Detection of prolonged postprandial hyperglycemia, glycemic peak linear prediction and insulin delivery adjustment
Postprandial glycemic peak can be predicted from a pre-prandial glucose measurement and a postprandial measurement few minutes after a meal defining a glucose rise rate. A linear relationship gives the peak glucose increase from the glucose rise rate. Hence, peak characteristics are obtained. Accurate peak prediction given known error margins is strongly correlated with healthy two-hour postprandial hyperglycemia profiles. Consequently, accuracy of the peak predictions is used to infer risks of postprandial hyperglycemia substantially prolonged beyond two hours. Appropriate correction of insulin intradermic delivery is then taken early in the process.
1 . A computer-aided method of predicting a postprandial glycemic peak of an individual and adjusting insulin delivery to the individual, comprising:
obtaining, from a glucose sensor, blood glucose level measurements of the individual, including one pre-prandial blood glucose level measurement,
determining a postprandial glucose change rate from the pre-prandial blood glucose level measurement and one postprandial blood glucose level measurement,
based on a linear inference, determining a peak glucose level from the determined postprandial glucose change rate and from the pre-prandial blood glucose level measurement, and
issuing, based on the inferred peak glucose level, a control signal to an insulin delivery device to adjust insulin delivery to the individual.
2 . The method of claim 1 , wherein the postprandial glucose change rate is determined from the pre-prandial blood glucose level measurement and only one postprandial blood glucose level measurement.
3 . The method of claim 2 , wherein a peak glucose increase is linearly inferred from the determined postprandial glucose change rate and the peak glucose level is a sum of the pre-prandial blood glucose level measurement with the peak glucose increase.
4 . The method of claim 3 , wherein a peak time is determined that is a sum of a ratio between the peak glucose increase and the postprandial glucose change rate with a pre-prandial time of the pre-prandial blood glucose level measurement.
5 . The method of claim 1 , wherein a peak glucose increase is linearly inferred from the determined postprandial glucose change rate, and the peak glucose level is a sum of the pre-prandial blood glucose level measurement with the peak glucose increase.
6 . The method of claim 5 , wherein a peak time is determined that is a sum of a ratio between the peak glucose increase and the postprandial glucose change rate with a pre-prandial time of the pre-prandial blood glucose level measurement.
7 . A method of assisting a diabetic individual in managing insulin delivery, using a glucose sensor and measurements of blood glucose levels of the individual, the method comprising:
computer-predicting a postprandial peak glucose level using the method of claim 1 ,
determining whether additional blood glucose level measurements include a measured postprandial peak glucose level matching the predicted postprandial peak glucose level, and
in response to a determination that the measured postprandial peak glucose level does not match the predicted postprandial peak glucose level, issuing a control signal to an insulin delivery device to adjust insulin delivery to the individual.
8 . The method of claim 7 , wherein determining whether the measured postprandial peak glucose level matches the predicted postprandial peak glucose level includes determining whether a determined peak time of the measured postprandial peak glucose level equals a predicted peak time of the predicted postprandial peak glucose level given a time margin, and/or whether the measured postprandial peak glucose level equals the predicted postprandial peak glucose level given a glucose margin.
9 . The method of claim 8 , wherein the glucose margin is at least +/−5% and at most +/−25% of the predicted postprandial peak glucose level or the measured postprandial peak glucose level.
10 . The method of claim 9 , wherein the time margin is at least +/−5 min and at most +/−25 min.
11 . The method of claim 9 , wherein the measured postprandial peak glucose level and determined peak time respectively correspond to a local maximum blood glucose level measured during a postprandial time period and to a corresponding measurement time.
12 . The method of claim 8 , wherein the time margin is at least +/−5 min and at most +/−25 min.
13 . The method of claim 8 , wherein the measured postprandial peak glucose level and determined peak time respectively correspond to a local maximum blood glucose level measured during a postprandial time period and to a corresponding measurement time.
14 . The method of claim 8 , wherein the glucose margin is at least +/−15% and at most +/−20% of the predicted postprandial peak glucose level or the measured postprandial peak glucose level.
15 . The method of claim 8 , wherein the time margin is at least +/−15 min and at most +/−20 min.
16 . A non-transitory computer-readable medium storing a program which, when executed by a microprocessor or computer system in a device, causes the device to perform the method of claim 1 .
17 . A computer device comprising:
a glucose sensor configured to obtain blood glucose level measurements of an individual, including one pre-prandial blood glucose level measurement,
a postprandial glycemia rate unit configured to determine a postprandial glucose change rate from the pre-prandial blood glucose level measurement and one postprandial blood glucose level measurement,
a peak determination unit configured to use linear inference to determine a peak glucose level from the determined postprandial glucose change rate and from the pre-prandial blood glucose level measurement, and
an insulin delivery device configured to receive a control signal based on the determined peak glucose level and to adjust insulin delivery to the individual in response thereto.
18 . The computer device of claim 17 , wherein the postprandial glycemia rate unit is configured to determine the postprandial glucose change rate from the pre-prandial blood glucose level measurement and only one postprandial blood glucose level measurement.
19 . A system comprising:
a computer device according to claim 17 configured to predict a postprandial glycemic peak based on some blood glucose level measurements,
a matching peak determination unit configured to determine whether additional blood glucose level measurements include a measured postprandial glycemic peak matching the predicted postprandial glycemic peak, and
a signal emitting unit configured to, in response to a determination that the measured postprandial glycemic peak does not match the predicted postprandial glycemic peak, issue the control signal to the insulin delivery device to adjust insulin delivery to the individual.
20 . A non-transitory computer-readable medium storing a program which, when executed by a microprocessor or computer system in a device, causes the device to perform the method of claim 7 .