System and method for titrating basal insulin doses
AssigneeDexCom, Inc.
InventorsStephen D. Patek, Matthew S. Gerber, Enrique Campos-Nanez, Thibault Gautier, Leah Ziegler
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Abstract
A continuous glucose monitor (CGM)-driven basal insulin titration system and method for patients with Type 2 Diabetes can be adapted to the needs and concerns of subjects just starting on basal insulin therapy. The method uses as inputs historical CGM data, basal insulin dose information, reports of hypoglycemia, and past recommendations and generates an adjusted insulin dose along with a report advising whether to continue the titration process, or to stop. The method can generate a new recommendation on a regular basis (e.g., each day) until it determines an adequate, consistent dose size.
Claims29
A basal titration adjustment device for titrating a basal insulin dose for a subject, comprising:
- one or more processors;
- a continuous glucose monitor (CGM) module that, when executed by the one or more processors, receives CGM data obtained over at least a series of days and further generates, from the CGM data, values of a plurality of daily glucose state parameters, each reflective of an aspect of a glucose state of the subject;
- an insulin module that, when executed by the one or more processors, receives daily basal insulin dose values administered to the subject over the series of days and generates therefrom daily effective doses that each account for an accumulation of insulin in the subject from previously administered doses that are still active;
- at least a first glucose state response modeler that, when executed by the one or more processors, receives a first of the plurality of daily glucose state parameters and one or more of the daily effective doses and generates therefrom a first regularized dose-response model relating the first daily glucose state parameter to an effective basal insulin dose;
- and
- a target dose adjuster that, when executed by the one or more processors, receives the first regularized dose-response model and generates therefrom a target basal insulin dose that is to produce a value of the first daily glucose state parameter.
A method for titrating a basal insulin dose for a subject, comprising:
- receiving CGM data obtained over at least a series of days;
- generating from the CGM data a plurality of glucose state parameters reflective of an aspect of a glucose state of the subject;
- receiving basal insulin dose values administered to the subject over the series of days and generating therefrom effective doses that each account for an accumulation of insulin in the subject from previously administered doses that are still active;
- receiving a first of the plurality of glucose state parameters and the effective doses and generating therefrom a first regularized dose-response model relating the first glucose state parameter to an effective basal insulin dose;
- and
- receiving the first regularized dose-response model and generating therefrom a target basal insulin dose.
A method for titrating a basal insulin dose for a subject without use of fasting glucose, comprising:
- receiving CGM data obtained over at least a series of days;
- generating from the CGM data one or more glucose state parameters reflective of an aspect of a glucose state of the subject, wherein the one or more glucose state parameters, wherein at least one of the one or more glucose state parameters is a low daily EGV parameter specifying whether or not the subject experienced an EGV below a specified level on a given day, and is further based on CGM values that are below a certain percentile of a glucose distribution of the subject;
- receiving basal insulin dose values administered to the subject over the series of days and generating therefrom effective doses that each account for an accumulation of insulin in the subject from previously administered doses that are still active;
- receiving a first of the plurality of glucose state parameters and the effective doses and generating therefrom a first regularized dose-response model relating the first glucose state parameter to an effective basal insulin dose;
- and
- receiving the first regularized dose-response model and generating therefrom a target basal insulin dose.
Dependencies are inferred from the claim text.