Embodiments of the subject matter described herein relate generally to medical devices, and more particularly, embodiments of the subject matter relate to fluid infusion devices accommodating multiple different infused fluids with common operating modes.
Infusion pump devices and systems are relatively well known in the medical arts, for use in delivering or dispensing an agent, such as insulin or another prescribed medication, to a patient. A typical infusion pump includes a pump drive system which typically includes a small motor and drive train components that convert rotational motor motion to a translational displacement of a plunger (or stopper) in a reservoir that delivers medication from the reservoir to the body of a user via a fluid path created between the reservoir and the body of a user. Use of infusion pump therapy has been increasing, especially for delivering insulin for diabetics.
Continuous insulin infusion provides greater control of a diabetic's condition, and hence, control schemes are being developed that allow insulin infusion pumps to monitor and regulate a user's blood glucose level in a substantially continuous and autonomous manner. For example, an insulin infusion pump may operate in a closed-loop operating mode overnight while a user is sleeping to regulate the user's glucose level to a target glucose level. In practice, multiple different operating modes for providing continuous insulin infusion may be supported by an infusion pump, however, care must be taken when transitioning between operating modes to avoid potentially compromising a user's condition and ensure compliance with applicable regulatory requirements.
Infusion pumps have been traditionally designed and configured with a particular drug and physiological condition in mind. However, as different drugs enter or exit the market, or different physiological conditions are capable of being regulated via fluid infusion, it is desirable to accommodate future infusion scenarios as seamlessly as possible while maintaining compliance with applicable regulatory requirements.
Infusion devices, systems and related methods of operation are provided. One exemplary method of operating an infusion device to deliver fluid to a user in accordance with an operating mode involves identifying a fluid type associated with the fluid currently onboard the infusion device from among a plurality of possible fluid types that is different from a previous type of fluid previously onboard the infusion device. The identified fluid type has pharmacokinetics characteristics that are different from pharmacokinetics characteristics associated with the previous fluid type. The method continues by updating one or more parameters referenced by a control module of the infusion device implementing the operating mode to reflect the pharmacokinetics characteristics associated with the identified fluid type and autonomously operating the infusion device to deliver the fluid of the identified fluid type to the user in accordance with the operating mode and the one or more updated control parameters.
In another embodiment, a method of operating an infusion device in accordance with an operating mode involves autonomously operating the infusion device to deliver a first fluid to a user in accordance with the operating mode and first values for one or more parameters of the operating mode referenced by a control module of the infusion device implementing the operating mode, where the first values are associated with a first fluid type of the first fluid. Thereafter, the method identifies a second fluid type associated with a second fluid onboard the infusion device that has pharmacokinetics characteristics different from the first fluid type. In response to identifying the second fluid type, the method automatically updates the one or more parameters referenced by the control module to second values associated with the second fluid type of the second fluid that reflect the pharmacokinetics characteristics associated with the second fluid type, and after updating the one or more parameters, autonomously operating the infusion device to deliver the second fluid to the user in accordance with the operating mode and the second values for the one or more parameters.
An embodiment of an infusion device is also provided. The infusion device includes a data storage element to maintain initial values for control parameters of an operating mode, a motor operable to deliver fluid influencing a physiological condition to a body of a user, and a control system coupled to the motor and the data storage element. The control system operates the motor to deliver the fluid to the user in accordance with the operating mode using the initial values for the control parameters of the operating mode. Thereafter, the control system identifies a different fluid type associated with the fluid currently onboard the infusion device having pharmacokinetics characteristics different from a previous fluid type onboard the infusion device from among a plurality of possible fluid types. In response to identifying the different fluid type, the control system updates control parameter values maintained by the data storage element to updated values that are different from the initial values and reflect the pharmacokinetics characteristics of the identified fluid type, and thereafter, the control system operates the motor to deliver the fluid to the user in accordance with the operating mode using the updated values for the control parameters of the operating mode.
This summary is provided to introduce a selection of concepts in a simplified form that are further described below in the detailed description. This summary is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used as an aid in determining the scope of the claimed subject matter.
A more complete understanding of the subject matter may be derived by referring to the detailed description and claims when considered in conjunction with the following figures, wherein like reference numbers refer to similar elements throughout the figures, which may be illustrated for simplicity and clarity and are not necessarily drawn to scale.
The following detailed description is merely illustrative in nature and is not intended to limit the embodiments of the subject matter or the application and uses of such embodiments. As used herein, the word “exemplary” means “serving as an example, instance, or illustration.” Any implementation described herein as exemplary is not necessarily to be construed as preferred or advantageous over other implementations. Furthermore, there is no intention to be bound by any expressed or implied theory presented in the preceding technical field, background, brief summary or the following detailed description.
While the subject matter described herein can be implemented in any electronic device that includes a motor, exemplary embodiments described below are implemented in the form of medical devices, such as portable electronic medical devices. Although many different applications are possible, the following description focuses on a fluid infusion device (or infusion pump) as part of an infusion system deployment. For the sake of brevity, conventional techniques related to infusion system operation, insulin pump and/or infusion set operation, and other functional aspects of the systems (and the individual operating components of the systems) may not be described in detail here. Examples of infusion pumps may be of the type described in, but not limited to, U.S. Pat. Nos. 4,562,751; 4,685,903; 5,080,653; 5,505,709; 5,097,122; 6,485,465; 6,554,798; 6,558,320; 6,558,351; 6,641,533; 6,659,980; 6,752,787; 6,817,990; 6,932,584; and 7,621,893; each of which are herein incorporated by reference.
Embodiments of the subject matter described herein generally relate to fluid infusion devices including a motor that is operable to linearly displace a plunger (or stopper) of a reservoir provided within the fluid infusion device to deliver a dosage of fluid, such as insulin, to the body of a user. Dosage commands that govern operation of the motor may be generated in an automated and autonomous manner in accordance with the delivery control scheme associated with a particular operating mode. For example, in a closed-loop operating mode, the dosage commands are generated based on a difference between a current (or most recent) measurement of a physiological condition in the body of the user (e.g., an interstitial fluid glucose level) and a target (or reference) value for that physiological condition. In a predictive operating mode, the dosage commands may be influenced by a predicted value (or anticipated measurement) for that physiological condition in the body of the user at some point in the future. Conversely, in an open-loop operating mode, the dosage commands may be configured to implement a predetermined delivery rate substantially independent of the current or predicted measurements of the physiological condition of the user.
As described in greater detail below in the context of
Turning now to
In the illustrated embodiment of
The sensing arrangement 104 generally represents the components of the infusion system 100 configured to sense, detect, measure or otherwise quantify a condition of the user, and may include a sensor, a monitor, or the like, for providing data indicative of the condition that is sensed, detected, measured or otherwise monitored by the sensing arrangement. In this regard, the sensing arrangement 104 may include electronics and enzymes reactive to a biological condition, such as a blood glucose level, or the like, of the user, and provide data indicative of the blood glucose level to the infusion device 102, the CCD 106 and/or the computer 108. For example, the infusion device 102, the CCD 106 and/or the computer 108 may include a display for presenting information or data to the user based on the sensor data received from the sensing arrangement 104, such as, for example, a current glucose level of the user, a graph or chart of the user's glucose level versus time, device status indicators, alert messages, or the like. In other embodiments, the infusion device 102, the CCD 106 and/or the computer 108 may include electronics and software that are configured to analyze sensor data and operate the infusion device 102 to deliver fluid to the body of the user based on the sensor data and/or preprogrammed delivery routines. Thus, in exemplary embodiments, one or more of the infusion device 102, the sensing arrangement 104, the CCD 106, and/or the computer 108 includes a transmitter, a receiver, and/or other transceiver electronics that allow for communication with other components of the infusion system 100, so that the sensing arrangement 104 may transmit sensor data or monitor data to one or more of the infusion device 102, the CCD 106 and/or the computer 108.
Still referring to
As described above, in some embodiments, the CCD 106 and/or the computer 108 may include electronics and other components configured to perform processing, delivery routine storage, and to control the infusion device 102 in a manner that is influenced by sensor data measured by and/or received from the sensing arrangement 104. By including control functions in the CCD 106 and/or the computer 108, the infusion device 102 may be made with more simplified electronics. However, in other embodiments, the infusion device 102 may include all control functions, and may operate without the CCD 106 and/or the computer 108. In various embodiments, the CCD 106 may be a portable electronic device. In addition, in various embodiments, the infusion device 102 and/or the sensing arrangement 104 may be configured to transmit data to the CCD 106 and/or the computer 108 for display or processing of the data by the CCD 106 and/or the computer 108.
In some embodiments, the CCD 106 and/or the computer 108 may provide information to the user that facilitates the user's subsequent use of the infusion device 102. For example, the CCD 106 may provide information to the user to allow the user to determine the rate or dose of medication to be administered into the patient's body. In other embodiments, the CCD 106 may provide information to the infusion device 102 to autonomously control the rate or dose of medication administered into the body of the user. In some embodiments, the sensing arrangement 104 may be integrated into the CCD 106. Such embodiments may allow the user to monitor a condition by providing, for example, a sample of his or her blood to the sensing arrangement 104 to assess his or her condition. In some embodiments, the sensing arrangement 104 and the CCD 106 may be used for determining glucose levels in the blood and/or body fluids of the user without the use of, or necessity of, a wire or cable connection between the infusion device 102 and the sensing arrangement 104 and/or the CCD 106.
In some embodiments, the sensing arrangement 104 and/or the infusion device 102 are cooperatively configured to utilize a closed-loop system for delivering fluid to the user. Examples of sensing devices and/or infusion pumps utilizing closed-loop systems may be found at, but are not limited to, the following U.S. Pat. Nos. 6,088,608, 6,119,028, 6,589,229, 6,740,072, 6,827,702, 7,323,142, and 7,402, 153, all of which are incorporated herein by reference in their entirety. In such embodiments, the sensing arrangement 104 is configured to sense or measure a condition of the user, such as, blood glucose level or the like. The infusion device 102 is configured to deliver fluid in response to the condition sensed by the sensing arrangement 104. In turn, the sensing arrangement 104 continues to sense or otherwise quantify a current condition of the user, thereby allowing the infusion device 102 to deliver fluid substantially continuously in response to the condition currently (or most recently) sensed by the sensing arrangement 104 indefinitely. In some embodiments, the sensing arrangement 104 and/or the infusion device 102 may be configured to utilize the closed-loop system only for a portion of the day, for example, only when the user is asleep or awake.
As best illustrated in
The housing 202 is formed from a substantially rigid material having a hollow interior 214 adapted to allow an electronics assembly 204, a sliding member (or slide) 206, a drive system 208, a sensor assembly 210, and a drive system capping member 212 to be disposed therein in addition to the reservoir 205, with the contents of the housing 202 being enclosed by a housing capping member 216. The opening 220, the slide 206, and the drive system 208 are coaxially aligned in an axial direction (indicated by arrow 218), whereby the drive system 208 facilitates linear displacement of the slide 206 in the axial direction 218 to dispense fluid from the reservoir 205 (after the reservoir 205 has been inserted into opening 220), with the sensor assembly 210 being configured to measure axial forces (e.g., forces aligned with the axial direction 218) exerted on the sensor assembly 210 responsive to operating the drive system 208 to displace the slide 206. In various embodiments, the sensor assembly 210 may be utilized to detect one or more of the following: an occlusion in a fluid path that slows, prevents, or otherwise degrades fluid delivery from the reservoir 205 to a patient's body; when the reservoir 205 is empty; when the slide 206 is properly seated with the reservoir 205; when a fluid dose has been delivered; when the infusion pump 200 is subjected to shock or vibration; when the infusion pump 200 requires maintenance.
Depending on the embodiment, the fluid-containing reservoir 205 may be realized as a syringe, a vial, a cartridge, a bag, or the like. In certain embodiments, the infused fluid is insulin, although many other fluids may be administered through infusion such as, but not limited to, HIV drugs, drugs to treat pulmonary hypertension, iron chelation drugs, pain medications, anti-cancer treatments, medications, vitamins, hormones, or the like. As best illustrated in
In the illustrated embodiment of
As best shown in
As illustrated in
The motor assembly 207 includes one or more electrical leads 236 adapted to be electrically coupled to the electronics assembly 204 to establish communication between the control electronics 224 and the motor assembly 207. In response to command signals from the control electronics 224 that operate a motor driver (e.g., a power converter) to regulate the amount of power supplied to the motor from a power supply, the motor actuates the drive train components of the drive system 208 to displace the slide 206 in the axial direction 218 to force fluid from the reservoir 205 along a fluid path (including tubing 221 and an infusion set), thereby administering doses of the fluid contained in the reservoir 205 into the patient's body. Preferably, the power supply is realized one or more batteries contained within the housing 202. Alternatively, the power supply may be a solar panel, capacitor, AC or DC power supplied through a power cord, or the like. In some embodiments, the control electronics 224 may operate the motor of the motor assembly 207 and/or drive system 208 in a stepwise manner, typically on an intermittent basis; to administer discrete precise doses of the fluid to the user according to programmed delivery profiles.
Referring to
Referring to
In exemplary embodiments, the sensing arrangement 504 includes one or more interstitial glucose sensing elements that generate or otherwise output electrical signals having a signal characteristic that is correlative to, influenced by, or otherwise indicative of the relative interstitial fluid glucose level in the body 501 of the user. The output electrical signals are filtered or otherwise processed to obtain a measurement value indicative of the user's interstitial fluid glucose level. In exemplary embodiments, a blood glucose meter 530, such as a finger stick device, is utilized to directly sense, detect, measure or otherwise quantify the blood glucose in the body 501 of the user. In this regard, the blood glucose meter 530 outputs or otherwise provides a measured blood glucose value that may be utilized as a reference measurement for calibrating the sensing arrangement 504 and converting a measurement value indicative of the user's interstitial fluid glucose level into a corresponding calibrated blood glucose measurement value. For purposes of explanation, sensor glucose value, sensed glucose value, glucose measurement value, or variants thereof should be understood to encompass any glucose value indicative of a current measured glucose level in the body of the user that is based on the electrical signals output by the sensing element(s) of the sensing arrangement 504.
The pump control system 520 generally represents the electronics and other components of the infusion device 502 that control operation of the fluid infusion device 502 according to a desired infusion delivery program in a manner that may be influenced by the sensed glucose value indicative of a current glucose level in the body 501 of the user. The particular operating mode being implemented by the pump control system 520 influences the generated dosage commands for operating the motor 507 to displace the plunger 517 and deliver insulin to the body 501 of the user. For example, in a closed-loop (CL) operating mode, the pump control system 520 generates or otherwise determines dosage commands for operating the motor 507 based on the difference between a sensed glucose value and the target (or commanded) glucose value to regulate the sensed glucose value to the target. In other operating modes, the pump control system 520 may generate or otherwise determine dosage commands configured to maintain the sensed glucose value below an upper glucose limit, above a lower glucose limit, or otherwise within a desired range of glucose values. For example, in a predictive low glucose management (PLGM) operating mode, the pump control system 520 calculates or otherwise determines a predicted glucose value based on the currently sensed glucose value, and generates dosage commands configured to provide a basal infusion rate when the predicted glucose value is greater than a predictive suspend threshold and automatically suspends delivery (e.g., by providing dosage commands equal to zero) when the predicted glucose value is less than the predictive suspend threshold. In a low glucose suspend (LGS) operating mode, the pump control system 520 generates dosage commands configured to provide a basal infusion rate when the sensed glucose value is greater than a suspend threshold (which may be different from the predictive suspend threshold) and automatically suspends delivery when the sensed glucose value is less than the suspend threshold. In an open-loop (OL) operating mode, the pump control system 520 generates dosage commands configured to provide a predetermined open-loop basal infusion rate independent of the sensed glucose value. In practice, the infusion device 502 may store or otherwise maintain the target value, suspension threshold values, and/or other glucose threshold value(s) in a data storage element accessible to the pump control system 520.
The target glucose value and other threshold values may be received from an external component (e.g., CCD 106 and/or computing device 108) or be input by a user via a user interface element 540 associated with the infusion device 502. In practice, the one or more user interface element(s) 540 associated with the infusion device 502 typically include at least one input user interface element, such as, for example, a button, a keypad, a keyboard, a knob, a joystick, a mouse, a touch panel, a touchscreen, a microphone or another audio input device, and/or the like. Additionally, the one or more user interface element(s) 540 include at least one output user interface element, such as, for example, a display element (e.g., a light-emitting diode or the like), a display device (e.g., a liquid crystal display or the like), a speaker or another audio output device, a haptic feedback device, or the like, for providing notifications or other information to the user. It should be noted that although
In exemplary embodiments, the pump control system 520 includes or otherwise accesses a data storage element, memory, or other non-transitory computer-readable medium capable of storing programming instructions for execution by the pump control system 520. The computer-executable programming instructions, when read and executed, cause the pump control system 520 to determine dosage commands in accordance with a particular operating mode and perform various additional tasks, operations, functions, and processes described herein.
Still referring to
In exemplary embodiments, the energy source 503 is realized as a battery housed within the infusion device 502 (e.g., within housing 202) that provides direct current (DC) power. In this regard, the motor driver module 514 generally represents the combination of circuitry, hardware and/or other electrical components configured to convert or otherwise transfer DC power provided by the energy source 503 into alternating electrical signals applied to respective phases of the stator windings of the motor 507 that result in current flowing through the stator windings that generates a stator magnetic field and causes the rotor of the motor 507 to rotate.
The motor control module 512 is configured to receive or otherwise obtain a commanded dosage from the pump control system 520, convert the commanded dosage to a commanded translational displacement of the plunger 517, and command, signal, or otherwise operate the motor driver module 514 to cause the rotor of the motor 507 to rotate by an amount that produces the commanded translational displacement of the plunger 517. For example, the motor control module 512 may determine an amount of rotation of the rotor required to produce translational displacement of the plunger 517 that achieves the commanded dosage received from the pump control system 520. Based on the current rotational position (or orientation) of the rotor with respect to the stator that is indicated by the output of the rotor sensing arrangement 516, the motor control module 512 determines the appropriate sequence of alternating electrical signals to be applied to the respective phases of the stator windings that should rotate the rotor by the determined amount of rotation from its current position (or orientation). In embodiments where the motor 507 is realized as a BLDC motor, the alternating electrical signals commutate the respective phases of the stator windings at the appropriate orientation of the rotor magnetic poles with respect to the stator and in the appropriate order to provide a rotating stator magnetic field that rotates the rotor in the desired direction. Thereafter, the motor control module 512 operates the motor driver module 514 to apply the determined alternating electrical signals (e.g., the command signals) to the stator windings of the motor 507 to achieve the desired delivery of fluid to the user.
When the motor control module 512 is operating the motor driver module 514, current flows from the energy source 503 through the stator windings of the motor 507 to produce a stator magnetic field that interacts with the rotor magnetic field. In some embodiments, after the motor control module 512 operates the motor driver module 514 and/or motor 507 to achieve the commanded dosage, the motor control module 512 ceases operating the motor driver module 514 and/or motor 507 until a subsequent dosage command is received. In this regard, the motor driver module 514 and the motor 507 enter an idle state during which the motor driver module 514 effectively disconnects or isolates the stator windings of the motor 507 from the energy source 503. In other words, current does not flow from the energy source 503 through the stator windings of the motor 507 when the motor 507 is idle, and thus, the motor 507 does not consume power from the energy source 503 in the idle state, thereby improving efficiency.
Depending on the embodiment, the motor control module 512 may be implemented or realized with a general purpose processor, a microprocessor, a controller, a microcontroller, a state machine, a content addressable memory, an application specific integrated circuit, a field programmable gate array, any suitable programmable logic device, discrete gate or transistor logic, discrete hardware components, or any combination thereof, designed to perform the functions described herein. Furthermore, the steps of a method or algorithm described in connection with the embodiments disclosed herein may be embodied directly in hardware, in firmware, in a software module executed by the motor control module 512, or in any practical combination thereof. In exemplary embodiments, the motor control module 512 includes or otherwise accesses a data storage element or memory, including any sort of random access memory (RAM), read only memory (ROM), flash memory, registers, hard disks, removable disks, magnetic or optical mass storage, or any other short or long term storage media or other non-transitory computer-readable medium, which is capable of storing programming instructions for execution by the motor control module 512. The computer-executable programming instructions, when read and executed by the motor control module 512, cause the motor control module 512 to perform the tasks, operations, functions, and processes described herein.
It should be appreciated that
Referring to
The pump control module 602 generally represents the hardware, circuitry, logic, firmware and/or other component(s) of the pump control system 600 that is configured to determine dosage commands for operating the motor 507 to deliver fluid to the body 501 based on measurement data received from the sensing arrangement 504 and perform various additional tasks, operations, functions and/or operations described herein. Depending on the embodiment, the pump control module 602 may be implemented or realized with a general purpose processor, a microprocessor, a controller, a microcontroller, a state machine, a content addressable memory, an application specific integrated circuit, a field programmable gate array, any suitable programmable logic device, discrete gate or transistor logic, discrete hardware components, or any combination thereof, designed to perform the functions described herein. In this regard, the steps of a method or algorithm described in connection with the embodiments disclosed herein may be embodied directly in hardware, in firmware, in a software module executed by the pump control module 602, or in any practical combination thereof.
In exemplary embodiments, the pump control module 602 includes or otherwise accesses the data storage element or memory 606, which may be realized using any sort of non-transitory computer-readable medium capable of storing programming instructions for execution by the pump control module 602. The computer-executable programming instructions, when read and executed by the pump control module 602, cause the pump control module 602 to perform the tasks, operations, functions, and processes described herein. In this regard, a control scheme or algorithm implemented by the pump control module 602 may be realized as control application code that is stored or otherwise maintained in the memory 606 and executed by the pump control module 602 to implement or otherwise provide one or more of the components in software. For example, the control application code may be executed by the control module 602 to obtain a command generation application 610 that implements or otherwise provides one or more of the closed-loop PID control components of the closed-loop control system 700 described in greater detail below in the context of
The illustrated pump control module 602 also implements or otherwise executes a notification application 612 that generates or otherwise provides user notifications or alerts via a user interface element 608 based at least in part on a current measurement value for the condition in the body 501 of the user. For example, the notification application 612 may access patient-specific notification criteria associated with the current operating mode implemented by the command generation application 610 and automatically generate user notifications in a manner that is influenced by the sensor glucose measurement values received from the sensing arrangement 504 and/or the dosage commands generated by the command generation application 610. Various implementation details pertaining to determining generating user notifications are described in greater detail in U.S. patent application Ser. No. 14/174,487, which is incorporated by reference.
Additionally, the pump control module 602 may implement or otherwise execute a data prediction application 614 that calculates or otherwise determines one or more predicted values for the physiological condition sensed by the sensing arrangement 504 based on the sequence of the most recent measurement values received from the sensing arrangement 504. For example, the data prediction application 614 may calculate a predicted value for the user's glucose level at a particular amount of time in the future based on the recent measurement values received from the sensing arrangement 504 and/or the recent dosage commands generated by the command generation application 610. In some embodiments, the predicted value may be utilized by the particular operating mode being implemented by the command generation application 610 to modify current and/or future dosage commands (e.g., to suspend and/or resume infusion, increase and/or decrease the amount of fluid being delivered, or the like). Additionally, the predicted value may be utilized by the notification application 612 to generate notifications in accordance with the patient-specific notification criteria stored in the user settings registers 622. Various implementation details pertaining to determining predicted values and generating corresponding notifications are described in greater detail in U.S. patent application Ser. No. 14/261,266, which is incorporated by reference.
The illustrated pump control module 602 also implements or otherwise executes a diagnostics application 616 that determines the viability of a particular operating mode implemented by the command generation application 610. For example, in various operating modes may require a particular amount of historical delivery data, measurement data, calibration data, or the like in order to calculate control parameters for implementing the operating mode. Thus, prior to when an operating mode is to be entered, the diagnostics application 616 may perform one or more diagnostic checks to verify or otherwise confirm the required information is available for calculating the required control parameter(s) for implementing a subsequent instance of the operating mode. Various implementation details pertaining to operating mode diagnostics are described in greater detail in U.S. patent application Ser. No. 14/561,128, which is incorporated by reference.
Still referring to
The user settings registers 622 generally represent the hardware, circuitry and/or other components of the pump control system 600 that are configured to store patient-specific parameters or other patient-specific information for the control schemes, notification schemes, and/or operating modes implemented by the pump control module 602. For example, the user setting registers 622 may store or maintain patient-specific control parameters and/or other control information referenced by the command generation application 610 when implementing a particular control scheme, such as insulin delivery limits for the patient, a patient-specific total daily insulin value, a patient-specific insulin sensitivity value, a patient-specific carbohydrate ratio value, patient-specific delivery thresholds, and/or other patient-specific mathematical model parameter values that characterize or otherwise describe the user's insulin sensitivity and/or meal response. Additionally, the user setting registers 622 may store or maintain patient-specific notification criteria, and/or other information referenced by the user notification application 612 for generating alerts or other notifications.
It should be understood that
The illustrated closed-loop control system 700 receives or otherwise obtains a target glucose value at input 702. In exemplary embodiments, the target glucose value is stored or otherwise maintained by the infusion device 502 (e.g., in memory 606), however, in some alternative embodiments, the target value may be received from an external component (e.g., CCD 106 and/or computer 108). In one or more embodiments, the target glucose value may be dynamically calculated or otherwise determined prior to entering the closed-loop operating mode based on one or more patient-specific control parameters maintained in memory 606 (e.g., in registers 620, 622). For example, the target blood glucose value may be calculated based at least in part on a patient-specific reference basal rate and a patient-specific daily insulin requirement, which may be manually input by a user or dynamically determined based on historical delivery information over a preceding interval of time (e.g., the amount of insulin delivered over the preceding 24 hours). The closed-loop control system 700 also receives or otherwise obtains a current glucose measurement value from the sensing arrangement 504 at input 704. The illustrated closed-loop control system 700 implements or otherwise provides proportional-integral-derivative (PID) control to determine or otherwise generate dosage (or delivery) commands for operating the motor 510 based at least in part on the difference between the target glucose value and the current glucose measurement value. In this regard, the PID control attempts to minimize the difference between the measured value and the target value, and thereby regulates the measured value to the desired value. PID control parameters are applied to the difference between the target glucose level at input 702 and the measured glucose level at input 704 to generate or otherwise determine a dosage command provided at output 730. Based on that delivery command, the motor control module 512 operates the motor 510 to deliver the corresponding amount of onboard fluid to the body of the user to influence the user's glucose level, and thereby reduce the difference between a subsequently measured glucose level and the target glucose level.
The illustrated closed-loop control system 700 includes or otherwise implements a summation block 706 configured to determine a difference between the target value obtained at input 702 and the measured value obtained from the sensing arrangement 504 at input 704, for example, by subtracting the target value from the measured value. The output of the summation block 706 represents the difference between the measured and target values, which is then provided to each of a proportional term path, an integral term path, and a derivative term path. The proportional term path includes a gain block 720 that multiplies the difference by a proportional gain coefficient, KP, to obtain the proportional term. The integral term path includes an integration block 708 that integrates the difference and a gain block 722 that multiplies the integrated difference by an integral gain coefficient, KI, to obtain the integral term. The derivative term path includes a derivative block 710 that determines the derivative of the difference and a gain block 724 that multiplies the derivative of the difference by a derivative gain coefficient, KD, to obtain the derivative term. The proportional term, the integral term, and the derivative term are then added or otherwise combined to obtain a delivery command that is utilized to operate the motor at output 730. Various implementation details pertaining to closed-loop PID control and determine gain coefficients are described in greater detail in U.S. Pat. No. 7,402,153, which is incorporated by reference.
In exemplary embodiments, the PID gain coefficients may be maintained by the memory 606 accessible to the pump control module 602. For example, the values for the gain coefficient blocks 720, 722, 724 may be maintained in the control parameter registers 620 and retrieved by the command generation application 610 during implementation of the closed-loop operating mode. In some embodiments, the PID gain coefficients are patient-specific and dynamically calculated or otherwise adjusted prior to entering the closed-loop operating mode based on one or more patient-specific control parameters maintained in the user settings registers 622 (e.g., an insulin sensitivity factor, a daily insulin requirement, an insulin limit, a reference basal rate, a reference fasting glucose, an active insulin action duration, pharmodynamical time constants, or the like) to compensate, correct, or otherwise adjust the PID gain coefficients to account for various operating conditions experienced and/or exhibited by the infusion device 502. Additionally, the target glucose value may be maintained in the user settings register 622 and retrieved by the command generation application 610 during operation.
Still referring to
As described in greater detail below in the context of
In a similar manner, the notification schemes implemented by the notification application 612, the prediction schemes implemented by the data prediction application 614, and the diagnostic checks implemented by the diagnostics application 616 may be updated to reflect the different pharmacokinetics of the different types of fluid that may be supported by the infusion device 502. For example, the notification criteria in the user settings registers 622 may be updated to reflect notification criteria that were previously specified by a user for the new insulin drug, or the notification criteria in the user settings registers 622 may be adjusted to reflect the different pharmacokinetics for the new insulin drug. In this regard, the patient may receive alerts relatively sooner or later to account for the faster or slower response of the glucose level in the patient's body to dosages of the new insulin drug. Similarly, the prediction time, the number of samples, the weighting factors, and other control parameters for the data prediction algorithm utilized by the data prediction application 614 may be adjusted to reflect the different pharmacokinetics for the new insulin drug. For example, the prediction time may be reduced and/or the most recent measurement samples may be more heavily weighted to account for a new insulin drug with a faster response time in the body, or conversely, the prediction time may be increased to account for a new insulin drug with a slower response time in the body. Likewise, the diagnostics criteria referenced by the diagnostics application 616 for the diagnostic checks may be changed to reflect different amounts of historical delivery data, measurement data, calibration data, or the like that may be required (e.g., by regulatory requirements) for implementing a particular operating mode with a particular drug type.
Additionally, it should be noted that the subject matter described herein is not limited to the closed-loop operating mode depicted in
In exemplary embodiments, the extensible infusion process 800 initializes or otherwise begins by detecting or otherwise identifying the type of fluid that is currently onboard the infusion device (task 802). In this regard, the pump control system 520, 600 identifies or otherwise determines when the type of fluid within the reservoir 205 is different from the type of fluid that was previously onboard the infusion device 200, 502. In some embodiments, when a new reservoir 205 is inserted into the infusion device 200, 502 or when the reservoir 205 is refilled, the pump control module 602 may generate or otherwise provide a graphical user interface (GUI) on the user interface 540, 608 associated with the infusion device 200, 502 that prompts a user to identify or otherwise confirm the type of insulin drug within the reservoir 205, with the pump control module 602 identifying the type of fluid onboard the infusion device 200, 502 based on the user input received via the GUI. For example, in response to insertion of a reservoir 205 into the infusion device 200, 502, the pump control module 602 may automatically generate or otherwise provide a GUI on the user interface 540, 608 that includes a list of the possible types of insulin drugs that are supported by the pump control system 520, 602 and identify the type of fluid onboard the infusion device 200, 502 based on the user selection from the list. In such embodiments, the pump control module 602 may store or otherwise maintain, in memory 606, one or more data tables that maintain information identifying the different types of insulin drugs supported by the pump control system 520, 600 and corresponding sets of control parameters associated with the respective insulin drug types. For example, each entry or row in a data table in memory 606 may correspond to a particular insulin drug type, with the columns of that respective entry or row including values for the pharmacokinetics control parameters or other pharmacokinetics information associated with that particular insulin drug type along with patient-specific values or criteria for that particular insulin drug type.
In one or more embodiments, the pump control system 520, 600 automatically detects the type of insulin infusion drug onboard the infusion device 200, 502 based on a detectable feature or characteristic (or a combination of detectable features) of the reservoir 205. For example, the reservoir 205 may include a particular physical feature (e.g., a tab, a notch, a physical pattern, or the like) or a combination thereof that is uniquely associated with a particular infusion drug type (e.g., only vials or reservoirs of that drug include the particular feature), with the infusion device 200, 502 including one or more contact sensors configured to detect the presence or absence of the particular physical features of the reservoirs 205 associated with the possible infusion drug types supported by the pump control system 520, 600. In such embodiments, the pump control module 602 may be coupled to the output of the contact sensor(s) and detect or otherwise identify the type of insulin infusion drug onboard the infusion device 200, 502 based on the output of the contact sensor(s).
Similarly, the reservoir 205 may include a particular optical, electrical, or magnetic feature that is uniquely associated with a particular infusion drug type, with the infusion device 200, 502 including corresponding sensors configured to detect the presence or absence of the particular features of the reservoir 205 onboard the infusion device 200, 502. For example, the reservoir 205 may include a barcode or similar feature imprinted or provided thereon that is scanned or otherwise read by an appropriate optical sensing device, with the pump control module 602 utilizing the scanned identifier to identify the type of insulin drug in the reservoir 205 onboard the infusion device 200, 502. In this regard, in some embodiments, using the barcode or other scanned identifier obtained from the reservoir 205, the pump control module 602 may operate the communications interface 604 to transmit or otherwise provide an identification request to a remote server (or another device 106, 108 in an infusion system 100), which in turn, performs a look-up operation using the scanned identifier included in the request to identify the insulin drug type and provide a corresponding response to the pump control module 602. For example, the remote server may provide, to the pump control module 602, the name or other identifier associated with the insulin drug type currently onboard the infusion device 200, 502 along with the pharmacokinetics characteristics associated with that insulin drug type.
Referring again to
In one or more exemplary embodiments, the unique set of control parameters for the identified drug type currently onboard the infusion device 200, 502 are stored or otherwise maintained onboard the infusion device 200, 502 in memory 606 and retrieved or otherwise obtained from memory 606. For example, the pump control module 602 may access the data table(s) in memory 606 that maintain information for the possible insulin drugs supported by the pump control system 520, 600 and perform a lookup operation using an identifier associated with the identified onboard drug type to locate a corresponding entry associated with the identified onboard drug type that includes values for the pharmacokinetics control parameters, patient-specific criteria or settings, and/or other pharmacokinetics information associated with the onboard insulin drug type.
In another embodiment, the unique set of control parameters for the identified drug type currently onboard the infusion device 200, 502 are downloaded, retrieved or otherwise obtained from an external device. For example, the pump control module 602 may operate the communications interface 604 to transmit or otherwise provide a request for the set of control parameters for the identified drug type to another device 106, 108 in the infusion system 100. In response to receiving a request from the pump control module 602, the requested device 106, 108 may contact a remote server, a networked database, or the like via an external communications network (e.g., the Internet, a cellular network, or the like) to download or otherwise obtain the requested set of control parameters for the identified drug type. Thereafter, the requested device 106, 108 relays or otherwise retransmits the downloaded set of control parameters for the identified drug type to the pump control module 602. In some embodiments, the pump control module 602 may contact a remote server, a networked database, or the like via an external communications network directly without using another device 106, 108 of the infusion system 100 as an intermediary. For example, the pump control module 602 may transmit a download request identifying the currently onboard insulin drug type to a remote server, which, in turn, responds by providing the set of control parameters for the identified drug type to the pump control module 602. In some embodiments, the pump control module 602 may update the memory 606 to persistently maintain the downloaded set of control parameters for future reference, for example, by creating a new entry or row in one or more data tables in memory 606 that stores or otherwise maintains the downloaded parameter values in association with the identified insulin drug type currently onboard.
In yet other embodiments, the pump control module 602 calculates or otherwise determines the unique set of control parameters for the identified drug type currently onboard the infusion device 200, 502 by converting a reference set of control parameters based on the pharmacokinetics characteristics of the identified drug type, as described in greater detail below in the context of
It should be noted that the unique set of control parameters for the identified drug type currently onboard the infusion device 200, 502 may be obtained in a variety of manners. For example, the pump control module 602 may construct the unique set of control parameters by downloading the pharmacokinetics control parameters for the onboard insulin drug type from an external device while converting patient-specific control parameters for a reference drug type (e.g., the preceding onboard insulin drug type) to updated values using pharmacokinetics characteristics associated with the current onboard insulin drug type, which may also be downloaded from the external device in concert with downloading the pharmacokinetics control parameters. As another example, the pump control module 602 may construct the unique set of control parameters by converting pharmacokinetics control parameters for a reference drug type to updated values using pharmacokinetics characteristics associated with the current onboard insulin drug type while maintaining the same patient-specific control parameters for the reference drug type for use with the current onboard insulin drug type.
Still referring to
In the illustrated embodiment, the extensible infusion process 800 generates or otherwise provides a user notification that indicates the currently onboard fluid type and automatically operates the infusion device in accordance with the unique set of control parameters associated with currently onboard fluid type (tasks 808, 810). For example, the pump control module 602 may generate an icon, a modal window, a textual notification, or another suitable graphical element on a display device 540, 608 associated with the infusion device 502 that indicates, to the user, the fluid type that has been identified by the pump control module 602 as being currently onboard and whose control parameters will be utilized to control operations of the infusion device 502. Thereafter, the pump control module 602 may autonomously operate the motor 507 in accordance with the control parameters associated with currently onboard fluid type to deliver dosages of the fluid to the body 501 of the patient. For example, as described above, the closed-loop operating mode implemented by the command generation application 610 may utilize the unique PID gain coefficients associated with the currently onboard fluid type that have been transferred to the control parameter registers 620 to implement the closed-loop control system 700 and deliver dosages configured to regulate the patient's glucose level to a target value. Additionally, the pump control module 602 utilizes control parameters associated with currently onboard fluid type to automatically generate appropriate user notifications, perform diagnostic checks, data predictions, and the like.
It should be noted that the extensible infusion process 800 may be automatically initiated by the pump control system 520, 600 whenever a new reservoir 205 is inserted in the infusion device 200, 502 (or alternatively, whenever the reservoir cap 223 is reengaged with the housing 202 after the reservoir 205 is refilled). In this regard, prior to an iteration of the extensible infusion process 800, the pump control module 602 may automatically operate the motor 507 to deliver dosages of an initial insulin drug type to regulate a glucose level in the patient's body 501 in accordance with the operating modes or control schemes implemented by the applications 610, 612, 614, 616 and the unique set of control parameters associated with that initial insulin drug type that are maintained in the control parameter registers 620, 622. Thereafter, when a new reservoir 205 with a different insulin drug is inserted into the housing 202, the pump control module 602 may automatically obtain unique set of control parameters associated with the new insulin drug, update the control parameter registers 620, 622 by transferring those obtained control parameter values to the control parameter registers 620, 622, and thereafter automatically operate the motor 507 to deliver dosages of a new insulin drug type to regulate the glucose level in the patient's body 501 in accordance with the unique set of control parameters associated with new insulin drug type. In this regard, the pump control module 602 autonomously controls operation of the infusion device 200, 502 using the same operating modes, control schemes and/or algorithms that were utilized by the applications 610, 612, 614, 616 for the preceding insulin drug type, but with different control parameters that reflect the different pharmacokinetics characteristics of the new insulin drug type. If another reservoir 205 containing that initial insulin drug type is subsequently inserted into the infusion device 200, 502, the pump control module 602 may automatically perform another iteration of the extensible infusion process 800 to transfer the prior control parameters that reflect the pharmacokinetics characteristics of the initial insulin drug type back into the control parameter registers 620, 622 for subsequent autonomous operation. In this manner, the pump control system 520, 600 is dynamically extensible to accommodate whichever type of fluid is provided in the reservoir 205.
The parameter conversion process 900 begins by retrieving or otherwise obtaining a reference set of control parameters for operating the infusion device and corresponding reference pharmacokinetics characteristics associated with the reference set of control parameters (tasks 902, 904). The reference set of control parameters may correspond to a particular fluid type supported by the pump control system 520, 600. For example, the reference set of control parameters may be associated with an insulin drug type for which the operating modes, control schemes, and the like implemented by the pump control module 602 were initially designed for use with. In this regard, the reference set of control parameters may be dictated or otherwise influenced by the pharmacokinetics characteristics of that insulin drug type. In some embodiments, the reference set of control parameters and reference pharmacokinetics characteristics of the reference insulin drug type are stored or otherwise maintained in memory 606. In other embodiments, the reference set of control parameters and reference pharmacokinetics characteristics of the reference insulin drug type may be downloaded or otherwise obtained by the pump control module 602 from a remote device. In yet other embodiments, the reference set of control parameters and reference pharmacokinetics characteristics may correspond to the preceding infusion drug type that was being delivered by the infusion device 200, 502 prior to the reservoir 205 being replaced or refilled.
The parameter conversion process 900 continues by retrieving or otherwise obtaining pharmacokinetics characteristics that reflect the typical biological response to the new insulin drug type onboard the infusion device (task 906). Depending on the embodiment, the pharmacokinetics characteristics of the new insulin drug type (alternatively referred to herein as the new pharmacokinetics characteristics) may be stored or otherwise maintained in memory 606, or alternatively, the new pharmacokinetics characteristics associated with the new insulin drug type may be downloaded or otherwise obtained by the pump control module 602 from a remote device. After obtaining the new pharmacokinetics characteristics, the parameter conversion process 900 calculates or otherwise determines an updated set of control parameters for operating the infusion device to deliver the new insulin drug type based on the relationship between the reference pharmacokinetics characteristics and the new pharmacokinetics characteristics (task 908). In this regard, the pump control module 602 may ratiometrically increase or decrease values from the reference set of control parameters based on the ratio of the corresponding new pharmacokinetics characteristics that influence a respective control parameter to the counterpart reference pharmacokinetics characteristics that influence that control parameter. Thus, the closed-loop PID gain coefficient values may be adjusted so that the closed-loop PID control system 700 responds faster after identifying a faster acting insulin onboard the infusion device 502, or alternatively, slower after identifying a slower acting insulin onboard.
Thereafter, the parameter conversion process 900 updates the infusion device to implement the updated set of control parameters with the preexisting operating modes, control schemes, and the like that are supported by the infusion device (task 910). As described above, the values for the updated set of control parameters may be transferred to the parameter registers 620, 622 referenced by the control applications 610, 612, 614, 616 during autonomous operation of the infusion device 200, 502. For example, values for the updated set of control parameters may be used to overwrite the corresponding values for the reference set of control parameters that were previously transferred or maintained in the parameter registers 620, 622. Thereafter, the pump control module 602 autonomously generates dosage commands, provides user notifications, performs diagnostics checks, and the like in accordance with the new values from the updated set of control parameters in the registers 620, 622 during subsequent operation of the infusion device 200, 502.
To briefly summarize, the subject matter describes herein provides an extensible infusion device that can accommodate multiple different types of fluid for infusion. In this regard, control schemes or algorithms that have been tested, verified, certified, or otherwise approved for use (e.g., by regulatory bodies or the like) may be extended to be used with new drugs that are developed during the lifetime of the infusion device. For example, values for gain coefficients of a PID control system may be automatically updated to values that reflect the pharmacokinetics of a new drug, with the PID control system autonomously operating the infusion device by generating dosage commands to deliver the new drug to regulate a physiological condition of the user to a target value using the same PID control-loop that was utilized for a previous drug but with the updated gain coefficient values associated with the new drug. Similarly, values for patient-specific parameters may be updated to reflect values that have either been specified by a user for use with the new drug, or alternatively, patient-specific parameters may be adjusted to reflect the pharmacokinetics of the new drug. The updated patient-specific parameter values may then be utilized to adjust pharmacokinetic control parameters (e.g., PID gain coefficient values) in a patient-specific manner to fine tune dosage commands for the patient, or the updated patient-specific parameter values may be utilized to modify the notification behavior of the infusion device (e.g., based on updated patient-specific notification criteria) in a manner that accounts for the pharmacokinetics of the new drug. Predictive operations, diagnostics operations, or other behaviors of the infusion device may also adapt to account for the pharmacokinetics of whatever drug is currently onboard.
For the sake of brevity, conventional techniques related to glucose sensing and/or monitoring, closed-loop glucose control, predictive glucose management, sensor calibration and/or compensation, and other functional aspects of the subject matter may not be described in detail herein. In addition, certain terminology may also be used in the herein for the purpose of reference only, and thus is not intended to be limiting. For example, terms such as “first”, “second”, and other such numerical terms referring to structures do not imply a sequence or order unless clearly indicated by the context. The foregoing description may also refer to elements or nodes or features being “connected” or “coupled” together. As used herein, unless expressly stated otherwise, “coupled” means that one element/node/feature is directly or indirectly joined to (or directly or indirectly communicates with) another element/node/feature, and not necessarily mechanically.
While at least one exemplary embodiment has been presented in the foregoing detailed description, it should be appreciated that a vast number of variations exist. It should also be appreciated that the exemplary embodiment or embodiments described herein are not intended to limit the scope, applicability, or configuration of the claimed subject matter in any way. For example, the subject matter described herein is not limited to the infusion devices and related systems described herein. Moreover, the foregoing detailed description will provide those skilled in the art with a convenient road map for implementing the described embodiment or embodiments. It should be understood that various changes can be made in the function and arrangement of elements without departing from the scope defined by the claims, which includes known equivalents and foreseeable equivalents at the time of filing this patent application. Accordingly, details of the exemplary embodiments or other limitations described above should not be read into the claims absent a clear intention to the contrary.
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Number | Date | Country | |
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20160263315 A1 | Sep 2016 | US |