System and method for switching between closed loop and open loop control of an ambulatory infusion pump
An infusion pump system providing therapy to a patient in a closed-loop or semi-closed loop mode can safely automatically revert to open-loop therapy. The system stores a default open-loop basal rate profile in memory. The system also continually tracks the insulin on board for the patient over a plurality of closed-loop therapy intervals. When an error or event occurs requiring reversion to open-loop therapy, the system automatically provides therapy according to the open-loop basal rate profile and the tracked insulin on board amount.
1. An infusion pump system, comprising:
a pump mechanism configured to facilitate delivery of a medicament to a patient;
a memory adapted to store parameters relating to delivery of the medicament, including an open-loop basal rate profile for the patient;
a communications device adapted to receive information from a continuous glucose monitoring system; and
a processor functionally linked to the pump mechanism, the memory and the communications device to obtain the information from the continuous glucose monitoring system, the processor configured to:
cause the pump mechanism to deliver the medicament to the patient in a closed-loop mode in which therapy parameters are automatically determined and medicament is automatically delivered according to the therapy parameters based on the information from the continuous glucose monitoring system;
continually track an amount of insulin on board in the patient during closed-loop mode;
detect that an error has occurred, the error requiring reversion from closed-loop mode to an open-loop mode; and
cause the pump mechanism to begin to deliver the medicament to the patient in the open-loop mode in amounts according to the open-loop basal rate profile stored in memory and the amount of insulin on board in the patient in response to detection of the error.
2. The infusion pump system of claim 1 , wherein the processor is configured to deliver the medicament to the patient in the closed-loop mode for a plurality of time intervals,
wherein continually tracking the amount of insulin on board includes tracking the amount of insulin on board over a first time interval, and
wherein the processor is further configured to modify the open-loop basal rate profile stored in memory after the first time interval based on the tracked amount of insulin on board over the first time interval.
3. The infusion pump system of claim 2 , wherein continually tracking the amount of insulin on board includes tracking the amount of insulin on board for each subsequent time interval after the first time interval, and
wherein the processor is configured to modify the open-loop basal rate profile stored in memory after each of the subsequent time intervals based on the tracked amount of insulin on board over each of the respective subsequent time intervals.
4. The infusion pump system of claim 1 , wherein the error is selected from the set consisting of: a calibration error of a sensor of the continuous glucose monitoring system, a failure to calibrate the sensor within a calibration time interval, a failure of the sensor, an expiration of the sensor, a loss of signal between the sensor and the continuous glucose monitoring system, a loss of signal between the sensor and the processor, and a loss of signal between the continuous glucose monitoring system and the processor.
5. The infusion pump system of claim 1 , wherein the processor is further configured to determine the therapy parameters for the closed-loop mode.
6. The infusion pump system of claim 1 , wherein the processor is further configured to receive the therapy parameters for the closed-loop mode from a separate device.
7. The infusion pump system of claim 1 , wherein a portion of the continuous glucose monitoring system is incorporated into a common housing with the pump mechanism, memory, communications device and processor, and wherein the communications device is configured to receive the information directly from a sensor of the continuous glucose monitoring system.
8. The infusion pump system of claim 1 , wherein the communications device is configured to receive the information from a continuous glucose monitor receiver of the continuous glucose monitoring system.
9. The infusion pump system of claim 1 , wherein the processor is further configured to calculate the amount of insulin on board based on a difference between an amount of insulin delivered to the patient over a time interval during closed-loop mode and an amount of insulin in the open-loop basal rate profile over the time interval.
10. An infusion pump system, comprising:
a pump mechanism configured to facilitate delivery of a medicament to a patient;
a memory adapted to store parameters relating to delivery of the medicament, including an open-loop basal rate profile for the patient; and
a processor functionally linked to the pump mechanism and the memory, the processor configured to:
receive information from a continuous glucose monitoring system;
cause the pump mechanism to automatically deliver the medicament to the patient based on therapy parameters automatically determined based on the information from the continuous glucose monitoring system;
continually track an amount of insulin on board in the patient while automatically delivering the medicament based on the therapy parameters;
detect an error pertaining to the continuous glucose monitoring system; and
cause the pump mechanism to cease automatically delivering the medicament based on the therapy parameters and to begin to deliver the medicament in amounts according to the open-loop basal rate profile stored in memory and the amount of insulin on board in the patient in response to detection of the error.
11. The infusion pump system of claim 10 , wherein the processor is configured to automatically deliver the medicament to the patient based on the therapy parameters for a plurality of time intervals,
wherein continually tracking the amount of insulin on board includes tracking the amount of insulin on board over a first time interval and
wherein the processor is further configured to modify the open-loop basal rate profile stored in memory after the first time interval based on the tracked amount of insulin on board over the first time interval.
12. The infusion pump system of claim 11 , wherein continually tracking the amount of insulin on board includes tracking the amount of insulin on board for each subsequent time interval after the first time interval, and
wherein the processor is configured to modify the open-loop basal rate profile stored in memory after each of the subsequent time intervals based on the tracked amount of insulin on board over each of the respective subsequent time intervals.
13. The infusion pump system of claim 10 , wherein the error is selected from the set consisting of: a calibration error of a sensor of the continuous glucose monitoring system, a failure to calibrate the sensor within a calibration time interval, a failure of the sensor, an expiration of the sensor, a loss of signal between the sensor and the continuous glucose monitoring system, a loss of signal between the sensor and the processor and a loss of signal between the continuous glucose monitoring system and the processor.
14. The infusion pump system of claim 10 , wherein the processor is further configured to determine the therapy parameters.
15. The infusion pump system of claim 10 , wherein the processor is further configured to receive the therapy parameters from a separate device.
16. The infusion pump system of claim 10 , wherein a portion of the continuous glucose monitoring system is incorporated into a common housing with the pump mechanism, memory and processor, and wherein the processor is configured to receive the information directly from a sensor of the continuous glucose monitoring system.
17. The infusion pump system of claim 10 , wherein the processor is configured to receive the information from a continuous glucose monitor receiver of the continuous glucose monitoring system.
18. The infusion pump system of claim 10 , wherein the processor is further configured to calculate the amount of insulin on board based on a difference between an amount of insulin delivered to the patient over a time interval when medicament is automatically delivered according to the therapy parameters and an amount of insulin in the open-loop basal rate profile over the time interval.
19. An infusion pump system, comprising:
an infusion pump including a pump mechanism configured to facilitate delivery of a medicament to a patient;
a continuous glucose monitoring system configured to obtain information from which estimated blood glucose levels of the patient are determined; and
a processor configured to:
cause the infusion pump to deliver the medicament to the patient in a closed-loop mode in which therapy parameters are automatically determined and medicament is automatically delivered according to the therapy parameters based on the estimated blood glucose levels;
continually track an amount of insulin on board in the patient during closed-loop mode;
detect that an error has occurred, the error requiring reversion from closed-loop mode to an open-loop mode; and
cause the infusion pump to begin to deliver the medicament to the patient in the open-loop mode in amounts according to an open-loop basal rate profile and the amount of insulin on board in the patient in response to detection of the error.
20. The infusion pump system of claim 19 , wherein the processor is disposed in one of the infusion pump, the continuous glucose monitoring system, or a third device separate from the infusion pump and the continuous glucose monitoring system.