The present invention relates to an appliance for recording diagnostic values in the body, using at least one sensor element which has an associated housing, and the housing can be implanted together with the at least one sensor element.
Appliances such as these, in particular blood glucose measurement appliances, are known on the market in many forms and versions, and are commercially available. In this case, modern methods and appliances for carrying out the methods are known, with a glucose concentration being determined outside laboratories, for example by means of test strips. In this case, the result of a chemical reaction to a substance on the strip and the blood applied to it is recorded electrically and/or photometrically. In order to repeat the measurement, a new test strip must in each case be inserted in a measurement appliance, in which case sufficient blood must be available for this purpose. Furthermore, a conventional test strip must be in a good state and must match the type of measurement appliance.
This has the disadvantage that a test method such as this allows only costly measurement because of the large number of test strips, causing pain to the patient because of the permanent need to take blood repeatedly and with the patient being bound to a specific measurement appliance and test strip. Furthermore, a measurement such as this may not be possible sufficiently frequently, for example only five times per day. In particular, tests such as these of certain patient groups, such as children, the blind, and those with physical and psychological impediments, cannot be considered reasonable in all cases. Furthermore, such test results are inaccurate, because of the limited number of measurements, in terms of changes in the blood glucose content, so that exact medication is virtually impossible.
WO 03/055391 A1 discloses a housing which can be implanted and has an integrated fixed sensor element, which is released for the purpose of a measurement. The release process generally injures connective tissue. For this purpose, a separate cover, slide or the like is provided on the housing of the apparatus in order to remove contamination from the permanently installed sensor element.
WO 03/034902 A2 discloses a sensor element which can be implanted subcutaneously. WO 01/80728 A1 describes an apparatus for automatically determining the glucose content of the blood, with an assembly which can be implanted and a multiplicity of microchambers being provided, and in which case the individual chambers can be opened and closed as required.
WO 01/03572 A1 discloses an apparatus for measuring the human glucose level, in which a catheter is used. In addition, the measurement point has a separate cleaning apparatus, in order to remove tissue parts which have been deposited from the blood.
The present invention is therefore based on the object of providing an appliance for recording diagnostic values in the body, in particular of the blood, which overcomes the stated disadvantages and in which a selected diagnostic value of the body, in particular of the blood, can be determined permanently or at desired time intervals, without causing pain to the patient, as well as exactly and precisely.
This object is achieved by the features of the present invention, wherein it has been particularly advantageous by varying the surface area, volume or extent of an appliance which can be implanted completely, subcutaneously under the skin, fixed or implanted in a bone, to tear open or to tear encapsulation of binding tissue, so that fresh tissue fluid, in particular blood, enters the area of a sensor element.
In this case, mechanically movable elements, such as pins, needles, canulars, blades or the like, can also be moved with respect to the appliance in order, after encapsulation of a subcutaneously implanted appliance, to apply fresh tissue fluid to a sensor element. The sensor element is preferably associated with this movable element. However, it may also be arranged in the area of the housing or the housing surface. The invention is not intended to be restricted to this.
This allows diagnostic values of the body to be recorded at selectable time intervals or continuously. Considerably more measured values, for example of the glucose level, can be achieved at relatively short time intervals. The precision of the measurements can be considerably increased and the correspondingly discontinuous or continual dosage of medicaments can be subjected to appropriately exact open-loop and closed-loop control. This makes it possible to avoid hypoglycemia and hyperglycemia, while considerably improving safety and life expectancy of diabetics. Furthermore, this makes it much simpler for the patient to handle his illness, his quality of life is directly improved, and his entire health system is in this way relieved of major problems, since the handling of diabetes is considerably simplified. Furthermore, the exact determination of the blood glucose level allows a permanent supply of insulin, or the use of insulin pumps, to be subjected to closed-loop and open-loop control, so that, for example, insulin pump therapy can be carried out and automated completely independently of the patient. Furthermore, another aim is also to use the sensor element to additionally record and evaluate further values, such as the heart rate, blood pressure, vitamin levels, and illness causes. This is likewise intended to be within the scope of the present invention.
One aim of the present invention is to determine any desired values, diagnostic values or blood values permanently, continually or at selectable time intervals by means of an appliance which can be implanted completely. This is intended to allow a controlled supply of medicaments to be provided by determining, for example cholesterol values, hemoglobin values, and values of medicaments in the blood, as a concentration. Another aim in this case is also to allow, for example, the heart rate or blood pressure as well as a value of a specific medicament in the blood to be determined in order to provide closed-loop and open-loop control for an additional supply if the concentration changes.
By way of example, for pain therapy, the medicament concentration of the analgesic in the blood can be determined permanently or at selectable time intervals and, if the values change, more medicament can be given in order to achieve the required concentration in an automated form or externally again, by means of the fully implanted appliance.
The determined measured values are transmitted telemetrically and/or without contact to an external medicament supply device, or to a medicament supply device which can be implanted completely, in particular an insulin pump. This is then operated appropriately for the required concentrations or medicaments in the body. Another aim within the scope of the present invention is that it should be possible to combine the measurement system for determination of the blood glucose level and the medicament supply device or insulin pump within one system. This system can also be implanted completely.
Further advantages, features and details of the invention will become evident from the following description of preferred exemplary embodiments and from the drawing, in which:
a shows a schematically illustrated longitudinal section through an appliance for determining the blood glucose level, in a retracted in-use position;
b shows a schematically illustrated longitudinal section through the appliance shown in figure
a and 2b each show two further exemplary embodiments of appliances with a variable volume extent for determining the blood glucose level;
a and 5b show further exemplary embodiments of appliances for determining the blood glucose level.
As shown in
With the present invention, it has been found to be particularly advantageous to vary the volume, the extent or the surface area of the housing 1. Variation of the volume, extent or surface area, in particular enlargement of the housing 1, allows a connective tissue 3 to be torn into, torn or torn open, which is formed automatically over the course of time around a foreign body which has been inserted subcutaneously under the skin. The housing 1 of the appliance R1 and therefore the sensor element 4, is no longer accessible to the tissue liquid, because of the corresponding encapsulation by means of the binding tissue 3.
b indicates the connective tissue 3 being torn open so that tissue fluid, in particular blood, can enter the area of the housing 1 again. Immediately after the tissue fluid enters the housing 1, the blood glucose level is determined, for example, by means of at least one sensor element 4, which is preferably in the form of a glucose measurement sensor.
The appliance R1 essentially comprises two housing parts 5.1, 5.2 which are positioned coaxially one inside the other and can be moved backwards and forwards in the direction of the illustrated double-headed arrow X by means of at least one actuator 6, in particular a linear actuator, and a motor and/or gearbox and/or control unit 7. The sensor element 4 is preferably situated on the movable housing part 5.2. The sensor element 4 may also be arranged in the housing 1, in which case blood is taken from outside the housing 1 by means of any desired device, for example a canular, and is supplied to the sensor element 4 that is arranged in the housing 1.
The motor unit and/or gearbox unit and/or control unit 7 is supplied with power with or without the use of wires, for example inductively, and is also used for bidirectional telemetric data interchange relating to the determination of the blood glucose level.
In this case, the housing part 5.2 is moved out of the housing part 1.2 by means of the actuator 6 and/or a spindle 8, with the spindle 8 being driven via the motor unit and/or gearbox unit and/or control unit 7, and with the housing part 5.2 being moved controllably out of the housing part 5.1. This makes it possible to tear open, burst or tear any connective tissue 3 that may exist, for example as is indicated in
This process can be repeated selectively or uncontrollably, that is to say the volume, the extent or the surface area of the housing is changed before each determination of the diagnostic values, for example before determining the blood glucose level.
A further exemplary embodiment of an appliance R2 is shown in
In this case, the housing 1 may have many different cross sections, so that the invention is not restricted to one specific cross section. As is illustrated in the exemplary embodiment shown in
Another aim of the present invention, as is indicated for an appliance R4 in a further exemplary embodiment shown in
In another exemplary embodiment of the present invention as shown in
The appliance R5 is implanted subcutaneously under a person's skin 12, with encapsulation of the appliance R5 by the connective tissue 3 being torn open, torn or otherwise perforated by movement of the element 9 by means of the actuator 6 in the illustrated X direction and/or by radial movement, in order then to appropriately exactly determine the glucose content of the blood by means of the sensor element 4.
This process can be repeated permanently or at selectable time intervals, for example every hour, so that the data or the exact determination of the blood glucose content is then passed with or without the use of wires to an evaluation unit 13 which then, for example, determines an insulin concentration and then appropriately controls the insulin supply.
The exemplary embodiment in
The scope of the present invention is also intended to cover, for example, the at least one sensor element 4 being arranged externally on the housing 1.
Number | Date | Country | Kind |
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10 2005 055 398.2 | Nov 2005 | DE | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/EP06/10327 | 10/26/2006 | WO | 00 | 5/12/2008 |