Systems and methods for determining insulin therapy for a patient
Inventors
Ruchti, Timothy L. • BURGESS, William Patrick • Dumas, III, John • Lisiecki, Ronald • MARTIN, CAROL Dian • Santana, Laura • THORNLEY, JOHN Harrison • WATT, JOANNE Marie
Assignees
Interested in licensing this patent?
MTEC can help explore whether this patent might be available for licensing for your application.
Publication Number
US-10842935-B2
Publication Date
2020-11-24
Expiration Date
Abstract
In example methods and systems described, insulin therapy for a patient can be determined. At least one of a short-acting subcutaneous insulin dosage recommendation, a correction subcutaneous insulin dosage recommendation, an intravenous insulin dosage recommendation, a recommended amount of carbohydrates to be administered to the patient, or combinations thereof, can be determined. In addition, information indicating a confirmation of a nutrition intake for the patient, and a long-acting insulin-on-board for the patient can be received, and based on this information, a required long-acting subcutaneous or intravenous insulin dosage for the patient can be determined. The short-acting subcutaneous or intravenous insulin dosage recommendation can be adjusted based, at least in part, on a difference between the long-acting insulin-on-board and the required long-acting subcutaneous or intravenous insulin dosage.
Core Innovation
The invention provides therapeutic decision support for hospitalized diabetes patients by receiving glucose measurements, anticipated nutrition with confirmation, and insulin-on-board information for short-acting and long-acting insulin. Based on these inputs, the system determines a required long-acting subcutaneous insulin dosage and computes adjustments to a short-acting subcutaneous insulin dosage recommendation and/or an intravenous insulin dosage recommendation.
The core logic adjusts the recommendation by using a difference between a long-acting subcutaneous insulin-on-board measurement and a required long-acting subcutaneous insulin dosage, and by using insulin-on-board measurements remaining from short-acting subcutaneous or intravenous insulin dosages. The recommendation is lowered or increased according to predetermined values and sign conditions, including whether remaining insulin-on-board values are positive or negative, and whether the difference crosses the predetermined value.
The decision support system includes a hospital information system and a workstation with a clinician input and measuring units such as glucometers or CGM, and it outputs an indication through a user interface workflow. It also estimates GFR from serum creatinine and demographics and applies GFR-corrected insulin effect curves derived from PK/PD to compute insulin-on-board and generate insulin dose adjustments to reduce insulin stacking and to support un-stacking.
Claims Coverage
The partial document includes four independent claims (non-transitory computer readable medium or method). Each independent claim centers on adjusting insulin dosage recommendations using insulin-on-board measurements and predetermined value threshold logic with lowering/increasing rules, followed by outputting an indication of the recommendation.
Threshold-based adjustment of short-acting subcutaneous or intravenous insulin using long-acting insulin-on-board difference and insulin-on-board remaining
Adjusting a short-acting subcutaneous insulin dosage recommendation or an intravenous insulin dosage recommendation for a patient based on a difference between a long-acting subcutaneous insulin-on-board measurement and a required long-acting subcutaneous insulin dosage, or based on an insulin-on-board measurement remaining from a short-acting subcutaneous insulin dosage, or based on an insulin-on-board measurement remaining from an intravenous insulin dosage; lowering the recommendation when predetermined-value and sign/greater-than conditions are met, increasing the recommendation when predetermined-value and sign/less-than conditions are met; and outputting an indication of the recommendation.
Therapy determination using long-acting insulin-on-board difference and insulin-on-board remaining for lowering and increasing recommendations
Adjusting a short-acting subcutaneous insulin dosage recommendation or an intravenous insulin dosage recommendation for a patient based on a difference between a long-acting subcutaneous insulin-on-board measurement and a required long-acting subcutaneous insulin dosage, or based on an insulin-on-board measurement remaining from a short-acting subcutaneous insulin dosage, or based on an insulin-on-board measurement remaining from an intravenous insulin dosage; lowering the recommendation when predetermined-value and sign/greater-than conditions are met, increasing the recommendation when predetermined-value and sign/less-than conditions are met; and outputting an indication of the recommendation.
Threshold-based adjustment of short-acting subcutaneous insulin using long-acting insulin-on-board difference and short-acting insulin-on-board remaining
Adjusting a short-acting subcutaneous insulin dosage recommendation for a patient based on a difference between a long-acting subcutaneous insulin-on-board measurement and a required long-acting subcutaneous insulin dosage or an insulin-on-board measurement remaining from a short-acting subcutaneous insulin dosage; lowering the recommendation when predetermined-value and greater-than/positive-value conditions are met; increasing the recommendation when predetermined-value and less-than/negative-value conditions are met; and outputting an indication of the short-acting subcutaneous recommendation.
Insulin-on-board-based adjustment of intravenous insulin dosage recommendation with predetermined value logic
Adjusting an intravenous insulin dosage recommendation for a patient based on an insulin-on-board measurement from an intravenous insulin dosage; lowering the recommendation if the insulin-on-board measurement from the intravenous insulin dosage is more than a predetermined value; and increasing the recommendation if a different between the insulin-on-board measurement and an insulin-on-board required to reach a targeted intravenous insulin dosage is more than the predetermined value and the insulin-on-board required to reach the targeted intravenous insulin dosage has a positive value; and outputting an indication of the intravenous insulin dosage recommendation.
Across the independent claims, the coverage is focused on insulin dosage recommendation adjustment using insulin-on-board measurements tied to long-acting and short-acting (subcutaneous or intravenous) dosing, applying lowering/increasing logic based on predetermined values and sign conditions, and outputting an indication of the resulting recommendation.
Stated Advantages
Reduces insulin stacking and supports un-stacking, as described in the partial document summary.
Documented Applications
Therapeutic decision support for hospitalized diabetes patients, including determination and adjustment of short-acting subcutaneous and intravenous insulin dosage recommendations based on insulin-on-board and glucose/nutrition inputs.
Hospital workflow support using hospital information system, workstation/application server, measuring units (e.g., glucometers/CGM), clinician input, and GUI output of insulin dosage recommendations and indications.
Interested in licensing this patent?