Insulin management
A method of administering insulin includes receiving glucose measurements of a patient at a data processing device from a continuous glucose monitoring system. The glucose measurements are separated by a time interval. The method also includes receiving patient information at the data processing device and selecting a subcutaneous insulin treatment from a collection of subcutaneous insulin treatments. The selection is based on the glucose measurements and the patient information. The selection includes one or more of a subcutaneous standard program, a subcutaneous program without meal boluses, a meal-by-meal subcutaneous program without carbohydrate counting, a meal-by-meal subcutaneous program with carbohydrate counting, and a subcutaneous program for non-diabetic patients. The method also includes executing, using the data processing device, the selected subcutaneous insulin treatment.
1. A computer-implemented method executed on data processing hardware that causes the data processing hardware to perform operations comprising:
receiving a glucose measurement of a patient;
obtaining a Carbohydrate-to-Insulin Ratio for the patient;
determining an adjustment factor based on the received glucose measurement;
adjusting the Carbohydrate-to-Insulin Ratio for the patient by dividing the Carbohydrate-to-Insulin Ratio by the adjustment factor;
determining a recommended meal bolus for the determined glucose type based on the adjusted Carbohydrate-to-Insulin Ratio, the recommended meal bolus corresponding to a number of units of rapid-acting insulin to be administered to the patient at a time of day of the received glucose measurement to bring and maintain the patient's glucose level into a target range; and
displaying on a display, at the time of day of the received glucose measurement, the number of units of rapid-acting insulin corresponding to the recommended meal bolus for the patient to administer.
2. The computer-implemented method of claim 1 , wherein receiving the glucose measurement of the patient comprises receiving the glucose measurement from a continuous glucose monitoring system.
3. The computer-implemented method of claim 1 , wherein the operations further comprise transmitting the recommended meal bolus to an administration device in communication with the data processing hardware, the administration device comprising:
a doser; and
an administration computing device in communication with the doser, the administration computing device configured to cause the doser to administer a number of units of insulin to the patient using the recommended meal bolus.
4. The computer-implemented method of claim 1 , wherein the operations further comprise determining a pre-meal correction bolus by calculating:
CB=(BG−BG Target )/CF,
wherein CB is the pre-meal correction bolus, BG is the received glucose measurement, BG Target is a target glucose value of a patient, and CF is a correction factor.
5. The computer-implemented method of claim 1 , wherein determining the adjustment factor comprises:
determining a value of the glucose measurement is within one of a plurality of target ranges of values; and
setting the adjustment factor to a target adjustment factor associated with the corresponding target range of values that includes the glucose measurement.
6. The computer-implemented method of claim 5 , wherein the plurality of target ranges of values comprises:
a first target range of values including glucose values less than a first configurable constant;
a second target range of values including glucose values greater than or equal to the first configurable constant and less than a low target glucose value of a target glucose range for the patient;
a third target range of values including glucose values greater than or equal to the low target glucose value and less than a high target glucose value of the target glucose range;
a fourth target range of values including glucose values greater than or equal to the high target glucose value and less than a second configurable constant;
a fifth target range of values including glucose values greater than or equal to the second configurable constant and less than a third configurable constant; and
a sixth target range of values including glucose values greater than or equal to the third configurable constant.
7. The computer-implemented method of claim 1 , wherein determining the recommended meal bolus comprises:
receiving a number of carbohydrates to be consumed by the patient for a meal associated with time of day of the glucose measurement; and
dividing the received number of carbohydrates by the adjusted Carbohydrate-to-Insulin Ratio.
8. The computer-implemented method of claim 1 , wherein the operations further comprise:
determining the glucose measurement comprises a pre-lunch glucose measurement,
wherein adjusting the Carbohydrate-to-Insulin Ratio for the patient comprises:
obtaining a previous Carbohydrate-to-Insulin Ratio for breakfast; and
determining a recommended Carbohydrate-to-Insulin Ratio for lunch by dividing the previous Carbohydrate-to-Insulin Ratio for breakfast by the adjustment factor.
9. The computer-implemented method of claim 1 , wherein the operations further comprise:
determining the glucose measurement comprises a pre-dinner glucose measurement,
wherein adjusting the Carbohydrate-to-Insulin Ratio for the patient comprises:
obtaining a previous Carbohydrate-to-Insulin Ratio for lunch; and
determining a recommended Carbohydrate-to-Insulin Ratio for dinner by dividing the previous Carbohydrate-to-Insulin Ratio for lunch by the adjustment factor.
10. The computer-implemented method of claim 1 , wherein the operations further comprise:
determining the glucose measurement comprises a pre-breakfast glucose measurement,
wherein adjusting the Carbohydrate-to-Insulin Ratio for the patient comprises:
obtaining a previous Carbohydrate-to-Insulin Ratio for dinner;
obtaining a previous bedtime glucose measurement;
determining a bedtime adjustment factor based on the previous bedtime glucose measurement; and
determining a recommended Carbohydrate-to-Insulin Ratio for breakfast by dividing the previous Carbohydrate-to-Insulin Ratio for dinner by the bedtime adjustment factor.
11. A system comprising:
data processing hardware; and
memory hardware in communication with the data processing hardware and storing instructions that when executed on the data processing hardware causes the data processing hardware to perform operations comprising:
receiving a glucose measurement of a patient;
obtaining a Carbohydrate-to-Insulin Ratio for the patient;
determining an adjustment factor based on the received glucose measurement;
adjusting the Carbohydrate-to-Insulin Ratio for the patient by dividing the Carbohydrate-to-Insulin Ratio by the adjustment factor;
determining a recommended meal bolus for the determined glucose type based on the adjusted Carbohydrate-to-Insulin Ratio, the recommended meal bolus corresponding to a number of units of rapid-acting insulin to be administered to the patient at a time of day of the received glucose measurement to bring and maintain the patient's glucose level into a target range; and
displaying on a display, at the time of day of the received glucose measurement, the number of units of rapid-acting insulin corresponding to the recommended meal bolus for the patient to administer.
12. The system of claim 11 , wherein receiving the glucose measurement of the patient comprises receiving the glucose measurement from a continuous glucose monitoring system.
13. The system of claim 11 , wherein the operations further comprise transmitting the recommended meal bolus to an administration device in communication with the data processing hardware, the administration device comprising:
a doser; and
an administration computing device in communication with the doser, the administration computing device configured to cause the doser to administer a number of units of insulin to the patient using the recommended meal bolus.
14. The system of claim 11 , wherein the operations further comprise determining a pre-meal correction bolus by calculating:
CB=(BG−BG Target )/CF,
wherein CB is the pre-meal correction bolus, BG is the received glucose measurement, BG Target is a target glucose value of a patient, and CF is a correction factor.
15. The system of claim 11 , wherein determining the adjustment factor comprises:
determining a value of the glucose measurement is within one of a plurality of target ranges of values; and
setting the adjustment factor to a target adjustment factor associated with the corresponding target range of values that includes the glucose measurement.
16. The system of claim 15 , wherein the plurality of target ranges of values comprises:
a first target range of values including glucose values less than a first configurable constant;
a second target range of values including glucose values greater than or equal to the first configurable constant and less than a low target glucose value of a target glucose range for the patient;
a third target range of values including glucose values greater than or equal to the low target glucose value and less than a high target glucose value of the target glucose range;
a fourth target range of values including glucose values greater than or equal to the high target glucose value and less than a second configurable constant;
a fifth target range of values including glucose values greater than or equal to the second configurable constant and less than a third configurable constant; and
a sixth target range of values including glucose values greater than or equal to the third configurable constant.
17. The system of claim 11 , wherein determining the recommended meal bolus comprises:
receiving a number of carbohydrates to be consumed by the patient for a meal associated with time of day of the glucose measurement; and
dividing the received number of carbohydrates by the adjusted Carbohydrate-to-Insulin Ratio.
18. The system of claim 11 , wherein the operations further comprise:
determining the glucose measurement comprises a pre-lunch glucose measurement,
wherein adjusting the Carbohydrate-to-Insulin Ratio for the patient comprises:
obtaining a previous Carbohydrate-to-Insulin Ratio for breakfast; and
determining a recommended Carbohydrate-to-Insulin Ratio for lunch by dividing the previous Carbohydrate-to-Insulin Ratio for breakfast by the adjustment factor.
19. The system of claim 11 , wherein the operations further comprise:
determining the glucose measurement comprises a pre-dinner glucose measurement,
wherein adjusting the Carbohydrate-to-Insulin Ratio for the patient comprises:
obtaining a previous Carbohydrate-to-Insulin Ratio for lunch; and
determining a recommended Carbohydrate-to-Insulin Ratio for dinner by dividing the previous Carbohydrate-to-Insulin Ratio for lunch by the adjustment factor.
20. The system of claim 11 , wherein the operations further comprise:
determining the glucose measurement comprises a pre-breakfast glucose measurement,
wherein adjusting the Carbohydrate-to-Insulin Ratio for the patient comprises:
obtaining a previous Carbohydrate-to-Insulin Ratio for dinner;
obtaining a previous bedtime glucose measurement;
determining a bedtime adjustment factor based on the previous bedtime glucose measurement; and
determining a recommended Carbohydrate-to-Insulin Ratio for breakfast by dividing the previous Carbohydrate-to-Insulin Ratio for dinner by the bedtime adjustment factor.