Insulin Infusion Correction Bolus Control Using Meal-Triggered Thresholds
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Solution Overview
Problem
Existing insulin infusion pumps face challenges in accurately delivering correction boluses to maintain blood glucose levels within a desired range, particularly when accounting for variations in patient activity and insulin response, leading to potential postprandial glucose excursions.
Innovation Solution
A processor-implemented method that adjusts correction bolus amounts based on predicted future glucose levels, using mathematical models to iteratively scale down initial bolus amounts to maintain glucose levels above a threshold, incorporating sensor readings and physiological models to anticipate insulin response.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If a manually-initiated correction bolus is delivered to account for rising glucose trends, then the blood glucose level can be corrected, but there is a risk of postprandial glucose excursion or hypoglycemia if preceding insulin deliveries are not properly accounted for
Solution Approach 1:
The system continuously monitors blood glucose levels and insulin on board (IOB) to dynamically adjust correction bolus dosing. The feedback loop ensures that the pump accounts for preceding insulin deliveries by measuring current glucose levels and IOB before calculating the correction bolus amount, thereby preventing both hyperglycemia and hypoglycemia
Solution Approach 2:
The system performs preliminary calculations of the correction bolus dose by accounting for active insulin on board before the bolus is administered. This preliminary action ensures that the correction bolus is accurately sized to prevent postprandial glucose excursions while avoiding excessive dosing that could cause hypoglycemia
2Productivity
If correction bolus dosing is increased to manage rising glucose trends, then glucose control improves, but the risk of hypoglycemic events increases
Solution Approach 1:
The system applies partial action by delivering correction boluses that are precisely calibrated to the actual glucose elevation and insulin on board, rather than using fixed or excessive dosing. This ensures glucose control is achieved without over-correction that would lead to hypoglycemia
Solution Approach 2:
The system dynamically changes dosing parameters based on real-time glucose levels and insulin on board measurements. The correction bolus amount is adjusted as a variable parameter rather than a fixed value, allowing the system to respond to changing physiological conditions and prevent hypoglycemic events
3Ease of operation
If automatic correction bolus delivery is implemented to reduce manual intervention, then ease of operation improves, but the complexity of control algorithms increases
Solution Approach 1:
The system provides self-service by automatically calculating and delivering correction boluses without requiring manual user input. The pump autonomously monitors glucose levels, calculates the appropriate bolus dose based on insulin on board and current glucose, and delivers the correction, thereby improving ease of operation despite the underlying algorithmic complexity
Data Source
AI summary
Techniques disclosed herein relate to safe correction boluses. In some embodiments, the techniques involve obtaining a plurality of sensor glucose readings for a patient. The techniques may further involve determining, based on the plurality of sensor glucose readings that the patient has consumed a meal. The techniques may further involve in response to determining the patient has consumed the meal, reducing a hypoglycemia threshold from a first value to a second value lower than the first value. The techniques may further involve determining a correction bolus dosage based on the reduced hypoglycemia threshold.