Insulet Corporation

General Electric Company

Lockheed Martin Corporation

Yibin Zheng

Joon Bok Lee

Jason B O'Connor

Ashutosh Zade

Jason O'connor

Trang Ly

Thomas Arnold Peyser

Steven P Cardinali

Mengdi Li

Jennifer Lena Schneider

Eric Benjamin

Kai-Bor Yu

Khalil John Maalouf

Todd Vienneau

David I Nazzaro

Ralph Thomas Hoctor

Ian T McLaughlin

Kamal Mannar

Rajiv Gupta

William Whiteley

Ian Mclaughlin

Christopher James Dailey

Bruce Richard Everling

Terry Wayne Taylor

Lon Raymond Bischoff

Bonnie Dumais

Saeed Salavati

Fang Tu

Mert Sevil

Rangarajan Narayanaswami

Connor Gullifer

Kyle Grover

Sam Carl

A wearable drug delivery device, techniques, and computer-readable media that provide an application that implements a diabetes treatment plan for a user are described. The drug delivery device may include a controller operable to direct operation of the wearable drug delivery device. The controller may provide a selectable activity mode of operation for the user. Operation of the drug delivery device in the activity mode of operation may reduce a likelihood of hypoglycemia during times of increased insulin sensitivity for the user and may reduce a likelihood of hyperglycemia during times of increased insulin requirements for the user. The activity mode of operation may be manually activated by the user or may be activated automatically by the controller. The controller may automatically activate the activity mode of operation based on a detected activity level of the user and/or a detected location of the user.

Activity mode for artificial pancreas system

The exemplary embodiments may modify a glucose cost component of the cost function of the control loop of an insulin delivery device to compensate for persistent positive low level glucose excursions relative to a target glucose level. The exemplary embodiments may enable use of different glucose cost component functions for different glucose levels of the user. These glucose cost component functions may be employed in piecewise fashion with a different piece being applied for each respective range of glucose level values for the user. The final glucose cost function for calculating the glucose cost component may be a weighted combination of a piecewise glucose cost function and a weighted standard cost function (such as a quadratic function). The weights may reflect the magnitude and/or persistence of glucose excursions relative to a target glucose level.

Medicament delivery device with an adjustable and piecewise analyte level cost component to address persistent positive analyte level excursions

Exemplary embodiments described herein relate to a closed loop artificial pancreas system. The artificial pancreas system seeks to automatically and continuously control the blood glucose level of a user by emulating the endocrine functionality of a healthy pancreas. The artificial pancreas system uses a closed loop control system with a cost function. The penalty function helps to bound the infusion rate of insulin to attempt to avoid hypoglycemia and hyperglycemia. However, unlike conventional systems that use a generic or baseline parameter for a user's insulin needs in a cost function, the exemplary embodiments may use a customized parameter in the cost function that reflects the individualized insulin needs of the user. The use of the customized parameter causes the cost function to result in insulin dosages over time better suited to the individualized insulin needs of the user. This helps to better avoid hypoglycemia and hyperglycemia.

User parameter dependent cost function for personalized reduction of hypoglycemia and/or hyperglycemia in a closed loop artificial pancreas system

Disclosed herein is a method for execution by a drug delivery device for determining an optimal dose of a liquid drug for current cycle of a medication delivery algorithm, the method utilizing a stepwise evaluation of a model and a cost function across a coarse search space consisting of coarse discrete quantities of the drug and a refined search space consisting of refined discrete quantities of the drug.

Optimizing embedded formulations for drug delivery

Described are techniques, processes, devices, computer-readable media that enable provision of an indication of whether it is safe for a person with diabetes to participate in exercise while using a wearable drug delivery system. A processor may receive or obtain physiological data related to a condition of a wearer of the wearable drug delivery system and by evaluating an exercise model that uses inputs related to the physiological data to make the determination of whether it is safe to exercise and output an exercise safety signal. Modifications to the wearer's medication treatment plan and other actions may be based on an outputted exercise safety signal.

Exercise safety prediction based on physiological conditions

Exemplary embodiments may modify the cost function parameters based on current and projected mean outcomes in blood glucose level control performance. The exemplary embodiments may modify the weight coefficient R for the insulin cost so that the value of R is not fixed and is not based solely on clinical determined values. Exemplary embodiments may also adjust the cost function to address persistent low-level blood glucose level excursions for users. The exemplary embodiments may reduce the penalty of the insulin cost by the sum of the converted insulin cost of the glucose excursions above target for a period divided by a number of cycles of average insulin action time. The AID system reduces the insulin cost by the lack of insulin in previous cycles.

Adaptive update of automatic insulin delivery (AID) control parameters

In an automated insulin delivery device, fuzzy logic may be applied to the responding to the possibility of a user taking additional action that may affect the blood glucose concentration. Fuzzy sets may be defined for empirically derived different likelihoods of the user taking such additional action based on correlated factors. A membership function may be provided for each fuzzy set. The membership function may provide a probability of membership in the set based on a parameter. Each fuzzy set may have a response that is reflective of the likelihood of additional user action associated with the fuzzy set. The responses by the AID device to each of these cases may reflect the probability of each such case occurring as evidenced by empirical data.

Use of fuzzy logic in predicting user behavior affecting blood glucose concentration in a closed loop control system of an automated insulin delivery device

Disclosed are techniques to establish a modified pump rate that mitigates the effects of a pump occlusion and enables a recommended dosage of insulin to be output by a pump mechanism over the course of a control cycle. In an example, the pump rate may be reduced by adding a calculated time interval between application of actuation commands to extend the amount of time over which insulin may be output by the pump mechanism.

Techniques to reduce risk of occlusions in drug delivery systems

Disclosed are techniques to establish initial settings for an automatic insulin delivery device. An adjusted total daily insulin (TDI) factor usable to calculate a TDI dosage may be determined. The adjusted TDI factor may be a TDI per unit of a physical characteristic of the user (e.g., weight) times a reduction factor. The adjusted TDI factor may be compared to a maximum algorithm delivery threshold. Based on the comparison result, the application or algorithm may set a TDI dosage and output a control signal. Blood glucose measurement values may be collected from a sensor over a period of time. A level of glycated hemoglobin of the blood may be determined based on the obtained blood glucose measurement values. In response to the level of glycated hemoglobin, the set TDI dosage may be modified. A subsequent control signal including the modified TDI dosage may be output to actuate delivery of insulin.

Initial total daily insulin setting for user onboarding

Exemplary embodiments may address the problem of missing blood glucose concentration readings from a glucose monitor that transmits blood glucose concentration readings over a wireless connection due to problems with the wireless connection. In the exemplary embodiments, an automated insulin delivery (AID) device uses an estimate in place of a missing blood glucose concentration reading in determining a predicted future blood glucose concentration reading for a user. Thus, the AID device is able to operate normally in generating insulin delivery settings despite not receiving a current blood glucose concentration reading for a current cycle. There is no need to suspend delivery of insulin to the user due to the missing blood glucose concentration reading.

Compensation for missing readings from a glucose monitor in an automated insulin delivery system

Disclosed herein are systems and methods for the delivery of a co-formulation of insulin and a second drug, such as GLP-1, using an automated insulin delivery system. In a first embodiment, a dose of insulin is calculated by a medication delivery algorithm and a reduction factor is applied to account for the effect of second drug on the user's daily insulin requirement. In a second embodiment of the invention, a total amount of the second drug administered to the user during the past 24 hours is used to modify the correction factor and the insulin-to-carbohydrate ratio used by the medication delivery algorithm to cause a reduction in the insulin delivered to the user to account for the effect of the administration of the second drug portion of the co-formulation.

Systems and methods for incorporating co-formulations of insulin in an automatic insulin delivery system

The exemplary embodiments may provide a drug delivery device that receives glucose level values for a user (e.g., a diabetic patient) and based on the glucose level values, determines when the user has consumed a meal. In some embodiments, the drug delivery device may calculate an appropriate bolus dose and automatically deliver the drug bolus to the user. In some embodiments, instead of detecting the meal, the user may announce the meal, such as by activating an element on the drug delivery device or on a management device for the drug delivery device. Responsive to the meal announcement, the drug delivery device may calculate the drug bolus dose and deliver the drug bolus. In conjunction with the delivery of the drug bolus, the drug delivery device may relax one or more safety constraints for a relaxation period following the drug bolus delivery so that additional basal drug may be delivered, if needed, under relaxed constraints.

Automatically or manually initiated meal bolus delivery with subsequent automatic safety constraint relaxation

Disclosed are a system, methods and computer-readable medium products that provide safety constraints for an insulin-delivery management program. Various examples provide safety constraints for a control algorithm-based drug delivery system that provides automatic delivery of a drug based on sensor input. Glucose measurement values may be received at regular time intervals from a sensor. A processor may predict future glucose values based on prior glucose measurement values. The safety constraints assist in safe operation of the drug delivery system during various operational scenarios. In some examples, predicted future glucose values may be used to implement safety constraints that mitigate under-delivery or over-delivery of the drug while not overly burdening the user of the drug delivery system and without sacrificing performance of the drug delivery system. Other safety constraints are also disclosed.

Safety constraints for a control algorithm based drug delivery system

Exemplary embodiments provide an approach to predicting meal and/or exercise events for an insulin delivery system that otherwise does not otherwise identify such events. The insulin delivery system may use a model of glucose insulin interactions that projects estimated future glucose values based on a history of glucose values and insulin deliveries for a user. The predictions of meal events and/or exercise events may be based on residuals between actual glucose values and predicted glucose values. The exemplary embodiments may calculate a rate of change of the residuals over a period of time and compare the rate of change to thresholds to determine whether there likely has been a meal event or an exercise event. The insulin delivery system may then take measures to account for the meal event or the exercise event by the user.

Prediction of meal and/or exercise events based on persistent residuals

The exemplary embodiments attempt to identify impending hypoglycemia and/or hyperglycemia and take measures to prevent the hypoglycemia or hyperglycemia. Exemplary embodiments may provide a drug delivery system for delivering insulin and glucagon as needed by a user of the drug delivery system. The drug delivery system may deploy a control system that controls the automated delivery of insulin and glucagon to a patient by the drug delivery system. The control system seeks among other goals to avoid the user experiencing hypoglycemia or hyperglycemia. The control system may employ a clinical decision support algorithm as is described below to control delivery of insulin and glucagon to reduce the risk of hypoglycemia or hyperglycemia and to provide alerts to the user when needed. The control system assesses whether the drug delivery system can respond enough to avoid hypoglycemia or hyperglycemia and generates alerts when manual action is needed to avoid hypoglycemia or hyperglycemia.

Growing community of inventors

Hartland, WI, United States of America

Yibin Zheng