Insulin and pramlintide delivery systems, methods, and devices
The present disclosure relates to systems and methods for controlling physiological glucose concentrations in a patient.
1. A system to control glucose in a patient, the system comprising:
a medication delivery device configured to deliver medication to the patient; and
a controller in communication with the medication delivery device and including control logic operative to calculate a bolus delivery schedule comprising an initial bolus delivery amount and a delayed bolus delivery amount, wherein the initial bolus delivery amount relative to the delayed bolus delivery amount is based, at least in part, on a pre-meal glucose level.
2. The system of claim 1 , wherein the initial bolus delivery amount and the delayed bolus delivery amount are based, at least in part, on comparing a pre-meal glucose level to an upper threshold and a lower threshold.
3. The system of claim 2 , wherein the initial bolus delivery amount is greater than the delayed bolus delivery amount when the pre-meal glucose level is greater than the upper threshold.
4. The system of claim 2 , wherein the delayed bolus delivery amount is half the initial bolus delivery amount.
5. The system of claim 4 , wherein the initial bolus delivery amount is equal to the delayed bolus delivery amount when the pre-meal glucose level is between than the lower threshold and the upper threshold.
6. The system of claim 2 , wherein the initial bolus delivery amount is less than the delayed bolus delivery amount when the pre-meal glucose level is less than the lower threshold.
7. The system of claim 2 , wherein the upper threshold is 8 mmol/L and the lower threshold is 6 mmol/L.
8. The system of claim 1 , wherein the initial bolus delivery amount is delivered in a first delivery and the delayed bolus delivery amount is delivered in a second delivery and a third delivery.
9. The system of claim 8 , wherein the first, second, and third deliveries are scheduled 5-15 minutes apart from each other.
10. The system of claim 1 , wherein the initial bolus delivery amount and the delayed bolus delivery amount comprise insulin and pramlintide.
11. The system of claim 10 , wherein the insulin and the pramlintide are delivered as a co-formulation.
12. The system of claim 10 , wherein the insulin and the pramlintide are delivered separately.
13. The system of claim 10 , wherein the insulin and the pramlintide are delivered at a fixed ratio.
14. The system of claim 10 , wherein the fixed ratio is 6 μg/u.
15. The system of claim 1 , wherein the medication delivery device comprises a single reservoir for storing medication.
16. The system of claim 1 , wherein the medication delivery device comprises 2 or 3 reservoirs for storing medication.
17. The system of claim 16 , wherein the medication delivery device includes a single injector.
18. The system of claim 16 , wherein the medication delivery device includes multiple injectors.
19. The system of claim 1 , wherein the medication delivery device includes a single pump.
20. The system of claim 1 , wherein the medication delivery device includes multiple pumps.
21. The system of claim 1 , wherein the initial bolus delivery amount is 75% of a total calculated bolus and the delayed bolus delivery amount is 25% of the total calculated bolus.
22. The system of claim 1 , wherein the initial bolus delivery amount is 25-50% of a total calculated bolus and the delayed bolus delivery amount is 50-75% of the total calculated bolus.
23. The system of claim 22 , wherein the delayed bolus delivery amount is allocated based on a function of a current or estimated glucose level.
24. The system of claim 1 , wherein the delayed bolus delivery amount is allocated between two bolus deliveries that are substantially equal to each other.
25. The system of claim 1 , wherein the initial bolus delivery amount and the delayed bolus delivery amount are based, at least in part, on a carbohydrate content of a meal.
26. The system of claim 25 , wherein the delayed bolus delivery amount is decreased if a carbohydrate content of a meal is less than a predetermined threshold.
27. The system of claim 26 , wherein the predetermined threshold is 30-50 grams.
28. The system of claim 1 , wherein the medication delivery device is configured to deliver insulin to the patient, in response to the calculated bolus delivery schedule.
29. The system of claim 1 , further comprising: a user interface in communication with the controller and configured to receive input from the patient.
30. The system of claim 1 , further comprising: a glucose measurement device in communication with the controller and configured to measure glucose data associated with the patient.
31. A system to control glucose in a patient, the system comprising: a medication delivery device configured to deliver medication to the patient; and means for calculating a bolus delivery schedule comprising an initial bolus delivery amount and a delayed bolus delivery amount based, at least in part, on a pre-meal glucose level.
32. The system of claim 31 , wherein the initial bolus delivery amount relative to the delayed bolus delivery amount is based, at least in part, on a pre-meal glucose level.