Delayed Meal Bolus Calculator to Prevent Insulin Stacking
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Solution Overview
Problem
Existing automated insulin delivery systems face issues with 'insulin stacking' when users delay meal boluses, leading to increased risk of hypoglycemia due to separate insulin deliveries in response to rising blood glucose levels.
Innovation Solution
A delayed bolus calculator that accounts for the time since a meal was consumed and any additional insulin delivered by the closed loop algorithm, using formulas like Bolus=CarbsCR+min(BG-110CF,0)-max(Swan6hr_IOB,0) or Bolus=CarbsCR*D6(t)+min(BG-110CF,0)-max(Swan6hr_IOB,0) to calculate a delayed bolus amount.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If the automated insulin delivery system delivers correction boluses based on CGM readings when blood glucose rises, then the system responds effectively to hyperglycemia, but if a meal bolus is subsequently delivered, insulin stacking occurs causing blood glucose to drop to low levels
Solution Approach 1:
The system performs preliminary action by delivering correction boluses in advance when hyperglycemia is detected via CGM readings. This preliminary correction addresses the rising blood glucose before a meal bolus would be administered, preventing insulin stacking and subsequent hypoglycemia while maintaining effective hyperglycemia management
Solution Approach 2:
The system uses continuous feedback from CGM readings to monitor blood glucose levels in real-time. This feedback mechanism allows the system to detect hyperglycemia, deliver appropriate correction boluses, and prevent insulin stacking by accounting for the interaction between correction and meal boluses, thereby reducing hypoglycemia risk
2Ease of operation
If a user delays delivering a meal bolus, then the user has more time to prepare or decide on insulin dosage, but the user's blood glucose begins to rise prior to the meal bolus being delivered
Solution Approach 1:
The system employs continuous feedback from CGM readings to monitor blood glucose levels during the delay period. This real-time feedback allows the system to detect rising blood glucose and automatically deliver correction boluses, maintaining glycemic control even when the user delays the meal bolus decision
Solution Approach 2:
The system performs self-service by automatically delivering correction boluses based on CGM readings during the user's decision delay period. This autonomous correction mechanism maintains blood glucose control without requiring immediate user action, enabling the user to take their time with the meal bolus decision while the system manages the rising glucose independently
Data Source
AI summary
Disclosed herein are apparatuses and methods that can provide a delayed bolus calculator for use in closed loop diabetes therapy that can account for additional factors not taken into account in regular meal bolus calculations when a user wants to deliver a meal bolus a period of time after a meal was consumed. A delayed bolus calculator can enable the user to enter a period of time since the meal was consumed in addition to the number of carbohydrates consumed in a meal. This enables the system to account for the amount of increased insulin from the closed loop algorithm in response to the meal and/or the time since the meal to ensure that the risk of hypoglycemia is mitigated while still reducing hyperglycemia.