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Publication Number
US-12295752-B2
Publication Date
2025-05-13
Expiration Date
Abstract
In some examples, a system includes a glucose sensor configured to generate a signal indicative of a blood glucose level of a patient, a medical device configured to deliver insulin to the patient, a peritoneal dialysis (PD) device, and control circuitry. The control circuitry is configured to control the PD device to deliver PD therapy to a patient during a PD cycle, determine a blood glucose level of the patient during the PD cycle based on a signal from the glucose sensor, determine that the blood glucose level is greater than or equal to a predetermined blood glucose level threshold, and control the medical device to deliver insulin to the patient in response to determining the blood glucose level is greater than or equal to the predetermined blood glucose level threshold.
Core Innovation
A peritoneal dialysis (PD) system is controlled during a current PD cycle using blood glucose information. Control circuitry determines a blood glucose level of the patient during the current PD cycle and determines that the blood glucose level is greater than or equal to a predetermined blood glucose level threshold during the current PD cycle. In response, the control circuitry controls a medical device to deliver insulin to the patient during the current PD cycle to provide closed-loop glycemic control during PD cycles.
After insulin delivery during the current PD cycle, the control circuitry determines a modification to a parameter of the PD therapy during the current PD cycle. The parameter comprises at least one of a dialysate glucose concentration, an alternate osmotic solute concentration, a PD dialysate volume, a PD dialysate dwell time, an ultrafiltration volume, or a number of PD cycles within a time period. The modification is determined based on blood glucose and can be tied to ultrafiltration targets and patient transport characteristics to maintain glycemic control while meeting ultrafiltration targets and improving PD efficacy.
The system includes a glucose sensor configured to generate a signal indicative of a blood glucose level of a patient and a medical device configured to deliver insulin to the patient. The glucose sensor and insulin delivery are integrated with the PD device and control circuitry to adjust PD therapy parameters during the current PD cycle in response to the threshold condition. Optional operations include cease PD therapy and resume PD therapy based on subsequent blood glucose readings, and the dialysate can include an alternate osmotic solute comprising at least one of a glucose polymer or an amino acid.
Claims Coverage
The document includes two independent claims, covering both a method and a system. Across the independent claims, the core inventive set comprises threshold-based insulin delivery during a PD cycle and subsequent modification of one or more PD therapy parameters chosen from a defined parameter set.
Threshold-based insulin delivery during a current PD cycle
The control circuitry determines a blood glucose level of the patient during the current PD cycle, determines the blood glucose level is greater than or equal to a predetermined blood glucose level threshold during the current PD cycle, and controls a medical device to deliver insulin to the patient during the current PD cycle in response to the determination.
Insulin-triggered modification of PD therapy parameters during the current PD cycle
In response to the medical device delivering insulin to the patient during the current PD cycle, determining a modification to a parameter of the PD therapy during the current PD cycle, wherein the parameter comprises at least one of a dialysate glucose concentration, an alternate osmotic solute concentration, a PD dialysate volume, a PD dialysate dwell time, an ultrafiltration volume, or a number of PD cycles within a time period.
PD cycle integration with glucose sensor and control circuitry
A glucose sensor generates a signal indicative of a blood glucose level of a patient, and control circuitry is configured to determine the blood glucose level based on the signal during the current PD cycle and to control the PD device to deliver PD therapy to a patient during the current PD cycle.
Collectively, the independent claims require closed-loop use of blood glucose thresholding during a PD cycle to trigger insulin delivery, and then require modifying a PD therapy parameter from the defined set during the same current PD cycle.
Stated Advantages
Maintain glycemic control while meeting ultrafiltration targets and improving PD efficacy.
Documented Applications
Closed-loop glycemic control during PD cycles.
Cease PD therapy and resume PD therapy based on subsequent blood glucose readings.
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