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EP-4322851-B1 - DETECTION OF PROLONGED POSTPRANDIAL HYPERGLYCEMIA, GLYCEMIC PEAK LINEAR PREDICTION AND INSULIN DELIVERY ADJUSTMENT

EP4322851B1EP 4322851 B1EP4322851 B1EP 4322851B1EP-4322851-B1

Inventors

  • GOUZE, JEAN NOEL

Dates

Publication Date
20260513
Application Date
20220414

Claims (13)

  1. A computer-aided method of predicting a postprandial glycemic peak of an individual, comprising: obtaining (400, 405), from a glucose sensor (100), blood glucose level measurements (g i , t i ) of the individual, including one pre-prandial blood glucose level measurement (g 0 , t 0 ), determining (410) a postprandial glucose change rate (Cf) from the pre-prandial blood glucose level measurement (g 0 , t 0 ) and one postprandial blood glucose level measurement (g 1 , t 1 ), and linearly inferring (415) a peak glucose level (g peak-pred ) from the determined postprandial glucose change rate and from the pre-prandial blood glucose level measurement.
  2. The method of Claim 1, wherein the postprandial glucose change rate (Cf) is determined from the pre-prandial blood glucose level measurement (g 0 , t 0 ) and only one postprandial blood glucose level measurement (g 1 , t 1 ).
  3. The method of Claim 1 or 2, wherein a peak glucose increase (ΔG pred ) is linearly inferred from the determined postprandial glucose change rate (Cf) and the peak glucose level (g peak-pred ) is a sum of the measured pre-prandial glucose level (g 0 ) with the peak glucose increase (ΔG pred ).
  4. The method of Claim 3, wherein, a peak time (t peak-pred ) is determined that is a sum of a ratio between the peak glucose increase (ΔG pred ) and the postprandial glucose change rate (Cf) with a pre-prandial time (t 0 ) of the pre-prandial blood glucose level measurement.
  5. A method of assisting a diabetic individual, using a glucose sensor (100), for obtaining measurements of blood glucose levels (g i ) of the individual, the method comprising: computer-predicting (510) a postprandial glycemic peak (g peak-pred , t peak-pred ) using the method of Claim 1, determining (525, 530, 540) whether additional blood glucose level measurements include a measured postprandial glycemic peak (g peak-measure , t peak-measure ) matching the predicted postprandial glycemic peak, and emitting (535) a signal of prolonged postprandial hyperglycemia in case of negative determining.
  6. The method of Claim 5, wherein evaluating a matching between peaks includes determining whether a measured peak time (t peak-measure ) of the measured postprandial glycemic peak equals a predicted peak time (t peak-pred ) of the predicted postprandial glycemic peak given a time margin, and/or whether a measured peak glucose level (g peak-measure ) of the measured postprandial glycemic peak equals a predicted peak glucose level (g peak-pred ) of the predicted postprandial glycemic peak given a glucose margin.
  7. The method of Claim 6, wherein the glucose margin is at least +/- 5% or +/- 10% and at most +/- 25%, preferably at least +/- 15% and at most +/- 20%, of the predicted or measured peak glucose level.
  8. The method of Claim 6 or 7, wherein the time margin is at least +/- 5 min or +/- 10 min and at most +/- 25 min, preferably at least +/- 15 min and at most +/- 20 min.
  9. The method of any one of Claims 6 to 8, wherein the measured peak glucose level and measured peak time respectively correspond to a local maximum blood glucose level measured during a postprandial time period and to the corresponding measure time.
  10. A non-transitory computer-readable medium storing a program which, when executed by a microprocessor or computer system in a device, causes the device to perform the method of any one of Claims 1 to 9.
  11. A computer device (700) comprising: a glucose sensor (100) configured to obtain blood glucose level measurements (g i , t i ) of an individual, including one pre-prandial blood glucose level measurement (g 0 , t 0 ), a postprandial glycemia rate unit (111) configured to determine a postprandial glucose change rate (Cf) from the pre-prandial blood glucose level measurement (g 0 , t 0 ) and one postprandial blood glucose level measurement (g 1 , t 1 ), and a peak determination unit (112, 113) configured to linearly infer a peak glucose level (g peak-pred ) from the determined postprandial glucose change rate and from the pre-prandial blood glucose level measurement.
  12. The computer device of Claim 11, wherein the postprandial glycemia rate unit (111) is configured to determine the postprandial glucose change rate (Cf) from the pre-prandial blood glucose level measurement (g 0 , t 0 ) and only one postprandial blood glucose level measurement (g1, t 1 ).
  13. A system (1) comprising: a computer device according to Claim 11 configured to predict a postprandial glycemic peak based on some blood glucose level measurements, a matching peak determination unit (120) configured to determine whether additional blood glucose level measurements include a measured postprandial glycemic peak matching the predicted postprandial glycemic peak, and a signal emitting unit (130) configured to emit a signal of prolonged postprandial hyperglycemia in case of negative determining.

Description

FIELD OF THE INVENTION The present invention relates to the field of computer technology, and in particular to computer-aided methods and apparatuses for detecting prolonged postprandial hyperglycemia, predicting postprandial glycemic peaks and assisting diabetic patients to dynamically adjust anti-diabetic drug, a storage medium and a computer device. BACKGROUND OF THE INVENTION Diabetes is the leading cause of death worldwide with a growing number of people living with the disease that should reach up to 580 million by 2045. Chronic hyperglycemia is the main characteristic of diabetes and is caused by defects in insulin secretion and/or insulin biological activity. Type 1 diabetes (T1D) is due to insulin production deficiency while type 2 diabetes results from an ineffective use by the body of insulin. Long-term complications of chronic hyperglycemia include inter alia kidney failure, neuropathy, retinopathy, cardiovascular disease and blood vessel failure. Blood glucose levels are physiologically highly variable and are influenced by many different factors such as carbohydrate uptake, hormones stimulating glucose release and/or uptake from cells and organs, but also by numerous external factors such as stress, medications, physical activity, behavior or environments. Physiological insulin secretion is permanent over the day and constantly balances blood sugar levels. Because carbohydrate uptake is the main contributor in blood sugar increase, pronounced secretory insulin peaks occur after meals while lower secretions occur during the rest of the day. To avoid above-mentioned long-term complications associated with chronic hyperglycemia, keeping blood sugar levels as close as possible to normal healthy range (70-120 mg/dL) represents the main goal and challenge of diabetes management. In insulin-dependent individuals, this blood glucose management is made through the injection (or delivery) of insulin using syringes, pens or pumps several times a day. In nondiabetic individuals, the plasma glucose concentration peaks in average one hour after the start of a meal and rarely exceeds 140 mg/dl. The return to pre-prandial levels (e.g. 80-120 mg/dL) then occurs within two to three hours after the meal. Hyperglycemia that occurs after a meal is called postprandial hyperglycemia (PPH) and accounts for most of the overall blood sugar imbalance in insulin-dependent individuals. Effectively controlling PPH is one of the most complicated challenges for diabetic patients as post-meal glycemic spikes are influenced by many factors despite the administration of insulin (e.g. nature of the carbohydrates ingested, presence of other nutrients, stress etc...). The PPH can be extremely variable in height and duration from meal to meal, day to day and from individual to individual. Although there is indisputable evidence that PPH contributes significantly to long-term damage to the body, various postprandial (PP) glycemic recommendations have been set. For instance, blood glycemic levels to be reached two hours post meal (i.e. two-hour postprandial glycemic or glucose or sugar levels) shall be lower than 140 mg/dl for the American Association of Clinical Endocrinologist, lower than 180 mg/dL for the American Diabetes Association, lower than 160-180 mg/dL for the European Association for the Study of Diabetes, and lower than 160 mg/dL for the International Diabetes Federation. Day-to-day real life analysis of glucose profiles shows that despite the delivery of a correct amount of insulin (corresponding to the carbohydrate uptake), the postprandial glycemic peak is often prolonged for more than two hours at high glucose levels (e.g. > 160 mg/dL), hence defining postprandial hyperglycemia. The duration of the PPH is extremely variable because abnormal glycemic states are randomly observed and the corrective measures to correct insulin delivery to the patient are often taken too late to maintain a healthy glycemic average value over the considered day. A need thus exists for insulin-dependent individuals to early anticipate the evolution of their postprandial blood glucose values and early detect any risk of prolonged (i.e. two hours or more) postprandial hyperglycemia. This would help them to early take appropriate corrective measures for insulin delivery, and hence to have a better management of PPH and indirectly of the long-term blood glucose level average. Corrective measures based on personalized corrective recommendations may ensure a rapid return to normalized blood sugar levels with reduced risks of postprandial hypoglycemia. Some modeling methods of blood glucose levels are already known and can be divided into two categories: physiological and data-driven methods. A physiological model consists in transforming known glucose metabolism in mathematical functions that can be implemented with different parameters such as addition of insulin, exercise, and emotional state. With the abundant and complete glucose profiles ob