Adaptive Basal Insulin Titration via Continuous Glucose Monitoring
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Solution Overview
Problem
Current insulin titration methods for diabetes patients are inadequate due to reliance on discrete blood glucose measurements, which can be inaccurate and missed, leading to excessive insulin dosing and poor glycemic control, especially with the dawn phenomenon affecting morning glucose levels.
Innovation Solution
A system that uses continuous glucose monitor data to autonomously detect a titration glucose level, filtering out inadequate quality data and accounting for the influence of short-acting insulin, to adjust long-acting insulin dosages dynamically, ensuring accurate basal insulin titration.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If discrete blood glucose measurements (SMBG) are used for insulin titration, then the measurement process is simple, but the measurement precision and reliability are poor due to missed measurements and inaccurate readings
Solution Approach 1:
The patent replaces the mechanical finger-stick measurement system with an electrochemical continuous glucose monitoring system that uses a sensor to detect glucose levels continuously, eliminating the need for repeated manual blood sampling and providing more reliable data for insulin titration
Solution Approach 2:
The patent implements continuous glucose monitoring instead of discrete measurements, maintaining constant surveillance of glucose levels to capture the true baseline value and avoid missed measurements, thereby improving measurement precision and reliability
2Reliability
If fasting blood glucose measurements are used for basal insulin titration, then the titration process is straightforward, but the reliability is poor due to the dawn phenomenon causing elevated morning glucose levels
Solution Approach 1:
The patent performs preliminary analysis of glucose data to identify the true baseline level before using it for titration decisions, detecting patterns such as the dawn phenomenon in advance and selecting appropriate measurement timepoints that reflect the actual basal glucose level rather than transient elevations
Solution Approach 2:
The patent incorporates feedback mechanisms that continuously monitor glucose levels and adjust the identified baseline value based on observed patterns, ensuring that the titration is based on reliable baseline data that accounts for physiological variations like the dawn phenomenon
3Measurement precision
If continuous glucose monitoring data is used to identify titration glucose levels, then the measurement precision improves, but the device complexity and data processing requirements increase
Solution Approach 1:
The patent segments the continuous glucose data into distinct periods (fasting, postprandial, bedtime) and applies different analysis methods to each segment, identifying the titration glucose level specifically from the fasting segment to improve precision while managing data complexity through structured organization
Solution Approach 2:
The patent implements dynamic algorithms that adaptively identify the titration glucose level based on the actual glucose profile and pattern recognition, allowing the system to automatically adjust to individual patient patterns and physiological variations rather than using fixed thresholds
4Productivity
If manual blood glucose monitoring is used, then the system is simple to operate, but the productivity and glycemic control effectiveness are reduced due to adherence barriers and missed measurements
Solution Approach 1:
The patent implements a system that automatically performs glucose measurements and data analysis without requiring active patient participation in each measurement event, with the CGM sensor continuously monitoring glucose levels and the algorithm automatically identifying titration-relevant values, thereby improving productivity while maintaining ease of operation through minimal user intervention
Data Source
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AI summary
Systems and methods are provided for adjusting long acting insulin medicament dosages for a subject. A plurality of timestamped glucose measurements of the subject is obtained. A titration glucose level (246) is computed as a measure of central tendency (244, 268, 274) of a titration subset of small glucose measurements (240, 269, 273) identified within the timestamped glucose measurements, wherein the measure of central tendency represents a measure of small glucose measurements for the primary time window. A long acting insulin medicament dosage (216) is adjusted or maintained based upon the obtained titration glucose level (246).