Enhanced 911/global position system wizard: a telemedicine application for the prevention of severe hypoglycemia--monitor, alert, and locate.
Intensive insulin therapy has an inherent risk of hypoglycemia that can lead to loss of consciousness, cardiac arrhythmia, seizure, and death ("dead-in-bed syndrome"). This risk of hypoglycemia is a major concern for patients, families, and physicians. The need for an automated system that can alert in the event of severe hypoglycemia is evident. In engineering systems, where there is a risk of malfunction of the primary control system, alert and safety mechanisms are implemented in layers of protection. This concept has been adopted in the proposed system that integrates a hypoglycemia prediction algorithm with a global position system (GPS) locator and short message service such that the current glucose value with the rate of change (ROC) and the location of the subject can be communicated to a predefined list. Furthermore, if the system is linked to the insulin pump, it can suspend the pump or decrease the basal insulin infusion rate to prevent the pending event. The system was evaluated on clinical datasets of glucose tracings from the DexCom Seven system. Glucose tracings were analyzed for hypoglycemia events and then a text message was broadcast to a predefined list of people who were notified with the glucose value, ROC, GPS coordinates, and a Google map of the location. In addition to providing a safety layer to a future artificial pancreas, this system also can be easily implemented in current continuous glucose monitors to help provide information and alerts to people with diabetes.
Department of Chemical Engineering, University of California at Santa Barbara, Santa Barbara, California 93106-5080, USA. dassau@engineering.ucsb.edu
Eyal
E
Dassau
Lois
L
Jovanovic
Francis J
FJ
Doyle
Howard C
HC
Zisser
D000465:Algorithms; D001786:Blood Glucose / Q000378:metabolism*; D056902:Clinical Alarms; D019719:Diagnostic Equipment; D004867:Equipment Design; D040362:Geographic Information Systems / Q000295:instrumentation; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects*; D007332:Insulin Infusion Systems; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods*; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D018511:Systems Integration; D017216:Telemedicine / Q000295:instrumentation
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin