# US 11,998,322 B2 · Intermittent monitoring

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- Number: US 11,998,322 B2
- Document ID: US11998322B2
- Status: Granted
- Kind: B2
- Application number: 16/717,834
- Filed: 2019-12-17
- Published: 2020-06-25
- Granted: 2024-06-04
- Earliest claimed: 2018-12-19
- Assignees: DexCom, Inc.
- Applicants: DexCom, Inc.
- Inventors: Apurv Ullas Kamath; Margaret A. Crawford; John Michael Gray; Hari Hampapuram; Matthew Lawrence Johnson; Subrai Girish Pai; Shawn Clay Sanders; Sumitaka Mikami
- Web page: https://patentgrep.com/patent/US11998322B2

## CPC

- A61B 5/14532: {for measuring glucose, e.g. by tissue impedance measurement}
- A61B 5/002: {Monitoring the patient using a local or closed circuit, e.g. in a room or building (A61B5/0017 takes precedence)}
- A61B 5/0022: {Monitoring a patient using a global network, e.g. telephone networks, internet}
- A61B 5/0024: {for multiple sensor units attached to the patient, e.g. using a body or personal area network}
- A61B 5/02055: {Simultaneously evaluating both cardiovascular condition and temperature}
- A61B 5/1118: {Determining activity level}
- A61B 5/14546: {for measuring analytes not otherwise provided for, e.g. ions, cytochromes}
- A61B 5/1455: using optical sensors, e.g. spectral photometrical oximeters
- A61B 5/7221: {Determining signal validity, reliability or quality (preventing, reducing or removing noise induced by motion artefacts A61B5/7207; noise originating from a therapeutic or surgical apparatus A61B5/7217)}
- A61B 5/7267: {involving training the classification device}
- A61B 5/742: {using visual displays (displays for heart-related electrical signals, e.g. ECG, A61B5/339)}
- A61B 5/7475: {User input or interface means, e.g. keyboard, pointing device, joystick}
- A61M 5/14244: {adapted to be carried by the patient, e.g. portable on the body}
- A61M 5/1723: {using feedback of body parameters, e.g. blood sugar or pressure}
- G06F 11/1004: {to protect a block of data words, e.g. CRC or checksum (G06F11/1076 takes precedence; security arrangements for protecting computers or computer systems against unauthorized activity G06F21/00)}
- G16H 10/60: for patient-specific data, e.g. for electronic patient records
- G16H 20/30: relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
- G16H 20/60: relating to nutrition control, e.g. diets
- G16H 40/67: for remote operation
- G16H 50/30: for calculating health indices; for individual health risk assessment
- A61B 5/0205: Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
- A61B 5/02438: {with portable devices, e.g. worn by the patient}
- A61B 2560/0209: adapted for power saving
- A61B 2560/0214: of power generation or supply
- A61M 2205/3303: Using a biosensor
- A61M 2205/3584: using modem, internet or Bluetooth®
- A61M 2205/50: with microprocessors or computers
- A61M 2205/502: User interfaces, e.g. screens or keyboards
- A61M 2205/52: with memories providing a history of measured variating parameters of apparatus or patient
- A61M 2205/8206: battery-operated
- A61M 2230/04: Heartbeat characteristics, e.g. ECG, blood pressure modulation
- A61M 2230/201: Glucose concentration
- A61M 2230/40: Respiratory characteristics
- A61M 2230/62: Posture
- A61M 2230/63: Motion, e.g. physical activity
- G16H 20/17: delivered via infusion or injection
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)}
- G06F: ELECTRIC DIGITAL DATA PROCESSING (computer systems based on specific computational models G06N)
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA

## Abstract

Various examples are directed to systems and methods for patient monitoring. An example method comprises receiving an estimated glucose concentration level of the patient from a continuous glucose monitoring (CGM) system for a first time period. The method may also include receiving non-glucose information relating to the patient for the first time period and determining a relationship between the estimated glucose concentration level and the non-glucose information. The method may also include receiving non-glucose information relating to the patient for a second time period and determining diabetic information about the patient for the second time period based upon the determined relationship and the non-glucose information. The method may include electronically delivering a notification about the diabetic information.

## Claims

### Claim 1

A method comprising:
during a first time period, monitoring glucose concentrations of a patient continuously measured by a continuous glucose monitoring (CGM) system worn by the patient, the monitoring comprising receiving a plurality of first glucose information of the patient from the CGM system, wherein the plurality of first glucose information is indicative of the glucose concentrations of the patient at a plurality of times during the first time period;
during the first time period, receiving a plurality of first non-glucose information of the patient from an activity monitor worn by the patient, wherein the plurality of first non-glucose information is indicative of physical activity of the patient corresponding to the plurality of times during the first time period;
determining relationships between the plurality of first glucose information and the plurality of first non-glucose information by correlating the physical activity of the patient with corresponding impacts on the glucose concentrations of the patient as the glucose concentrations vary;
determining, during a second time period, that glucose information from the CGM system is not available;
during the second time period in which glucose information from the CGM system is not available, receiving second non-glucose information of the patient from the activity monitor worn by the patient, wherein the second non-glucose information is indicative of physical activity of the patient corresponding to the second time period;
estimating, in real time, second glucose information of the patient for the second time period based upon the second non-glucose information of the patient and the determined relationships between the plurality of first glucose information and the plurality of first non-glucose information; and
electronically delivering, during the second time period, a notification about the second glucose information.

### Claim 2 (depends on 1)

The method of claim 1, further comprising:
receiving additional non-glucose information of the patient for the first time period, wherein the additional non-glucose information is different than the plurality of first non-glucose information; and
determining a relationship between the plurality of first glucose information, the plurality of first non-glucose information, and the additional non-glucose information, wherein the estimating second glucose information is based at least in part on the determined relationship.

### Claim 3 (depends on 1)

The method of claim 1, wherein the plurality of first non-glucose information that is indicative of physical activity of the patient and the second non-glucose information that is indicative of physical activity of the patient each include physiologic information about the patient.

### Claim 4 (depends on 3)

The method of claim 3, wherein the physiologic information includes at least one of heart rate, respiration, oxygen concentration, skin tone, moisture content on skin, activity, activity patterns, blood ketones, urine ketones, respiration, or acoustic information.

### Claim 5 (depends on 1)

The method of claim 1, wherein the plurality of first non-glucose information and the second non-glucose information each further include location information.

### Claim 6 (depends on 1)

The method of claim 1, wherein the estimating second glucose information includes determining an estimated glucose concentration level.

### Claim 7 (depends on 1)

The method of claim 1, wherein the estimating second glucose information includes determining an estimate of an amount or percentage of time that a glucose concentration level was in range during a specified time period.

### Claim 8 (depends on 1)

The method of claim 1, wherein the plurality of first non-glucose information of the patient comprises first activity data received from the activity monitor worn by the patient during the first time period and the determining relationships comprises correlating the first activity data with the plurality of first glucose information of the patient.

### Claim 9 (depends on 8)

The method of claim 8, wherein the activity monitor comprises a watch.

### Claim 10 (depends on 1)

The method of claim 1, further comprising tuning a glucose-estimation algorithm based on the determined relationships between the plurality of first glucose information and the plurality of first non-glucose information, wherein the estimating second glucose information comprises using the tuned glucose-estimation algorithm.

### Claim 11 (depends on 10)

The method of claim 10, further comprising:
monitoring the glucose concentrations of the patient during a third time period, the monitoring the glucose concentrations of the patient during the third time period comprising receiving a plurality of third glucose information of the patient from the CGM system, wherein the plurality of third glucose information is indicative of the glucose concentrations of the patient at a plurality of times during the third time period;
during the third time period, receiving a plurality of third non-glucose information of the patient from the activity monitor, wherein the plurality of third non-glucose information is indicative of physical activity of the patient corresponding to the plurality of times during the third time period; and
tuning the glucose-estimation algorithm based on a determined relationship between the plurality of third glucose information and the plurality of third non-glucose information.

### Claim 12 (depends on 10)

The method of claim 10, further comprising periodically tuning the glucose-estimation algorithm based on additional glucose information received from the CGM system during one or more subsequent time periods and additional non-glucose information received from the activity monitor during the one or more subsequent time periods.

### Claim 13 (depends on 1)

The method of claim 1, wherein the plurality of first non-glucose information and the second non-glucose information each comprise activity data.

### Claim 14 (depends on 1)

The method of claim 1, wherein the plurality of first non-glucose information and the second non-glucose information each comprise a same type of information, the same type of information comprising at least one of the following:
a number of steps;
an indicator of activity type;
an indicator of activity intensity; and
an indicator of an amount of time of activity.

### Claim 15 (depends on 1)

The method of claim 1, wherein the first time period comprises one of 3 days, 7 days, 10 days, 14 days, 30 days, 1 month, or 3 months.

### Claim 16 (depends on 1)

The method of claim 1, wherein the plurality of first glucose information and the second glucose information each comprise at least one glucose concentration level.

### Claim 17

A non-transitory computer-readable medium comprising instructions thereon that, when executed by at least one processor, causes the at least one processor to perform operations comprising:
during a first time period, monitoring glucose concentrations of a patient continuously measured by a continuous glucose monitoring (CGM) system adapted to be worn by the patient, the monitoring comprising receiving a plurality of first glucose information of the patient from the CGM system, wherein the plurality of first glucose information is indicative of the glucose concentrations of the patient at a plurality of times during the first time period;
during the first time period, receiving a plurality of first non-glucose information of the patient from an activity monitor adapted to be worn by the patient, wherein the plurality of first non-glucose information is indicative of physical activity of the patient corresponding to the plurality of times during the first time period;
determining relationships between the plurality of first glucose information and the plurality of first non-glucose information by correlating the physical activity of the patient with corresponding impacts on the glucose concentrations of the patient as the glucose concentrations vary;
determining, during a second time period, that glucose information from the CGM system is not available;
during the second time period in which glucose information from the CGM system is not available, receiving second non-glucose information of the patient from the activity monitor, wherein the second non-glucose information is indicative of physical activity of the patient corresponding to the second time period;
estimating, in real time, second glucose information of the patient for the second time period based upon the second non-glucose information of the patient and the determined relationships between the plurality of first glucose information and the plurality of first non-glucose information; and
electronically delivering, during the second time period, a notification about the second glucose information.

### Claim 18 (depends on 17)

The non-transitory computer-readable medium of claim 17, the operations further comprising:
determining guidance based at least in part on the second glucose information; and
displaying the guidance at a user interface.

### Claim 19 (depends on 17)

The non-transitory computer-readable medium of claim 17, the operations further comprising:
receiving additional non-glucose information of the patient for the first time period, wherein the additional non-glucose information is different than the plurality of first non-glucose information; and
determining a relationship between the plurality of first glucose information, the plurality of first non-glucose information, and the additional non-glucose information, wherein the estimating second glucose information is based at least in part on the determined relationship.

### Claim 20 (depends on 17)

The non-transitory computer-readable medium of claim 17, wherein the activity monitor comprises a watch.