Usability features for integrated insulin delivery system

Abstract

Various systems and methods for improving the usability of continuous glucose monitors and drug delivery pumps are described.

1 - 17 . (canceled) 
     
     
         18 . A delivery device for monitoring the glycemic state of a patient, comprising:
 a drug delivery device;   an interstitial fluid monitor, the interstitial fluid monitor configured to:
 receive information representative of the glycemic state of the patient, 
 determine if the glycemic state of the patient is a hypoglycemic state, and if so, control the drug delivery device adjust drug delivery to the patient, 
 determine a bolus volume of drug to be administered to the patient to make up for adjustment of drug delivery by: 
 determining an amount of drug remaining in a user's body such that: 
 drug remaining is equal to ((the amount of drug delivered before cessation)×(user's drug action time minus the time since drug was last delivered))/(user's drug action time), and 
 calculating a bolus delivery to equal the amount of drug delivery lost when the drug delivery was adjusted. 
   
     
     
         19 . The system of  claim 18 , wherein determining an amount of drug remaining includes using a model to estimate the amount of drug remaining. 
     
     
         20 . The system of  claim 18 , wherein the drug is insulin. 
     
     
         21 . The system of  claim 18 , wherein the drug delivery device is controlled to adjust drug delivery to the patient by stopping drug delivery to the patient. 
     
     
         22 . The system of  claim 18 , wherein the drug delivery to the patient is a basal delivery of insulin. 
     
     
         23 . The system of  claim 18 , wherein the interstitial fluid monitor includes a processor and a memory. 
     
     
         24 . A method for controlling a drug delivery device to halt a basal delivery of drug and for determining a drug delivery rate to be administered to a patient when the drug delivery device is restarted, comprising:
 monitoring interstitial fluid to determine a glycemic level of a patient;   determining from the glycemic level of the patient whether the glycemic level indicates a hypoglycemic state within a selected future time period, and if so, controlling the drug delivery device to adjust drug delivery to the patient;   determining a delivery rate of drug to be administered to the patient when the drug delivery device is restarted by:   a) receiving data representing a current glycemic level of the patient and predicting a future glycemic level in order to determine an appropriate drug bolus value to be delivered to the patient for a latest control command, and assuming that this command is immediately followed by a pre-programmed basal delivery rate of the drug that will be in effect thereafter,   b) analyzing the predicted future glycemic level using the drug bolus value of the latest control command plus a future basal rate to determine if the predicted future glycemic level is acceptable, and if so, waiting for a selected period of time and repeating step a);   c) if the predicted future glycemic level of step b) is not acceptable, computing an alternate temporary basal drug delivery amount that is lower than the previously assumed basal rate, and, if the predicted future glycemic level is acceptable, providing a temporary basal command at the computed basal rate and duration, waiting for a selected period of time and repeating step a);   d) if the predicted future glycemic level in step c) is unacceptable, decreasing the temporary basal delivery rate by the smallest increment allowed by the drug delivery device, projecting a future glycemic level and, if the future glycemic level is acceptable, providing a temporary basal command including the rate and duration and then waiting for a selected period of time and repeating step a);   e) if the predicted future glycemic level in step d) is unacceptable, reducing the basal rate delivery duration by a selected amount, projecting a future glycemic level, and if the predicted future glycemic level is acceptable, providing a temporary basal command include the rate and duration and then wait for a selected period of time and repeating step a); and   f) if the predicted future glycemic level in step e) is unacceptable, repeating steps d) and e) until an acceptable predicted glycemic level is achieved.   
     
     
         25 . The method of  claim 24 , further comprising alerting the user to take action to counter the effect of excessive insulin if an acceptable glycemic level cannot be obtained in step f). 
     
     
         26 . The method of  claim 24 , wherein controlling the drug delivery device to adjust basal delivery of drug to the patient includes stopping drug delivery by the drug delivery device. 
     
     
         27 . A method for reducing false hypoglycemic alarms in a drug delivery system, comprising:
 a) providing a current glucose level;   b) determining if the current glucose level is below a threshold level and if so, providing a further glucose level at the expiration of a selected period of time;   c) determining if the glucose level taken after the expiration of the selected period of time is below the threshold level, and if so, alerting the user of a low glucose condition if the time between providing the two glucose levels is greater than a selected duration of time, and if not, repeating step c) until either the time since the current glucose level and the last further glucose level exceeds the selected duration of time or the last further glucose level is above the threshold level; and   d) adjusting delivery of a drug by the drug delivery system if the low glucose level persists beyond a second selected duration of time.   
     
     
         28 . The method of  claim 28 , wherein adjusting delivery of the drug by the drug delivery system is stopping the drug delivery by the drug delivery system. 
     
     
         29 . A method of determining an insulin delivery profile when a drug delivery system terminates unexpectedly by stopping the delivery of insulin from a drug delivery device due to a determination by the drug delivery system that a patient is in a hypoglycemic state based upon information received by the drug delivery system, comprising:
 a) determining a present glucose level and predicting a future glucose level in order to determine an appropriate insulin delivery profile to be delivered to the patient;   b) analyzing the predicted future glucose level using the insulin delivery profile plus a future temporary basal rate to determine if the predicted future glucose level is acceptable, and if so, waiting for a selected period of time and repeating step a);   c) if the predicted glucose level of step b) is not acceptable, computing a first alternate insulin delivery profile that delivers insulin at a reduced rate than the previous insulin delivery profile, and if the predicted future glucose level is acceptable, delivering insulin in accordance with the first alternate insulin delivery profile, and waiting for a selected period of time and repeating step a);   d) if the predicted future glucose level in step c) is unacceptable, determining a second alternate insulin delivery profile that delivers insulin a reduced rate than the first alternate insulin delivery profile, projecting a future glucose level, and, if the future glucose level is acceptable, delivering insulin in accordance with the first alternate insulin delivery profile, and waiting for a selected period of time and repeating step a); and   e) if the predicted future glucose level in step d) is unacceptable, repeating steps d) until an acceptable predicted glucose level is achieved.   
     
     
         30 . The method of  claim 29 , further comprising alerting the user to take action to counter the effect of excessive insulin if an acceptable glucose level cannot be obtained in step e). 
     
     
         31 . The method of  claim 29 , wherein the insulin delivery system is a closed loop system.