diabetes based on glucose median, glucose variability, and hypoglycemic risk |
US10046112B2 (en) | 2013-05-24 | 2018-08-14 | Icu Medical, Inc. | Multi-sensor infusion system for detecting air or an occlusion in the infusion system |
EP3003442B1 (en) | 2013-05-29 | 2020-12-30 | ICU Medical, Inc. | Infusion system and method of use which prevents over-saturation of an analog-to-digital converter |
AU2014274146B2 (en) | 2013-05-29 | 2019-01-24 | Icu Medical, Inc. | Infusion system which utilizes one or more sensors and additional information to make an air determination regarding the infusion system |
RU2673076C2 (en) * | 2013-06-13 | 2018-11-22 | Ф.Хоффманн-Ля Рош Аг | Method and apparatus for characteristic monitoring in conjunction with mode of continuously measured blood glucose values and computer program product |
US20150066531A1 (en) | 2013-08-30 | 2015-03-05 | James D. Jacobson | System and method of monitoring and managing a remote infusion regimen |
US9662436B2 (en) | 2013-09-20 | 2017-05-30 | Icu Medical, Inc. | Fail-safe drug infusion therapy system |
US10311972B2 (en) | 2013-11-11 | 2019-06-04 | Icu Medical, Inc. | Medical device system performance index |
US10042986B2 (en) | 2013-11-19 | 2018-08-07 | Icu Medical, Inc. | Infusion pump automation system and method |
GB2523989B (en) | 2014-01-30 | 2020-07-29 | Insulet Netherlands B V | Therapeutic product delivery system and method of pairing |
JP2015142665A (en) * | 2014-01-31 | 2015-08-06 | セイコーエプソン株式会社 | Blood glucose level measuring unit and blood glucose level measuring method |
JP6291875B2 (en) * | 2014-01-31 | 2018-03-14 | セイコーエプソン株式会社 | Blood sugar level measuring device and blood sugar level measuring method |
ES2776363T3 (en) | 2014-02-28 | 2020-07-30 | Icu Medical Inc | Infusion set and method using dual wavelength in-line optical air detection |
WO2015168427A1 (en) | 2014-04-30 | 2015-11-05 | Hospira, Inc. | Patient care system with conditional alarm forwarding |
WO2015184366A1 (en) | 2014-05-29 | 2015-12-03 | Hospira, Inc. | Infusion system and pump with configurable closed loop delivery rate catch-up |
US9724470B2 (en) | 2014-06-16 | 2017-08-08 | Icu Medical, Inc. | System for monitoring and delivering medication to a patient and method of using the same to minimize the risks associated with automated therapy |
EP3174577A4 (en) | 2014-07-30 | 2018-04-18 | Tandem Diabetes Care, Inc. | Temporary suspension for closed-loop medicament therapy |
US9539383B2 (en) | 2014-09-15 | 2017-01-10 | Hospira, Inc. | System and method that matches delayed infusion auto-programs with manually entered infusion programs and analyzes differences therein |
US11344668B2 (en) | 2014-12-19 | 2022-05-31 | Icu Medical, Inc. | Infusion system with concurrent TPN/insulin infusion |
CN111905188B (en) | 2015-02-18 | 2022-07-22 | 英赛罗公司 | Fluid delivery and infusion device and method of use |
US10850024B2 (en) | 2015-03-02 | 2020-12-01 | Icu Medical, Inc. | Infusion system, device, and method having advanced infusion features |
EP3304370B1 (en) | 2015-05-26 | 2020-12-30 | ICU Medical, Inc. | Infusion pump system and method with multiple drug library editor source capability |
US10987129B2 (en) | 2015-09-04 | 2021-04-27 | Medos International Sarl | Multi-shield spinal access system |
US11672562B2 (en) | 2015-09-04 | 2023-06-13 | Medos International Sarl | Multi-shield spinal access system |
US11439380B2 (en) | 2015-09-04 | 2022-09-13 | Medos International Sarl | Surgical instrument connectors and related methods |
CN113143355A (en) | 2015-09-04 | 2021-07-23 | 美多斯国际有限公司 | Multi-shield spinal access system |
US11744447B2 (en) | 2015-09-04 | 2023-09-05 | Medos International | Surgical visualization systems and related methods |
US10569016B2 (en) | 2015-12-29 | 2020-02-25 | Tandem Diabetes Care, Inc. | System and method for switching between closed loop and open loop control of an ambulatory infusion pump |
WO2017123525A1 (en) | 2016-01-13 | 2017-07-20 | Bigfoot Biomedical, Inc. | User interface for diabetes management system |
EP3443998A1 (en) | 2016-01-14 | 2019-02-20 | Bigfoot Biomedical, Inc. | Adjusting insulin delivery rates |
EP4085944A1 (en) | 2016-05-13 | 2022-11-09 | ICU Medical, Inc. | Infusion pump system with common line auto flush |
WO2017214441A1 (en) | 2016-06-10 | 2017-12-14 | Icu Medical, Inc. | Acoustic flow sensor for continuous medication flow measurements and feedback control of infusion |
NZ750032A (en) | 2016-07-14 | 2020-05-29 | Icu Medical Inc | Multi-communication path selection and security system for a medical device |
EP3515535A1 (en) | 2016-09-23 | 2019-07-31 | Insulet Corporation | Fluid delivery device with sensor |
EP3568859A1 (en) | 2017-01-13 | 2019-11-20 | Bigfoot Biomedical, Inc. | Insulin delivery methods, systems and devices |
EP3758008A1 (en) * | 2017-06-15 | 2020-12-30 | Novo Nordisk A/S | Basal titration with adaptive target glucose level |
US10089055B1 (en) | 2017-12-27 | 2018-10-02 | Icu Medical, Inc. | Synchronized display of screen content on networked devices |
USD928199S1 (en) | 2018-04-02 | 2021-08-17 | Bigfoot Biomedical, Inc. | Medication delivery device with icons |
US11872368B2 (en) | 2018-04-10 | 2024-01-16 | Tandem Diabetes Care, Inc. | System and method for inductively charging a medical device |
CA3099113A1 (en) | 2018-05-04 | 2019-11-07 | Insulet Corporation | Safety constraints for a control algorithm-based drug delivery system |
CN108888246A (en) * | 2018-05-08 | 2018-11-27 | 广西师范大学 | A kind of intelligent nursing system of being hospitalized |
US10964428B2 (en) | 2018-07-17 | 2021-03-30 | Icu Medical, Inc. | Merging messages into cache and generating user interface using the cache |
AU2019306490A1 (en) | 2018-07-17 | 2021-02-04 | Icu Medical, Inc. | Updating infusion pump drug libraries and operational software in a networked environment |
CA3106519A1 (en) | 2018-07-17 | 2020-01-23 | Icu Medical, Inc. | Systems and methods for facilitating clinical messaging in a network environment |
US10861592B2 (en) | 2018-07-17 | 2020-12-08 | Icu Medical, Inc. | Reducing infusion pump network congestion by staggering updates |
US10692595B2 (en) | 2018-07-26 | 2020-06-23 | Icu Medical, Inc. | Drug library dynamic version management |
WO2020023231A1 (en) | 2018-07-26 | 2020-01-30 | Icu Medical, Inc. | Drug library management system |
EP3856285A1 (en) | 2018-09-28 | 2021-08-04 | Insulet Corporation | Activity mode for artificial pancreas system |
US11565039B2 (en) | 2018-10-11 | 2023-01-31 | Insulet Corporation | Event detection for drug delivery system |
USD920343S1 (en) | 2019-01-09 | 2021-05-25 | Bigfoot Biomedical, Inc. | Display screen or portion thereof with graphical user interface associated with insulin delivery |
US20220211941A1 (en) * | 2019-07-19 | 2022-07-07 | Medtrum Technologies Inc. | Integrated drug infusion device |
US11801344B2 (en) | 2019-09-13 | 2023-10-31 | Insulet Corporation | Blood glucose rate of change modulation of meal and correction insulin bolus quantity |
US11935637B2 (en) * | 2019-09-27 | 2024-03-19 | Insulet Corporation | Onboarding and total daily insulin adaptivity |
US11278671B2 (en) | 2019-12-04 | 2022-03-22 | Icu Medical, Inc. | Infusion pump with safety sequence keypad |
US11957875B2 (en) | 2019-12-06 | 2024-04-16 | Insulet Corporation | Techniques and devices providing adaptivity and personalization in diabetes treatment |
US11833329B2 (en) | 2019-12-20 | 2023-12-05 | Insulet Corporation | Techniques for improved automatic drug delivery performance using delivery tendencies from past delivery history and use patterns |
US11551802B2 (en) | 2020-02-11 | 2023-01-10 | Insulet Corporation | Early meal detection and calorie intake detection |
US11547800B2 (en) | 2020-02-12 | 2023-01-10 | Insulet Corporation | User parameter dependent cost function for personalized reduction of hypoglycemia and/or hyperglycemia in a closed loop artificial pancreas system |
US11324889B2 (en) | 2020-02-14 | 2022-05-10 | Insulet Corporation | Compensation for missing readings from a glucose monitor in an automated insulin delivery system |
US11607493B2 (en) | 2020-04-06 | 2023-03-21 | Insulet Corporation | Initial total daily insulin setting for user onboarding |
CA3189781A1 (en) | 2020-07-21 | 2022-01-27 | Icu Medical, Inc. | Fluid transfer devices and methods of use |
US11684716B2 (en) | 2020-07-31 | 2023-06-27 | Insulet Corporation | Techniques to reduce risk of occlusions in drug delivery systems |
US11135360B1 (en) | 2020-12-07 | 2021-10-05 | Icu Medical, Inc. | Concurrent infusion with common line auto flush |
US11904140B2 (en) | 2021-03-10 | 2024-02-20 | Insulet Corporation | Adaptable asymmetric medicament cost component in a control system for medicament delivery |
WO2023049900A1 (en) | 2021-09-27 | 2023-03-30 | Insulet Corporation | Techniques enabling adaptation of parameters in aid systems by user input |
US11439754B1 (en) | 2021-12-01 | 2022-09-13 | Insulet Corporation | Optimizing embedded formulations for drug delivery |
Citations (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5474552A (en) * | 1994-06-27 | 1995-12-12 | Cb-Carmel Biotechnology Ltd. | Implantable drug delivery pump |
US5820622A (en) * | 1994-11-04 | 1998-10-13 | Elan Medical Technologies Limited | Analyte-controlled liquid delivery device and analyte monitor |
US20030032867A1 (en) * | 2001-06-21 | 2003-02-13 | Animas Corporation. | System and method for managing diabetes |
US20030036683A1 (en) * | 2000-05-01 | 2003-02-20 | Kehr Bruce A. | Method, system and computer program product for internet-enabled, patient monitoring system |
US20050038674A1 (en) * | 2003-04-15 | 2005-02-17 | Braig James R. | System and method for managing a chronic medical condition |
US20060253097A1 (en) * | 2004-10-21 | 2006-11-09 | Braig James R | Methods of treating diabetes |
US7267665B2 (en) * | 1999-06-03 | 2007-09-11 | Medtronic Minimed, Inc. | Closed loop system for controlling insulin infusion |
US20080058628A1 (en) * | 2004-08-26 | 2008-03-06 | Robert Hellwig | Insulin bolus recommendation system |
US7509156B2 (en) * | 2005-05-18 | 2009-03-24 | Clarian Health Partners, Inc. | System for managing glucose levels in patients with diabetes or hyperglycemia |
US20090234213A1 (en) * | 2005-02-01 | 2009-09-17 | Medtronic Minimed, Inc. | Algorithm Sensor Augmented Bolus Estimator for Semi-Closed Loop Infusion System |
US20100324382A1 (en) * | 2009-06-17 | 2010-12-23 | Medtronic Minimed, Inc. | Closed-loop glucose and/or insulin control system |
Family Cites Families (21)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3837339A (en) * | 1972-02-03 | 1974-09-24 | Whittaker Corp | Blood glucose level monitoring-alarm system and method therefor |
CA1040271A (en) | 1975-01-22 | 1978-10-10 | Anthony M. Albisser | Artificial beta cell |
IT1142930B (en) * | 1981-11-04 | 1986-10-15 | Luigi Bernardi | PORTABLE APPARATUS THAT INFUSES INSULIN ON THE BASIS OF GLYCEMIC DETECTION |
US4515584A (en) * | 1982-07-06 | 1985-05-07 | Fujisawa Pharmaceutical Co., Ltd. | Artificial pancreas |
IT1170375B (en) * | 1983-04-19 | 1987-06-03 | Giuseppe Bombardieri | Implantable device for measuring body fluid parameters |
US4538616A (en) * | 1983-07-25 | 1985-09-03 | Robert Rogoff | Blood sugar level sensing and monitoring transducer |
EP0165973B1 (en) | 1983-12-16 | 1992-03-11 | AOKI, Thomas Takemi | Insulin delivery algorithm |
DD230730A3 (en) | 1984-01-02 | 1985-12-11 | Zentralinstitut Fuer Diabetes | DEVICE FOR THE PROSPECTIVE AUTOMATIC DETERMINATION OF INDIVIDUAL-SPECIFIC GLUCOSE REGULATION PARAMETERS |
US4634426A (en) | 1984-12-11 | 1987-01-06 | Baxter Travenol Laboratories | Medical infusion controller and user interface |
DE19634577A1 (en) | 1996-08-27 | 1998-03-05 | Eckhard Dipl Phys D Salzsieder | Method and arrangement for determining individual-specific daily profiles of blood sugar concentration, insulin activity and food absorption |
GB9803299D0 (en) | 1998-02-18 | 1998-04-08 | Gallagher George | Improved method and apparatus for monitoring intravenous drips |
US6835175B1 (en) * | 1998-04-10 | 2004-12-28 | Proactive Metabolics Co. | Medical devices for contemporaneous decision support in metabolic control |
US6175752B1 (en) * | 1998-04-30 | 2001-01-16 | Therasense, Inc. | Analyte monitoring device and methods of use |
DE19844252A1 (en) | 1998-09-26 | 2000-03-30 | Hendrik Lehnert | Modular unit for infusing insulin and glucose uses commercially-available computing systems to control automatic analysis and dosing, with upgradability and data exchange functions |
CA2365609A1 (en) * | 1999-02-12 | 2000-08-17 | Cygnus, Inc. | Devices and methods for frequent measurement of an analyte present in a biological system |
AU2001291189A1 (en) | 2000-09-22 | 2002-04-02 | Knobbe, Lim And Buckingham | Method and apparatus for real-time estimation and control of pysiological parameters |
US20030027089A1 (en) | 2001-02-19 | 2003-02-06 | Martin Mueller | Method and device for reducing the acidic pollutant emissions of industrial installations |
US20020130779A1 (en) | 2001-03-13 | 2002-09-19 | Herbert Ford | Intensive care calculator |
US6978286B2 (en) | 2001-08-27 | 2005-12-20 | Francis Mathis, Inc. | Handheld medication dosage calculator |
US20050197553A1 (en) * | 2002-07-30 | 2005-09-08 | Colleen Cooper | Patient management of diabetes treatment |
EP1711791B1 (en) * | 2003-12-09 | 2014-10-15 | DexCom, Inc. | Signal processing for continuous analyte sensor |
-
2005
- 2005-05-18 US US11/131,707 patent/US7509156B2/en active Active
-
2006
- 2006-05-17 CA CA2547224A patent/CA2547224C/en active Active
-
2008
- 2008-12-17 US US12/337,157 patent/US20090099438A1/en not_active Abandoned
-
2016
- 2016-07-07 US US15/203,978 patent/US20160310668A1/en not_active Abandoned
-
2017
- 2017-12-20 US US15/848,183 patent/US20180117250A1/en not_active Abandoned
Patent Citations (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5474552A (en) * | 1994-06-27 | 1995-12-12 | Cb-Carmel Biotechnology Ltd. | Implantable drug delivery pump |
US5820622A (en) * | 1994-11-04 | 1998-10-13 | Elan Medical Technologies Limited | Analyte-controlled liquid delivery device and analyte monitor |
US7267665B2 (en) * | 1999-06-03 | 2007-09-11 | Medtronic Minimed, Inc. | Closed loop system for controlling insulin infusion |
US20030036683A1 (en) * | 2000-05-01 | 2003-02-20 | Kehr Bruce A. | Method, system and computer program product for internet-enabled, patient monitoring system |
US20030032867A1 (en) * | 2001-06-21 | 2003-02-13 | Animas Corporation. | System and method for managing diabetes |
US20050038674A1 (en) * | 2003-04-15 | 2005-02-17 | Braig James R. | System and method for managing a chronic medical condition |
US20080058628A1 (en) * | 2004-08-26 | 2008-03-06 | Robert Hellwig | Insulin bolus recommendation system |
US20060253097A1 (en) * | 2004-10-21 | 2006-11-09 | Braig James R | Methods of treating diabetes |
US20090234213A1 (en) * | 2005-02-01 | 2009-09-17 | Medtronic Minimed, Inc. | Algorithm Sensor Augmented Bolus Estimator for Semi-Closed Loop Infusion System |
US7509156B2 (en) * | 2005-05-18 | 2009-03-24 | Clarian Health Partners, Inc. | System for managing glucose levels in patients with diabetes or hyperglycemia |
US20100324382A1 (en) * | 2009-06-17 | 2010-12-23 | Medtronic Minimed, Inc. | Closed-loop glucose and/or insulin control system |
Non-Patent Citations (2)
Title |
---|
Dextrose 10% or 50% in the treatment of hypoglycaemia out of hospital? A randomised controlled trial; C Moore, M Woollard; Emerg Med J 2005;22: 512-525 * |
Severe Hypoglycemia in Adults; MF Carroll, MR Burge, DS Schade; Reviews in Endocrine & Metabolic Disorders 2003;4:149-157 * |
Cited By (46)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9861745B2 (en) | 2010-03-05 | 2018-01-09 | B. Braun Melsungen Ag | System and method for monitoring time intervals during blood parameter monitoring |
US20160088428A1 (en) * | 2011-04-08 | 2016-03-24 | Dexcom, Inc. | Systems and methods for processing and transmitting sensor data |
US9897565B1 (en) | 2012-09-11 | 2018-02-20 | Aseko, Inc. | System and method for optimizing insulin dosages for diabetic subjects |
US9483619B2 (en) | 2012-09-11 | 2016-11-01 | Aseko, Inc. | Means and method for improved glycemic control for diabetic patients |
US11733196B2 (en) | 2012-09-11 | 2023-08-22 | Aseko, Inc. | System and method for optimizing insulin dosages for diabetic subjects |
US10102922B2 (en) | 2012-09-11 | 2018-10-16 | Aseko, Inc. | Means and method for improved glycemic control for diabetic patients |
US11131643B2 (en) | 2012-09-11 | 2021-09-28 | Aseko, Inc. | Method and system for optimizing insulin dosages for diabetic subjects |
US10629294B2 (en) | 2012-09-11 | 2020-04-21 | Aseko, Inc. | Means and method for improved glycemic control for diabetic patients |
US9171343B1 (en) | 2012-09-11 | 2015-10-27 | Aseko, Inc. | Means and method for improved glycemic control for diabetic patients |
US9811638B2 (en) | 2012-09-11 | 2017-11-07 | Aseko, Inc. | Means and method for improved glycemic control for diabetic patients |
US10410740B2 (en) | 2012-09-11 | 2019-09-10 | Aseko, Inc. | Means and method for improved glycemic control for diabetic patients |
US9773096B2 (en) | 2012-09-11 | 2017-09-26 | Aseko, Inc. | Means and method for improved glycemic control for diabetic patients |
US9965596B2 (en) | 2012-09-11 | 2018-05-08 | Aseko, Inc. | Means and method for improved glycemic control for diabetic patients |
US11158424B2 (en) | 2014-01-31 | 2021-10-26 | Aseko, Inc. | Insulin management |
US10811133B2 (en) | 2014-01-31 | 2020-10-20 | Aseko, Inc. | System for administering insulin boluses to a patient |
US9892235B2 (en) | 2014-01-31 | 2018-02-13 | Aseko, Inc. | Insulin management |
US20180122505A1 (en) * | 2014-01-31 | 2018-05-03 | Aseko, Inc. | Insulin Management |
US9898585B2 (en) | 2014-01-31 | 2018-02-20 | Aseko, Inc. | Method and system for insulin management |
US9965595B2 (en) | 2014-01-31 | 2018-05-08 | Aseko, Inc. | Insulin management |
US9504789B2 (en) | 2014-01-31 | 2016-11-29 | Aseko, Inc. | Insulin management |
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US9486580B2 (en) | 2014-01-31 | 2016-11-08 | Aseko, Inc. | Insulin management |
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US10535426B2 (en) | 2014-01-31 | 2020-01-14 | Aseko, Inc. | Insulin management |
US9710611B2 (en) | 2014-01-31 | 2017-07-18 | Aseko, Inc. | Insulin management |
US10255992B2 (en) | 2014-01-31 | 2019-04-09 | Aseko, Inc. | Insulin management |
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US11081233B2 (en) | 2014-01-31 | 2021-08-03 | Aseko, Inc. | Insulin management |
US11783945B2 (en) | 2014-01-31 | 2023-10-10 | Aseko, Inc. | Method and system for insulin infusion rate management |
US11490837B2 (en) | 2014-01-31 | 2022-11-08 | Aseko, Inc. | Insulin management |
US11804300B2 (en) | 2014-01-31 | 2023-10-31 | Aseko, Inc. | Insulin management |
US11311213B2 (en) | 2014-01-31 | 2022-04-26 | Aseko, Inc. | Insulin management |
US11468987B2 (en) | 2014-01-31 | 2022-10-11 | Aseko, Inc. | Insulin management |
US10128002B2 (en) | 2014-10-27 | 2018-11-13 | Aseko, Inc. | Subcutaneous outpatient management |
US10403397B2 (en) | 2014-10-27 | 2019-09-03 | Aseko, Inc. | Subcutaneous outpatient management |
US11081226B2 (en) | 2014-10-27 | 2021-08-03 | Aseko, Inc. | Method and controller for administering recommended insulin dosages to a patient |
US11678800B2 (en) | 2014-10-27 | 2023-06-20 | Aseko, Inc. | Subcutaneous outpatient management |
US11694785B2 (en) | 2014-10-27 | 2023-07-04 | Aseko, Inc. | Method and dosing controller for subcutaneous outpatient management |
US9892234B2 (en) | 2014-10-27 | 2018-02-13 | Aseko, Inc. | Subcutaneous outpatient management |
US10380328B2 (en) | 2015-08-20 | 2019-08-13 | Aseko, Inc. | Diabetes management therapy advisor |
US11574742B2 (en) | 2015-08-20 | 2023-02-07 | Aseko, Inc. | Diabetes management therapy advisor |
US11200988B2 (en) | 2015-08-20 | 2021-12-14 | Aseko, Inc. | Diabetes management therapy advisor |
US9886556B2 (en) | 2015-08-20 | 2018-02-06 | Aseko, Inc. | Diabetes management therapy advisor |
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CA2547224A1 (en) | 2006-11-18 |
US20160310668A1 (en) | 2016-10-27 |
US20180117250A1 (en) | 2018-05-03 |
CA2547224C (en) | 2014-05-13 |
US20060264895A1 (en) | 2006-11-23 |
US7509156B2 (en) | 2009-03-24 |
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