Method and system for the safety, analysis and supervision of insulin pump action and other modes of insulin delivery in diabetes
An insulin delivery supervisor (IDS) with a safety analysis and supervision function that can reside between the insulin request and the insulin delivery and can intercept any excessive insulin requests before the insulin was delivered. The IDS can be implemented in any system based on insulin pump or pen and will work with either SMBG or CGM modes of blood glucose monitoring.
1. A method for detecting and correcting for an excessive insulin request, the method comprising:
intercepting a signal requesting delivery to a patient of an amount of insulin at time t, u(t), wherein u(t) is based on a target blood glucose concentration, the intercepting occurring prior to the signal being received by an insulin delivery device;
determining that delivery of u(t) to the patient will result in hypoglycemia in the patient, the determining involving:
when self-monitoring BG assessment (SMBG) at time t, SMBG(t), is available:
calculating a projected blood glucose concentration of the patient based on SMBG(t);
calculating an amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t); and
classifying the insulin delivery request signal as an excessive insulin request when the calculated projected blood glucose concentration is less than a blood glucose concentration threshold and when the calculated amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t) is greater than a carbohydrate amount threshold:
when SMBG(t) is not available:
estimating an amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t):
classifying the insulin delivery request signal as an excessive insulin request when the estimated amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t) is greater than a carbohydrate amount threshold:
requesting SMBG(t) when the insulin delivery request signal is classified as an excessive insulin request:
upon receiving the SMBG(t):
calculating a projected blood glucose concentration of the patient based on SMBG(t);
calculating an amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t); and
classifying the insulin delivery request signal as an excessive insulin request when the calculated projected blood glucose concentration is less than a blood glucose concentration threshold and when the calculated amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t) is greater than a carbohydrate amount threshold;
when the insulin delivery request signal is classified as an excessive insulin request, generating an updated u(t) based on a blood glucose concentration threshold as opposed to the target blood glucose concentration for u(t); and
transmitting the updated u(t) to the insulin delivery device.
2. The method of claim 1 , wherein SMBG(t) is not available includes a SMBG not being available during any time prior to and including time t.
3. The method of claim 1 , wherein when SMBG(t) is available:
generating an instruction to consume the calculated amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t).
4. The method of claim 3 , comprising:
receiving a signal that the calculated amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t) has been consumed.
5. The method of claim 4 , comprising:
transmitting the un-updated u(t), as opposed to the updated u(t), to the insulin delivery device.
6. The method of claim 1 , wherein when SMBG(t) is not available:
generating an instruction to consume the estimated amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t).
7. The method of claim 6 , comprising:
receiving a signal that the estimated amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t) has been consumed.
8. The method of claim 7 , comprising:
transmitting the un-updated u(t), as opposed to the updated u(t), to the insulin delivery device for delivery of insulin to the patient.
9. A system for detecting and correcting for an excessive insulin request, comprising:
an insulin delivery device configured to deliver an amount of insulin to a diabetic patient in response to a request signal; and
a safety supervision module configured for:
intercepting a signal requesting delivery to the patient of an amount of insulin at time t, u(t), wherein u(t) is based on a target blood glucose concentration, the intercepting occurring prior to the signal being received by the insulin delivery device;
determining that delivery of u(t) to the patient will result in hypoglycemia in the patient, the determining involving:
when self-monitoring BG assessment (SMBG) at time t, SMBG(t), is available:
calculating a projected blood glucose concentration of the patient based on SMBG(t);
calculating an amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t); and
classifying the insulin delivery request signal as an excessive insulin request when the calculated projected blood glucose concentration is less than a blood glucose concentration threshold and when the calculated amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t) is greater than a carbohydrate amount threshold;
when SMBG(t) is not available:
estimating an amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t):
classifying the insulin delivery request signal as an excessive insulin request when the estimated amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t) is greater than a carbohydrate amount threshold:
requesting SMBG(t) when the insulin delivery request signal is classified as an excessive insulin request:
upon receiving the SMBG(t):
calculating a projected blood glucose concentration of the patient based on SMBG(t);
calculating an amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t); and
classifying the insulin delivery request signal as an excessive insulin request when the calculated projected blood glucose concentration is less than a blood glucose concentration threshold and when the calculated amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t) is greater than a carbohydrate amount threshold:
when the insulin delivery request signal is classified as an excessive insulin request, generating an updated u(t) based on a blood glucose concentration threshold as opposed to the target blood glucose concentration for u(t); and
transmitting the updated u(t) to the insulin delivery device.
10. The system of claim 9 , wherein SMBG(t) is not available includes a SMBG not being available during any time prior to and including time t.
11. The system of claim 9 , wherein when SMBG(t) is available the safety supervision module is configured for:
generating an instruction to consume the calculated amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t).
12. The system of claim 11 , wherein the safety supervision module is configured for:
receiving a signal that the calculated amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t) has been consumed.
13. The system of claim 12 , wherein the safety supervision module is configured for:
transmitting the un-updated u(t), as opposed to the updated u(t), to the insulin delivery device.
14. The system of claim 9 , wherein when SMBG(t) is not available the safety supervision module is configured for:
generating an instruction to consume the estimated amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t).
15. The system of claim 14 , wherein the safety supervision module is configured for:
receiving a signal that the estimated amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t) has been consumed.
16. The system of claim 15 , wherein the safety supervision module is configured for:
transmitting the un-updated u(t), as opposed to the updated u(t), to the insulin delivery device.
17. A non-transitory computer readable medium having stored thereon computer executable instructions for detecting and correcting for an excessive insulin request that when executed cause at least one processor to:
intercept a signal requesting delivery to a patient of an amount of insulin at time t, u(t), wherein u(t) is based on a target blood glucose concentration, the intercepting occurring prior to the signal being received by an insulin delivery device;
determine that delivery of u(t) to the patient will result in hypoglycemia in the patient, the determining involving:
when self-monitoring BG assessment (SMBG) at time t, SMBG(t), is available:
calculate a projected blood glucose concentration of the patient based on SMBG(t);
calculate an amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t); and
classify the insulin delivery request signal as an excessive insulin request when the calculated projected blood glucose concentration is less than a blood glucose concentration threshold and when the calculated amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t) is greater than a carbohydrate amount threshold;
when SMBG(t) is not available:
estimate an amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t):
classify the insulin delivery request signal as an excessive insulin request when the estimated amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t) is greater than a carbohydrate amount threshold;
request SMBG(t) when the insulin delivery request signal is classified as an excessive insulin request:
upon receiving the SMBG(t):
calculate a projected blood glucose concentration of the patient based on SMBG(t):
calculate an amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t); and
classify the insulin delivery request signal as an excessive insulin request when the calculated projected blood glucose concentration is less than a blood glucose concentration threshold and when the calculated amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t) is greater than a carbohydrate amount threshold:
when the insulin delivery request signal is classified as an excessive insulin request, generate an updated u(t) based on a blood glucose concentration threshold as opposed to the target blood glucose concentration for u(t); and
transmit the updated u(t) to the insulin delivery device.
18. The non-transitory computer readable medium of claim 17 , wherein SMBG(t) is not available includes a SMBG not being available during any time prior to and including time t.
19. The non-transitory computer readable medium of claim 17 , wherein when SMBG(t) is available the at least one processor:
generates an instruction to consume the calculated amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t).
20. The non-transitory computer readable medium of claim 17 , wherein when SMBG(t) is not available the at least one processor:
generates an instruction to consume the estimated amount of carbohydrates that is required to maintain the target blood glucose concentration for u(t).