CA2816388C - Maintaining multiple defined physiological zones using model predictive control - Google Patents

Maintaining multiple defined physiological zones using model predictive control Download PDF

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Publication number
CA2816388C
CA2816388C CA2816388A CA2816388A CA2816388C CA 2816388 C CA2816388 C CA 2816388C CA 2816388 A CA2816388 A CA 2816388A CA 2816388 A CA2816388 A CA 2816388A CA 2816388 C CA2816388 C CA 2816388C
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Prior art keywords
zone
insulin
controller
control
zones
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English (en)
French (fr)
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CA2816388A1 (en
Inventor
Francis J. Doyle, Iii
Benyamin Grosman
Eyal Dassau
Lois Jovanovic
Howard Zisser
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SANSUM DIABETES RESEARCH INSTITUTE
University of California San Diego UCSD
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SANSUM DIABETES RESEARCH INSTITUTE
University of California San Diego UCSD
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    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/10ICT 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
    • G16H20/17ICT 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 delivered via infusion or injection
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M31/00Devices for introducing or retaining media, e.g. remedies, in cavities of the body
    • A61M31/002Devices for releasing a drug at a continuous and controlled rate for a prolonged period of time
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P3/00Drugs for disorders of the metabolism
    • A61P3/08Drugs for disorders of the metabolism for glucose homeostasis
    • A61P3/10Drugs for disorders of the metabolism for glucose homeostasis for hyperglycaemia, e.g. antidiabetics
    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/66Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving blood sugars, e.g. galactose
    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/74Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving hormones or other non-cytokine intercellular protein regulatory factors such as growth factors, including receptors to hormones and growth factors
    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/50ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for simulation or modelling of medical disorders
    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16ZINFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS, NOT OTHERWISE PROVIDED FOR
    • G16Z99/00Subject matter not provided for in other main groups of this subclass
    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N2333/00Assays involving biological materials from specific organisms or of a specific nature
    • G01N2333/435Assays involving biological materials from specific organisms or of a specific nature from animals; from humans
    • G01N2333/575Hormones
    • G01N2333/62Insulins

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Hematology (AREA)
  • Chemical & Material Sciences (AREA)
  • Biomedical Technology (AREA)
  • Molecular Biology (AREA)
  • General Health & Medical Sciences (AREA)
  • Urology & Nephrology (AREA)
  • Immunology (AREA)
  • Medicinal Chemistry (AREA)
  • Public Health (AREA)
  • Pathology (AREA)
  • Medical Informatics (AREA)
  • Diabetes (AREA)
  • Biotechnology (AREA)
  • Biochemistry (AREA)
  • General Physics & Mathematics (AREA)
  • Analytical Chemistry (AREA)
  • Physics & Mathematics (AREA)
  • Food Science & Technology (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Microbiology (AREA)
  • Cell Biology (AREA)
  • Primary Health Care (AREA)
  • Epidemiology (AREA)
  • Endocrinology (AREA)
  • Veterinary Medicine (AREA)
  • Animal Behavior & Ethology (AREA)
  • Databases & Information Systems (AREA)
  • Data Mining & Analysis (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Anesthesiology (AREA)
  • Emergency Medicine (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Pharmacology & Pharmacy (AREA)
  • General Chemical & Material Sciences (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Organic Chemistry (AREA)
  • Obesity (AREA)
CA2816388A 2010-10-12 2011-10-12 Maintaining multiple defined physiological zones using model predictive control Active CA2816388C (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US39239910P 2010-10-12 2010-10-12
US61/392,399 2010-10-12
PCT/US2011/056022 WO2012051344A2 (en) 2010-10-12 2011-10-12 Maintaining multiple defined physiological zones using model predictive control

Publications (2)

Publication Number Publication Date
CA2816388A1 CA2816388A1 (en) 2012-04-19
CA2816388C true CA2816388C (en) 2016-12-06

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CA2816388A Active CA2816388C (en) 2010-10-12 2011-10-12 Maintaining multiple defined physiological zones using model predictive control

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US (1) US9700708B2 (enExample)
EP (1) EP2628115B1 (enExample)
JP (1) JP6062859B2 (enExample)
CA (1) CA2816388C (enExample)
DK (1) DK2628115T3 (enExample)
ES (1) ES2544874T3 (enExample)
WO (1) WO2012051344A2 (enExample)

Families Citing this family (72)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8417311B2 (en) 2008-09-12 2013-04-09 Optiscan Biomedical Corporation Fluid component analysis system and method for glucose monitoring and control
US7959598B2 (en) 2008-08-20 2011-06-14 Asante Solutions, Inc. Infusion pump systems and methods
US9757510B2 (en) 2012-06-29 2017-09-12 Animas Corporation Method and system to handle manual boluses or meal events for closed-loop controllers
US9486578B2 (en) * 2012-12-07 2016-11-08 Animas Corporation Method and system for tuning a closed-loop controller for an artificial pancreas
US9907909B2 (en) 2012-12-20 2018-03-06 Animas Corporation Method and system for a hybrid control-to-target and control-to-range model predictive control of an artificial pancreas
WO2014110541A1 (en) * 2013-01-14 2014-07-17 The Regents Of University Of California Daily periodic target-zone modulation in the model predictive control problem for artificial pancreas for type i diabetes applications
US9517306B2 (en) 2013-03-15 2016-12-13 Animas Corporation Method and system for closed-loop control of an artificial pancreas
US9795737B2 (en) 2013-03-15 2017-10-24 Animas Corporation Method and system for closed-loop control of an artificial pancreas
ES2671001T3 (es) 2013-03-15 2018-06-04 Animas Corporation Modelo de tiempo-acción de insulina
US9561324B2 (en) 2013-07-19 2017-02-07 Bigfoot Biomedical, Inc. Infusion pump system and method
US9474855B2 (en) 2013-10-04 2016-10-25 Animas Corporation Method and system for controlling a tuning factor due to sensor replacement for closed-loop controller in an artificial pancreas
US9861747B2 (en) 2013-12-05 2018-01-09 Lifescan, Inc. Method and system for management of diabetes with a glucose monitor and infusion pump to provide feedback on bolus dosing
GB2523989B (en) 2014-01-30 2020-07-29 Insulet Netherlands B V Therapeutic product delivery system and method of pairing
CA2957432C (en) * 2014-08-06 2017-07-25 Regents Of The University Of California Moving-horizon state-initializer for control applications
EP3733227B1 (en) 2015-02-18 2024-05-01 Insulet Corporation Fluid delivery and infusion devices
US10275573B2 (en) 2016-01-13 2019-04-30 Bigfoot Biomedical, Inc. User interface for diabetes management system
WO2017123703A2 (en) 2016-01-14 2017-07-20 Bigfoot Biomedical, Inc. Occlusion resolution in medication delivery devices, systems, and methods
EP4545005A3 (en) 2016-01-14 2025-07-02 Insulet Corporation Adjusting insulin delivery rates
FR3047098B1 (fr) * 2016-01-21 2018-05-25 Voluntis Gestion de l'equilibre glycemique d'un patient diabetique
WO2017136155A1 (en) * 2016-02-05 2017-08-10 Animas Corporation Visualization and analysis tool for a drug delivery system
US12383166B2 (en) 2016-05-23 2025-08-12 Insulet Corporation Insulin delivery system and methods with risk-based set points
EP3515535A1 (en) 2016-09-23 2019-07-31 Insulet Corporation Fluid delivery device with sensor
WO2018111928A1 (en) 2016-12-12 2018-06-21 Mazlish Bryan Alarms and alerts for medication delivery devices and related systems and methods
US10500334B2 (en) 2017-01-13 2019-12-10 Bigfoot Biomedical, Inc. System and method for adjusting insulin delivery
US10583250B2 (en) 2017-01-13 2020-03-10 Bigfoot Biomedical, Inc. System and method for adjusting insulin delivery
WO2018132723A1 (en) 2017-01-13 2018-07-19 Mazlish Bryan Insulin delivery methods, systems and devices
WO2018132765A1 (en) 2017-01-13 2018-07-19 Mazlish Bryan Insulin delivery methods, systems and devices
US10881793B2 (en) 2017-01-13 2021-01-05 Bigfoot Biomedical, Inc. System and method for adjusting insulin delivery
US10758675B2 (en) 2017-01-13 2020-09-01 Bigfoot Biomedical, Inc. System and method for adjusting insulin delivery
US11497851B2 (en) 2017-03-31 2022-11-15 Lifescan Ip Holdings, Llc Maintaining maximum dosing limits for closed loop insulin management systems
US10729849B2 (en) 2017-04-07 2020-08-04 LifeSpan IP Holdings, LLC Insulin-on-board accounting in an artificial pancreas system
US11147920B2 (en) 2017-04-18 2021-10-19 Lifescan Ip Holdings, Llc Diabetes management system with automatic basal and manual bolus insulin control
CN116531603A (zh) 2017-05-05 2023-08-04 伊莱利利公司 生理葡萄糖的闭环控制
EP3438858A1 (en) 2017-08-02 2019-02-06 Diabeloop Closed-loop blood glucose control systems and methods
CA3085930A1 (en) 2017-12-21 2019-06-27 Eli Lilly And Company Closed loop control of physiological glucose
JP6938363B2 (ja) * 2017-12-27 2021-09-22 オムロンヘルスケア株式会社 情報処理装置、生体情報測定装置、方法及びプログラム
USD928199S1 (en) 2018-04-02 2021-08-17 Bigfoot Biomedical, Inc. Medication delivery device with icons
US11147919B2 (en) 2018-04-23 2021-10-19 Medtronic Minimed, Inc. Methodology to recommend and implement adjustments to a fluid infusion device of a medication delivery system
US11158413B2 (en) * 2018-04-23 2021-10-26 Medtronic Minimed, Inc. Personalized closed loop medication delivery system that utilizes a digital twin of the patient
JP7124120B2 (ja) 2018-05-04 2022-08-23 インスレット コーポレイション 制御アルゴリズムベースの薬物送達システムのための安全制約
US12020797B2 (en) 2018-06-22 2024-06-25 Ypsomed Ag Insulin and pramlintide delivery systems, methods, and devices
CN112789070A (zh) 2018-09-28 2021-05-11 英赛罗公司 人造胰腺系统的活动模式
EP3864668A1 (en) 2018-10-11 2021-08-18 Insulet Corporation Event detection for drug delivery system
USD920343S1 (en) 2019-01-09 2021-05-25 Bigfoot Biomedical, Inc. Display screen or portion thereof with graphical user interface associated with insulin delivery
US11986629B2 (en) 2019-06-11 2024-05-21 Medtronic Minimed, Inc. Personalized closed loop optimization systems and methods
US11801344B2 (en) 2019-09-13 2023-10-31 Insulet Corporation Blood glucose rate of change modulation of meal and correction insulin bolus quantity
US11935637B2 (en) 2019-09-27 2024-03-19 Insulet Corporation Onboarding and total daily insulin adaptivity
EP4657456A2 (en) 2019-12-06 2025-12-03 Insulet Corporation Techniques and devices providing adaptivity and personalization in diabetes treatment
US11833329B2 (en) 2019-12-20 2023-12-05 Insulet Corporation Techniques for improved automatic drug delivery performance using delivery tendencies from past delivery history and use patterns
WO2021141941A1 (en) 2020-01-06 2021-07-15 Insulet Corporation Prediction of meal and/or exercise events based on persistent residuals
EP4100958A1 (en) 2020-02-03 2022-12-14 Insulet Corporation Use of fuzzy logic in predicting user behavior affecting blood glucose concentration
US11551802B2 (en) 2020-02-11 2023-01-10 Insulet Corporation Early meal detection and calorie intake detection
US11986630B2 (en) 2020-02-12 2024-05-21 Insulet Corporation Dual hormone delivery system for reducing impending hypoglycemia and/or hyperglycemia risk
US11547800B2 (en) 2020-02-12 2023-01-10 Insulet Corporation User parameter dependent cost function for personalized reduction of hypoglycemia and/or hyperglycemia in a closed loop artificial pancreas system
US11324889B2 (en) 2020-02-14 2022-05-10 Insulet Corporation Compensation for missing readings from a glucose monitor in an automated insulin delivery system
US12495994B2 (en) 2020-02-20 2025-12-16 Insulet Corporation Meal bolus subcategories in model based insulin therapy
US11607493B2 (en) 2020-04-06 2023-03-21 Insulet Corporation Initial total daily insulin setting for user onboarding
WO2022020197A1 (en) 2020-07-22 2022-01-27 Insulet Corporation Open-loop insulin delivery basal parameters based on insulin delivery records
US11684716B2 (en) 2020-07-31 2023-06-27 Insulet Corporation Techniques to reduce risk of occlusions in drug delivery systems
US12128215B2 (en) 2020-09-30 2024-10-29 Insulet Corporation Drug delivery device with integrated optical-based glucose monitor
WO2022072618A1 (en) 2020-09-30 2022-04-07 Insulet Corporation Secure wireless communications between a glucose monitor and other devices
US11160925B1 (en) 2021-01-29 2021-11-02 Insulet Corporation Automatic drug delivery system for delivery of a GLP-1 therapeutic
EP4305636A1 (en) 2021-03-10 2024-01-17 Insulet Corporation A medicament delivery device with an adjustable and piecewise analyte level cost component to address persistent positive analyte level excursions
US11904140B2 (en) 2021-03-10 2024-02-20 Insulet Corporation Adaptable asymmetric medicament cost component in a control system for medicament delivery
US12496398B2 (en) 2021-05-28 2025-12-16 Insulet Corporation Threshold based automatic glucose control response
US12406760B2 (en) 2021-06-07 2025-09-02 Insulet Corporation Exercise safety prediction based on physiological conditions
US12514980B2 (en) 2021-06-30 2026-01-06 Insulet Corporation Adjustment of medicament delivery by a medicament delivery device based on menstrual cycle phase
US12521486B2 (en) 2021-07-16 2026-01-13 Insulet Corporation Method for modification of insulin delivery during pregnancy in automatic insulin delivery systems
US11738144B2 (en) 2021-09-27 2023-08-29 Insulet Corporation Techniques enabling adaptation of parameters in aid systems by user input
US11439754B1 (en) 2021-12-01 2022-09-13 Insulet Corporation Optimizing embedded formulations for drug delivery
CA3275991A1 (en) 2023-01-06 2024-07-11 Insulet Corporation Automatic or manual administration of meal boluses with subsequent automatic relaxation of safety constraints
US20250166810A1 (en) * 2023-11-22 2025-05-22 Cilag Gmbh International Data streams multi-system interaction

Family Cites Families (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP3251224B2 (ja) * 1998-02-26 2002-01-28 勲 長澤 病棟情報システム
US8423113B2 (en) * 2003-07-25 2013-04-16 Dexcom, Inc. Systems and methods for processing sensor data
US9135402B2 (en) * 2007-12-17 2015-09-15 Dexcom, Inc. Systems and methods for processing sensor data
US8369919B2 (en) * 2003-08-01 2013-02-05 Dexcom, Inc. Systems and methods for processing sensor data
US7806854B2 (en) * 2005-05-13 2010-10-05 Trustees Of Boston University Fully automated control system for type 1 diabetes
US9392969B2 (en) * 2008-08-31 2016-07-19 Abbott Diabetes Care Inc. Closed loop control and signal attenuation detection
US8721584B2 (en) * 2006-11-02 2014-05-13 The University Of North Carolina At Chapel Hill Methods and systems for determining an intravenous insulin infusion rate to correct hyperglycemia of a patient, to maintain euglycemia of a patient, and to prevent hypoglycemia of a patient
US20080154513A1 (en) * 2006-12-21 2008-06-26 University Of Virginia Patent Foundation Systems, Methods and Computer Program Codes for Recognition of Patterns of Hyperglycemia and Hypoglycemia, Increased Glucose Variability, and Ineffective Self-Monitoring in Diabetes
CN101663059A (zh) * 2007-03-19 2010-03-03 梅丁格有限公司 药物输送设备中选择单次剂量的用户接口
US8221345B2 (en) * 2007-05-30 2012-07-17 Smiths Medical Asd, Inc. Insulin pump based expert system
WO2009139846A1 (en) * 2008-05-12 2009-11-19 Department Of Veterans Affairs Automated system and method for diabetes control
US9317657B2 (en) * 2008-11-26 2016-04-19 University Of Virginia Patent Foundation Method, system, and computer program product for tracking of blood glucose variability in diabetes
JP5661651B2 (ja) * 2009-02-25 2015-01-28 ユニバーシティ オブ ヴァージニア パテント ファウンデーション 低血糖のリスク査定およびなだらかなインスリン放出の減少による、cgmに基づいた低血糖の予防

Also Published As

Publication number Publication date
US20130231642A1 (en) 2013-09-05
JP6062859B2 (ja) 2017-01-18
US9700708B2 (en) 2017-07-11
EP2628115B1 (en) 2015-06-03
CA2816388A1 (en) 2012-04-19
EP2628115A2 (en) 2013-08-21
WO2012051344A2 (en) 2012-04-19
JP2013542011A (ja) 2013-11-21
EP2628115A4 (en) 2014-04-23
DK2628115T3 (en) 2015-08-24
HK1182496A1 (en) 2013-11-29
ES2544874T3 (es) 2015-09-04
WO2012051344A3 (en) 2012-07-19

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