CN112185552B - Method for automatically calculating insulin dosage - Google Patents
Method for automatically calculating insulin dosage Download PDFInfo
- Publication number
- CN112185552B CN112185552B CN201910599047.7A CN201910599047A CN112185552B CN 112185552 B CN112185552 B CN 112185552B CN 201910599047 A CN201910599047 A CN 201910599047A CN 112185552 B CN112185552 B CN 112185552B
- Authority
- CN
- China
- Prior art keywords
- blood glucose
- meal
- postprandial
- measured
- glucose
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Active
Links
Images
Classifications
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/30—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for calculating health indices; for individual health risk assessment
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
- G16H20/10—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients
Abstract
The invention relates to a method for automatically calculating insulin dosage, which comprises the following steps: setting a first target threshold for early fasting blood glucose (FBGT1), a second target threshold for early fasting blood glucose (FBGT2) and a blood glucose alert value (HBG), setting a first trigger interval (FBGR1) and setting a second trigger interval (FBGR2), measuring early Fasting Blood Glucose (FBG), and if the early Fasting Blood Glucose (FBG) measured twice consecutively is within the first trigger interval (FBGR1), executing a first adjustment scheme; performing a second adjustment scheme if two consecutive measured early Fasting Blood Glucose (FBG) s are both in a second trigger interval (FBGR 2); a first adjustment scheme is performed if two consecutive measured early Fasting Blood Glucose (FBGs) are in different trigger intervals.
Description
Technical Field
The invention relates to an intelligent algorithm, in particular to a method for automatically calculating insulin dosage.
Background
Since the invention of exogenous insulin in executive in the last 20 th century, the injection of exogenous insulin and the administration of secretion-promoting hypoglycemic drugs have been the main or preferred scheme for the treatment of type 1 and type 2 diabetes in human beings. Over the last 100 years, the global prevalence of type 2 diabetes has been high and has risen year by year. Human clinical trials in the last 20 years have shown that lifestyle intervention may be the more important key to reversing or even curing type 2 diabetes.
An increasing number of experts and scholars consider that the emphasis on treating type 2 diabetes should be shifted from addressing the symptoms and consequences of hyperglycemia in type 2 diabetes to addressing hyperinsulinemia and the major causes of insulin resistance in these types 2 diabetes. Wherein, a broad-spectrum or personalized diet scheme for optimizing the dietary structure and rhythm of type 2 diabetes patients, including low-carbohydrate diet, Mediterranean diet, intermittent diet and the like, becomes an effective life intervention mode for reversing or improving the course of disease. In the '2019 diabetes diagnosis and treatment standard' published by the American diabetes Association in 2018 and 12 months and the 'ketogenic diet intervention type-2 diabetes Chinese specialist consensus' published by the 'journal of practical clinical medicine' in 2019 and 1 month, 20 experts directly approve and recommend some life intervention modes including low-carbohydrate diet/ketogenic diet and Mediterranean diet as the first choice for reducing blood sugar and drug/preparation dependence of some type-2 diabetes patients. However, these non-medical life intervention modes conflict with the existing medical interventions of many type 2 diabetics, such as the injection of exogenous insulin and the taking of secretion-promoting hypoglycemic drugs, and are specifically expressed as the following two points:
first, many dietary interventions, such as low carbohydrate diets (ketogenic and atkins diets are all branches of a low carbohydrate diet), mediterranean diet, 16/8 intermittent fasting, greatly reduce the total amount of net carbohydrates in the diet of type 2 diabetic patients, i.e., the only fraction of the dietary source that directly increases blood glucose is greatly reduced. Meanwhile, the original medical intervention of the type 2 diabetes patients before changing the diet mode, such as insulin injection and hypoglycemic drug taking, is not changed. The blood sugar of the part of the existing dietary structure which raises the blood sugar is sharply reduced or even basically reduced while the blood sugar is reduced by the original medical intervention, so that the hypoglycemia of the patient is easily caused.
Therefore, type 2 diabetic patients, for example, adopt and test the effectiveness of life intervention which reduces the ratio of the blood sugar source to the total amount in the diet, and use hypoglycemic medical intervention, need to scientifically and gradually reduce the medical intervention according to the effect of dietary intervention. This method of successive reduction of medical intervention is currently very scarce or difficult to operate.
Type 2 diabetic patients in this case may also visit a hospital or community general practitioner for an interview to adjust medical intervention. However, because the fluctuation of blood sugar is large and the frequency is high, the difficulty of obtaining effective diagnosis and treatment and executing medical orders by patients every day is also large.
In most specifications of exogenous insulin, there is a brief introduction of how to adjust to blood glucose changes. The method is mainly used for estimating postprandial blood sugar based on preprandial blood sugar so as to regulate insulin use. The regulation of insulin in the Chinese expert guidance recommendation for clinical application of basal insulin for adult type 2 diabetes is mainly based on early fasting blood glucose. However, this has four limitations. Firstly, although the algorithm is simpler, certain reading and understanding thresholds, learning time and practical difficulty still exist, and particularly, the type 2 diabetes patients are mostly older; secondly, the existing insulin adjustment schemes are based on single blood sugar driving adjustment, i.e. drug administration/insulin increase and decrease are determined according to single blood sugar, and errors of single blood sugar measurement are not considered, and interference of other factors (such as weather, emotion and the like) is not eliminated; thirdly, the existing insulin regulation schemes do not consider the dietary structure and rhythm of a great amount of reduced glucose sources in the meals, such as low-carbohydrate diet and intermittent diet, but assume and preset that each meal has certain carbohydrate, so that the sensitivity is poor, and the regulation on the following medical intervention cannot be carried out according to the postprandial blood glucose condition of the patient; fourth, in existing guidelines, the frequency of insulin adjustments is too low, only 1 to 3 times per week, and oftentimes there is no way to sensitively and timely optimize optimal dosages and avoid hypoglycemia.
Problems may also arise if all medical interventions are removed directly in order to address the risk of hypoglycemia.
First, patient compliance decreases. If a patient is allowed to immediately remove all medical interventions in conjunction with a dietary intervention to avoid the occurrence of hypoglycemia, a hyperglycemic event may occur over a period of time, which, although likely temporary, can greatly affect the patient's confidence in receiving the dietary intervention and thus reduce his compliance, ultimately leading to global uncontrolled or failed life interventions.
Second, stress hyperglycemia may result. In extreme cases, particularly in cases where the human insulin patient is very resistant and the duration of medical intervention is long, stressful hyperglycemia may occur, and in severe cases, dangerous conditions such as hyperosmolar dehydration, azotemia, psychiatric symptoms, coma, and the like may occur.
Finally, sudden one-off subtraction of all medical interventions may cause blood glucose excursions affecting endocrine and leading to mood excursions that ultimately exacerbate blood glucose excursions.
It is noted that the present algorithmic invention is directed to type 2 diabetics who begin to execute a generalized low carbohydrate diet. In the present invention, the broad low carbon water diet refers to diets including, but not limited to, low carbohydrate diet, mediterranean diet, ketogenic diet, south beach diet, regional diet, low glycemic index diet, and atkins diet. The quantification is defined as the net carbohydrate intake per day, i.e. the total carbohydrate intake minus the intake of dietary fibre does not exceed 120g or the carbohydrate energy intake does not exceed 26%. Diets meeting this daily intake of carbohydrates, regardless of name, are in accordance with the broad low carbohydrate diet to which the present invention is directed.
In conclusion, when the life intervention and the medical intervention conflict, an individual dynamic balance point for avoiding hyperglycemia and preventing hypoglycemia needs to be found scientifically, gradually and gradiently.
Disclosure of Invention
To address the deficiencies of the prior art, it is an object of the present invention to provide a convenient and intelligent method of automatically calculating insulin dosage without cumbersome self-calculations.
According to one aspect of the present invention, there is provided a method of automatically calculating an insulin dose, the method comprising the steps of:
setting an early fasting glucose first target threshold (FBGT1), an early fasting glucose second target threshold (FBGT2) and a glycemic alert value (HBG), wherein the early fasting glucose first target threshold (FBGT1) is a threshold of impaired fasting glucose and euglycemia, wherein the early fasting glucose second target threshold (FBGT2) is a threshold of good glycemic control and an increased risk of hypoglycemia, and the glycemic alert value (HBG) is a threshold of further increased risk of hypoglycemia;
setting a first trigger interval (FBGR1) below said early fasting glucose first target threshold (FBGT1) while being above or equal to an early fasting glucose second target threshold (FBGT2), and setting a second trigger interval (FBGR2) below said early fasting glucose second target threshold (FBGT2) while being above or equal to said glycemic alert value (HBG);
measuring and recording the individual's early Fasting Blood Glucose (FBG);
performing a first adjustment scheme if two consecutive measured early Fasting Blood Glucose (FBG) s are both in a first trigger interval (FBGR 1);
performing a second adjustment scheme if two consecutive measured early Fasting Blood Glucose (FBGs) are both in a second trigger interval (FBGR 2);
a first adjustment scheme is performed if two consecutive measured early Fasting Blood Glucose (FBGs) are in different trigger intervals.
Preferably, the first adjustment regimen is a reduction of 14% to 16%, more preferably 15%, of the subject's total targeted insulin dose.
Preferably, the second adjustment regimen is a reduction of 19% to 21%, more preferably 20%, of the subject's total target insulin dose.
Preferably, the early fasting glucose first threshold (FBGT1) is in the range of 5.88-6.12 mmol/L, more preferably 6 mmol/L.
Preferably, the early fasting glucose second threshold (FBGT2) is in the range of 5.19-5.41 mmol/L, more preferably 5.3 mmol/L.
Preferably, the glycemic alert value (HBG) is in the range of 4.31 to 4.49mmol/L, more preferably 4.4 mmol/L.
Preferably, the first time blood glucose is measured to be below glycemic alert (HBG) at any one time, the individual is reduced by 30% of the total targeted insulin dose; more preferably, the second time below glycemic alert value (HBG), the individual is decreased by 50% of the total targeted insulin dose; still more preferably, the third time below glycemic alert value (HBG), the individual is decreased 100% of the total dose of the target insulin.
Preferably, blood glucose is also measured just before sleep and a small amount of glycemic food is consumed before sleep if blood glucose is below glycemic alert value (HBG).
Preferably, if reducing the subject's target total insulin dose involves multiple injections, the reduction is apportioned to each injection.
According to another aspect of the present invention, there is provided a method of automatically calculating an insulin dose, the method comprising the steps of:
setting a first target threshold (PoBGT1) of blood sugar for two hours after meal, a second target threshold (PoBGT2) of blood sugar for two hours after meal and a blood sugar warning value (HBG), wherein the first target threshold (PoBGT1) of blood sugar for two hours after meal is a critical value of impaired glucose tolerance and normality, and the second target threshold (PoBGT2) of blood sugar for two hours after meal is a critical value of stable control and approaching hypoglycemia warning;
setting a first trigger interval of postprandial blood glucose (PoBGR1) below said first target two-hour postprandial blood glucose threshold (PoBGT1) and at the same time above or equal to said second target two-hour postprandial blood glucose threshold (PoBGT2), and setting a second trigger interval of postprandial blood glucose (PoBGR2) below said second target two-hour postprandial blood glucose threshold (PoBGT2) and at the same time above or equal to said glycemic alert value (HBG);
defining breakfast, lunch and dinner as three kinds of meal;
measuring and recording the postprandial two hour blood glucose of the same meal of the individual;
executing a first adjustment scheme if the blood glucose for two consecutive measured hours after meal is within a first trigger interval of blood glucose after meal (PoBGR 1);
executing a second adjustment scheme if the blood glucose for two consecutive measured hours after meal is within a second trigger interval of blood glucose after meal (PoBGR 2);
if two hours of blood glucose after two consecutive measurements are in different trigger intervals, a first adjustment scheme is executed.
According to yet another aspect of the present invention, there is provided a method of automatically calculating an insulin dose, the method comprising the steps of:
setting a first target threshold (PoBGT1) of blood sugar for two hours after meal, a second target threshold (PoBGT2) of blood sugar for two hours after meal and a blood sugar warning value (HBG), wherein the first target threshold (PoBGT1) of blood sugar for two hours after meal is a critical value of impaired glucose tolerance and normality, and the second target threshold (PoBGT2) of blood sugar for two hours after meal is a critical value of stable control and approaching hypoglycemia warning;
setting a postprandial blood glucose first trigger interval (PoBGR1) below the two-hour postprandial blood glucose first target threshold (PoBGT1) while being above or equal to the two-hour postprandial blood glucose second target threshold (PoBGT2), and setting a postprandial blood glucose second trigger interval (PoBGR2) below the two-hour postprandial blood glucose second target threshold (PoBGT2) while being above or equal to the blood glucose alert value (HBG);
defining breakfast, lunch and dinner as three kinds of meal;
measuring and recording postprandial two-hour blood glucose of different meals of the individual;
executing a first adjustment scenario if the postprandial two hours of blood glucose measured three consecutive times are within a postprandial blood glucose first trigger interval (PoBGR 1);
executing a second adjustment scheme if the blood glucose two hours after meal measured three consecutive times is within a second trigger interval of blood glucose after meal (PoBGR 2);
if the two hours of postprandial blood glucose measured three consecutive times are in different trigger intervals, a first adjustment scheme is executed.
According to another aspect of the present invention, there is provided a method of automatically calculating an insulin dose, the method comprising the steps of:
setting a first target threshold (PoBGT1) of blood sugar for two hours after meal, a second target threshold (PoBGT2) of blood sugar for two hours after meal and a blood sugar warning value (HBG), wherein the first target threshold (PoBGT1) of blood sugar for two hours after meal is a critical value of impaired glucose tolerance and normality, and the second target threshold (PoBGT2) of blood sugar for two hours after meal is a critical value of stable control and approaching hypoglycemia warning;
setting a first trigger interval of postprandial blood glucose (PoBGR1) below said first target two-hour postprandial blood glucose threshold (PoBGT1) and at the same time above or equal to said second target two-hour postprandial blood glucose threshold (PoBGT2), and setting a second trigger interval of postprandial blood glucose (PoBGR2) below said second target two-hour postprandial blood glucose threshold (PoBGT2) and at the same time above or equal to said glycemic alert value (HBG);
defining breakfast, lunch and dinner as three kinds of meal;
measuring and recording the postprandial two-hour blood glucose of the individual;
if the postprandial two-hour blood glucose measured two times in succession is the postprandial two-hour blood glucose of the same meal species, and
executing a first adjustment scheme if the blood glucose of two consecutive measured hours after meal is within a first trigger interval of blood glucose after meal (PoBGR 1);
executing a second adjustment scheme if the blood glucose for two consecutive measured hours after meal is within a second trigger interval of blood glucose after meal (PoBGR 2);
if the blood sugar of two hours after meals measured for two times continuously is in different trigger intervals, executing a first adjusting scheme;
if the two hours of postprandial blood glucose measured two consecutive times is two hours of postprandial blood glucose of different meal species, a third two hours of postprandial blood glucose is measured again, and
if the three measured two hours post-prandial blood glucose are within the post-prandial blood glucose first trigger interval (PoBGR1), executing a first adjustment scheme;
if the three measured postprandial two hour blood glucose values are within a postprandial blood glucose second trigger interval (PoBGR2), executing a second adjustment protocol;
if the three measured postprandial blood glucose hours are in different trigger intervals, a first adjustment scheme is executed.
Preferably, the first adjustment regimen is a reduction of 14% to 16%, more preferably 15%, of the prandial insulin dosage for the individual's respective meal.
Preferably, the second adjustment regimen is a reduction of 19% to 21%, more preferably 20%, of the prandial insulin dose of the individual's respective meal.
Preferably, the second target threshold of blood glucose (PoBGT1) is in the range of 7.64-7.95 mmol/L, more preferably 7.8mmol/L, two hours after meal.
Preferably, the third threshold for postprandial blood glucose (PoBGT2) is in the range of 5.88-6.12 mmol/L, more preferably 6 mmol/L.
Preferably, the glycemic alert value (HBG) is in the range of 4.31 to 4.49mmol/L, more preferably 4.4 mmol/L.
Preferably, the meal-time insulin dose of the individual's respective meal is reduced by 30% when blood glucose is measured at any one time for the first time to be below glycemic alert value (HBG); more preferably, the second time below glycemic alert value (HBG), the 50% of the prandial insulin dose for the individual's respective meal is reduced; still more preferably, the third time below glycemic alert value (HBG) is 100% less than the prandial insulin dose for the respective meal of the individual.
Preferably, a small amount of glycemic food is consumed before sleep when blood glucose measured just before sleep is below a glycemic alert value (HBG).
The invention can be used for scientifically and stepwisely automatically calculating the adjustment of the insulin and the hypoglycemic drug, thereby greatly facilitating the user.
Drawings
The foregoing summary, as well as the following detailed description, will be better understood when read in conjunction with the appended drawings. For the purpose of illustration, certain embodiments of the disclosure are shown in the drawings. It should be understood, however, that the invention is not limited to the precise arrangements and instrumentalities shown. The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate implementations of systems and apparatus according to the invention and, together with the description, serve to explain the advantages and principles of the invention.
Wherein the content of the first and second substances,
FIG. 1 schematically shows a flow chart of an algorithm according to one embodiment of the invention;
FIG. 2 schematically shows an algorithm flow diagram according to another embodiment of the invention; while
Fig. 3 schematically shows an algorithm flow diagram according to yet another embodiment of the invention.
Detailed Description
Before explaining at least one embodiment of the invention in detail, it is to be understood that the invention is not limited in its application to the details of construction and to the arrangements of the components set forth in the following description or illustrated in the drawings. The drawings and written description are provided to guide those skilled in the art in making and using the invention for which patent protection is sought. The invention is capable of other embodiments and of being practiced and carried out in various ways. Those skilled in the art will appreciate that not all features of a commercial embodiment are shown for the sake of clarity and understanding. Those skilled in the art will also appreciate that the development of an actual commercial embodiment incorporating aspects of the present inventions will require numerous implementation-specific decisions to achieve the developer's ultimate goal for the commercial embodiment. While these efforts may be complex and time consuming, these efforts will be a routine undertaking for those of ordinary skill in the art having the benefit of this disclosure.
Also, it is to be understood that the phraseology and terminology employed herein is for the purpose of description and should not be regarded as limiting. For example, use of singular terms, such as "a," "an," and "the" is not intended to limit the number of items. Also, the use of relational terms, such as, but not limited to, "top," "bottom," "left," "right," "up," "down," "up," "side," and the like are used in the present description for clarity in specific reference to the figures and are not intended to limit the scope of the invention or the appended claims. Furthermore, it will be appreciated that any of the features of the present invention may be used alone, or in combination with other features. Other systems, methods, features and advantages of the invention will be, or will become, apparent to one with skill in the art upon examination of the following figures and detailed description. It is intended that all such additional systems, methods, features and advantages be included within this description, be within the scope of the invention, and be protected by the accompanying claims.
The first embodiment is as follows:
referring to fig. 1, the present embodiment provides a method for automatically calculating an insulin dosage, which mainly includes the following steps:
the first step is as follows: setting three early fasting blood glucose target thresholds, namely a first early fasting blood glucose target threshold (FBGT1), a second early fasting blood glucose target threshold (FBGT2) and a blood glucose alert value (HBG), wherein the FBGT1 is a critical value for glucose intolerance and euglycemia, the FGTB2 is a critical value for good blood glucose control and increased risk of hypoglycemia, the HBG is a critical value for further increased risk of hypoglycemia, the range of the first early fasting blood glucose threshold (FBGT1) is 5.88-6.12 mmol/L, in this embodiment, the value is 6.1mmol/L, the range of the second early fasting blood glucose threshold (FBGT2) is 5.19-5.41 mmol/L, and in this embodiment, the value is 5.3 mmol/L; HBG is the hypoglycemia early warning critical value of 4.4 mmol/L.
The second step is that: setting a first trigger interval (FBGR1) below said early fasting glucose first target threshold (FBGT1) while being above or equal to an early fasting glucose second target threshold (FBGT2), and setting a second trigger interval (FBGR2) below said early fasting glucose second target threshold (FBGT2) while being above or equal to said glycemic alert value (HBG); in this embodiment, the first trigger interval (FBGR1) is lower than the 6.1mmol/L and equal to or higher than 5.3mmol/L, and the second trigger interval (FBGR2) is lower than the 5.3mmol/L and equal to or higher than 4.4 mmol/L.
A third step of continuously measuring the early Fasting Blood Glucose (FBG), the first adjustment scheme being performed when the FBG is in the first trigger interval (FBGR1) twice in succession, i.e. both below said 6.1mmol/L and simultaneously above or equal to 5.3 mmol/L; when the FBG is in the second trigger interval (FBGR2) twice in succession, i.e. both times lower than said 5.3mmol/L and simultaneously higher than or equal to 4.4mmol/L, a second adjustment scheme is executed; the first adjustment scheme is performed when the FBGs are in different trigger intervals twice in succession.
Wherein the first adjustment scenario refers to a reduction of FBG target insulin, i.e. all long acting insulin, intermediate acting and premixed insulin before or at breakfast, total dose of all insulin before bedtime 15%; while the second adjustment would reduce the total dose of insulin by 20%. It should be noted that the target insulin does not include short-acting and ultra-short-acting insulin.
Taking the first adjustment scenario as an example, the fasting blood glucose at day 1 is 5.5mmol/L, the fasting blood glucose at day 2 is 5.7mmol/L, and the amount of 20U of Noso Rui 30 (premix) or insulin glargine (long acting) should be injected for breakfast by the user, which is reduced to 17U. Assuming that when the fasting blood glucose is 4.5mmol/L on day 1 and 4.7mmol/L on day 2, the insulin needs to be reduced to 16U, and when the fasting blood glucose is 5.8mmol/L on day 3, the reduction is continued to be 15% to 13.6 on the basis of 16U, which is rounded to 14U.
Example two:
referring to fig. 2, the present embodiment provides a method of automatically calculating an insulin dose, comprising the steps of:
the first step is as follows: setting a two-hour postprandial blood glucose set to three target thresholds, namely a two-hour postprandial blood glucose first target threshold (PoBGT1), a two-hour postprandial blood glucose second target threshold (PoBGT2) and a blood glucose alert value (HBG), wherein the two-hour postprandial blood glucose first target threshold (PoBGT1) is a critical value for impaired glucose endurance and normality, and the two-hour postprandial blood glucose second target threshold (PoBGT2) is a critical value for stable control and approaching hypoglycemia warning; the range of the first target threshold (PoBGT1) of blood sugar for two hours after meal is 7.64-7.95 mmol/L, and the value in the embodiment is 7.8 mmol/L; the range of the second target threshold value (PoBGT2) of the blood sugar for two hours after meal is 5.88-6.12 mmol/L, and the value in the embodiment is 6 mmol/L; the HBG is 4.4 mmol/L.
The second step is that: setting a first trigger interval of postprandial blood glucose (PoBGR1) below said first target two-hour postprandial blood glucose threshold (PoBGT1) and at the same time above or equal to said second target two-hour postprandial blood glucose threshold (PoBGT2), and setting a second trigger interval of postprandial blood glucose (PoBGR2) below said second target two-hour postprandial blood glucose threshold (PoBGT2) and at the same time above or equal to said glycemic alert value (HBG); in this embodiment, the value of the first trigger interval of postprandial blood glucose (PoBGR1) is lower than 7.8mmol/L and equal to or higher than 6mmol/L, and the value of the second trigger interval of postprandial blood glucose (PoBGR2) is lower than 6mmol/L and equal to or higher than 4.4 mmol/L.
The third step: continuously measuring the blood glucose two hours after meal of the same meal, when the measured value falls into the first triggering interval of the blood glucose after meal (PoBGR1) for two times in succession, namely two times lower than 7.8mmol/L and simultaneously higher than or equal to 6mmol/L, executing a first adjustment scheme; executing a second adjustment scheme when the measured value is in a second trigger interval (PoBGR2) of postprandial blood glucose for two consecutive times, namely for two times lower than 6mmol/L and at the same time higher than or equal to 4.4 mmol/L; when the measured values are in different trigger intervals twice in succession, the first adjustment scheme is executed again.
Wherein, the first adjustment scheme refers to reducing the dose of the meal time/meal postprandial insulin (whether long-acting, medium-acting, short-acting or ultra-short-acting insulin) of the corresponding meal type by 15 percent; while the second adjustment would reduce these insulin doses by 20%. The corresponding meal type here refers to the meal type to which the measured value relates.
Taking the first adjustment scenario as an example, if the blood glucose is 7.5 mmol/L2 hours after lunch on day 1 and 7.7 mmol/L2 hours after lunch on day 2, the user originally intends to inject 20U of Nookari (quick-acting) or Nookari 30 (premix) at lunch, the injection amount is reduced by 3U, that is, reduced to 17U; if the blood glucose was 5mmol/L after 2 hours of lunch on day 3, the injection amount was still reduced by 2.55U, rounded, i.e. 14U was injected, and if the blood glucose was 5.5mmol/L after 2 hours of lunch on day 4, the injection amount should be reduced by another 2.8U, rounded, reduced to 11U.
Example three:
referring to fig. 3, the present embodiment provides a method of automatically calculating an insulin dose, comprising the steps of:
the first step is as follows: setting the postprandial two-hour blood glucose as three target thresholds, namely a first postprandial two-hour blood glucose target threshold (PoBGT1), a second postprandial two-hour blood glucose target threshold (PoBGT2) and a blood glucose alert value (HBG), wherein the first postprandial two-hour blood glucose target threshold (PoBGT1) is a critical value for impaired glucose endurance and normality, and the second postprandial two-hour blood glucose target threshold (PoBGT2) is a critical value for stable control and approaching hypoglycemia warning; the range of the first target threshold value (PoBGT1) of blood sugar after two hours of meal is 7.64-7.95 mmol/L, and the value in the embodiment is 7.8 mmol/L; the range of the second target threshold (PoBGT2) of the blood sugar for two hours after meal is 5.88-6.12 mmol/L, and the value in the embodiment is 6 mmol/L; the HBG is 4.4 mmol/L;
the second step: setting a first trigger interval of postprandial blood glucose (PoBGR1) below said first target two-hour postprandial blood glucose threshold (PoBGT1) and at the same time above or equal to said second target two-hour postprandial blood glucose threshold (PoBGT2), and setting a second trigger interval of postprandial blood glucose (PoBGR2) below said second target two-hour postprandial blood glucose threshold (PoBGT2) and at the same time above or equal to said glycemic alert value (HBG); in this embodiment, the value of the first trigger interval of postprandial blood glucose (PoBGR1) is lower than 7.8mmol/L and equal to or higher than 6mmol/L, and the value of the second trigger interval of postprandial blood glucose (PoBGR2) is lower than 6mmol/L and equal to or higher than 4.4 mmol/L.
The third step: continuously measuring the postprandial two-hour blood glucose of different meals, and executing a first adjustment scheme when the measured values fall within a first trigger interval (PoBGR1) of postprandial blood glucose three times in succession, i.e. three times lower than 7.8mmol/L and at the same time higher than or equal to 6 mmol/L; executing a second adjustment scheme when the measured value is in a second trigger interval (PoBGR2) of postprandial blood glucose three times in succession, namely three times lower than 6mmol/L and at the same time higher than or equal to 4.4 mmol/L; when the measured value is in different trigger intervals for three times, the first adjusting scheme is executed again.
Wherein the first adjustment scheme refers to a 15% reduction in the corresponding prandial insulin (whether long-acting, medium-acting, short-acting, ultra-short acting insulin); while the second adjustment would reduce the total dose of insulin by 20%.
Taking the first adjustment as an example, for example, the blood glucose at 2 hours at dinner on day 1 is 6mmol/L, the blood glucose at 2 hours at lunch on day 2 is 6.7mmol/L, the blood glucose at 2 hours at breakfast on day 3 is 6.5mmol/L, and the amount of injection at lunch and dinner is reduced to 17U if the user originally intends to inject 20U of nordheim 30 (premix) or insulin glargine (long acting) at breakfast (since the measurement value involves three meals, if the user originally intends to inject also at lunch and dinner, the amount of injection at lunch and dinner is also reduced by 15%). Assuming that blood glucose was 5.5mmol/L at 2 hours of lunch on day 1, 5.7mmol/L at 2 hours of breakfast on day 2, and 6.8mmol/L at 2 hours of breakfast on day 3, the blood glucose was also reduced from 20U to 17U. If the blood glucose is 5.8mmol/L at 2 hours breakfast on day 4, it is reduced to 2.55U on 17U basis, rounded to 14U.
Example four:
the present embodiment provides a method for automatically calculating an insulin dosage, comprising the steps of:
the first step is as follows: setting a two-hour postprandial blood glucose set to three target thresholds, namely a two-hour postprandial blood glucose first target threshold (PoBGT1), a two-hour postprandial blood glucose second target threshold (PoBGT2) and a blood glucose alert value (HBG), wherein the two-hour postprandial blood glucose first target threshold (PoBGT1) is a critical value for impaired glucose endurance and normality, and the two-hour postprandial blood glucose second target threshold (PoBGT2) is a critical value for stable control and approaching hypoglycemia warning; the range of the first target threshold (PoBGT1) of blood sugar for two hours after meal is 7.64-7.95 mmol/L, and the value in the embodiment is 7.8 mmol/L; the range of the second target threshold (PoBGT2) of the blood sugar for two hours after meal is 5.88-6.12 mmol/L, and the value in the embodiment is 6 mmol/L; the HBG is 4.4 mmol/L;
the second step is that: setting a first trigger interval of postprandial blood glucose (PoBGR1) below said first target two-hour postprandial blood glucose threshold (PoBGT1) and at the same time above or equal to said second target two-hour postprandial blood glucose threshold (PoBGT2), and setting a second trigger interval of postprandial blood glucose (PoBGR2) below said second target two-hour postprandial blood glucose threshold (PoBGT2) and at the same time above or equal to said glycemic alert value (HBG); in this embodiment, the value of the first trigger interval of postprandial blood glucose (PoBGR1) is lower than 7.8mmol/L and equal to or higher than 6mmol/L, and the value of the second trigger interval of postprandial blood glucose (PoBGR2) is lower than 6mmol/L and equal to or higher than 4.4 mmol/L.
The third step: measuring the two-hour postprandial blood glucose of the individual, and if the two-hour postprandial blood glucose of the same meal is measured twice in succession, performing the subsequent steps with reference to example 2; if two consecutive measurements of two hours of blood glucose after meal of different meals are measured, the third measurement is made and the subsequent steps are performed with reference to example 3.
In the above embodiments, additional steps may be added, for example, measuring blood glucose below a glycemic alert value (HBG) at any one time, then performing a third adjustment regimen that reduces the subject's target total insulin dose by 30%. For another example, if blood glucose is measured just before sleep below a glycemic alert value (HBG), the user is notified to consume a small amount of glycemic food just before sleep. As another example, if reducing the subject's target total insulin dose involves multiple injections, the user is notified to apportion the reduction to each injection.
It should be understood that in the embodiment of the present invention, the user may be notified to execute each adjustment scheme instead of executing each adjustment scheme directly.
The foregoing has described in detail preferred embodiments of the present invention. It should be understood that numerous modifications and changes will readily occur to those skilled in the art to which the present invention relates without undue experimentation. Therefore, the technical solutions available to those skilled in the art through logic analysis, reasoning and limited experiments based on the design concept of the present invention should be within the scope of the present invention and/or the protection scope defined by the claims.
Claims (8)
1. A method of automatically calculating insulin dosage comprising the steps of:
setting an early fasting glucose first target threshold (FBGT1), an early fasting glucose second target threshold (FBGT2) and a glycemic alert value (HBG), wherein the early fasting glucose first target threshold (FBGT1) is a threshold of impaired fasting glucose and euglycemia, wherein the early fasting glucose second target threshold (FBGT2) is a threshold of good glycemic control and an increased risk of hypoglycemia, and the glycemic alert value (HBG) is a threshold of further increased risk of hypoglycemia;
setting a first trigger interval (FBGR1) below said early fasting glucose first target threshold (FBGT1) while being above or equal to an early fasting glucose second target threshold (FBGT2), and setting a second trigger interval (FBGR2) below said early fasting glucose second target threshold (FBGT2) while being above or equal to said glycemic alert value (HBG);
measuring and recording the individual's early Fasting Blood Glucose (FBG);
performing a first adjustment scheme if two consecutive measured early Fasting Blood Glucose (FBGs) are both in a first trigger interval (FBGR 1);
performing a second adjustment scheme if two consecutive measured early Fasting Blood Glucose (FBGs) are both in a second trigger interval (FBGR 2);
performing a first adjustment scheme if two consecutive measured early Fasting Blood Glucose (FBG) s are in different trigger intervals;
wherein the first adjustment is a 15% reduction in the subject's total target insulin dosage and the second adjustment is a 20% reduction in the subject's total target insulin dosage.
2. The method of automatically calculating insulin dosage according to claim 1, wherein the first time blood glucose is measured to be below glycemic alert (HBG) at any one time, the individual's target total insulin dosage is reduced by 30%.
3. The method of automatically calculating insulin dosage according to claim 2, wherein the glucose measured at any one time a second time below glycemic alert value (HBG) reduces the subject by 50% of the total targeted insulin dosage.
4. The method of automatically calculating insulin dosage according to claim 3, wherein the third sub-glycemic alert value (HBG) of blood glucose measured at any one time reduces 100% of the subject's target total insulin dosage.
5. A method of automatically calculating insulin dosage comprising the steps of:
setting a first target threshold (PoBGT1) of blood sugar for two hours after meal, a second target threshold (PoBGT2) of blood sugar for two hours after meal and a blood sugar warning value (HBG), wherein the first target threshold (PoBGT1) of blood sugar for two hours after meal is a critical value of impaired glucose tolerance and normality, and the second target threshold (PoBGT2) of blood sugar for two hours after meal is a critical value of stable control and approaching hypoglycemia warning;
setting a first trigger interval of postprandial blood glucose (PoBGR1) below said first two-hour postprandial blood glucose target threshold value (PoBGT1) while being higher than or equal to said second two-hour postprandial blood glucose target threshold value (PoBGT2), and setting a second trigger interval of postprandial blood glucose (PoBGR2) below said second two-hour postprandial blood glucose target threshold value (PoBGT2) while being higher than or equal to said glycemic alert value (HBG);
defining breakfast, lunch and dinner as three kinds of meal;
measuring and recording the postprandial two-hour blood glucose of the individual;
if the two-hour postprandial blood glucose measured two times in succession is the two-hour postprandial blood glucose of the same meal species, and
executing a first adjustment scheme if the postprandial two-hour blood glucose measured two consecutive times is within a postprandial blood glucose first trigger interval (PoBGR 1);
executing a second adjustment scheme if the blood glucose for two consecutive measured hours after meal is within a second trigger interval of blood glucose after meal (PoBGR 2);
if the blood sugar of two hours after meals measured for two times continuously is in different trigger intervals, executing a first adjusting scheme;
if the postprandial two-hour blood glucose measured two times in succession is postprandial two-hour blood glucose of different meal species, then the third postprandial two-hour blood glucose is measured, and
if the three measured postprandial two hour blood glucose values are within the postprandial blood glucose first trigger interval (PoBGR1), executing a first adjustment protocol;
if the three measured postprandial two hour blood glucose values are within a postprandial blood glucose second trigger interval (PoBGR2), executing a second adjustment protocol;
if the three measured postprandial blood glucose hours are in different trigger intervals, executing a first adjustment scheme;
wherein the first adjustment is a reduction of 15% of the prandial insulin dosage for the respective meal of the individual,
the second adjustment is a 20% reduction in the prandial insulin dosage for the individual's respective meal.
6. The method of automatically calculating insulin dosage according to claim 5, wherein the prandial insulin dosage for a respective meal is reduced by 30% when the measured blood glucose at any one time is below an alert value (HBG).
7. The method of automatically calculating insulin dosage according to claim 6, wherein when blood glucose is measured a second time below glycemic alert value (HBG) at any one time, the total meal insulin dosage for the corresponding meal is reduced by 50%.
8. The method of automatically calculating insulin dosage according to claim 7, wherein a third sub-glycemic alert value (HBG) of blood glucose measured at any one time reduces 100% of the total meal-time insulin dosage for the respective meal.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910599047.7A CN112185552B (en) | 2019-07-04 | 2019-07-04 | Method for automatically calculating insulin dosage |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910599047.7A CN112185552B (en) | 2019-07-04 | 2019-07-04 | Method for automatically calculating insulin dosage |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN112185552A CN112185552A (en) | 2021-01-05 |
| CN112185552B true CN112185552B (en) | 2022-09-20 |
Family
ID=73915402
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201910599047.7A Active CN112185552B (en) | 2019-07-04 | 2019-07-04 | Method for automatically calculating insulin dosage |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN112185552B (en) |
Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2005113036A1 (en) * | 2004-05-13 | 2005-12-01 | The Regents Of The University Of California | Method and apparatus for glucose control and insulin dosing for diabetics |
| CN102481101A (en) * | 2009-06-30 | 2012-05-30 | 生命扫描有限公司 | Analyte testing methods and device for calculating basal insulin therapy |
| CN103400028A (en) * | 2008-04-04 | 2013-11-20 | 海吉雅有限公司 | Device for optimizing patient's insulin dosage regimen |
-
2019
- 2019-07-04 CN CN201910599047.7A patent/CN112185552B/en active Active
Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2005113036A1 (en) * | 2004-05-13 | 2005-12-01 | The Regents Of The University Of California | Method and apparatus for glucose control and insulin dosing for diabetics |
| CN103400028A (en) * | 2008-04-04 | 2013-11-20 | 海吉雅有限公司 | Device for optimizing patient's insulin dosage regimen |
| CN102481101A (en) * | 2009-06-30 | 2012-05-30 | 生命扫描有限公司 | Analyte testing methods and device for calculating basal insulin therapy |
Non-Patent Citations (3)
| Title |
|---|
| 糖尿病患者应用胰岛素时的血糖控制;王念鸿;《临床和实验医学杂志》;20070530(第05期);全文 * |
| 糖尿病患者空腹高血糖的观察和处理;刘肖;《临床和实验医学杂志》;20071030(第10期);全文 * |
| 胰岛素连续皮下输注纠正2型糖尿病黄昏现象疗效分析;李莲花;《实用医技杂志》;20080415(第11期);全文 * |
Also Published As
| Publication number | Publication date |
|---|---|
| CN112185552A (en) | 2021-01-05 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| US20200214629A1 (en) | Unified platform for monitoring and control of blood glucose levels in diabetic patients | |
| US20210169409A1 (en) | Systems of centralized data exchange for monitoring and control of blood glucose | |
| Mesa et al. | The impact of strict COVID-19 lockdown in Spain on glycemic profiles in patients with type 1 diabetes prone to hypoglycemia using standalone continuous glucose monitoring | |
| Blauw et al. | Performance and safety of an integrated bihormonal artificial pancreas for fully automated glucose control at home | |
| Wang et al. | Contribution of postprandial glucose to excess hyperglycaemia in Asian type 2 diabetic patients using continuous glucose monitoring | |
| US11355238B2 (en) | Method, system and computer program product for evaluation of blood glucose variability in diabetes from self-monitoring data | |
| US20210193285A1 (en) | A system and method for use in disease treatment management | |
| Nimri et al. | The “Glucositter” overnight automated closed loop system for type 1 diabetes: a randomized crossover trial | |
| Bode | Clinical utility of the continuous glucose monitoring system | |
| Weintrob et al. | Glycemic patterns detected by continuous subcutaneous glucose sensing in children and adolescents with type 1 diabetes mellitus treated by multiple daily injections vs continuous subcutaneous insulin infusion | |
| Lanspa et al. | Percentage of time in range 70 to 139 mg/dL is associated with reduced mortality among critically ill patients receiving IV insulin infusion | |
| Al-Dorzi et al. | Glycaemic fluctuation predicts mortality in critically ill patients | |
| Kalra et al. | Hypoglycaemia in anesthesiology practice: Diagnostic, preventive, and management strategies | |
| Hersh et al. | Lower glucose target is associated with improved 30-day mortality in cardiac and cardiothoracic patients | |
| Ravi et al. | Current concepts and clinical importance of glycemic variability | |
| Bao et al. | Chinese clinical guidelines for continuous glucose monitoring (2018 edition) | |
| Kluemper et al. | Diabetes: the role of continuous glucose monitoring | |
| Deane et al. | Update on glucose control during and after critical illness | |
| Tsujino et al. | The relationship between HbA1c values and the occurrence of hypoglycemia as assessed by continuous glucose monitoring in patients with type 1 diabetes | |
| CN112185552B (en) | Method for automatically calculating insulin dosage | |
| Wright Jr et al. | Clinical use of professional continuous glucose monitoring | |
| Kapitza et al. | Continuous glucose monitoring: reliable measurements for up to 4 days with the SCGM1 system | |
| Kohnert et al. | Relationships between glucose variability and conventional measures of glycemic control in continuously monitored patients with type 2 diabetes | |
| Kudva et al. | Glycemic variation and hypoglycemia in patients with well-controlled type 1 diabetes on a multiple daily insulin injection program with use of glargine and ultralente as basal insulin | |
| Nimri et al. | Overnight automated type 1 diabetes control under MD-logic closed-loop system: a randomized crossover trial. |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| PB01 | Publication | ||
| PB01 | Publication | ||
| SE01 | Entry into force of request for substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| GR01 | Patent grant | ||
| GR01 | Patent grant |