US20090177142A1 - Insulin pump with add-on modules - Google Patents

Abstract

This document discusses, among other things, an apparatus comprising a pump configured to deliver insulin, a wireless communication port, a controller, and a housing to enclose the apparatus. The controller is configured to communicate with a second device via the communication port using an open standard wireless communication protocol. The housing includes a mechanical coupling to slidably engage the second device which includes a second wireless communication port. Slidably engaging the second device positions the first and second communication ports opposite each other to allow communication via the first and second communication ports when slidably engaged.

Description

BACKGROUND
• People who suffer from diabetes require insulin to keep their blood glucose level as close as possible to normal levels. It is essential for people with diabetes to manage their blood glucose level to within a normal range. Complications from diabetes can include heart disease (cardiovascular disease), blindness (retinopathy), nerve damage (neuropathy), and kidney damage (nephropathy). Insulin is a hormone that reduces the level of blood glucose in the body. Normally, insulin is produced by beta cells in the pancreas. In non-diabetic people, the beta cells release insulin to satisfy two types of insulin needs. The first type is a low-level of background insulin that is released throughout the day. The second type is a quick release of a higher-level of insulin in response to eating. Insulin therapy replaces or supplements insulin produced by the pancreas.
• Conventional insulin therapy typically involves one or two injections a day. The low number of injections has the disadvantage of allowing larger variations in a person's insulin levels. Some people with diabetes manage their blood glucose level with multiple daily injections (MDI). MDI may involve more than three injections a day and four or more blood glucose tests a day. MDI offers better control than conventional therapy. However, insulin injections are inconvenient and require a diabetic person to track the insulin doses, the amount of carbohydrates eaten, and their blood glucose levels among other information critical to control.
• It is important for a diabetic person to be treated with the proper amount of insulin. As discussed previously, high blood sugar can lead to serious complications. Conversely, a person with low blood sugar can develop hypoglycemia. Ideally, insulin therapy mimics the way the body works. An insulin pump is one way to mimic the body's insulin production. An insulin pump can provide a background or basal infusion of insulin throughout the day and provide a quick release or bolus of insulin when carbohydrates are eaten. If a person develops high blood sugar, a correction bolus can be delivered by the pump to correct it. While insulin pumps improve convenience and flexibility for a diabetic person, they can be sophisticated devices. It is desirable for an insulin pump to have features that make the pump more convenient or more effective for the patient to use.
Overview
• This document discusses, among other things, devices and methods for managing insulin therapy. A device example includes a pump configured to deliver insulin, a wireless communication port, a controller, and a housing to enclose the apparatus. The controller is configured to communicate with a second device via the communication port using an open standard wireless communication protocol. The housing includes a mechanical coupling to slidably engage the second device which includes a second wireless communication port. Slidably engaging the second device positions the first and second communication ports opposite each other to allow communication via the first and second communication ports when slidably engaged.
• A method example includes positioning a mechanical coupling on a housing that encloses the insulin pump device so that the mechanical coupling slidably engages a second device, positioning a first wireless communication port in relation to the mechanical coupling such that, when the second device is in a slidably engaged position, the first wireless communication port is positioned opposite a second wireless communication port of the second device, and communicating with the second device via the first and second communication ports using an open standard wireless communication protocol.
• This section is intended to provide an overview of the subject matter of the present patent application. It is not intended to provide an exclusive or exhaustive explanation of the invention. The detailed description is included to provide further information about the subject matter of the present patent application.
BRIEF DESCRIPTION OF THE DRAWINGS
• In the drawings, which are not necessarily drawn to scale, like numerals may describe similar components in different views. Like numerals having different letter suffixes may represent different instances of similar components. The drawings illustrate generally, by way of example, but not by way of limitation, various embodiments discussed in the present document.
• FIGS. 1A and 1B illustrate portions of a device that includes an insulin pump.
• FIG. 2 is a block diagram of portions of a system to provide add-on features to an insulin pump device.
• FIG. 3 is an illustration showing a mechanical coupling for an add-on module.
• FIG. 4 shows a flow diagram of an embodiment of a method to provide add-on features to an insulin pump device.
• FIG. 5 shows a flow diagram of an embodiment of method to manage blood glucose of an insulin pump user in response to activity.
• FIG. 6 is a block diagram of portions of an embodiment of a device that helps a user manage their blood glucose in response to activity.
• FIG. 7 is a block diagram of portions of another embodiment of a device that helps a user manage their blood glucose in response to activity.
• FIG. 8 shows an example of a table that indexes an amount of carbohydrates to an intensity and duration of exercise.
• FIG. 9 is a block diagram of portions of still another embodiment of a device that helps a user manage their blood glucose in response to activity.
• FIG. 10 is a flow diagram of an embodiment of a method of assisting an insulin pump user in managing their diabetes.
• FIG. 11 is a block diagram of portions of an embodiment of a system that includes compressed audio files to assist an insulin pump user in managing their diabetes.
• FIG. 12 is a flow diagram of an embodiment of a method to monitor insulin temperature.
• FIG. 13 is a block diagram of portions of a device to monitor temperature of insulin.
• FIG. 14 is a flow diagram of an embodiment of a method of determining an amount of insulin to deliver in a bolus in response to a pump user ingesting a meal.
• FIG. 15 is a block diagram of an embodiment of a device to determine an amount of insulin in an insulin bolus using food nutrient information.
• FIG. 16 illustrates a graph of an example of a combination bolus of insulin.
• FIG. 17 is a flow diagram of another embodiment of a method of automatically determining an amount of insulin to deliver in a bolus.
• FIG. 18 is a block diagram of another embodiment of a device to automatically determine an amount of insulin in an insulin bolus using food nutrient information.
• FIG. 19 shows a flow diagram of an embodiment of a method to program an insulin pump device using an interactive calendar.
• FIG. 20 is a block diagram of portions of an embodiment of a system that includes an insulin pump device.
• FIG. 21 is a flow diagram of an embodiment of a method of operating an insulin pump device.
• FIG. 22 is a block diagram of portions of an embodiment of a device to provide voice control of insulin therapy.
• FIG. 23 is block diagram of portions of an embodiment of a device to provide insulin therapy.
• FIG. 24 is a flow diagram of an embodiment of a method of extending the battery life of an insulin pump.
DETAILED DESCRIPTION
• Insulin pumps can be sophisticated devices. Additional pump features may assist an insulin pump user in being more effective in treating their diabetes.FIGS. 1A and 1B illustrate portions of adevice100 that includes an insulin pump. Thedevice100 includes a cassette or cartridge of insulin. The cartridge is connectable toinfusion tubing140 connectable to a patient such as by aLuer lock145 or infusion set142. Thedevice100 includes adisplay102 and a user interface that may include thedisplay102 and include one ormore keys104 in a keypad. Because it is important for an insulin pump user to properly treat their diabetes using the pump, it is desirable for a pump to have features that make the pump more convenient or more effective to use. The features may be integral to the device or may be provided by add-on modules.
Add-On Module
• FIG. 2 is a block diagram of portions of asystem200 to provide add-on features to an insulin pump device to expand its functional capability. Thesystem200 includes afirst device205 and asecond device210. Thefirst device205 includes apump215 configured to deliver insulin, a firstwireless communication port220, and acontroller225.
• Thepump215 may be a positive displacement pump. Descriptions of an example of a medication pump to deliver insulin are found in Vilks et al., “Cartridge and Rod for Axially Loading a Medication Pump,” U.S. Pat. No. 7,033,338, filed Feb. 28, 2002, which is incorporated herein by reference in its entirety. Thepump215 may drive a plunger in a removable insulin cartridge to deliver the insulin. The firstwireless communication port220 may be an infrared (IR) communication port, or the firstwireless communication port220 may be a radio communication port (e.g., a radio frequency or RF port).
• Thecontroller225 can be implemented using hardware circuits, firmware, software or any combination of hardware, firmware, and software. Examples, include a microcontroller, a logical state machine, a field programmable gate array (FPGA), application specific integrated circuit (ASIC), and a processor such as a microprocessor, digital signal processor, or other type of processor. Thecontroller225 is configured to perform or execute a function or functions. Such functions correspond to modules to provide features integral to the first device. Modules may be software, hardware, firmware or any combination thereof. Multiple functions may be performed in one or more modules. In some embodiments, software or firmware is provided on a computer readable medium. The computer readable medium includes instructions therein, which when processed (such as by thecontroller225 for example) results in a device performing the functions described herein. Examples of a computer readable medium include a compact disc (CD), memory stick, or remote storage accessible via a communication network such as the internet or a cell phone network.
• Thesecond device210 includes a secondwireless communication port230. Thesecond device210 provides a feature or features to thefirst device205 by communicating information via the wireless ports. In this way thesecond device210 is an add-on module to the first device. Add-on modules perform a function or functions external to thefirst device205. The functions may be performed by a controller included in thesecond device210.
• FIG. 3 is an illustration showing a mechanical coupling of thefirst device305 and thesecond device310. Thefirst device305 includes ahousing335 that encloses thefirst device305. Thehousing335 includes amechanical coupling350 to slidably engage thesecond device310. By slidably mounting thesecond device310 next to theinsulin cartridge cap340 of thefirst device305, thefirst device305 does not have to become any thicker and the change in effective length can be minimized by using the empty space next to theinsulin cartridge cap340. This prevents a module added-on to the insulin pump device from making the device more cumbersome for the user to wear. The slide mounting also allows for quick and easy attachment by the user; making it more likely that the user will use the add-on module.
• In some embodiments, themechanical coupling350 includes a locking mechanism to lock the second apparatus in the slidably engaged position and thesecond device310 includes a release mechanism to release thesecond device310 from the slidably engaged position, or to otherwise detach thesecond device310 from thefirst device305. In certain embodiments, the release mechanism is a release button that may be located on aside surface355 of the second device. In some embodiments, thesecond device310 includes a battery tray that slides into thebottom surface345 of the second device.
• In some embodiments, slidably engaging thesecond device310 and thefirst device305 positions the firstwireless communication port220 ofFIG. 2 opposite the secondwireless communication port230. This allows infrared communication ports to be aligned for communication. In some embodiments, thefirst device205 and thesecond device210 communicate using a proprietary protocol. In some embodiments, thefirst device205 and thesecond device210 communicate using an open standard wireless communication protocol. An example of an open standard wireless communication protocol includes, among other things, the Infrared Data Association (IRDA) protocol. Use of an open standard wireless communication protocol may ease development of add-on modules for the insulin pump device.
• In some embodiments, thesecond device210 includes a blood glucose monitor. A blood glucose monitor or meter measures blood glucose levels using a sample of blood or of interstitial fluid. Some monitors require a finger-stick to acquire the sample that is applied to a test strip to get a blood glucose reading. Some monitors are able to provide continuous monitoring of blood glucose. A continuous blood glucose monitor may include a blood glucose sensor circuit to produce an electrical blood glucose signal representative of a blood glucose level of the patient. A description of a blood glucose sensor circuit can be found in Steil et al., “Closed Loop System for Controlling Insulin Infusion,” U.S. Pat. No. 6,558,351, filed Jun. 1, 2000, which is incorporated herein by reference in its entirety. The blood glucose monitor provides information regarding the blood glucose level of the user (e.g., blood glucose data) to thefirst device205.
• In some embodiments, thesecond device210 includes a glycosylated hemoglobin (Hb_Alc) tester. When a diabetic is not effectively controlling their diabetes, blood sugar combines with hemoglobin and the hemoglobin becomes abnormally glycated. The Hb_Alctester determines if the Hb_Alclevel of the user is within a normal range. In some embodiments, thesecond device210 includes an activity monitor. The activity monitor includes a sensor that produces an activity sensor signal that is representative of the activity of the user. In some embodiments, the activity sensor is an accelerometer. In some embodiments, the activity monitor includes a pedometer function. The activity monitor provides information related to activity of a user. In some embodiments, thesecond device210 includes a blood ketone tester. Monitoring blood ketone level is useful to detect diabetic ketoacidosis. The blood ketone tester provides information regarding the blood ketone level of the user to the first device. Other embodiments of thesecond device210 implement any of the features described herein.
• FIG. 4 shows a flow diagram of an example of amethod400 to provide add-on features to an insulin pump device. Atblock405, a mechanical coupling is positioned on a housing that encloses an insulin pump device. The mechanical coupling slidably engages a second device.
• Atblock410, a first wireless communication port is positioned in relation to the mechanical coupling such that when a second device is in a slidably engaged position, the first wireless communication port is positioned opposite a second wireless communication port of the second device. Atblock415, the insulin pump device communicates with the second device via the first and second communication ports using an open standard wireless communication protocol.
Activity Monitoring
• Activity of the insulin pump user may lead to a change in insulin therapy of the user. A pump user may not always know when activity such as exercise leads to a change in therapy, or the user may neglect to address a change required by the activity.
• FIG. 5 shows a flow diagram of an embodiment ofmethod500 to manage blood glucose of an insulin pump user in response to activity. Atblock505, information related to activity of a user is received into a device that includes an insulin pump. Atblock510, a change in insulin therapy is determined according to the activity information. Atblock515, the changed insulin therapy is delivered using the insulin pump device.
• FIG. 6 is a block diagram of portions of an embodiment of adevice600 that helps a user manage their blood glucose in response to activity. Thedevice600 includes apump615 configured to deliver insulin, aninput622, and acontroller625. Thecontroller625 receives information related to activity of a user of the apparatus via theinput622. In some embodiments, thedevice600 includes a user interface communicatively coupled to theinput622. The communicative coupling allows the controller6255 to exchange electrical signals with theinput622 and pump615 even though intervening circuitry may be present. The user interface may include one or more keys in a keypad. Thecontroller625 receives the information related to activity of a user via the user interface.
• In some embodiments, the device includes acommunication port620 and thecontroller625 receives the information from a separate second device. In certain embodiments, thecommunication port620 is a wired port (e.g., a universal serial bus (USB) port, Firewire port, or RS232 port). In certain embodiments, thecommunication port620 is a wireless port (e.g., an IR port or an RF port).
• In some embodiments, the second device that provides activity information is an add-on module that includes an activity monitor. In certain embodiments, the activity monitor attaches to thedevice600 slidably as inFIG. 3. In certain embodiments, the activity monitor attaches to thedevice600 by a clasp mechanism. Descriptions of devices and methods that attach add-on modules to an insulin pump device are found in Goodnow et al., “Glucose Measuring Module and Insulin Pump Combination,” U.S. Patent Publication No. 20040254434, filed Jun. 10, 2003, which is incorporated herein by reference in its entirety.
• Thecontroller625 includes aninsulin calculation module630. Theinsulin calculation module630 calculates a change in insulin therapy according to the activity information. Thecontroller625 then initiates delivery of the changed insulin therapy. The change to insulin therapy may include a change to a meal bolus or carbohydrate bolus, a change to a correction bolus, a change to a basal infusion of insulin (e.g., a basal insulin rate pattern or basal rate profile), or may include the insulin calculation module recommending that the user consume carbohydrates.
• FIG. 7 is a block diagram of portions of another embodiment of adevice700 that helps a user manage their blood glucose in response to activity. Thedevice700 includes apump715 configured to deliver insulin, aninput722, acontroller725, and aninsulin calculation module730 included in thecontroller725. Thedevice700 also includes auser interface735. Information related to exercise of the user is received by thecontroller725 via theuser interface735.
• Theinsulin calculation module730 uses the exercise information to calculate an amount of carbohydrates metabolized by the exercise. In some embodiments, theinsulin calculation module730 estimates the amount of carbohydrates metabolized by the exercise according to a conversion rule. For example, theinsulin calculation module730 may estimate that the user metabolizes 15 to 30 grams every 30 to 60 minutes. The exact conversion rule can be tailored for the pump user and programmed into thecontroller725 by the user or a diabetes professional. The conversion rule can be programmed via theuser interface735 or via acommunication port620 as shown inFIG. 6.
• In some embodiments, thedevice700 includes amemory740. The conversion rule is a lookup table stored in thememory740. The lookup table indexes the amount of carbohydrates metabolized according to the exercise intensity and the exercise duration. An exercise with a higher intensity (e.g., running) would have a higher intensity level and metabolize more carbohydrates than an exercise with a lower intensity (e.g., golfing). An example of a table that indexes an amount of carbohydrates to the intensity and duration of exercise is the ExCarbs Table published by Diabetes Services, Inc. and reproduced inFIG. 8. The intensity and duration of the exercise is entered via theuser interface735. In some examples, the table includes the amount of carbohydrates metabolized per amount of body weight (e.g., per 100 pounds). Theinsulin calculation module730 calculates the amount of carbohydrates metabolized by the exercise from the user's body weight.
• Theinsulin calculation module730 calculates a reduction of an amount of insulin in a bolus by an amount that covers the metabolized amount of carbohydrates. In some examples, theinsulin calculation module730 calculates the reduction in insulin using a carbohydrate ratio stored in thedevice700. A carbohydrate ratio refers to the amount of carbohydrates covered by a unit of insulin. It is sometimes referred to as a carbohydrate factor, or carb factor, and is typically specified as grams of carbohydrates per unit of insulin. Theinsulin calculation module730 converts the amount of metabolized carbohydrates into an amount of insulin using the carbohydrate ratio and reduces the amount of insulin in a bolus by that amount. For example, the patient may metabolize seventy grams of carbohydrates during an exercise session. If the carbohydrate ratio is ten grams of carbohydrates per unit of insulin, the insulin pump may determine that seven units of insulin are required to cover the carbohydrates and reduce an amount of insulin in a bolus by seven units.
• In some embodiments, theinsulin calculation module730 reduces the insulin in a meal bolus by an amount that covers the metabolized amount of carbohydrates. A meal bolus is an amount of insulin delivered in anticipation of, or in response to, eating a meal. In some examples, theinsulin calculation module730 reduces the insulin in a correction bolus. A correction bolus is a bolus of insulin designed to bring high blood glucose back to normal. In some examples, theinsulin calculation module730 reduces the insulin in a basal insulin rate pattern by an amount that covers the metabolized amount of carbohydrates. Theinsulin calculation module730 temporarily reduces the rate of basal insulin delivery until the insulin reduction is covered and then restores the original rate of basal insulin delivery.
• In some embodiments, thedevice700 includes adisplay745. After calculating an amount of carbohydrates metabolized by the exercise, theinsulin calculation module730 recommend, via the display, that the user consume the calculated amount of carbohydrates.
• In some embodiments, one or more exercise regimens are stored in thememory740. This is useful if the insulin pump user regularly repeats a type of exercise (e.g., regularly plays a round of golf at the same golf course or regularly runs a certain distance). An exercise regimen can be labeled “run” and can index a specified intensity and duration. The exercise intensity and duration may be used to determine the amount of metabolized carbohydrates, such as by using a lookup table as described previously. The exercise regimens may be received into thedevice700 via theuser interface735, or may be received into thedevice700 from a second separate device via a communication port.
• Thedevice700 receives an indication, via theuser interface735, that the user will exercise according to a stored exercise regimen. In response to the received indication, thecontroller725 presents on thedisplay745 an exercise insulin delivery pattern corresponding to the exercise regimen. In some examples, the exercise insulin delivery pattern is a basal insulin rate pattern that includes a reduction in insulin according to the carbohydrates metabolized during the exercise. The device receives, via the user interface, at least one of a selection of the exercise insulin delivery pattern into the device or a modification to the exercise insulin delivery pattern into the device. Thecontroller725 then initiates delivery of the selected or modified exercise insulin delivery pattern. The user may also cancel the exercise insulin delivery pattern via theuser interface735.
• FIG. 9 is a block diagram of portions of still another embodiment of adevice900 that helps a user manage their blood glucose in response to activity. Thedevice900 includes apump915 configured to deliver insulin, aninput922, acontroller925, and aninsulin calculation module930 included in thecontroller925. Thedevice900 includes anactivity sensor950 communicatively coupled to theinput922. Theactivity sensor950 provides activity information in the form of an activity sensor signal that is an electrical signal representative of patient activity.
• According to some embodiments, thedevice900 includes asecond input952 and adisplay945. Thecontroller925 receives information related to blood glucose into the insulin pump device via the second input and displays activity information in association with the blood glucose information on thedevice display945. In certain embodiments, thecontroller925 displays an indication of a period of high blood glucose level or a period of low blood glucose level on thedevice display945 together with activity information. In certain embodiments, thecontroller925 displays indications of both periods of high and low blood glucose levels together with an indication of activity level on thedevice display945.
• In some embodiments, thedevice900 includes a user interface communicatively coupled to thesecond input952. Thecontroller925 receives information related to blood glucose entered manually via the user interface.
• In some embodiments, thedevice900 includes a communication port communicatively coupled to thesecond input952. The port may be a wired port or a wireless port. Thecontroller925 receives information related to blood glucose via the communication port from a second separate device. In some examples, the second device is a blood glucose monitor. In some embodiments, the second device is a blood glucose monitor included in an add-module to thedevice900. In some embodiments, a blood glucose monitor955 is integral to thedevice900 and is communicatively coupled to thesecond input952.
• According to some embodiments, thedevice900 includes amemory940 and adisplay945. Thememory940 stores a basal insulin rate pattern for an indicated activity level. For example, thememory940 may store one basal rate pattern for an activity with an intensity level of “3” and a different basal rate pattern for an activity with an intensity level of “5”. Thecontroller925 includes anactivity module960. Theactivity module960 uses the activity sensor signal from theactivity sensor950 to determine an actual activity level of the patient during delivery of the basal insulin rate pattern, which may be different from the indicated activity level. Thecontroller925 displays an indication when the actual activity level deviates from the indicated activity level and displays a recommended change to the basal rate pattern.
• In certain embodiments, if the actual level of exercise is less than the indicated level, the exercise basal rate pattern may not deliver enough insulin. Theinsulin calculation module930 determines the difference between the actual carbohydrates metabolized and the amount of carbohydrates metabolized according to the stored indicated activity level and recommends an amount of insulin in a correction bolus to cover the difference. In certain embodiments, if the actual level of exercise is more than the indicated level, the exercise basal rate pattern may deliver too much insulin. The insulin calculation module determines the difference between the amount of carbohydrates covered by the insulin and the amount of carbohydrates metabolized, and thecontroller925 displays an indication for the user to eat an amount of carbohydrates corresponding to the calculated difference.
• In some embodiments, theactivity module960 establishes a baseline level of patient activity for a period of time. The period of time may be a period during the day when the pump user is more active, or may be a period of normal activity. In some examples, theactivity module960 establishes a baseline level for a specific activity (e.g., playing tennis).
• In certain embodiments, theactivity module960 establishes a baseline activity level using a central tendency (e.g., an average value, or a median value) of the activity sensor signal. Theactivity module960 then determines an actual level of patient activity during a time period (e.g., the time of day, or when the user indicates to thedevice900 that they are playing tennis) using the activity sensor signal, and compares the actual level of patient activity to the baseline level. If the actual level of patient activity exceeds the baseline level by a threshold value, the insulin calculation module calculates and displays an amount of carbohydrates for the patient to consume.
• If the actual level of patient activity is less than the baseline level by the same or a different threshold value, thecontroller925 prompts the user, via thedisplay945, to initiate blood glucose tests more frequently. In certain embodiments, if theactivity module960 determines that the actual level of patient exercise is less than the baseline level by more than a threshold value, theinsulin calculation module930 calculates an amount of insulin to deliver in a correction bolus to bring the patient's blood glucose to a target level. Thecontroller925 may then display the recommended amount to the pump user who may then initiate the correction bolus through a user interface.
• According to some embodiments, thememory940 stores basal rate patterns in association with patient activity levels. For example, thememory940 may store exercise basal rate patterns to be used during or after exercise. Theactivity module960 determines a level of patient activity using the activity sensor signal. Thecontroller925 activates the exercise basal rate pattern according to the level of patient activity determined by theactivity module960. As an illustrative example, thememory940 may store one basal rate pattern for normal activity, a first exercise basal rate pattern for an activity with an intensity level of “3”, and a second exercise basal rate pattern for an activity with an intensity level of “5”. When theactivity module960 determines that the activity level of the patient is “3”, thecontroller925 activates the first exercise basal rate pattern.
• Other motion signatures in the activity sensor signal may provide other information to thedevice900. For example, a sudden spike in the activity sensor signal may indicate that thedevice900 underwent an impact. In some embodiments, theactivity module960 determines that the activity signal exceeds a signal threshold value associated with the insulin pump device undergoing an impact. In response to the determined impact, the controller displays a recommendation to check the insulin pump device, an insulin cartridge, or both the insulin pump device and insulin cartridge for damage.
Audio Capability
• Because visual indications may be too difficult for a sight impaired pump user to see on a display, audible indications from an insulin pump may be desirable. Also, audio indications may be useful in attracting a non-sight impaired pump user's attention to the device in case of a pump-related alarm condition.
• FIG. 10 is a flow diagram of amethod1000 of assisting an insulin pump user in managing their diabetes. Atblock1005, information is communicated between a first device that includes an insulin pump and a second device that includes a memory to store a plurality of compressed audio data files. This includes atblock1010, communicating a command from the first device to the second device to cause the second device to play a compressed audio data file when the command is received. The audio data file may include an alert concerning the insulin pump device, or may include a status of the insulin pump device.
• FIG. 11 is a block diagram of portions of an embodiment of asystem1100 that includes compressed audio files to assist an insulin pump user in managing their diabetes. Thesystem1100 includes afirst device1105 and asecond device1110. The first device includes apump1115 configured to deliver insulin, acommunication port1120, and acontroller1125 communicatively coupled to thepump1115 and thecommunication port1120. Thecontroller1125 communicates with thesecond device1110 via thecommunication port1120. Thecommunication port1120 may be a wired port or a wireless communication port.
• Thesecond device1110 includes aprocessor1127 and amemory1140 integral to or communicatively coupled to theprocessor1127. Thememory1140 stores one or more files of compressed audio data. In some embodiments, the compressed audio data file1142 is compressed using a lossy compression algorithm, such as the MPEG-1 Audio Layer 3 (MP3) format for example. In some embodiments, the compressed audio data file1142 is compressed using a lossless compression algorithm. Thesecond device1110 also includes acommunication port1130 and anaudio port1160. Thecommunication port1130 may be a wired port or a wireless communication port. In some embodiments, thesecond device1110 is an add-on module that may be attached by any of the methods described or incorporated herein. In some embodiments, thesecond device1110 includes a housing that includes a belt clip for wearing thesecond device1110 with a belt. In certain embodiments, the communication ports are IR ports and the belt positions thesecond device1110 for IR communication. Theaudio port1160 may communicatively coupled to a speaker or to an audio jack, such as to receive an audio headphone connection for example.
• Thecontroller1125 of thefirst device1105 transmits a command to thesecond device1110 to cause thesecond device1110 to play the compressed audio data file1142. In some examples, the command is communicated using an open standard wireless communication protocol. Theprocessor1127 of thesecond device1110 receives the command and plays the compressed audio data file1142 via theaudio port1160 in accordance with the command.
• In some embodiments, the compressedaudio file1142 communicates an alert concerning thefirst device1105 when played. In certain embodiments, the compressedaudio file1142 communicates an occlusion alarm when blockage tubing of thefirst device1105 is detected. In certain embodiments, the compressedaudio file1142 communicates a status of the second device when played. Examples of status alerts include, among other things, that the device is currently running a test, details of insulin therapy provided by the device, and any insulin pump problems. Communicating audible alerts is useful to assist a sight impaired user of an insulin pump device.
• In some embodiments, the compressedaudio file1142 communicates a result of a test run using thefirst device1105. In certain embodiments, thecontroller1125 may be configured to run a test to check operation of thepump1115. In certain embodiments, thecontroller1125 of thefirst device1105 maybe configured to calculate a carbohydrate ratio, to run a correction factor test, or to run a basal rate test.
• As noted previously, a carbohydrate ratio refers to the amount of carbohydrates covered by a unit of insulin. Descriptions of devices and methods that perform a carbohydrate ratio test are found in Blomquist, “Carbohydrate Ratio Testing Using Frequent Blood Glucose Input,” U.S. patent application Ser. No. 11/679,712, filed Feb. 27, 2007, which is incorporated herein by reference in its entirety. A correction factor refers to the amount in drop in blood sugar, or blood glucose, for one unit of insulin. Descriptions of devices and methods that perform a correction factor test are found in Blomquist et al., “Correction Factor Testing Using Frequent Blood Glucose Input,” U.S. patent application Ser. No. 11/626,653, filed Jan. 24, 2007, which is incorporated herein by reference in its entirety. A basal rate test determines if a change should be made to a basal rate pattern. Descriptions of devices and methods that perform a basal rate test are found in Blomquist et al., “Basal Rate Testing Using Frequent Blood Glucose Input,” U.S. patent application Ser. No. 11/685,617, filed Mar. 13, 2007, which is incorporated herein by reference in its entirety. After running such a test, thecontroller1125 transmits a command to thesecond device1110 to cause thesecond device1110 to play a compressed audio data file1142 regarding the test.
• In some embodiments, thememory1140 stores a plurality of compressedaudio data files1142 and the command indicates which audio data file to play. In some embodiments, thefirst device1105 communicates a file of compressed audio data to the second device via thecommunication ports1120,1130. Thesecond device1110 then plays the communicated audio data file.
• In some embodiments, thefirst device1105 includes auser interface1135 which includes adisplay1145. Thecontroller1125 displays a menu containing a plurality of audio files (e.g., songs) playable on thesecond device1110. Thecontroller1125 receives an audio file selection via theuser interface1135 and communicates a selected audio file option to thesecond device1110 which plays the corresponding compressed audio data file1142.
Temperature Monitoring
• Stability of insulin is impacted by temperature. Insulin may become bad if exposed to extremes of heat or cold.FIG. 12 is a flow diagram of an embodiment of amethod1200 to help an insulin pump user make best use of their pump. Atblock1205, temperature is monitored using a device that includes an insulin pump. Atblock1210, it is determined that a cartridge of insulin has been installed in the device. Atblock1215, a temperature that exceeds a first temperature threshold value is detected while the insulin cartridge is installed. Atblock1220, a warning is displayed when the temperature exceeds the first temperature threshold value.
• FIG. 13 is a block diagram of portions of adevice1300 to monitor temperature of insulin. Thedevice1300 includes apump1315 configured to deliver insulin and adetection circuit1365 configured to detect when a cartridge of insulin is installed in thedevice1300. In some embodiments, thedetection circuit1365 includes a switch (e.g., a button) that is activated when an insulin cartridge is inserted in thedevice1300. Thedevice1300 also includes atemperature sensor1350 that produces an electrical temperature signal representative of temperature, adisplay1345, and acontroller1325. Thecontroller1325 is communicatively coupled to thepump1315, thedetection circuit1365, and thetemperature sensor1350.
• Thecontroller1325 includes acomparison module1330 to detect when the temperature exceeds a first temperature threshold value while an insulin cartridge is installed. Thecontroller1325 displays a warning when the temperature exceeds the first temperature threshold value. In certain embodiments, thecontroller1325 displays a warning that the insulin has been exposed to a high temperature, or displays a recommendation that the user initiate more frequent blood glucose readings. In some examples, thecomparison module1330 detects that the temperature is less than a second lower temperature threshold value while an insulin cartridge is installed. Thecontroller1325 then displays a warning that insulin has been exposed to a low temperature.
• According to some embodiments, thetemperature sensor1350 monitors the temperature of the insulin cartridge. For example, thetemperature sensor1350 may be located proximate to or in contact with the insulin cartridge. Thecomparison module1330 detects whether the temperature is below a second lower temperature threshold value. When thecomparison module1330 indicates that the temperature is below the second lower temperature threshold value, thecontroller1325 displays a warning to check the insulin cartridge. In some embodiments, thecomparison module1330 detects when the temperature of the insulin cartridge rises from a temperature below the second temperature threshold to a temperature above the first temperature threshold. Thecontroller1325 then displays a recommendation that the user check for bubbles in the insulin cartridge.
• Measuring a time-temperature product may provide a better indication of whether the insulin has been affected by temperature. According to some examples, thedevice1300 includes atimer circuit1370. Thecomparison module1330 measures the temperature using the temperature signal from thetemperature sensor1350, and measures a duration of time that the measured temperature exceeds a threshold temperature value. Thecomparison module1330 then determines a product of the measured time duration and the measured temperature, and detects when the product of the measured time duration and temperature exceed a threshold product value. If the product of measured time and temperature exceeds the threshold product value, thecontroller1325 displays a warning, such as to check the insulin cartridge for bubbles or a warning that the time-temperature rating has been exceeded, for example.
Food Scale Interface
• A meal bolus is an amount of insulin delivered in anticipation of, or in response to, eating a meal. Typically, the meal bolus insulin is to counteract or cover the amount the amount of carbohydrates in the meal. The proper amount of insulin can be influenced by many factors such as the nutrient content of the food in the meal. Nutrient content refers to the amount of carbohydrates, fiber, protein, and fat in the meal. Nutrient content may also include further indicate an amount of fast-absorbing carbohydrates in the meal. Determining an appropriate amount of insulin in the meal bolus can be difficult for a pump user due to difficulty in estimating the nutrient content of the food.
• A food database contains the nutrient content for various types of food. The food database may include one or more food entries. A food database entry may include the nutrient content for a particular food (e.g., apple), and the database entries can be combined to determine the nutrient content of a meal (e.g., chicken, potato, green beans). An electronic food scale is helpful in determining the nutrient content of the meal. For example, the protein content of chicken per gram stored in the food database can be multiplied by the number of grams of chicken determined by the food scale. Estimating the amount of nutrient content in food would be easier for the insulin pump user if an electronic food scale communicated food information with an insulin pump. In some embodiments, the food data base is stored in the insulin pump and the insulin pump receives food weight information from the food scale. In some embodiments, the food database is stored in the food scale and the insulin pump receives food nutrient information from the food scale.
• FIG. 14 is a flow diagram of an embodiment of amethod1400 of automatically determining an amount of insulin to deliver in a bolus in response to a pump user ingesting a meal (e.g., a meal bolus). Atblock1405, a database of food options is stored in association with a known nutrient content in a memory of a device that includes an insulin pump. In some embodiments, a food database entry represents a food or a combination of foods. A food database entry may be stored as a record including the food name and the nutrient content of the food which includes at least one of the amounts of carbohydrates, fiber, protein, and fat in the food. The food database entries may be combined to determine the nutrient content for a meal. The food database entries may be programmed into the insulin pump device by the user or a diabetes professional, or the food entries may be downloaded into the insulin pump device from a separate device.
• Atblock1410, a food selection of a user is received into the insulin pump device, such as via a user interface for example. In some embodiments, selecting a food option includes scrolling through a list of food options which may be displayed using text or using a graphic of the food. Atblock1415, receiving a weight of the food selected is received into the insulin pump device from a second device. In some embodiments, the second device includes a food scale.
• Atblock1420, the insulin pump device calculates an amount of nutrient content in the food selection using the received weight. Atblock1425, an amount of insulin to deliver is determined using the calculated amount of nutrient content.
• FIG. 15 is a block diagram of an embodiment of adevice1500 to automatically determine an amount of insulin in an insulin bolus using food nutrient information. Thedevice1500 includes apump1515 configured to deliver insulin and amemory1540 to store afood database1542. In thefood database1542, food options are stored in association with a known amount of nutrient content. Thedevice1500 also includes auser interface1535 configured to receive a food selection from a user, acommunication port1520, and acontroller1525. Thecommunication1520 may be a wired port or a wireless port.
• Thecontroller1525 is communicatively coupled to thepump1515, thememory1540, theuser interface1535, and thecommunication port1520. Thecontroller1525 receives, via thecommunication port1520, a weight of the food selected into the insulin pump device from a second device (e.g., an electronic food scale). If thecommunication port1520 is a wired port, the wired connection may be removable when not communicating information. Thecontroller1525 includes anutrient calculation module1532 that calculates an amount of nutrient content in the food selection using the received weight. For example, thefood database1542 may include the amount of at least one of carbohydrates, fiber, protein, or fat per gram of the food. Thenutrient calculation module1532 then multiplies the nutrient information by the received weight to determine the nutrient content of the meal.
• Thecontroller1525 also includes aninsulin calculation module1530. Theinsulin calculation module1530 determines an amount of insulin to deliver using the calculated amount. In some embodiments, theinsulin calculation module1530 uses at least one of a carbohydrate ratio, protein ratio, fat ratio, or fiber content to determine the amount of insulin to deliver. A carbohydrate ratio is sometimes referred to as a carbohydrate (or carb) factor and refers to the amount of carbohydrates covered by a unit of insulin. Theinsulin calculation module1530 may use the carbohydrate ratio to automatically determine an amount of insulin required to match a number of carbohydrates ingested by the patient, or at least an amount required to keep post-meal blood glucose within a range that is healthy for a patient. For example, the nutrient information may indicate that the food the pump user plans to eat includes 70 grams of carbohydrates. If the carbohydrate ratio is 10 grams of carbohydrates per unit of insulin (10 g/u), the insulin pump determines that 7 units of insulin are required to cover the carbohydrates. Because fiber is considered a carbohydrate but not metabolized as a carbohydrate, the grams of fiber may be subtracted from the total grams of carbohydrates. Similar to a carbohydrate ratio, theinsulin calculation module1530 may use a protein ratio to determine an amount of insulin required to cover the protein in the meal, and/or a fat ratio to determine an amount of insulin required to cover the fat in the meal.
• In some embodiments, the insulin is delivered as a meal bolus. In some embodiments, theinsulin calculation module1530 determines a change to a type of meal bolus using the calculated amount of nutrient content. For example, the nutrient content may indicate an amount of fast absorbing carbohydrates and an amount of slow absorbing carbohydrates. Based on the presence of fast and slow absorbing carbohydrates, theinsulin calculation module1530 may determine to deliver the insulin to cover the meal in a combination bolus.
• FIG. 16 illustrates agraph1600 of an example of a combination bolus of insulin. Thegraph1600 shows an amount of insulin delivered versus time. The combination meal bolus includes afirst portion1605 of insulin that is delivered immediately beginning at time t₀. The amount of insulin in thefirst portion1605 may be determined using the amount of fast absorbing carbohydrates. Thefirst portion1605 concludes at time t₁when asecond portion1610 of insulin begins to be delivered. Thesecond portion1610 is delivered over an extended period of time until time t₂. The extended portion is delivered at a lower rate and for a longer period of time than thefirst portion1605. The amount of insulin in thesecond portion1610 may be determined using the amount of slow absorbing carbohydrates.
• FIG. 17 is a flow diagram of another embodiment of amethod1700 of automatically determining an amount of insulin to deliver in a bolus. Atblock1705, a database of food options is stored in association with a known nutrient content in a memory of a first device that includes a weight scale (e.g., an electronic food weight scale). Atblock1710, a food selection of a user of a second device is received into the first device. The second device includes the insulin pump. Atblock1715, food information is transmitted to the insulin pump device using the weight scale device. The food information includes an amount of nutrient content of the food. Atblock1720, an amount of insulin to deliver by the insulin pump device is determined using the food information.
• FIG. 18 is a block diagram of another example of adevice1800 to automatically determine an amount of insulin in an insulin bolus using food nutrient information. Thedevice1800 includes apump1815 configured to deliver insulin, acommunication port1820, and acontroller1825. Thecontroller1825 receives information regarding the nutrient content of food via thecommunication port1820. The nutrient content is of food to be eaten by the pump user and the information is transmitted by a second device, such as a device that includes a weight scale for example. In certain embodiments, thecommunication port1820 may be a wired port and the user connects the port when the information is to be communicated. In certain embodiments, thecommunication port1820 is a wireless communication port.
• Thecontroller1825 includes aninsulin calculation module1830 that determines an amount of insulin to deliver, in anticipation of the user eating the meal, using the nutrient content information received into thedevice1800. In some embodiments, the insulin is delivered as a meal bolus. In some embodiments, the insulin calculation module determines, using the nutrient content, whether the meal bolus should include an extended bolus. In certain examples, the extended bolus is included in a combination bolus, such as the illustrative example shown inFIG. 16. Thesecond portion1610 of the combination bolus is an extended bolus.
Personal Information Manager Feature
• Information related to the daily routine of an insulin pump user is often in electronic form. For example, the user may have a personal information manager (PIM) device, such as a personal data assistant (PDA) or the like. Information related to daily events of the user is stored in the device using an interactive calendar. This information may useful in setting or adjusting insulin therapy from an insulin pump.
• FIG. 19 shows a flow diagram of an embodiment of amethod1900 to program an insulin pump device using an interactive calendar. Atblock1905, information is communicated between a first device that includes an insulin pump and a second device that includes an interactive calendar. In some embodiments, the second device is an add-on module to the insulin pump device. In some embodiments, the second device is a separate device (e.g., a PDA or any computing device running an interactive calendar program). The information communicated between the two devices includes a calendar event of a user of the first device entered into the interactive calendar of the second device.
• Atblock1910, operation of the first device is altered according to the communicated calendar event. Examples of altering operation if the first device include, among other things, changing a delivery of insulin, activating an exercise basal rate pattern, and changing an alarm mode of the first device.
• FIG. 20 is a block diagram of portions of asystem2000 that includes an insulin pump device. Thesystem2000 includes afirst device2005 and asecond device2010. Thefirst device2005 is an insulin pump device and includes thepump2015, afirst communication port2020, and acontroller2025 that initiates insulin therapy delivered by thepump2015.
• Thesecond device2010 implements an interactive calendar and includes amemory2040 to store a plurality of calendar events of a user, auser interface2035 including adisplay2045, asecond communication port2030, and aprocessor2027. Theuser interface2035 receives a calendar event into thememory2040 of thesecond device2010 and theprocessor2027 displays the calendar event. Theprocessor2027 is configured to communicate information to thefirst device2005 using thesecond communication port2030. The communicated information includes a calendar event of the user. Thecontroller2025 of thefirst device2005 alters operation of the first device according to the communicated calendar event.
• According to some embodiments, the communicated calendar event includes a meal time of the user. Thecontroller2025 schedules a missed meal bolus alarm in a time relation to the meal time (e.g., a specified time duration after the scheduled meal time). If the user fails to initiate a meal bolus using thefirst device2005, thecontroller2025 generates a missed meal bolus alarm, or other kind of alert to the user. The user may then initiate the meal bolus if they did indeed eat and forgot to initiate a meal bolus, or may merely cancel the alarm if they did not eat at the scheduled time.
• According to some embodiments, the communicated calendar event includes an exercise time. In some embodiments, the exercise time is when the user exercises according to a specified exercise regimen (e.g., walking a specified distance). Thecontroller2025 of the insulin pump device changes a delivery of insulin in relation to the communicated exercise time. For example, thecontroller2025 may automatically change the basal rate pattern delivered by the device to an exercise basal rate pattern or profile that corresponds to the specified exercise. Thecontroller2025 changes to the exercise basal pattern in relation to the communicated exercise time (e.g., a specified time duration before the exercise regimen begins, as the regimen is scheduled to begin, or a time duration after the exercise regimen begins). In some examples, thefirst device2005 includes a display and displays a prompt as to whether the user wishes to activate the exercise basal rate pattern. The user may then enable or cancel activation of the exercise basal rate pattern.
• In some embodiments, thecontroller2025 calculates an amount of carbohydrates metabolized by the specified exercise regimen and reduces an amount of insulin to be delivered by thefirst device2005 by an amount that covers the metabolized carbohydrates. Examples of devices that calculate carbohydrates metabolized by exercise were described previously in regard toFIG. 7.
• Thefirst device2005 may include anaudible indicator2070 and avibration mechanism2075 communicatively coupled to thecontroller2025. An example of anaudible indicator2070 is a transducer or speaker. Thecontroller2025 may include an alarm module2032 to generate an audible alert, such as a reminder to initiate a meal bolus or a reminder to take a blood glucose measurement for example. The alarm module2032 generates a vibratory alert for such reminders using thevibration mechanism2075. In some embodiments, the communicated calendar event includes a meeting time and, according to the meeting time, the alarm module2032 switches an alarm mode of thefirst device2005 between an audible mode and a vibratory mode according to the communicated meeting time. Thus, the alarm module2032 automatically switches from the audible alert to a silent alert during the meeting time, and may switch back from the silent alert to the audible alert after the meeting time.
• According to some examples, thefirst device2005 includes amemory2042 coupled to or integral to thecontroller2025. Thememory2042 includes an insulin therapy eventlog memory area2044. Thecontroller2025 stores an event related to insulin therapy in association with the communicated calendar event as a log entry in the insulin therapy eventlog memory area2044. Storing an insulin therapy event in association with the communicated calendar event is useful to provide context to insulin therapy events such as blood glucose readings or pump deliveries of insulin. In some examples, thecontroller2025 generates a report that includes one or more log entries from the insulin therapy eventlog memory area2044. The report may be displayed via a display included in thefirst device2005, or the report may be communicated via the communication port to thesecond device2010 or a third device for display or printing. The generated report may be useful in making decisions concerning adjustment to insulin therapy provided by the insulin pump device.
Speech Recognition
• In some situations it may be desirable to communicate with an insulin pump device without the need to navigate operational menus displayed on the insulin pump device. For example, the pump user may be visually impaired. For this reason, it is desirable to provide speech recognition capability in an insulin pump device.
• FIG. 21 is a flow diagram of an embodiment of amethod2100 of operating an insulin pump device. Atblock2105, acoustic energy is received into a device that includes an insulin pump. Typically, the acoustic energy is radiated from speech of the insulin pump user. Atblock2110, an electrical audio signal is generated by the insulin pump device using the received acoustic energy. Atblock2115, a command is derived from the electrical audio signal. At block2135, altering operation of the insulin pump device is altered according to the derived command. For example, the command may be, among other things, a command to initiate or change a delivery of insulin from the insulin pump device, to run a device test, or to change an operating parameter of the device.
• FIG. 22 is a block diagram of portions of adevice2200 to provide voice control of insulin therapy. Thedevice2200 includes apump2215 configured to deliver insulin, anacoustic transducer2250, aspeech recognition circuit2280, and acontroller2225. Theacoustic transducer2250 receives acoustic energy and generates an electrical transducer signal representative of the acoustic energy. An example of an acoustic transducer is a microphone. The acoustic energy is typically generated from speech of the pump user or another person interacting with thedevice2200. The device may include a transducer interface circuit such as asampling circuit2252 that produces digitized samples of the electrical transducer signal. Thespeech recognition circuit2280 derives a command from the digitized samples. In some embodiments, thespeech recognition circuit2280 includes digital signal processing circuitry to derive the command. In some embodiments, theacoustic transducer2250, the transducer interface circuit, and thespeech recognition circuit2280 are included in an add-on module. The add-on module may include a second processor, such as a digital signal processor (DSP), coupled to thespeech recognition circuit2280 to derive the command and a communication port to communicate a derived command to thecontroller2225.
• Thecontroller2225 alters operation of thedevice2200 according to the derived command. In some embodiments, the command derived by thespeech recognition circuit2280 from the electrical transducer signal is to initiate delivery of a correction bolus of insulin. In some embodiments, the command derived by thespeech recognition circuit2280 from the electrical transducer signal is to initiate delivery of a meal bolus of insulin. Thecontroller2225 then initiates delivery of the correction bolus or meal bolus according to the derived command.
• In some embodiments, the command derived by thespeech recognition circuit2280 is to change a basal insulin rate pattern or basal rate profile. In certain embodiments, thedevice2200 may include amemory2240 that stores a plurality of basal rate patterns. The derived command may be to activate a different basal rate pattern than the basal rate pattern that is currently active. For example, thememory2240 may store different basal rate patterns for different activity levels of the pump user. The pump user may speak a command to activate an exercise basal rate pattern, and thespeech recognition circuit2280 derives the user's command. In some embodiments, thespeech recognition circuit2280 derives a command to deactivate insulin pump therapy andcontroller2225 deactivates the therapy provided by the pump when the command is derived. This deactivation may be implemented as an emergency shut-off command.
• According to some embodiments, thecontroller2225 runs one or more device-based tests. Thespeech recognition circuit2280 is configured to derive a command to run a device test, and thecontroller2225 is configured to initiate the test according to the command. In certain embodiments, thecontroller2225 is configured to execute a device diagnostic test. In certain embodiments, thecontroller2225 is configured to execute a carbohydrate ratio test. Descriptions of devices and methods that perform a carbohydrate ratio test are found in the previously mentioned U.S. patent application Ser. No. 11/679,712. In certain embodiments, thecontroller2225 is configured to execute a correction factor test. Descriptions of devices and methods that perform a correction factor test are found in the previously mentioned U.S. patent application Ser. No. 11/626,653. In certain embodiments, thecontroller2225 is configured to execute a basal rate test. Descriptions of devices and methods that perform a basal rate test are found in the previously mentioned U.S. patent application Ser. No. 11/685,617. Thecontroller2225 runs the carbohydrate ratio test, the correction factor test, or the basal rate test according to the derived command.
• According to some embodiments, at least oneoperating parameter2244 of thedevice2200 is stored in thememory2240. Thespeech recognition circuit2280 derives a command from the transducer signal to change theoperating parameter2244 of thedevice2200. Thecontroller2225 updates theoperating parameter2244 in thememory2240 in response to the derived command. In certain embodiments, the operating parameter is a correction factor. The pump user speaks a command to update the correction factor to a specified value. Thespeech recognition circuit2280 derives the command to change the correction factor and derives the specified value of the correction factor from the transducer signal. Thecontroller2225 updates the correction factor inmemory2240.
• In certain embodiments, the operating parameter is a carbohydrate ratio. The pump user speaks a command to update the carbohydrate ratio to a specified value. Thespeech recognition circuit2280 derives the command to change the carbohydrate ratio and derives the specified value of carbohydrate ratio from the transducer signal. Thecontroller2225 updates the carbohydrate ratio inmemory2240.
• It may be desirable to enable operation of thedevice2200 with speech recognition only during certain times. This may help avoid inadvertent changes to operation of thedevice2200. In some embodiments, the speech recognition feature must be enabled on thedevice2200 before use. Thedevice2200 includes auser interface2235 communicatively coupled to thecontroller2225. Thecontroller2225 deactivates processing of audio signals until an activation signal is received via theuser interface2235. The processing of audio signals continues until a deactivation signal is received via theuser interface2235.
• Ambient noise may make it difficult for the speech recognition feature to derive commands from speech. In some embodiments, thedevice2200 includes avibration mechanism2075 communicatively coupled to thecontroller2225. Thespeech recognition circuit2280 generates an indication when ambient noise prevents speech recognition from the digitized samples. For example, thespeech recognition circuit2280 may detect that ambient noise is above a threshold ambient noise level. When thecontroller2225 receives such an indication from the speech recognition circuit, thecontroller2225 provides a vibratory alert using the vibratory mechanism. Thus, thedevice2200 alerts the user when speech recognition may not be usable.
• It may be desirable to add a measure of security in using the speech recognition feature. In some embodiments, operation of thedevice2200 by speech recognition is enabled by a specified password. Thespeech recognition circuit2280 derives a message corresponding to a spoken password from the digitized samples from thesampling circuit2252. Thecontroller2225 deactivates altering operation of the device according to a derived command until the message with the password is derived. Thus, speech recognition is active, but commands to alter operation of the device are not derived until the password is detected.
• In some embodiments, operation of thedevice2200 by speech recognition is only allowed when thedevice2200 verifies the speaker is the insulin pump user. This is referred to as voice recognition or speaker verification. In some embodiments, thedevice2200 includes aspeaker verification circuit2285 communicatively coupled to thesampling circuit2252 and thecontroller2225. The speak verification circuit is configured to verify that the digitized samples from thesampling circuit2252 correlate to a pump user's voice. The controller alters operation of thedevice2200 using the derived command from thespeech recognition circuit2280 only when thespeaker verification circuit2285 also verifies that the command came from the user's voice. In certain embodiments, thespeaker verification circuit2285 includes a DSP. In certain embodiments, thespeaker verification circuit2285 executes adaptive learning to recognize the pump user's voice.
• According to some embodiments, voice operation of the insulin pump device includes outputting recorded voice prompts to the insulin pump user. In some embodiments, thememory2240 stores one or more files of compressed audio data. Thedevice2200 includes anaudio port2260 communicatively coupled to thecontroller2225. Theaudio port2260 may be coupled to a speaker or to an audio jack to receive headphones. Thecontroller2225 plays the compressed audio data file via theaudio port2260. For example, thecontroller2225 may play a compressed audio data file to ask the user whether they want to initiate a meal bolus. This may be played as part of a meal bolus reminder. The controller initiates the meal bolus when thespeech recognition circuit2280 derives the word “yes” from the user, and does not initiate the meal bolus if thespeech recognition circuit2280 derives the word “no” from the user. Other compressed data files may be played to provide alarms or alerts to the user, to inquire whether the user wants to run a device test, or to provide an acknowledge message to the pump user that a command from the user was derived and executed.
Kinetic Battery
• Insulin pumps are typically battery powered devices. It may desirable to extend the battery life of an insulin pump device.FIG. 23 is block diagram of portions of an embodiment of adevice2300 to provide insulin therapy. Thedevice2300 includes apump2315 configured to deliver insulin and acontroller2325 to initiate delivery of insulin therapy from thepump2315. Thedevice2300 also includes aprimary battery circuit2390 and akinetic battery circuit2392. Theprimary battery circuit2390 provides energy to thedevice2300 from aprimary battery2388. Thekinetic battery circuit2392 provides energy to at least a portion of thedevice2300 from akinetic battery2391. Thekinetic battery circuit2392 also converts motion of a user to charge stored in akinetic battery2391, such as by using moving magnets to create electrical energy in coils of wire.
• Thedevice2300 further includes acomparison circuit2394 and aswitching circuit2396. Theswitching circuit2396 switches the power source of at least of a portion of thedevice2300 between theprimary battery circuit2390 and thekinetic battery circuit2392. Thecomparison circuit2394 compares a charge on thekinetic battery2391 to a threshold charge value. When thecomparison circuit2394 detects that the charge on thekinetic battery2391 exceeds the threshold, theswitching circuit2396 provides energy from thekinetic battery circuit2392 to at least a portion of thedevice2300. When the charge on thekinetic battery2391 is less than the threshold, theswitching circuit2396 provides energy to the portion from theprimary battery circuit2390. In some embodiments, thekinetic battery circuit2392 andkinetic battery2391 are included in an add-on module that is connected to theswitching circuit2396.
• According to some examples, because thekinetic battery circuit2392 converts movement of the pump user into battery energy, thekinetic battery circuit2392 can be used to detect user activity. In some embodiments, thedevice2300 includes acharge measurement circuit2398 communicatively coupled to the kinetic battery circuit and the controller, which is configured to measure a level of charge on thekinetic battery2391. Thecontroller2325 includes anactivity detection module2360 configured to determine an activity level of the user from the measured level of charge. For example, theactivity detection module2360 may store a first value Q₁representing a level of charge on the kinetic battery at time t₁. At a later time, t₂, theactivity detection module2360 may determine that the charge on the kinetic battery has increased to a second value Q₂during the time period from time t₁to t₂. Theactivity detection module2360 may detect that the activity level of the user is increasing from the increase in charge.
• In some embodiments, theactivity detection module2360 may determine the activity level of the user from the difference between the first value of charge and the second value of charge (e.g., Q₂−Q₁). In certain embodiments, thecharge measurement circuit2398 is configured to measure a rate of change of the charge on thekinetic battery2391. Theactivity detection module2360 determines the activity level of the user using the measured rate of change of the charge. For example, theactivity detection module2360 may determine the rate of change by dividing the difference in charge values by the difference in time, or
• $\frac{Q_2-Q_1}{t_2-{\mathrm{<figure-callout\; label="t"\; filenames="US20090177142A1-20090709-D00005.png"\; state="\{\{state\}\}">t</figure-callout>}}_1}.$
• Larger values for the rate of change indicate a higher activity level of the pump user.
• In some embodiments, thecontroller2325 includes aninsulin calculation module2330 that calculates a change in a delivery of insulin according to the indicated activity level. The calculated change to insulin therapy may include a calculated reduction in an amount of insulin in at least one of a correction bolus, a meal bolus, or a basal insulin rate pattern according to the activity level. As discussed previously in regard toFIGS. 6 and 7, theinsulin calculation module2330 uses the activity level to calculate an amount of carbohydrates metabolized by the exercise, such as by using a conversion rule for example. Theinsulin calculation module2330 then calculates a reduction of an amount of insulin by an amount that covers the metabolized amount of carbohydrates.
• In some embodiments, thedevice2300 includes amemory2340 that may be integral to thecontroller2325 or communicatively coupled to thecontroller2325. Thememory2340 stores an exercise basal rate pattern. Thecontroller2325 activates the exercise basal rate pattern according to the indicated activity level.
• Thekinetic battery circuit2392 may be used to provide energy to theentire device2300 or to portions of thedevice2300. In some embodiments, thedevice2300 includes a bloodglucose sensor circuit2355 to produce an electrical blood glucose signal representative of a blood glucose level of the patient. Theswitching circuit2396 provides energy to the bloodglucose sensor circuit2355 from thekinetic battery2391 when the charge on thekinetic battery2391 exceeds the threshold charge value. In some embodiments, thedevice2300 includes atemperature sensing circuit2350 that produces an electrical temperature signal representative of temperature. Theswitching circuit2396 provides energy to thetemperature sensing circuit2350 from thekinetic battery2391 when the charge on thekinetic battery2391 exceeds the threshold charge value. In some embodiments, thedevice2300 includes adisplay2345. Theswitching circuit2396 provides energy to thedisplay2345 from thekinetic battery2391 when the charge on thekinetic battery2391 exceeds the threshold charge value.
• FIG. 24 is a flow diagram of an embodiment of amethod2400 of extending the primary battery life of an insulin pump. Atblock2405, motion of a user of a device that includes an insulin pump is used to charge a kinetic battery of the insulin pump device. Atblock2410, energy is provided to a circuit of the insulin pump device from the kinetic battery when the charge on the kinetic battery exceeds a threshold charge value. Atblock2415, energy is provided to the circuit of the insulin pump from the primary battery when the charge on the kinetic battery is less than the threshold charge value.
• The above detailed description includes references to the accompanying drawings, which form a part of the detailed description. The drawings show, by way of illustration, specific embodiments in which the invention can be practiced. These embodiments are also referred to herein as “examples.” All publications, patents, and patent documents referred to in this document are incorporated by reference herein in their entirety, as though individually incorporated by reference. In the event of inconsistent usages between this document and those documents so incorporated by reference, the usage in the incorporated reference(s) should be considered supplementary to that of this document; for irreconcilable inconsistencies, the usage in this document controls.
• It is to be understood that the above description is intended to be illustrative, and not restrictive. For example, the above-described embodiments (and/or aspects thereof) may be used in combination with each other. Many other embodiments will be apparent to those of skill in the art upon reviewing the above description. The scope of the invention should, therefore, be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled. In the appended claims, the terms “including” and “in which” are used as the plain-English equivalents of the respective terms “comprising” and “wherein.” Also, in the following claims, the terms “including” and “comprising” are open-ended, that is, a system, device, article, or process that includes elements in addition to those listed after such a term in a claim are still deemed to fall within the scope of that claim. Moreover, in the following claims, the terms “first,” “second,” and “third,” etc. are used merely as labels, and are not intended to impose numerical requirements on their objects. In this document, the terms “a” or “an” are used, as is common in patent documents, to include one or more than one. In this document, the term “or” is used to refer to a nonexclusive or, such that “A or B” includes “A but not B,” “B but not A,” and “A and B,” unless otherwise indicated.
• The Abstract is provided to comply with 37 C.F.R. §1.72(b), to allow the reader to quickly ascertain the nature of the technical disclosure. It is submitted with the understanding that it will not be used to interpret or limit the scope or meaning of the claims. Also, in the above Detailed Description, various features may be grouped together to streamline the disclosure. This should not be interpreted as intending that an unclaimed disclosed feature is essential to any claim. Rather, inventive subject matter may lie in less than all features of a particular disclosed embodiment. Thus, the following claims are hereby incorporated into the Detailed Description, with each claim standing on its own as a separate embodiment. The scope of the invention should be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled.

Claims (153)

1. An apparatus comprising:

a pump configured to deliver insulin;

a wireless communication port;

a controller communicatively coupled to the pump and the communication port, wherein the controller is configured to communicate with a second device via the communication port using an open standard wireless communication protocol; and

a housing to enclose the apparatus, wherein the housing includes a mechanical coupling to slidably engage the second device which includes a second wireless communication port, and wherein slidably engaging the second device positions the first and second communication ports opposite each other to allow communication via the first and second communication ports when slidably engaged.

2. The apparatus ofclaim 1, wherein the mechanical coupling includes a locking mechanism to lock the second device in the slidably engaged position, and wherein the second device includes a release mechanism to release the second device from the slidably engaged position.

3. The apparatus ofclaim 1, wherein the communication port is an infrared communication port.

4. The apparatus ofclaim 1, wherein the communication port is a radio communication port.

5. The apparatus ofclaim 1, wherein the second device includes at least one of a glucose monitor, a glycosylated hemoglobin (Hb_Alc) tester, an activity monitor, or a blood ketone tester.

6. A method of expanding functional capability of a device that includes an insulin pump, the method comprising:

positioning a mechanical coupling on a housing that encloses the insulin pump device, wherein the mechanical coupling slidably engages a second device;

positioning a first wireless communication port in relation to the mechanical coupling such that, when the second device is in a slidably engaged position, the first wireless communication port is positioned opposite a second wireless communication port of the second device; and

communicating with the second device via the first and second communication ports using an open standard wireless communication protocol.

7. The method ofclaim 6 including:

slidably engaging the second device until a locking mechanism included in the mechanical coupling locks the second apparatus in the slidably engaged position; and

detaching the second device from the slidably engaged position using a release mechanism.

8. The method ofclaim 6, wherein positioning a wireless communication port includes positioning an infrared communication port.

9. The method ofclaim 6, wherein positioning a wireless communication port includes positioning a radio communication port.

10. The method ofclaim 6, communicating with the second device includes communicating with at least one of a glucose monitor, an Hb_Alctester, an activity monitor, or a blood ketone tester.

11. An apparatus comprising:

a pump configured to deliver insulin;

an input; and

a controller communicatively coupled to the pump and the input,

wherein the controller is configured to receive information related to

activity of a user of the apparatus via the input,

wherein the controller includes an insulin calculation module to calculate a change in insulin therapy according to the activity information, and

wherein the controller is configured to initiate the delivery of insulin.

12. The apparatus ofclaim 11, including a user interface communicatively coupled to the input,

wherein the information related to exercise is received via the user interface,

wherein the insulin calculation module is configured to:

calculate, using the exercise information, an amount of carbohydrates metabolized by the exercise; and

reduce insulin in at least one of an insulin meal bolus or a correction insulin bolus by an amount that covers the metabolized amount of carbohydrates.

13. The apparatus ofclaim 11, including a user interface communicatively coupled to the input,

wherein the information related to exercise is received via the user interface,

wherein the insulin calculation module is configured to:

calculate, using the exercise information, an amount of carbohydrates metabolized by the exercise; and

and temporarily reduce a basal insulin rate pattern by an amount that covers the metabolized amount of carbohydrates.

14. The apparatus ofclaim 11, including:

a user interface communicatively coupled to the input; and

a display communicatively coupled to the controller,

wherein the information related to exercise is received via the user interface,

wherein the insulin calculation module is configured to:

calculate, using the exercise information, an amount of carbohydrates metabolized by the exercise; and

recommend, via the display, that the user consume the calculated amount of carbohydrates.

15. The apparatus ofclaim 11, including:

a memory communicatively coupled to the controller and configured to store an exercise regimen;

a user interface communicatively coupled to the controller and configured to receive an indication that the user will exercise according to the exercise regimen; and

a display communicatively coupled to the controller, wherein the controller is configured to present on the display an exercise insulin delivery pattern corresponding to the exercise regimen, and to receive, via the user interface, at least one of a selection of the exercise insulin delivery pattern into the device or a modification to the exercise insulin delivery pattern into the device.

16. The apparatus ofclaim 11, including an activity sensor communicatively coupled to the input, to provide an activity sensor signal, wherein the activity sensor signal is an electrical signal representative of patient activity.

17. The apparatus ofclaim 16, including:

a second input, wherein the controller is configured to receive information related to blood glucose into the insulin pump device via the second input; and

a display, wherein the controller is configured to display activity information in association with the blood glucose information on the insulin pump device.

18. The apparatus ofclaim 17, including a blood glucose monitor communicatively coupled to the second input.

19. The apparatus ofclaim 17, wherein the controller is configured to display an indication of a period of high blood glucose level, a period of low blood glucose level, or both periods of high and low blood glucose levels together with an indication of activity level.

20. The apparatus ofclaim 16 including:

a memory to store a basal insulin rate pattern and an indicated activity level corresponding to the basal insulin rate pattern; and

a display;

wherein the controller includes an activity module configured to determine, using the activity sensor signal, an actual activity level of the patient during delivery of the basal insulin rate pattern, and

wherein the controller is configured to display an indication when the actual activity level deviates from the indicated activity level and display a recommended change to the basal rate pattern.

21. The apparatus of claim ofclaim 16, including:

a display, and

wherein the controller includes:

an activity module configured to:

establish a baseline level of patient activity for a period of time;

determine an actual level of patient activity during the period using the activity sensor signal; and

compare the actual level of patient activity to the baseline level; and

an insulin calculation module configured to:

calculate and display an amount of carbohydrates for the patient to consume when the actual level of patient activity exceeds the baseline level by a threshold value; and

prompt the user, via the display, to initiate blood glucose tests more frequently when the actual level of patient activity is less than the baseline level by the same or a different threshold value.

22. The apparatus ofclaim 16, including a memory to store a basal rate pattern in association with a patient activity level;

wherein the controller includes an activity module configured to determine a level of patient activity using the activity sensor signal, and

wherein the controller is configured to activate the exercise basal rate pattern according to the level of patient activity.

23. The apparatus ofclaim 16, wherein the controller includes an activity module configured to determine that the activity signal exceeds a signal threshold value associated with the insulin pump device undergoing an impact, and wherein the controller is configured to display a recommendation to check the insulin pump device, an insulin cartridge, or both the insulin pump device and insulin cartridge for damage.

24. A method comprising:

receiving information related to activity of a user into a device that includes an insulin pump;

determining a change in insulin therapy according to the activity information; and

delivering the insulin using the insulin pump device.

25. The method ofclaim 24,

wherein receiving information related to activity includes receiving information related to exercise of the user,

wherein determining a change in insulin therapy includes:

calculating an amount of carbohydrates metabolized by the exercise; and

reducing an amount of insulin in at least one of a meal bolus or a correction bolus by an amount of insulin that covers the calculated metabolized amount of carbohydrates.

26. The method ofclaim 24,

wherein receiving information related to activity includes receiving information related to exercise of the user,

wherein determining a change in insulin therapy includes:

calculating an amount of carbohydrates metabolized by the exercise; and

temporarily reducing a basal insulin rate pattern by an amount of insulin that covers the calculated metabolized amount of carbohydrates.

27. The method ofclaim 24,

wherein receiving information related to activity includes:

receiving an exercise regimen into the device; and

receiving an indication that a user will exercise according to the exercise regimen, and

wherein determining a change in the delivery of insulin includes:

presenting an exercise insulin delivery pattern corresponding to the exercise regimen to the user; and

receiving at least one of a selection of the exercise insulin delivery pattern into the device or a modification to the exercise insulin delivery pattern into the device.

28. The method ofclaim 24, wherein receiving information related to activity includes receiving an activity signal from an activity sensor included in the insulin pump device, wherein the activity signal is an electrical signal representative of patient activity.

29. The method ofclaim 28, including:

receiving information related to blood glucose into the insulin pump device; and

displaying activity information in association with the blood glucose information on the insulin pump device.

30. The method ofclaim 29, including indicating a period of high blood glucose level, a period of low blood glucose level, or both periods of high and low blood glucose levels on the display together with an indication of activity level.

31. The method ofclaim 28, including:

receiving a basal insulin rate pattern and an indicated activity level corresponding to the basal insulin rate pattern into the insulin pump device;

determining an actual activity level for the patient using the activity signal during delivery of the basal insulin rate pattern; and

displaying an indication when the actual activity level deviates from the indicated activity level and displaying a recommended change to the basal rate pattern.

32. The method ofclaim 28, including:

establishing a baseline level of patient activity for a period of time;

determining an actual level of patient activity during the period using the activity signal;

comparing the actual level of patient activity to the baseline level; and

displaying, according to the comparison, one of an amount of carbohydrates for the patient to consume, or a prompt to the user to test blood glucose more frequently.

33. The method ofclaim 32, including calculating an amount of insulin in a correction bolus when the actual level of patient exercise is less than the baseline level by more than a threshold value.

34. The method ofclaim 28, including:

determining an exercise basal insulin rate pattern, wherein the exercise basal insulin rate pattern is to be used during user exercise;

determining a level of patient activity using the activity signal; and

activating the exercise basal rate pattern according to the level of patient activity indicated by the activity signal.

35. The method ofclaim 28, including:

determining that the activity signal exceeds a signal threshold value associated with the insulin pump device undergoing an impact; and

displaying a recommendation to check the insulin pump device, an insulin cartridge, or both the insulin pump device and insulin cartridge for damage.

36. A method comprising:

receiving information related to activity of a user into a device that includes an insulin pump;

calculating, using the activity information, an amount of carbohydrates metabolized by the exercise; and

presenting a recommendation to the user to consume the calculated amount of carbohydrates.

37. A apparatus comprising:

a memory configured to store a file of compressed audio data;

a communication port;

an audio port; and

a processor communicatively coupled to the memory, the audio port, and the communication port, wherein the processor is configured to communicate, via the communication port, with a second device that includes a pump configured to deliver insulin, and further configured to receive a command from the second device and to play the compressed audio data file via the audio port in accordance with the command.

38. The apparatus ofclaim 37, wherein the compressed audio file communicates an alert concerning the second device when played.

39. The apparatus ofclaim 38, wherein the compressed audio file communicates a status of the second device when played.

40. The apparatus ofclaim 37, wherein the processor is configured to receive the file of compressed audio data from the second device via the communication port.

41. The apparatus ofclaim 37, wherein the communication port is a wireless communication port.

42. An apparatus comprising:

a pump configured to deliver insulin;

a communication port; and

a controller communicatively coupled to the pump and the communication port;

wherein the controller is configured to communicate, via the communication port, with a second device that includes a memory configured to store a file of compressed audio data, and further configured to transmit a command to the second device to cause the second device to play the compressed audio data file.

43. The apparatus ofclaim 42, wherein the controller is configured to transmit a file of compressed audio data to the second device via the communication port.

44. The apparatus ofclaim 42, wherein the compressed audio file communicates an alert concerning insulin pump therapy when played by the second device.

45. The apparatus ofclaim 42, wherein the communication port is a wireless communication port.

46. The apparatus ofclaim 42, including a user interface communicatively coupled to the controller and including a display, wherein the controller is configured to:

display a menu on the user interface that includes a plurality of audio files to be played on the second device; and

communicate a selected audio file option to the second device.

47. A system comprising:

a first device including:

a pump configured to deliver insulin;

a first communication port; and

a controller communicatively coupled to the pump and the communication port; and

a second device including

a memory configured to store a file of compressed audio data;

a second communication port; and

a processor communicatively coupled to the memory, and the communication port,

wherein the processor is configured to receive, via the second communication port, a command from the first device and to play the compressed audio data file in accordance with the command.

48. The system ofclaim 47, wherein the controller of the first device is configured to transmit a file of compressed audio data to the second device via the first communication port.

49. The system ofclaim 47,

wherein the first device includes a user interface communicatively coupled to the processor, wherein the user interface includes a display, and

wherein the controller is configured to:

display a menu on the first device that includes audio file selections playable using the second device; and

communicate an audio file selection to the second device, and

wherein the processor of the second device is configured to play the selected audio file.

50. The system ofclaim 48, wherein the first and second communication ports are wireless ports.

51. The system ofclaim 50, wherein the second device includes a housing that includes a belt clip.

52. A method comprising:

communicating information between a first device that includes an insulin pump and a second device that includes a memory to store a plurality of compressed audio data files, wherein the communicating includes communicating a command from the first device to the second device to cause the second device, when the command is received, to play a compressed audio data file.

53. The method ofclaim 52, wherein communicating a message includes communicating a message to cause the second device to play a compressed audio data file that includes an alert concerning the first device.

54. The method ofclaim 52, wherein communicating a message includes communicating a message to cause the second device to play a compressed audio data file that includes a status of the first device.

55. The method ofclaim 52, including:

displaying a menu on the first device that includes audio file selections playable using the first device; and

communicating an audio file selection from the second device to the first device.

56. The method ofclaim 52, wherein communicating information includes communicating information wirelessly between the first device and the second device.

57. An apparatus comprising:

a pump configured to deliver insulin;

a detection circuit configured to detect when a cartridge of insulin is installed in the apparatus;

a temperature sensor that produces an electrical temperature signal representative of temperature;

a display; and

a controller communicatively coupled to the pump, the detection circuit, and the temperature sensor,

wherein the controller includes a comparison module configured to detect that the temperature exceeds a first temperature threshold value while the insulin cartridge is installed, and

wherein the controller is configured to display a warning when the temperature exceeds the first temperature threshold value.

58. The apparatus ofclaim 57, wherein the controller is configured to display a warning that insulin has been exposed to a high temperature.

59. The apparatus ofclaim 57,

wherein the temperature sensor is configured to monitor a temperature of the insulin cartridge,

wherein the comparison module is configured to detect that the temperature is below a second lower temperature threshold value, and

wherein the controller is configured to display a warning to check the insulin cartridge.

60. The apparatus ofclaim 59,

wherein the comparison module is configured to detect that the temperature of the insulin cartridge rises from below the second temperature threshold to above the first temperature threshold, and

wherein the controller is configured to display a recommendation that the user check for bubbles in the insulin cartridge.

61. The apparatus ofclaim 57,

wherein the comparison module is configured to detect that the temperature is less than a second lower temperature threshold value while the insulin cartridge is installed, and

wherein the controller is configured to display a warning that insulin has been exposed to a low temperature.

62. The apparatus ofclaim 57, wherein the controller is configured to display a recommendation that the user initiate more frequent blood glucose readings.

63. The apparatus ofclaim 57, including a timer circuit, wherein the comparison module is configured to:

measure the temperature using the temperature signal;

measure a duration of time that the measured temperature exceeds a threshold temperature value;

determine a product of the measured time duration and the measured temperature; and

detect when the product of the measured time duration and temperature exceed a product threshold value; and

wherein the controller is configured to display a warning when the product of measured time and temperature exceeds the product threshold value.

64. A method comprising:

monitoring temperature using a device that includes an insulin pump;

determining that a cartridge of insulin has been installed in the device;

detecting that the temperature exceeds a first temperature threshold value while the insulin cartridge is installed; and

displaying a warning when the temperature exceeds the first temperature threshold value.

65. The method ofclaim 64, including displaying a warning that insulin has been exposed to a high temperature.

66. The method ofclaim 64,

wherein monitoring temperature includes monitoring temperature of the insulin cartridge,

wherein the method includes detecting that the insulin cartridge is below a second lower temperature threshold value when installed; and

wherein displaying a warning includes displaying a warning to check the insulin cartridge.

67. The method ofclaim 66, including:

determining that a temperature of the insulin cartridge rises from below the second temperature threshold to above the first temperature threshold, and

wherein displaying a warning when the temperature exceeds the first temperature threshold value includes displaying a recommendation that the user check for bubbles in the insulin cartridge.

68. The method ofclaim 64, including

detecting that the temperature is less than a second lower temperature threshold value while the insulin cartridge is installed; and

displaying a warning that insulin has been exposed to a low temperature.

69. The method ofclaim 64, including displaying a recommendation that the user initiate more frequent blood glucose readings.

70. The method ofclaim 64, wherein detecting that the temperature exceeds a first temperature threshold value includes measuring the temperature using the temperature signal, wherein the method includes:

measuring a time duration that the temperature exceeds the first temperature threshold value; and

calculating a product of the measured temperature and the time duration; and

wherein displaying a warning includes displaying a warning when the product of the measured time duration and temperature exceeds a threshold product value.

71. An apparatus comprising:

a pump configured to deliver insulin;

a communication port; and

a controller communicatively coupled to the pump and the communication port, wherein the controller is configured to receive, from a second device via the communication port, nutrient content of a food selection of a user into the insulin pump device, and

wherein the controller includes an insulin calculation module, configured to determine, using the nutrient content, an amount of insulin to deliver.

72. The apparatus ofclaim 71, wherein the insulin calculation module is configured to determining an amount of insulin in a meal bolus using the nutrient content.

73. The apparatus ofclaim 71, wherein the insulin calculation module is configured to determine, using the nutrient content, whether to include an extended bolus in the meal bolus.

74. The apparatus ofclaim 71, wherein the communication port is a wireless port and includes at least one of an infrared (IR) communication port or a radio frequency (RF) communication port.

75. An apparatus comprising:

a pump configured to deliver insulin;

a memory to store a database of food options in association with a known amount of nutrient content;

a user interface configured to receive a food selection from a user;

a communication port; and

a controller communicatively coupled to the pump, the memory, the user interface, and the communication port, wherein the controller is configured to receive, via the communication port, a weight of the food selected into the insulin pump device from a second device, and wherein the controller includes:

a nutrient calculation module, configured to calculate an amount of nutrient content in the food selection using the received weight; and

an insulin calculation module, configured to determine an amount of insulin to deliver using the calculated amount.

76. The apparatus ofclaim 75, wherein the communication port is a wireless port and includes at least one of an infrared (IR) communication port and a radio frequency (RF) communication port.

77. The apparatus ofclaim 75, wherein the insulin calculation module is configured to determine an amount of insulin in a meal bolus using the calculated amount of nutrient content.

78. The apparatus ofclaim 75, wherein the insulin calculation module is configured to determine a change to a type of meal bolus using the calculated amount of nutrient content.

79. A method comprising:

storing a database of food options in association with a known nutrient content in a memory of a first device that includes a weight scale;

receiving a food selection of a user of a second device into the first device, wherein the second device includes an insulin pump;

transmitting food information to the second device using the first device, wherein the food information includes an amount of nutrient content of the food; and

determining an amount of insulin to deliver by the second device using the food information.

80. The method ofclaim 79, wherein determining an amount of insulin includes determining an amount of insulin in a meal bolus using the amount of nutrient content.

81. The method ofclaim 80, wherein determining an amount of insulin includes determining a type of meal bolus using the amount of nutrient content.

82. The method ofclaim 79, wherein transmitting food information to the second device includes receiving the food information into the second device via an infrared communication port.

83. The method ofclaim 79, wherein transmitting food information to the second device includes receiving the food information into the second device via a radio frequency (RF) communication port.

84. A method comprising:

storing a database of food options in association with a known nutrient content in a memory of a device that includes an insulin pump;

receiving a food selection of a user into the insulin pump device;

receiving a weight of the food selected into the insulin pump device from a second device;

calculating an amount of nutrient content in the food selection using the received weight; and

determining an amount of insulin to deliver using the calculated amount.

85. The method ofclaim 84, wherein determining an amount of insulin includes determining an amount of insulin in a meal bolus.

86. The method ofclaim 84, wherein determining an amount of insulin includes determining whether to include an extended bolus in the meal bolus.

87. The method ofclaim 84, wherein receiving the weight of the food includes receiving the weight into the second device via a wireless communication port.

88. The method ofclaim 87, wherein receiving the weight into the second device includes receiving the weight into the second device via an infrared communication port.

89. The method ofclaim 87, wherein receiving the weight into the second device includes receiving the weight into the second device via a radio frequency (RF) communication port.

90. An apparatus comprising:

a pump configured to deliver insulin;

a communication port; and

a controller communicatively coupled to the pump and the communication port;

wherein the controller is configured to communicate information, via the communication port, with a second device that implements an interactive calendar, wherein the information includes a calendar event of a user, and wherein the controller is further configured to alter operation of the apparatus according to the communicated calendar event.

91. The apparatus ofclaim 90,

wherein the communicated calendar event includes a meal time, and

wherein the controller is configured to:

schedule a missed meal bolus alarm in a time relation to the meal time; and

generate a missed meal bolus alarm if the user fails to initiate a meal bolus.

92. The apparatus ofclaim 90,

wherein the communicated calendar event includes an exercise time, and

wherein the controller is configured to change a delivery of insulin in relation to the communicated exercise time.

93. The apparatus ofclaim 92, wherein the controller is configured to:

calculate an amount of carbohydrates metabolized by the exercise; and

reduce an amount of insulin to be delivered by an amount that covers the metabolized carbohydrates.

94. The apparatus ofclaim 92, wherein the controller is configured to change delivery of insulin according to an exercise basal rate pattern in relation to the communicated exercise time.

95. The apparatus ofclaim 90, including an audible indicator and a vibration mechanism communicatively coupled to the controller,

wherein the communicated calendar event includes a meeting time, and

wherein the controller includes an alarm module configured to switch an alarm mode of the first device between an audible mode and a vibratory mode according to the communicated meeting time.

96. An apparatus comprising:

a memory configured to store calendar events of a user;

a user interface including a display, wherein the user interface is configured to receive a calendar event into the device and to display the calendar event;

a communication port; and

a processor communicatively coupled to the memory, the user interface and the communication port, wherein the processor is configured to communicate information, via the communication port, with a second device that includes a pump configured to deliver insulin, wherein the information includes the calendar event.

97. The apparatus ofclaim 96, wherein the calendar event includes a meal time of the user.

98. The apparatus ofclaim 96, wherein the calendar event includes an exercise time of the user.

99. The apparatus ofclaim 96, wherein the calendar event includes a meeting time of the user.

100. A system comprising:

a first device including:

a pump configured to deliver insulin;

a first communication port; and

a controller communicatively coupled to the pump and the communication port; and

a second device including:

a memory configured to store a plurality of calendar events of a user;

a user interface including a display, wherein the user interface is configured to receive a calendar event into the second device and to display the calendar event;

a second communication port; and

a processor communicatively coupled to the memory, the user interface and the communication port,

wherein the processor is configured to communicate information, via the second communication port, to the first device,

wherein the information includes a calendar event of a user, and

wherein the controller of the first device is configured to alter operation of the first device according to the communicated calendar event.

101. The system ofclaim 100,

wherein the communicated calendar event includes a meal time, entered into the second device via the user interface, and

wherein the controller of the first device is configured to:

schedule a missed meal bolus alarm in a time relation to the meal time; and

generate a missed meal bolus alarm if the user fails to initiate a meal bolus.

102. The system ofclaim 100,

wherein the communicated calendar event includes an exercise time, entered into the second device via the user interface, and

wherein the controller of the first device is configured to change a delivery of insulin in relation to the communicated exercise time.

103. The system ofclaim 100,

wherein the first device includes an audible indicator and a mechanical vibration mechanism communicatively coupled to the controller,

wherein the communicated calendar event includes a meeting time, and

wherein the controller of the first device includes an alarm module configured to switch an alarm mode of the first device between an audible mode and a vibratory mode according to the meeting time.

104. The system ofclaim 100,

wherein the first device includes a memory communicatively coupled to the controller,

wherein the memory includes an insulin therapy event log memory area, and

wherein the controller is configured to store an event related to insulin therapy in association with the communicated calendar event as a log entry in the insulin therapy event log memory area.

105. A method comprising:

communicating information between a first device that includes an insulin pump and a second device that includes an interactive calendar, wherein the information includes a calendar event of a user of the first device entered into the interactive calendar of the second device; and

altering operation of the first device according to the communicated calendar event.

106. The method ofclaim 105,

wherein communicating the information includes communicating a meal time, entered into the interactive calendar of the second device, to the first device, and

wherein altering operation of the first device includes scheduling a missed meal bolus alarm in the first device in a time relation to the communicated meal time.

107. The method ofclaim 105,

wherein communicating the information includes communicating an exercise time into the interactive calendar of the second device, to the first device, and

wherein altering operation of the first device includes changing a delivery of insulin in relation to the communicated exercise time.

108. The method ofclaim 107, wherein changing a delivery of insulin includes:

calculating an amount of carbohydrates metabolized by the exercise; and

reducing an amount of insulin to be delivered by an amount that covers the metabolized carbohydrates.

109. The method ofclaim 107, wherein changing a delivery of insulin includes activating an exercise basal rate pattern according to the communicated exercise time.

110. The method ofclaim 105,

wherein communicating the information includes communicating a meeting time, entered into the interactive calendar of the second device, to the first device, and

wherein altering operation of the first device includes switching an alarm of the first device between an audible mode and a vibratory mode according to the meeting time.

111. An apparatus comprising:

a pump configured to deliver insulin;

an acoustic transducer configured to receive acoustic energy and generate an electrical transducer signal representative of the acoustic energy;

a sampling circuit, communicatively coupled to the acoustic transducer, configured to produce digitized samples of the electrical transducer signal;

a speech recognition circuit, communicatively coupled to the sampling circuit, configured to derive a command from the digitized samples; and

a controller, communicatively coupled to the speech recognition circuit and the pump, configured to alter operation of the device according to the derived command.

112. The apparatus ofclaim 111, wherein the speech recognition circuit is configured to derive a command to deliver at least one of a correction bolus, or a meal bolus, and

wherein the controller is configured to initiate delivery of the bolus according to the command.

113. The apparatus ofclaim 111, wherein the speech recognition circuit is configured to derive a command to change a basal insulin rate pattern.

114. The apparatus ofclaim 111, wherein the speech recognition circuit is configured to derive a command to run a device test, and wherein the controller is configured to initiate the test according to the command.

115. The apparatus ofclaim 114, wherein the speech recognition circuit is configured to derive a command to run at least one of a carbohydrate ratio test, a correction factor test, or a basal rate test, and wherein the controller is configured to initiate the test.

116. The apparatus ofclaim 111, wherein the speech recognition circuit is configured to derive a command to change an operating parameter of the device, and wherein the controller is configured to update the parameter in a memory of the device.

117. The apparatus ofclaim 116, wherein the speech recognition circuit is configured to derive a command to change at least one of a correction factor, or a carbohydrate ratio.

118. The apparatus ofclaim 111, including a user interface communicatively coupled to the controller, and wherein the controller is configured deactivate processing of audio signals until an activation signal is received via the user interface.

119. The apparatus ofclaim 111, wherein the speech recognition circuit is configured to derive a message corresponding to a spoken password from the digitized samples, and wherein the controller is configured deactivate altering operation of the device according to a derived command until the message is derived.

120. The apparatus ofclaim 111, wherein the speech recognition circuit is configured to derive a command to deactivate insulin pump therapy provided by the pump.

121. The apparatus ofclaim 111, including a vibration mechanism communicatively coupled to the controller, wherein the speech recognition circuit is configured to generate an indication when ambient noise prevents speech recognition from the digitized samples, and wherein the controller is configured to provide a vibratory alert using the vibration mechanism upon receiving the indication from the speech recognition circuit.

122. The apparatus ofclaim 111, including a speaker verification circuit, communicatively coupled to the sampling circuit and the controller, configured to verify that the digitized samples correlate to a user's voice.

123. The apparatus ofclaim 111, including:

a memory configured to store a file of compressed audio data; and

an audio port, wherein the memory and the audio port are communicatively coupled to the controller, and

wherein the controller is configured to play the compressed audio data file via the audio port.

124. A method comprising:

receiving acoustic energy into a device that includes an insulin pump;

generating an electrical audio signal using the received acoustic energy;

deriving a command from the electrical audio signal; and

altering operation of the insulin pump device according to the derived command.

125. The method ofclaim 124, wherein deriving the command includes deriving a command to deliver at least one of a correction bolus, or a meal bolus.

126. The method ofclaim 124, wherein deriving the command includes deriving a command to change a basal insulin rate pattern.

127. The method ofclaim 124, wherein deriving the command includes deriving a command to run a device test.

128. The method ofclaim 127, wherein deriving a command to run a device test includes deriving a command to run at least one of a carbohydrate ratio test, a correction factor test, or a basal rate test.

129. The method ofclaim 124, wherein deriving the command includes deriving a command to change an operating parameter of the device.

130. The method ofclaim 129, wherein deriving a command to change an operating parameter of the device includes deriving a command to change at least one of a correction factor, or a carbohydrate ratio.

131. The method ofclaim 124, including deactivating processing of audio signals until an activation signal is received into the device via a user interface.

132. The method ofclaim 124, including deactivating the altering operation of the insulin pump according to a derived command until a message corresponding to a spoken password is derived.

133. The method ofclaim 124, wherein deriving a command to change an operating parameter of the device includes deriving a command to deactivate insulin pump therapy provided by the pump.

134. The method ofclaim 124, including providing a vibratory alert when ambient noise prevents deriving a command from the electrical audio signal.

135. The method ofclaim 124, including verifying that the electrical audio signal was generated by a user's voice.

136. An apparatus comprising:

a pump configured to deliver insulin;

a controller communicatively coupled to the pump and configured to initiate delivery of insulin;

a kinetic battery circuit, configured to convert motion of a user to charge stored in a kinetic battery;

a primary battery circuit to provide energy to the apparatus from a primary battery;

a comparison circuit, communicatively coupled to the kinetic battery circuit, configured to compare a charge on the kinetic battery to a threshold charge value; and

a switching circuit communicatively coupled to the comparison circuit, the kinetic battery circuit, and the primary battery circuit, wherein the switching circuit is configured to:

provide energy from the kinetic battery circuit to at least a portion of the apparatus when the charge on the kinetic battery exceeds the threshold; and

provide energy from the primary battery circuit to the portion of the apparatus when the charge on the kinetic battery is less than the threshold.

137. The apparatus ofclaim 136, including:

a charge measurement circuit communicatively coupled to the kinetic battery circuit and configured to measure a level of charge on the kinetic battery; and

wherein the controller includes an activity detection module configured to determine an activity level of the user from the measured level of charge.

138. The apparatus ofclaim 137, wherein the charge measurement circuit is configured to measure a rate of change of the charge on the kinetic battery, and wherein the activity detection module is configured to determine the activity level of the user using the measured rate of change of the charge.

139. The apparatus ofclaim 137, wherein the controller includes an insulin calculation module configured to calculate a change in a delivery of insulin according to the activity level.

140. The apparatus ofclaim 139, wherein the insulin calculation module is configured to calculate a reduction in an amount of insulin in at least one of a correction bolus, a meal bolus, or a basal insulin rate pattern according to the activity level.

141. The apparatus ofclaim 137, including:

a memory, communicatively coupled to the controller, to store an exercise basal insulin rate pattern; and

wherein the controller is configured to activate the exercise basal rate pattern according to the activity level.

142. The apparatus ofclaim 136, including a blood glucose sensor circuit, wherein the switching circuit is configured provide energy to the blood glucose sensor circuit from the kinetic battery when the charge on the kinetic battery exceeds the threshold charge value.

143. The apparatus ofclaim 136, including a temperature sensing circuit, wherein the switching circuit is configured provide energy to the temperature sensing circuit from the kinetic battery when the charge on the kinetic battery exceeds the threshold charge value.

144. The apparatus ofclaim 136, including a display, wherein the switching circuit is configured provide energy to the display from the kinetic battery when the charge on the kinetic battery exceeds the threshold charge value.

145. A method comprising:

using motion of a user of a device that includes an insulin pump to charge a kinetic battery of the insulin pump device;

providing energy to a circuit of the insulin pump device from the kinetic battery when the charge on the kinetic battery exceeds a threshold charge value; and

providing energy to the circuit of the insulin pump from the primary battery when the charge on the kinetic battery is less than the threshold charge value.

146. The method ofclaim 145, including:

measuring a level of charge on the kinetic battery; and

determining an activity level of the user from the measured level of charge.

147. The method ofclaim 146, wherein measuring a level of charge includes measuring a rate of change of the charge on the kinetic battery, and wherein determining an activity level includes determining the activity level of the user from the measured rate of change of the charge.

148. The method ofclaim 146, including calculating a change in a delivery of insulin according to the activity level.

149. The method ofclaim 148, wherein calculating a change in a delivery of insulin includes calculating a reduction in an amount of insulin in at least one of a correction bolus, a meal bolus, or a basal insulin rate pattern according to the activity level.

150. The method ofclaim 146, including:

receiving an exercise basal insulin rate pattern into the insulin pump device; and

activating the exercise basal rate pattern according to the activity level.

151. The method ofclaim 145, wherein providing energy to a circuit of the insulin pump device from the kinetic battery includes providing energy to a blood glucose sensing circuit of the insulin pump device from the kinetic battery.

152. The method ofclaim 145, wherein providing energy to a circuit of the insulin pump device from the kinetic battery includes providing energy to a temperature sensing circuit of the insulin pump device from the kinetic battery.

153. The method ofclaim 145, wherein providing energy to a circuit of the insulin pump device from the kinetic battery includes providing energy to a display circuit of the insulin pump device from the kinetic battery.

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