Adaptive Insulin Delivery System for Glycemic Control
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Solution Overview
Problem
Standard insulin therapies for diabetes lack adaptive mechanisms to account for long-term changes in a patient's insulin needs due to factors like growth, illness, or hormonal fluctuations, and are susceptible to uncontrolled insulin dosing escalation when insulin is administered subcutaneously, especially in outpatient settings.
Innovation Solution
The system modulates basal insulin infusion rates around a nominal rate using control strategies like model predictive control, proportional-integral-derivative control, or neural networks, allowing for long-term adaptation and preventing runaway escalation by constraining the maximum instantaneous rate, and also adapts meal-time insulin doses based on recent glucose data.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Extent of automation
If pre-programmed basal insulin infusion rate is used in insulin pump therapy, then automated insulin delivery is achieved, but the system cannot adapt to long-term changes in patient's insulin needs
Solution Approach 1:
The patent implements dynamic adaptation of the nominal basal insulin infusion rate over time. The system continuously adjusts the nominal rate based on observed glucose levels and insulin-on-board information, allowing the pre-programmed rate to evolve and adapt to long-term changes in patient needs such as growth, illness, or hormonal fluctuations, while maintaining automated delivery
Solution Approach 2:
The system uses feedback from continuous glucose monitoring to adjust the nominal basal insulin infusion rate. By observing glucose levels and insulin-on-board data over time, the system automatically modifies the nominal rate to account for long-term changes in insulin requirements, resolving the contradiction between automation and adaptability
2Ease of operation
If subcutaneous insulin administration is used in outpatient settings, then insulin delivery is simplified, but uncontrolled insulin dosing escalation can occur
Solution Approach 1:
The patent implements feedback control by continuously monitoring glucose levels and insulin-on-board information. This feedback mechanism prevents uncontrolled dosing escalation by adjusting subsequent insulin deliveries based on observed responses, while maintaining the simplicity of automated subcutaneous administration
Solution Approach 2:
The system takes preliminary anti-action by constraining the maximum instantaneous infusion rate and using predicted insulin-on-board levels to prevent potential dosing escalation before it occurs. This proactive approach maintains reliability while preserving ease of operation
3Measurement precision
If glucose-sensor data is used to modulate basal infusion rate, then blood glucose control is improved, but the system assumes insulin appears instantly in blood which is inaccurate
Solution Approach 1:
The patent introduces an intermediary model for insulin absorption and action. Instead of assuming instant appearance, the system uses a pharmacokinetic model that accounts for subcutaneous absorption delays and insulin-on-board effects. This intermediary modeling layer reconciles the precision of glucose sensing with the biological reality of delayed insulin appearance
Solution Approach 2:
The system changes the parameter representation by tracking insulin-on-board levels and absorption rates rather than assuming instant insulin appearance. This parameter transformation allows accurate modeling of subcutaneous insulin delivery while maintaining precise glucose control through adjusted modulation strategies
Data Source
AI summary
Techniques are used for adaptation of drug-administration parameters that control insulin delivery in a blood glucose control system. One technique provides long-term adaptation of a nominal basal infusion rate, adapting to longer-term changes in a patient's needs due to growth, illness, hormonal fluctuations, physical activity, aging, etc. Another technique provides adaptation of priming dose size at mealtimes for overall better glycemic control and also adapting to longer-term changes in a patient's needs. Adaptation calculations use a receding-horizon window of recent values of the adapted parameter. Doses of a counter-regulatory agent (e.g., glucagon) may also be delivered in response to information about estimated accumulation of exogenously infused insulin (subcutaneously, intramuscularly, intraperitoneally, or intravenously) and/or the effect insulin might have on glucose levels (blood glucose concentration or interstitial fluid glucose concentration).