Medtronic Paradigm 522 User guide

Medtronic Paradigm 522 User guide
INSULIN PUMP AND
CONTINUOUS GLUCOSE MONITORING SYSTEM
Insulin Pump User Guide
Paradigm®
522 and 722 Insulin Pumps
User Guide
© 2006, Medtronic MiniMed. All rights reserved.
This product is covered by U.S. Patent Nos. 6,551,276; 6,554,798; 6,872,200; 6,936,029; 6,979,326; 6,997,920 and 7,025,743.
Other U.S. and/or foreign patents may be pending.
Bolus Wizard®, Dual Wave®, Paradigm®, Quick-serter®, Quick-set®, Silhouette®, Sof-set®, and Square Wave® are registered
trademarks of Medtronic MiniMed.
Easy Bolus™ is a trademark of Medtronic MiniMed.
Energizer® is a registered trademark of Eveready Battery Company.
Glucagon Emergency Kit® is a registered trademark of Eli Lilly and Company.
6025250-011 090506
REF MMT-522
MMT-722
Important Safety Information
Regarding Your Paradigm Insulin Infusion Pump
(includes all models)
Avoid Immersing Your Pump In Water
Although it is unlikely that water damage will occur if your pump is splashed or briefly dunked, you
should avoid immersing your Paradigm infusion pump in water. To swim or participate in other water
activities, always disconnect from your Paradigm pump and reconnect after water play.
If you inadvertently submerge your pump in water, dry the pump quickly using a soft, clean towel and
verify that it is working properly by selecting “self test” from the pump’s UTILITIES MENU. If you believe
that water has entered your pump or you observe any other possible pump malfunction, please check
your blood glucose, treat high blood glucose (if necessary) with an injection and contact our 24 Hour
HelpLine at 1-800-MINIMED (1-800-646-4633) for further assistance. Symptoms of high blood glucose
include fatigue, excessive thirst and nausea. You should always contact your healthcare professional if
you experience excessively high or low blood glucose levels, or if you have any questions about your
care.
Electrostatic Discharge
Although your Paradigm pump is designed to be unaffected by typical levels of electrostatic discharge
(ESD), very high levels of ESD can result in a reset of the pump’s software with an associated pump error
alarm. In most cases, exposure to high levels of ESD will trigger the pump’s A-13 alarm although, under
certain circumstances, high level ESD exposure can cause A-44, Bolus Stopped or Max Delivery alarms.
High levels of ESD are more likely in situations where the relative humidity is very low, such as inside a
heated building during the winter in areas where it is cold outside.
If your pump experiences an A-13 or other error alarm, press the “ESC” and “ACT” buttons to clear the
alarm. If you are unable to clear the alarm by pressing “ESC” and “ACT,” you may need to remove and
replace the pump’s battery to clear the alarm. After clearing the alarm, you should always verify that
your pump is set to the correct date and time and that all other settings (basal rate, max basal and bolus
limits, etc.) are programmed to the desired values, since the software reset could erase your previously
programmed settings. Please see the Alarms and Alerts section of this User Guide for more details
regarding what to do if your pump displays an error alarm or other alert message.
Please contact our 24-Hour Line at 1-800-MINIMED (1-800-646-4633) to report any error alarms or other
problems that occur with your pump.
Contents
Your personal information ............................................. xi
Basal rate .................................................................................................. xi
Carb ratios (meal bolus information) ............................................................... xii
Chapter 1 Introduction .................................................1
Availability ................................................................................................. 1
Assistance .................................................................................................. 1
Emergency kit ............................................................................................. 2
Disposables ................................................................................................. 3
Accessories ................................................................................................. 3
How to wear your pump ................................................................................. 4
How to use this guide .................................................................................... 5
User safety ................................................................................................. 6
Indications ............................................................................................. 6
Contraindications ..................................................................................... 6
Warnings ............................................................................................... 6
Reservoir and infusion sets ...................................................................... 6
X-rays, MRIs and CT scans ........................................................................ 6
Precautions ............................................................................................ 7
Avoid extreme temperatures .................................................................... 7
Infusion sets and sites ............................................................................ 7
Notice ....................................................................................................... 8
Insulin pump and RF accessories ................................................................... 8
Chapter 2 The basics ..................................................9
Your pump ................................................................................................. 9
Install battery ........................................................................................... 10
Pump buttons ............................................................................................ 12
The pump screen ....................................................................................... 13
HOME screen ............................................................................................. 13
Screen icons ..........................................................................................13
Battery .............................................................................................13
Contents
i
Time display .......................................................................................14
Reservoir volume .................................................................................14
Alert and alarm icons ............................................................................14
Sensor icons .......................................................................................14
Scroll bar ..............................................................................................15
Screen backlight .....................................................................................15
Beep/vibrate ............................................................................................. 15
Operating modes ........................................................................................ 16
Menus ..................................................................................................... 17
STATUS screen .......................................................................................... 19
If you remove your pump ............................................................................. 20
Pump settings ........................................................................................20
Insulin ..................................................................................................20
Chapter 3 Basic programming ........................................ 21
Setting the time and date ............................................................................. 21
Bolus ....................................................................................................... 22
Normal bolus .........................................................................................22
From the menu ..................................................................................22
Using the EXPRESS BOLUS button ..............................................................22
Review your bolus deliveries ......................................................................... 27
Bolus details ..........................................................................................28
Maximum bolus limit ................................................................................... 29
BG reminder ..........................................................................................30
Basal ....................................................................................................... 31
Start and stop times .................................................................................31
Your basal settings ..................................................................................32
Basal programming and delivery ..................................................................32
Basal review ..........................................................................................34
Current basal delivery ...........................................................................34
Daily basal rate(s) ................................................................................34
Max basal rate ........................................................................................... 36
Stopping your pump .................................................................................... 37
Resume pump delivery ................................................................................ 39
Chapter 4 Starting on insulin ........................................ 41
Prepare your pump for use ........................................................................... 41
Filling the reservoir ................................................................................... 42
ii
Contents
Changing your infusion set ............................................................................ 44
Removing the reservoir .............................................................................44
Rewinding your pump ...............................................................................45
Inserting the reservoir in your pump .............................................................46
Manual prime .........................................................................................47
Insert the infusion set ...............................................................................48
Quick-set infusion set (with Quick-serter®) .................................................49
Disconnecting Quick-set ...................................................................50
Reconnecting Quick-set ....................................................................51
Fixed prime ...........................................................................................52
Prime history ............................................................................................ 52
Record keeping for diabetes management ........................................................ 53
Determining your pump settings .................................................................... 53
Using your daily journal ............................................................................... 54
Chapter 5 Using the Bolus Wizard feature ......................... 55
What is it? ................................................................................................ 55
Information you need .................................................................................. 55
Food entry ............................................................................................55
Your blood glucose reading ........................................................................55
Your personal Bolus Wizard feature settings ....................................................55
How the Bolus Wizard feature works ............................................................... 58
More about the Bolus Wizard feature ............................................................59
About high or low BG levels ....................................................................59
About maximum delivery .......................................................................59
About active insulin ..............................................................................60
How to program the Bolus Wizard feature ........................................................ 61
Bolus Wizard feature On/Off ......................................................................61
Carb units .............................................................................................62
Carb/Exch ratios .....................................................................................62
BG units ...............................................................................................64
Insulin sensitivity ....................................................................................64
BG targets .............................................................................................65
Active insulin time ..................................................................................67
Review your Bolus Wizard feature settings ....................................................... 68
Meter option ............................................................................................. 68
Meter rules ............................................................................................69
Contents
iii
Add, delete, review meter IDs .....................................................................69
Normal bolus using Bolus Wizard feature .......................................................... 71
Bolus Wizard feature examples ...................................................................... 73
Chapter 6 Optimizing pump therapy ................................. 77
Square Wave and Dual Wave bolus .................................................................. 77
Dual Wave/Square Wave bolus On/Off ...........................................................78
Square Wave or Dual Wave bolus without Bolus Wizard feature .............................78
Using the Bolus Wizard feature for a Square Wave or Dual Wave bolus .....................82
Easy bolus ................................................................................................ 84
Easy bolus setup .....................................................................................84
Step value setup ..................................................................................85
Deliver Easy Bolus ...................................................................................85
Basal patterns ........................................................................................... 88
Patterns on/off ......................................................................................88
Program a pattern ...................................................................................89
Select a pattern ......................................................................................90
Temp basal rates ........................................................................................ 92
How does temp basal work? ........................................................................92
Temp basal types ....................................................................................93
Insulin rate ........................................................................................93
Percent of basal ..................................................................................94
Selecting temp basal type ..........................................................................96
Deliver a temp basal ................................................................................96
Verifying temp basal delivery ......................................................................97
Canceling a temp basal .............................................................................98
Chapter 7 Insulin pump therapy follow-up ......................... 101
Recommended follow-up .............................................................................101
Everyday ............................................................................................ 101
Every month ........................................................................................ 101
Every 3 months ..................................................................................... 101
Laboratory tests .................................................................................... 101
Every visit ........................................................................................... 102
Annually ............................................................................................. 102
Chapter 8 Utilities .................................................. 103
Alarm review ...........................................................................................103
iv
Contents
Alarm details ....................................................................................... 103
Setting your alert type ...............................................................................103
Auto-off ..................................................................................................104
Low resv alert (Low reservoir warning) ...........................................................104
Review daily insulin totals ...........................................................................106
Pump data management .......................................................................... 107
Days to average ................................................................................. 109
Personal reminders ....................................................................................111
Alarm clock ......................................................................................... 111
Remote control option ................................................................................111
Turn on remote control option .................................................................. 112
Add, delete, review remote control IDs ....................................................... 112
Block feature ...........................................................................................113
Turn Block on ....................................................................................... 113
Lock keypad feature ..................................................................................115
To lock keypad ..................................................................................... 115
To unlock keypad .................................................................................. 115
Selftest ...................................................................................................116
User settings ............................................................................................117
Save settings ....................................................................................... 117
Restore settings .................................................................................... 118
Clear settings ....................................................................................... 119
History ............................................................................................... 120
Language setting .......................................................................................120
Chapter 9 Troubleshooting .......................................... 121
My pump has a no delivery alarm... ............................................................ 121
What happens if I leave the battery out too long? ........................................... 122
Why doesn’t my pump battery last very long? ................................................ 122
What is a CHECK SETTINGS alarm? .............................................................. 123
My screen appears distorted ..................................................................... 123
I cannot get out of the priming loop ............................................................ 123
The pump is asking me to rewind ............................................................... 124
My bolus stopped .................................................................................. 124
My pump buttons are not acting right during a bolus ........................................ 124
My pump won’t display my BG reading from my meter ..................................... 124
I dropped my pump ................................................................................ 125
I submerged my pump in water ................................................................. 125
Contents
v
I cannot get to the User Settings menu ........................................................ 125
Alert conditions ........................................................................................126
What to do .......................................................................................... 126
Low reservoir alert ............................................................................. 126
Low Battery alert ............................................................................... 127
Alarms ....................................................................................................127
What to do .......................................................................................... 128
Alarm conditions .......................................................................................129
A (Alarm) ............................................................................................ 129
Auto off ............................................................................................. 129
Batt out limit ....................................................................................... 129
Bolus stopped ....................................................................................... 129
Button error ........................................................................................ 129
Check settings ...................................................................................... 130
E (Error) ............................................................................................. 130
Empty reservoir .................................................................................... 130
Failed batt test .................................................................................... 130
Is priming complete? .............................................................................. 130
Max delivery ........................................................................................ 131
Motor error ......................................................................................... 131
No delivery .......................................................................................... 131
No reservoir ......................................................................................... 131
Off no power ....................................................................................... 131
Reset ................................................................................................. 132
Weak Battery ....................................................................................... 132
Chapter 10 Pump maintenance ...................................... 133
Battery ...................................................................................................133
Storage ...................................................................................................133
Cleaning your pump ...................................................................................134
Chapter 11 Pump specifications .................................... 135
Alarms and error messages ..........................................................................135
Alarm history ...........................................................................................135
Backlight .................................................................................................135
Basal ......................................................................................................135
BG target ................................................................................................135
Bolus delivery ..........................................................................................135
vi
Contents
Bolus history ............................................................................................135
Bolus Wizard feature ..................................................................................136
Carb ratios ..............................................................................................136
Carb units ...............................................................................................136
Daily totals ..............................................................................................136
Default screen ..........................................................................................136
Pump motor .............................................................................................136
Dual Wave bolus .......................................................................................136
Easy bolus ...............................................................................................137
Infusion pressure ......................................................................................137
Insulin sensitivity ......................................................................................137
Low resv (reservoir) warning ........................................................................137
Meter value .............................................................................................137
Normal bolus ............................................................................................137
Occlusion detection ...................................................................................138
Percent temp basal ....................................................................................138
Power supply ...........................................................................................138
Prime function .........................................................................................138
Prime history ...........................................................................................138
Program safety checks ................................................................................138
Pump size ...............................................................................................139
Pump weight ............................................................................................139
Remote control .........................................................................................139
Reservoir ................................................................................................139
Square Wave bolus ....................................................................................139
Temporary (temp) basal rate ........................................................................139
Time and date screen .................................................................................139
Status screen ...........................................................................................140
Bolus Wizard feature specifications ...............................................................141
Bolus Wizard feature examples .................................................................. 143
Default settings ........................................................................................145
Icon table ...............................................................................................147
Glossary .............................................................. 149
Index ................................................................. 155
Contents
vii
viii
Contents
Practice lessons and examples
Bolus examples
Meal bolus
Normal meal bolus using the exchange system ..................................................23
Bolus practice .........................................................................................24
Normal meal bolus practice using exchanges ....................................................24
Normal meal bolus using carbohydrate counting ................................................24
Correction bolus
Meal bolus, correction bolus and insulin sensitivity ............................................25
Practice: Meal bolus .................................................................................26
Max bolus
Example 1: Max bolus ................................................................................29
Example 2: Max bolus ................................................................................29
Basal examples
Basal programming
Practice: Basal programming .......................................................................33
Max basal
Example 1: Max Basal ................................................................................36
Example 2: Max Basal ................................................................................36
Suspend/Resume examples
Example: Suspend function .........................................................................38
Practice: Suspend function .........................................................................38
Practice: Resume basal delivery after a suspend ...............................................39
Bolus Wizard feature examples
ix
Example 1: BG on target (normal BG) and no active insulin ...................................73
Example 2: BG above target (high BG) and no active insulin ..................................74
Example 3: Blood glucose below target (low BG) and no active insulin .....................74
Example 4: Blood glucose above target (high BG) with active insulin .......................75
Example 5: Blood glucose below target (low BG) with active insulin ........................76
Square Wave bolus examples
Your turn: Square Wave bolus practice ...........................................................80
Your turn: Dual Wave bolus practice ..............................................................81
Easy bolus examples
Example #1: Easy bolus ..............................................................................87
Your turn: Easy bolus practice .....................................................................87
Basal patterns examples
Example 1: Basal patterns ..........................................................................91
Example 2: Basal patterns ..........................................................................91
Your turn ...............................................................................................91
Temp Basal examples
Example 1: Temp Basal for a decreased temporary basal rate ...............................98
Example 2: Temp Basal for an increased temporary basal rate ...............................99
Your turn ...............................................................................................99
Block examples
Example 1: Block ................................................................................... 114
Example 2: Block ................................................................................... 114
x
Your personal information
You may need the following information from your healthcare professional before going to your
pump start appointment. If you are unsure, contact your healthcare professional or pump trainer for
instructions.
NOTE - This information is not for the Bolus Wizard® feature. Refer to chapter 5 for Bolus
Wizard feature settings.
Basal rate
Basal insulin is required to maintain your target
glucose values when you are not eating. Your pump
can be programmed with up to three (3) basal
patterns (standard, pattern A, pattern B) to
accommodate your varying insulin needs on
different days (example: weekday versus weekend
day). Each pattern can have up to 48 basal rates.
When you first start pump therapy, your healthcare
professional may only have you program one or two
basal rates. Get your basal rate settings from your
healthcare professional.
Standard
Basal rate
number
Start time
Basal rate
(units per
hour)
#1
midnight
#2
#3
Additional basal rates
#4
#5
#6
#7
#8
xi
Pattern B
Pattern A
Basal rate
Start time
number
#1
midnight
#2
#3
(additional basal rates)
#4
#5
#6
#7
#8
Basal rate
(units per hour)
Carb ratios (meal bolus
information)
Your carb ratios are used to calculate your
meal boluses.
If you count grams: this ratio is the number
of carb grams covered by one (1) unit of
insulin.
If you count exchanges: this ratio is the
number of insulin units you need to cover one
carb exchange.
xii
Basal rate
Start time
number
#1
midnight
#2
#3
(additional basal rates)
#4
#5
#6
#7
#8
When
breakfast
lunch
dinner
snacks
Start time
Basal rate
(units per hour)
(grams/u or
u/exch)
Chapter 1
Introduction
Thank you for choosing Medtronic MiniMed as your partner in helping you gain better control of
your diabetes. Whether you are beginning pump therapy for the first time or upgrading from a
previous model, we believe that the combination of state-of-the-art technology and the simple,
menu-driven programming of the pump will provide many benefits.
This user guide is designed to help you to understand pump therapy and the operation of your
pump. We strongly recommend that you work closely with your healthcare professional for a safe and
complete pump start.
Your pump is indicated for the continuous delivery of insulin, at set and variable rates, for the
management of diabetes mellitus for persons requiring insulin. Based on your settings, the pump
delivers your custom basal automatically and continuously 24-hours a day. It also provides bolus
deliveries to support your immediate insulin needs for food intake and/or high blood glucose. The
Bolus Wizard feature can calculate your bolus amount for you based on your personal settings.
Availability
The pump and accompanying products are available from Medtronic MiniMed and authorized
distributors.
Assistance
Medtronic MiniMed provides a 24 Hour
HelpLine for assistance. The HelpLine is
staffed with technicians who are trained in
the set-up and operation of the pump and are
able to answer pump-related questions.
When calling the HelpLine or your local
Medtronic MiniMed office, please have your
pump and serial number available. The phone
number for the 24 Hour HelpLine is also on
the back of your pump.
Department
Telephone number
24 Hour HelpLine (calls
within the United States)
800.646.4633
(800.M i n i M e d )
24 Hour HelpLine (calls
outside the United States)
818.576.5555
Web site
www.minimed.com
Introduction
1
Emergency kit
Keep an emergency kit with you at all times to make sure that you always have necessary supplies.
Inform a family member, co-worker, and/or friend where this emergency kit is kept. Please refer to
the “User safety” section in this chapter for more information on pump safety. Your emergency kit
should include these items:
➠
Fast-acting glucose tablets
➠
Paradigm® Wallet Card
➠
Blood glucose monitoring supplies
➠
Dressing and adhesive
➠
Urine ketone monitoring supplies
➠
Glucagon Emergency Kit®
➠
Extra Paradigm infusion set and Paradigm
reservoir
➠
Extra AAA alkaline batteries (Energizer® brand
is recommended)
➠
Insulin syringe and fast-acting insulin (with
dosage instructions from your healthcare
professional)
CAUTION:
2
Chapter 1
If you give yourself insulin by using a syringe, the Bolus Wizard feature will not
be able to correctly determine the active insulin in your system.You must
generally wait at least 8 hours after an injection before relying on your Bolus
Wizard feature to calculate your active insulin. But, the length of time you need
to wait depends on your active insulin setting in the Bolus Wizard feature. See
“About active insulin” on page 60 for more information.
Disposables
The pumps use disposable reservoirs and infusion sets for insulin delivery. Installation instructions
for Paradigm reservoir and infusion sets are provided in chapter 4, “Starting on insulin.”
➠
Reservoirs: The 522 pump is intended for use with a 176-unit Paradigm reservoir (MMT-326). The
722 pump is intended for use with a 300-unit Paradigm reservoir (MMT-332), however it can also use
the MMT-326 as well.
➠
Infusion sets: Medtronic MiniMed provides a variety of Paradigm infusion sets to fit your needs.
Contact your healthcare professional who will assist you to choose an infusion set that fits your
needs.
WARNING:
For your protection the pump has undergone extensive testing to confirm
appropriate operation when used with Paradigm reservoirs and Paradigm
infusion sets manufactured or distributed by Medtronic MiniMed. We
recommend using Medtronic MiniMed infusion sets and reservoirs as we cannot
guarantee appropriate operation if the pump is used with reservoirs or infusion
sets offered by third-parties and therefore we are not responsible for any injury
or malfunctioning of the pump that may occur in association with such use.
Accessories
➠
➠
➠
Meter: You can program your pump to automatically receive your BG reading from a linked meter
which may have been included with your pump.
Remote control: The optional Paradigm remote control can be used with the pump to deliver
normal boluses and suspend/resume the pump from a distant location. (This User Guide provides
programming instructions for the remote control. Refer to the remote control User Guide for
operating instructions.)
Transmitter: The transmitter (MMT-7703) is a small device that connects to the sensor. It comes
with a blue tester and a charger. When connected to a sensor that is inserted in the body, the
transmitter automatically initializes the sensor and begins to periodically transmit glucose data to
the pump using a radio signal.
Introduction
3
➠
➠
Sensor: The sensor continuously converts tiny amounts of glucose from your fatty layer under the
skin into an electronic signal.
ComLink: The Medtronic MiniMed ComLink is used to download the Paradigm 522 or 722 pump data
to the diabetes management software using a serial communications interface cable installed on
your computer.
To order supplies, call 800-646-4633 (1-800-MiniMed) 818-362-5958 (outside U.S.)
www.minimed.com
How to wear your pump
There are different ways to wear your pump. Medtronic MiniMed has optional accessories that can
hide, protect, and add to the convenience of wearing a pump. Refer to the accessories catalog or the
website (www.minimed.com) for more information.
➠
➠
➠
➠
4
Holster: to wear the pump on your belt.
Pump clip: to wear the pump underneath your clothing.
Activity guard: If you are active in sports, or you are a child, use the guard to protect the pump
from disconnecting.
Leather case: Fine leather lined with nylon. Styling complements business and formal wear. Velcro
flap provides easy access to pump for programming. Wear it vertically with the built-in belt clip.
Chapter 1
How to use this guide
NOTE - This user guide shows sample screens only. Your pump screens may be slightly different.
For step-by-step instructions, refer to the appropriate sections in this guide. Refer to the Glossary
for definitions of terms and functions. The terms and symbols used in this guide are in the table
below.
Term / symbol
Meaning
“Press”
to push and release the button
“Hold”
to push and keep pressure on the button
“Select”
to press
“Exit the menus”
press ESC until the HOME screen appears
Pump Buttons
always bold and uppercase; for example, ESC, ACT
/
to highlight a screen item you want to select
Screen and menu names always uppercase; for example, MAIN MENU, REWIND screen
Menu selections
always bold; for example, 12-Hour Setup, On, Off
Flashing (blinking)
screen item
you can change the value for that item with the
NOTE and TIP
additional helpful information
CAUTION
warns of a potential hazard which, if not avoided, may result in minor or
moderate injury to the equipment
WARNING
notifies you of a potential hazard which, if not avoided, could result in
death or serious injury. It may also describe potential serious adverse
reactions and safety hazards
/
buttons
when a step instructs you to “Go to” a screen, the path to that screen is
shown. For example:
Go to the ALARM MENU.
“Go to the...screen.”
Main > Utilities > Alarm
1. From the MAIN MENU, select Utilities and press ACT.
2. In the UTILITIES MENU, select Alarm and press ACT.
3. The ALARM MENU appears.
Introduction
5
User safety
Indications
Pump
The Paradigm 522/722 pump is indicated for the continuous delivery of insulin, at set and variable
rates, for the management of diabetes mellitus in persons requiring insulin.
Sensor and transmitter
The sensor and transmitter components are indicated for continuous or periodic monitoring of
glucose levels in the fluid under the skin, and possible low and high blood glucose episodes in adults
(ages 18 and older). It alerts if a glucose level falls below or rises above preset values. Values are
not intended to be used directly for making therapy adjustments, but rather to provide an indication
of when a fingerstick may be required. All therapy adjustments should be based on measurements
obtained using a home glucose monitor and not on Paradigm 522/722 pump system values.
Contraindications
Pump therapy is not recommended for people who are unwilling or unable to perform a minimum of
four (4) blood glucose tests per day and to maintain contact with their healthcare professional.
Successful insulin pump therapy requires sufficient vision or hearing to allow recognition of the pump
signals and alarms.
Warnings
Reservoir and infusion sets
Standard Luer sets are not compatable with the Medtronic Minimed Paradigm pump. Medtronic
MiniMed Paradigm reservoir and Paradigm infusion sets are specifically designed for use with the
pump. Do not modify your Paradigm reservoir or Paradigm infusion set.
Do not put any other drugs/medications inside your reservoir to use with this pump. Only insulin
that has been prescribed by your physician can be used in this pump.
X-rays, MRIs and CT scans
If you are going to have an X-ray, CT scan, MRI or other type of exposure to radiation, take off your
pump, meter and remote control and remove them from the area.
The Paradigm pump is designed to withstand common electromagnetic interference, including
airport security systems. Be sure to carry the Airport Card provided when you are traveling.
6
Chapter 1
Precautions
Although the pump has multiple safety alarms, it cannot notify you if the set is leaking or the
insulin has lost its potency. It is essential, therefore, that you test your blood glucose levels at least
four times per day. If your BG is out of range, check the pump and the infusion set to ensure that the
necessary amount of insulin is being delivered.
Avoid extreme temperatures
1 Avoid exposure of your pump and remote control to temperatures above 108°F (42°C) or below 34°F
(1°C).
2 Insulin solutions freeze near 32°F (0°C) and degrade at high temperatures. If you are outside in cold
weather, wear your pump close to your body and cover it with warm clothing. If you are in a warm
environment, take measures to keep your pump and insulin cool.
3 Do not steam, sterilize or autoclave your pump or remote control.
Infusion sets and sites
Avoid using an infusion site that will be irritated by clothing and accessories, or by rigorous
stretching and exercise.
Introduction
7
Notice
CAUTION: Any changes or modifications to the devices not expressly approved by Medtronic
MiniMed could void your ability to operate the equipment.
Insulin pump and RF accessories
The pump, meter, transmitter and remote control comply with the United States Federal
Communications Commission and international standards for electromagnetic compatibility.
Do not use the RF meter to send your BG reading to the pump while on an aircraft. Manually enter
your BG. Do not use the sensor feature while on an aircraft.
These devices comply with Part 15 of the FCC Rules. Operation is subject to the following two
conditions: (1) this device may not cause harmful interference, and (2) this device must accept any
interference received, including interference that may cause undesirable operation. It does not
interfere with any RF signals transmitted from outside sources.
These standards are designed to provide reasonable protection against excessive radio frequency
interference and prevent undesirable operation of the device from unwanted electromagnetic
interference. Operation is subject to the following two conditions:
1 This device has been tested and found to comply with the regulations governing such devices in your
area. For the specific regulation and test results for your area, please contact the Medtronic
MiniMed 24 Hour HelpLine.
2 This device generates, uses, and can radiate radio frequency energy and, if installed and used in
accordance with the instruction, may cause harmful interference to radio communications. If the
device does cause interference to radio or television reception, you are encouraged to try to correct
the interference by one or more of the following measures:
➠ Reorient or relocate the insulin pump/remote control/transmitter/meter
➠ Increase the separation between the insulin pump/remote control/transmitter/meter and the
device that is receiving/emitting interference
The meter and the transmitter transmit information to the pump using radio frequency. If other
devices that use radio frequency are in use, such as cell phones, cordless phones and wireless
networks, they may prevent communication between the pump and the meter. This interference
will not cause any incorrect data to be sent and will not cause any harm to your pump or meter.
Moving away from or turning off these other devices may allow communication. Refer to Chapter 9,
“Troubleshooting” to correct interference problems you may have.
If you have questions, please contact the Medtronic MiniMed 24 Hour HelpLine.
8
Chapter 1
Chapter 2
The basics
Your pump
CAUTION:
Never use sharp objects to press the buttons on your Paradigm pump as this
can damage the buttons or compromise the seal of the pump. Some examples
of sharp objects that may damage your keypad are fingernail files, pens or
pencils, paper clips, knives, scissors, and keys.
Take a look at your pump. The reservoir window allows you to view the insulin in the reservoir. The
reservoir, with the tubing connector attached, is inserted into the reservoir compartment of the
pump.
screen
reservoir
window
battery
compartment
ESC
tubing
connector
ACT
ESC
ACT
buttons
reservoir
compartment
The basics
9
Install battery
CAUTION:
Do not use a rechargeable or carbon zinc battery in your pump. For best
results, a new AAA Energizer alkaline battery is recommended.
Medtronic MiniMed designed the pump to only accept a NEW battery. As a safety measure, if you
install a battery that does not have full power, the “weak battery” or “failed batt test” alarm may
sound. If you receive a “weak battery” alarm, respond to the alarm and continue. The pump will still
operate normally, but with a decreased battery life. The pump uses one AAA alkaline battery.
1 Make sure all the following apply:
➠ Clear (ESC, ACT) any alarms and/or alerts before removing and replacing the battery
➠ Make sure the pump is at the HOME (idle) screen when you remove the battery.
➠ Do NOT remove the battery during a bolus or prime delivery.
2 Use the edge of a coin to remove the battery cap. Turn the cap in a counter-clockwise direction.
3 Remove the old battery and dispose of it per the
disposable requirements of your state or country. Put
the new battery in the pump with the negative (-) end
going in first. Check the label on the back of the pump
to make sure the battery is inserted correctly.
NOTE - Do not use batteries that have been in
cold storage (i.e., in the refrigerator or your car in
the winter).
Battery cap
ESC
Battery
4 Place the battery cap in the pump and tighten so the slot is
aligned horizontally with the pump as shown here:
Do NOT apply force when you turn the cap.
CAUTION: Do NOT over-tighten the battery cap.
You should not turn the cap more than
four half-turns. If you over-tighten the
cap, you may not be able to remove it
and you can damage your pump.
10 Chapter 2
one half-turn
one half-turn
ACT
5 While the pump turns on, it will show various screens until the HOME screen appears.
7
Ver X.XX
HOME screen
NOTE - If you are replacing a battery for a pump that has recently been in use, the only screen
you will see before the HOME screen is the one displaying the version number.
If the HOME screen does not appear, do these steps:
a. Check that the battery is inserted correctly. If the battery has been installed backwards,
remove the battery and install it properly.
b. If your pump still does not turn on or you get a FAILED BATT TEST alarm, remove and replace
the battery with a new one.
c. If the pump is still not on, call the Medtronic MiniMed 24 Hour HelpLine.
6 Check to make sure the time and date are correct. If more than 5 minutes have passed since you
removed the battery, you will be prompted to check the time and date. Refer to the section,
“Setting the time and date” in chapter 3 for programming instructions.
7 Press ESC to view the STATUS screen, making sure no alarms are active. If an alarm is active, follow
the instructions on the screen.
NOTE - Make sure that you dispose of the battery per your local battery disposal regulations.
The basics 11
Pump buttons
The buttons on the pump are used to navigate through the menus and screens, and to program
the features of the pump.
UP button
(From the HOME screen,
this is the EASY BOLUS
button.)
EXPRESS
BOLUS
button
DOWN button
ESC button
From the HOME screen
EASY BOLUS™ button—Shortcut to set and
deliver an Easy Bolus.
Turns the backlight on/off from the
HOME screen.
Opens the MAIN MENU.
If Sensor is off:
Opens the pump STATUS screen.
If Sensor is on:
1 press shows a 3-hour BG graph,
2 presses show a 24-hour BG graph,
3 presses open a pump STATUS screen,
4 presses open a sensor STATUS screen.
ACT button
From the menus and programming screens
Increases / decreases the value of a
flashing item.
Scrolls up and down the items in a
list.
Accepts a selected menu item or
activates a selected setting.
Returns to previous screen. Cancels
settings if the ACT button has not
been pressed yet.
EXPRESS BOLUS button: Short-cut
from the HOME screen to the SET
BOLUS menu or Bolus Wizard to set
up any bolus.
Press simultaneously with
to
turn on backlight when in the
menus, or press as a “shift” button
in combination with another button
to access certain features.
12 Chapter 2
The pump screen
The screen shows five lines of text at one time. The first is the operating mode. The second is the
current open menu or function. The last three lines show either information or text that you can
select for the current function.
NOTE - The screen text in the examples used in this guide might not exactly match the text on
your pump screen. Please follow your pump screen instructions. If you have any questions, call the
Medtronic MiniMed 24 Hour HelpLine.
HOME screen
The HOME screen serves as the starting point to
access the programming screens. When no buttons
are pressed for about 30 seconds, the pump returns
to this screen.
in the HOME screen, the area below
the icons is blank.
When you press ACT from the HOME screen, the
MAIN MENU will appear.
When the pump is on, the following icons always
appear across the top of the screen: reservoir
volume icon, the time (12 or 24 hr), and the battery icon. If these do not appear, the pump is not
operating.
Screen icons
There are various icons that appear at the top of your pump screen, like the time, battery and
reservoir icons mentioned above. The next sections describe what the icons mean.
Battery
The battery icon tells you how much usable life is left in your
battery. There are four segments in the icon. Each segment
represents approximately 25 percent of the usable battery life you
have left until you reach Low Battery point. If you only have one
segment left, make sure you have a new battery available.
At least 75% left
Battery
Indicator
icons
Low battery
The basics 13
Time display
The current time of day is displayed across the top of the pump
screen in the format you select—12-hour or 24-hour. The AM or PM is
only displayed for the 12-hour format. For instructions on setting
the time on your pump, see“Setting the time and date” on page 21.
12-Hr
Time Display
Reservoir volume
The reservoir volume icon tells you how much insulin is in your
pump. This icon is also divided into four segments. Each segment
represents approximately 25 percent of the reservoir volume you
have left . Refer to your STATUS screen to view the number of units
left in reservoir.
NOTE - If using the Paradigm 722, your reservoir icon will only
appear full if using a filled 300 unit Paradigm reservoir.
75 to 100
percent left
Reservoir
Volume
Indicator
icons
Low Reservoir
Alert and alarm icons
An open circle (alert) or a closed circle (alarm) are displayed in
the upper part of your pump screen only when there is an alert or
alarm condition on your pump. For alarm and alert information, see
“Alarms” on page 127. For sensor alarms and alerts, see the user
guide that came with your pump, called “Paradigm 522 and 722
Sensor Features.”
Alert icon
Alarm icon
Sensor icons
If an antenna icon displays, the pump and transmitter are
communicating. If the antenna colors are reversed, the Sensor
feature is on, but there is no communication.For information about
the Sensor feature, see the user guide that came with your pump,
called “Paradigm 522 and 722 Sensor Features.”
14 Chapter 2
Sensor On and
communicating with the
transmitter
Sensor On, but not
communicating with the
transmitter
Scroll bar
If there is more text than the screen can show, a scroll
bar appears in the right side of the screen. Press
view any additional text.
to
scroll bar
Screen backlight
When you press
from the HOME screen, the light on the screen turns on or off. During
programming, the backlight can be turned on by pressing the
and the
together. The light will
stay on while you are pressing any of the pump buttons. It will stay on as long as the current screen
is active.
To conserve your battery, the backlight will turn off automatically while the pump is vibrating.
After the vibration is finished, the light will turn back on. The backlight cannot be turned on in a Low
Battery condition.
Beep/vibrate
Your pump will beep or vibrate to indicate activity. Refer to the section, “Setting your alert type”
in chapter 8 for setup instructions.
The basics 15
Operating modes
The screen lets you know when a special feature is active or if there is a condition that needs your
attention. The active features and pump status will determine the operating mode. The screens for
the three modes are shown below.
WARNING: When the pump is in “Attention mode,” all insulin deliveries are stopped.
Normal - mode for standard pump operations for normal basal and
bolus delivery. No special features are active (i.e., basal patterns,
temp basal, etc.). No alarms or alerts exist.
Normal Mode
Special - indicates a special feature is active or an alert condition(s)
exists. Special mode does not restrict any of the pump functions.
When the pump is in Special mode, an open circle appears at the
top of the screen and it will beep/vibrate periodically to remind
you of the condition. The conditions and features that will put the
pump in Special mode are:
➠
Low Reservoir condition
➠
Low Battery condition
➠
Block feature is on
16 Chapter 2
➠
Dual or Square Wave bolus
delivery
➠
Basal pattern A or B is active
Special Mode
➠
Sensor alerts
➠
Temporary basal delivery
Attention - indicates insulin delivery has stopped. This can mean that
the pump is in Suspend mode. It can also mean an alarm is active or
an alarm condition exists that needs immediate attention for insulin
delivery to resume. A solid circle appears at the top of the screen
and the pump will beep periodically until either the pump is taken
out of Suspend mode or the condition is cleared. The screen will
show text describing the condition that put the pump in Attention
mode. For example, if the reservoir is empty, “Empty Reservoir” will
appear on the screen.
Attention Mode
When the pump is in Attention mode, it will beep/vibrate periodically to remind you of the
condition. The beep/vibrate frequency varies depending on the condition that put the pump in
Attention mode. Refer to the section “Alarm conditions” in chapter 9 for alarm conditions that will
trigger the Attention mode. See “Stopping your pump” in chapter 3 to learn about the Suspend
mode.
Menus
The MAIN MENU is the highest level menu. There are submenus, functions, status and programming
screens in the lower menu levels. The menus are described in the following paragraphs.
TIP - If a screen item is flashing (blinking), during programming, press
value.
/
to change the
MAIN MENU - Highest menu level in the menu system. When you press ACT from the HOME screen,
the MAIN MENU will appear.
BOLUS MENU - Contains the settings and function for bolus deliveries. The
button allows direct
access to the MANUAL BOLUS or to the Bolus Wizard feature without having to navigate through the
menus. Refer to Chapter 3, “Basic programming” for the manual bolus information or to Chapter 5,
“Using the Bolus Wizard feature” for bolusing using the Bolus Wizard feature.
SUSPEND - Stops all current insulin deliveries (basal, bolus and fixed prime). Refer to section
“Stopping your pump” in chapter 3 for more information.
The basics 17
SENSOR - Contains the functions to setup the interface between the sensor and the pump and has
access to the pump’s sensor features. Refer to the sensor user guide that came with you pump,
“Paradigm 522 and 722 Sensor features,” for more information.
BASAL MENU - Contains the functions to setup and deliver your basal insulin. Refer to chapter 3,
“Basal” for more information.
PRIME MENU - Contains the functions required to change your reservoir and fill the infusion set with
insulin. Refer to the section “Changing your infusion set” in chapter 4 for more information.
UTILITIES MENU - Contains features for your safety and convenience. Refer to Chapter 8,
“Utilities” for more information.
18 Chapter 2
STATUS screen
The STATUS screen shows information about what your pump is doing. The information that shows
on the STATUS screen depends on the current activities and conditions of your pump.
➠
To open the STATUS screen, press ESC until the STATUS screen appears
➠
To view more text on STATUS screen, press
/
to scroll and view all of the information.
To exit the STATUS screen, press ESC until the STATUS screen disappears.
The screen includes information about:
➠
Recent insulin deliveries (basal and
bolus)
➠ Special features that are turned on
➠
➠
Reservoir status
➠
Battery status
NOTE - Do not check your pump status (press
ESC) when you are programming your pump.
If you press ESC during programming, you will
cancel the settings you are trying to enter.
Refer to Chapter 11, “Pump specifications” for
a complete list of the information that is
accessed from the STATUS screen.
➠
Time and date
STATUS
U100
Last Bolus: N 3.8U
9:07A 18 MAR
Basal 1: 0.15U/H
Reservoir Started:
13MAR, 12:44P
Units left: 144.0U
Time left: > 24 Hours
BG Reminder in 2:04h
Meter: On
Battery: Normal
Auto Off - 12HR
Fri 21 MAR 2004
S/N# 123456
Paradigm 522
VER X.XX X.X
Sample STATUS
screen
The basics 19
If you remove your pump
Pump settings
You may have an occasion when you need or want to remove your pump. If you have to remove and
store your pump, it is recommended that you store it with the battery in place. Keep a record of your
current basal rates. To preserve battery life, reset the basal rates to 0 (zero), turn off the RF options
(meter, remote), and set Auto-off to dashes or zeroes.
NOTE - Your pump keeps a record of the basal and bolus insulin it delivers. Setting your basal to
0.0 while you are disconnected ensures that the insulin delivery records in your pump are accurate.
Insulin
Remember, your body still needs insulin while your pump is removed.
It is important that you consult with your healthcare professional to determine an alternate
method of receiving your insulin. You can remove your pump for up to one (1) hour without taking
insulin. If you remove your pump for more than one hour, you will have to use another way to take
your insulin, such as injections of fast-acting insulin, or reconnecting your pump to take boluses.
Take the injection or bolus approximately every four (4) hours. Calculate the amount of insulin to
take based on the total of your basal insulin in four (4) hours. Include the amount you need for meal
and correction boluses. If you will have your pump off for several days, you will need to return to a
multiple injection regimen.
20 Chapter 2
Chapter 3
Basic programming
Setting the time and date
Setting the correct time and date in your pump is necessary for accurate basal insulin delivery and
allows you to keep an accurate record of your insulin delivery and other pump functions. You can
select a 12-hour or 24-hour clock. You must reset the time and date if you receive a CHECK SETTINGS
alarm or you clear your settings (Clear Settings function).
1 Go to the TIME/DATE SETUP screen.
TIME/DATE SETUP
Main > Utilities > Time/Date
12 Hour Setup
24 Hour Setup
2 Select 12-Hour Setup or 24-Hour Setup
and press ACT.
TIME/DATE SET
ACT
12:00A
01JAN2004
Press ACT to change
3 Press ACT again to change the settings.
4 Change each of the settings as follows:
Hour
SET HOUR
12:00A
Change the hour.
Press ACT.
For 12-hour setups,
press
until
/
the correct A (am) or
P (pm) appears.
Minutes
SET MINUTES
9:00A
Change the
minutes. Press
ACT.
Year
Month
SET YEAR
SET MONTH
Change the year.
Press ACT.
Change the month. Change the day.
Press ACT.
Press ACT.
2004
Day
01
SET DAY
01
Basic programming 21
5 The TIME SET AT screen will show the settings that you programmed. Press
ACT and exit the menus.
Your time/date settings are complete.
TIME SET AT
8:33 AM
26FEB2004
Bolus
There are three bolus types: Normal, Square Wave®, and Dual Wave®. This section gives
instructions for a Normal bolus using the express bolus button and navigating through the menus. (For
information about Square Wave and Dual Wave boluses, refer to chapter 6, “Optimizing pump
therapy.”)
The Normal bolus delivers an immediate food or correction bolus. It can be delivered at any time
except during another Normal bolus. During a Normal bolus, most pump features are disabled until
after all the bolus has been delivered. The Suspend function and the STATUS screen, however, are
always available.
Normal bolus
Normal bolus can be used to cover the carbohydrate in a meal or snack and/or to correct a blood
glucose that is higher than the target that was chosen for you.
The following instructions are for a Normal bolus when the Bolus Wizard feature is turned off.
From the menu
Using the EXPRESS BOLUS button
1 Go to the BOLUS MENU.
Main > Bolus
Select Set Bolus and
press ACT. Go to step 2.
1 Press
BOLUS MENU
2 If the BOLUS TYPE
BOLUS TYPE
screen appears:
Normal Bolus
Square Wave Bolus
(Dual/Square
Dual Wave Bolus
Wave is on) Select
Normal Bolus and press ACT. Go to
step 3.
Set Bolus
Bolus History
Bolus Wizard Setup
Max Bolus
Dual/Square Bolus
Easy Bolus
BG Reminder
2 If the SET BOLUS screen
appears: (Dual/Square option
is off) Go to step 3.
3 Enter your bolus amount and
press ACT.
SET BOLUS
0.0 U
SET BOLUS*
0.0
U
/
* SET NORMAL BOLUS will show if
Dual/Square option is on.
22 Chapter 3
on your pump. Go to Step 2.
SET BOLUS*
2.5
ACT
U
NOTE - If you have BG Reminder turned on, a screen displays allowing you to accept or modify
the length of time after this bolus before you are reminded to check your blood glucose. See
the section, “BG reminder” for information about this feature.
4 Press ACT to accept and deliver the bolus. The
Normal bolus will start. As the bolus delivers, the
amount shown on the screen will increase until the
entire bolus has been delivered.
BOLUS DELIVERY
11:53A
Normal
0.1
U
BOLUS DELIVERY
11:53A
Normal
2.5
U
The pump will beep/vibrate at the start of the bolus. When the
bolus is finished, the pump will beep/vibrate again and the HOME
screen will appear.
Below are some practice lessons that will help you understand this
pump feature.
Normal meal bolus using the exchange system
Normal bolus can be used to cover the carbohydrate in a meal or snack and to correct a blood glucose
that is higher than the target that was chosen for you.
Fred has been taught that he needs to take 1 unit of insulin for every carbohydrate exchange that he
eats (every milk, starch or fruit). For lunch today he will eat:
Turkey sandwich with two slices of bread
2 starches
1 small apple
1 fruit
1 cup of non-fat milk
1 milk
_________
Total carbohydrate exchanges =
4
Fred's lunch has a total of 4 carbohydrate exchanges so he will take a meal bolus of 4 units for his lunch.
Basic programming 23
Bolus practice:
Going through the menus, program a 2.0 unit Normal bolus now.
Check here if you were able to program it.
Using the EXPRESS BOLUS button
, program a 2.0 unit Normal bolus now.
NOTE - Make sure
that you are not
connected to your
pump while
practicing.
Check here if you were able to program it.
Normal meal bolus practice using exchanges:
Choose a meal you might eat and fill in the blanks.
Food:
__________
exchange:
____________
__________
exchange:
____________
__________
exchange:
____________
total exchanges:
____________
You will take _______units of insulin for each exchange. Your total bolus is _______ for this meal.
Normal meal bolus using carbohydrate counting
Lydia has been taught that she needs to take 1 unit of insulin for every 10 grams of carbohydrate. This is
her insulin to carbohydrate ratio. For dinner she will have:
4 oz. broiled chicken
0 grams
2/3 cup of rice
30 grams
½ cup cooked broccoli
5 grams
1 oz. dinner roll
15 grams
1 tsp margarine
0 grams
____________
total grams of carbohydrates =
50 grams
Lydia's dinner totals 50 grams of carbohydrate. Her insulin to carbohydrate ratio is 1 unit: 10 grams. She
will take a meal bolus of 5 units for her dinner. She determined this by dividing 50 (total grams of
carbohydrate) by 10 (insulin to carbohydrate ratio).
24 Chapter 3
Choose a meal you might eat and fill in the blanks.
Food:
________
grams of carbohydrate:
______________
________
grams of carbohydrate:
______________
________
grams of carbohydrate:
______________
total grams of carbohydrate:
________________
Your insulin to carbohydrate ratio: 1 unit of insulin for _______ grams carbohydrate.
Divide your total carbohydrates by your insulin to carbohydrate ratio and take _____units of insulin
for your meal.
Meal bolus, correction bolus and insulin sensitivity
3a
Jason is ready to eat his breakfast. He has calculated that he will need 4.0 units for his food.
He tests his blood glucose and finds that it is 200 mg/dL (11.1 mmol/L). Jason knows that his blood
glucose level is above his blood glucose target and will need additional insulin before he eats.
Jason's healthcare professional has determined the following for him:
Target BG:
Insulin sensitivity:1
110 mg/dL (6.1 mmol/L)
36 mg/dL (2.0 mmol/L)
3b
Jason determines that he will need a correction bolus of 2.5 units insulin to lower his elevated blood
glucose. The 2.5 correction bolus will lower his current BG of 200 mg/dL (11.1 mmol/L) to his target of
110 mg/dL (6.1 mmol/L).
Elevated blood glucose:
200 - 110 = 90 mg/dL (11.1 - 6.1 = 5 mmol/L)
Correction bolus:
90 / 36 (insulin sensitivity) = 2.5 units
(He will add this 2.5 correction bolus to the 4.0 units of insulin that he will need for his meal bolus.
Jason will take a total bolus of 6.5 units.)
1.Insulin sensitivity is the amount (in mg/dL or mmol/L) by which blood glucose will be lowered after taking 1 unit of insulin.
Consult with your healthcare professional to determine your insulin sensitivity.
Basic programming 25
Practice: Meal bolus
You have determined your meal bolus as: _______ units.
Your target blood glucose range is: _______ to _______ (average is _______ ).
Your current blood glucose level is: _________.
Your correction factor is: 1 unit of insulin will drop your BG _________.
You will take ________ unit(s) of insulin to correct your high BG level.
Your total bolus (meal bolus plus correction bolus) is _________.
26 Chapter 3
Review your bolus deliveries
You can view a list of your bolus deliveries in the BOLUS HISTORY screen. This screen shows a list of
the dates, times, units, and types for your last 24 boluses. This feature is helpful for record keeping
or to check if you bolused for your last meal.
If a bolus was stopped before delivery was complete, the BOLUS HISTORY screen will show only the
amount actually delivered. Refer to the next section “Bolus details” for instructions about viewing
bolus details.
Do the following steps to view the BOLUS HISTORY screen:
1 Go to the BOLUS HISTORY screen and scroll through the
bolus deliveries.
Main > Bolus > Bolus History
If you used the Bolus Wizard feature to deliver any of
these boluses, the screen shows the carbohydrate/food
(CH) and BG values that the Bolus Wizard feature used
to calculate the boluses.
2 Refer to the instructions in the next section “Bolus
details” to see the details for any of these boluses.
(with Bolus
Wizard feature)
BOLUS HISTORY
Last 12:48P 0.7N
CH: 13 BG: 150
05SEP 01:05P 0.2N
BOLUS HISTORY
Last 12:48P 0.7N
05SEP 01:05P 0.2N
05SEP 06:30P 4.8S
date
carb value
time
amount/type
BG value
N = Normal
S = Square Wave
D = Dual Wave
DN = Normal part of dual bolus
DS = Square part of dual bolus
Basic programming 27
Bolus details
You can view the details for any of the deliveries in the BOLUS HISTORY screen. The details include:
Bolus types: Normal, Square, and Dual
➠ Programmed bolus amount
➠ Delivered bolus amount
➠
Bolus Wizard feature information (if used)
To see the details for any bolus, do these
steps:
➠
1 In the BOLUS HISTORY screen, select the
bolus that you want to review and press
ACT.
2 The details for that bolus will appear on
the screen. Scroll through the details.
3 Exit when you are done.
(without Bolus Wizard
feature)
BOLUS HISTORY
Last 05:45P 0.7N
05SEP 01:05P 02N
05SEP 06:30P 4.8S
ACT
(delivery is active)
BOLUS DETAIL
Normal
Type:
User Entry:
4.0U
Delivered:
0.7U
(delivery stopped)
BOLUS DETAIL
Normal
Type:
4.0U
User Entry:
0.7
Stopped at:
(delivery completed)
BOLUS DETAIL
Normal
Type:
Delivered:
4.0U
28 Chapter 3
If the Bolus Wizard
feature calculated your
bolus, this information will
also appear in the BOLUS
DETAIL screen.
Bolus Wizard:
Est total:
Food intake:
(Meter) BG:
Food:
Correction:
Active Ins:
Est time:
4.0U
45gr
160
3.0U
2.0U
1.0U
12:03P
(values shown are for
example only)
Maximum bolus limit
The maximum bolus (max bolus) is a safety feature that limits the amount of insulin that can be
delivered in a single bolus. The factory setting is 10.0 units. You can specify the limit from 0.0 to
25.0 units. It is important to discuss this feature with your healthcare professional to determine your
maximum bolus amount.
To set the maximum bolus limit, do these steps:
1 Go to the MAX BOLUS SETUP
screen.
2 Set your maximum bolus limit
and press ACT.
3 Your maximum bolus is
set. Exit the menus.
Main > Bolus > Max Bolus
x __
MAX BOLUS SETUP
0-25
10.0
U
MAX BOLUS SETUP
0-25
15.0
U
ACT
BOLUS MENU
Bolus Wizard Setup
Max Bolus
Dual/Square Bolus
ESC
(flashing)
Example 1: Max bolus
Shelby takes very small doses of insulin for her meal boluses. As a safety limit, she and her healthcare
professional reset her pump with a maximum bolus of 5.0 units.
Example 2: Max bolus
David is a growing teenager. He loves to eat big meals and requires very large doses of insulin for his
food. He reset his pump with a maximum bolus of 20.0 units so he can take more insulin when he needs
to.
Basic programming 29
BG reminder
When you deliver a bolus, you may want to check your BG afterwards. The BG Reminder is an
optional feature that makes your pump beep or vibrate to remind you to check your BG after a bolus.
Your pump is set at the factory with this feature turned off. If the BG Reminder is on, during bolus
programming your pump will ask for the amount of time you want to be reminded after your bolus
delivers. This time can be from 30 minutes to 5 hours, or NONE. If you do not want to use the BG
Reminder at all, set the option to Off. (BG Reminder is not available after an Easy Bolus.)
1 Go to the BG REMINDER SETUP screen.
Main > Bolus > BG Reminder
2 Select On and press ACT. The BG reminder is
now enabled. Exit the menus.
BG REMINDER SETUP
Off
On
The next time you program a bolus, your pump will ask you for the amount
of time before you want to be reminded to check your BG.
BG REMINDER DURATION
2:00
NOTE - If you press ESC when the BG Reminder Duration screen
(flashing)
appears, your pump will begin delivering the bolus without setting a
reminder. If you program another bolus with a BG Reminder before a
previously scheduled BG Reminder goes off, the previous BG Reminder will be cancelled.
12:40P
CHECK
BG
This is a reminder
to check your BG
ESC, ACT to clear
30 Chapter 3
When the BG
Reminder goes off,
your pump will beep
or vibrate and the
message “CHECK BG”
will appear on the
screen. Your pump
will beep or vibrate
periodically until it is
cleared (ESC, ACT).
U100
STATUS
BG Reminder in 0:18h
Battery: Normal
Tues 08 MAR 2004
When you set a BG
Reminder after a bolus,
the STATUS screen will
show the amount of time
remaining before the
reminder will go off.
Here, the STATUS screen
indicates BG Reminder will
go off in 18 minutes.
Basal
Basal insulin is required to maintain your target glucose values when you are not eating. Your
healthcare professional will calculate this rate for you. Your basal insulin should account for
approximately one half of the body’s total daily insulin requirements. Your pump mimics your
pancreas by delivering insulin continuously over 24-hours.
You can set your insulin pump to change rates during the day to match your needs. Your needs
depend on your lifestyle and insulin requirements. Some people only use one rate throughout the
day, while others find they need more. Your basal rates are made up of insulin deliveries that have
start and stop times. Once set, these rates make up your 24-hour basal pattern and are repeated
daily.
Start and stop times
When you set your basal rate(s) in
the BASAL MENU, your pump prompts
you to set the start time for each
basal delivery. The stop time is the
time that one basal rate stops and
the next basal rate starts (see
figure).
It is recommended that you record
your basal rates on paper. The Quick
Reference card is provided with your
pump for this purpose. For best
results, setting or changing your
basal rate(s) should be discussed
with your healthcare professional.
Basal rate 2
Basal rate 1
start #1
stop #1
(midnight)
*12:00 a.m.
or
00:00
■
■
Basal rate 3
start #2
stop #2
7:00 a.m.
or
7:00
start #3
stop #3
3:00 p.m.
or
15:00
(midnight)
12:00 a.m.
or
00:00
The start time of one basal rate is the stop time of the previous
rate. This gives you continuous basal insulin through a 24-hour
period.
You cannot set a start time for one basal rate to overlap the next.
basal rate. The addition of a new basal rate will erase any basal
rates that follow.
* For Basal Rate 1, the start time cannot be changed (only the rate can be
changed). Basal Rate 1 always starts at 12 a.m. or 00:00, depending on the time
format selected.
Basic programming 31
Your basal settings
You must program your basal settings before you can deliver basal insulin. Keep a written record of
your basal settings.
It is recommended that you set your basal rates with the assistance of your healthcare
professional.
If you plan to take off your pump for an extended period of time, i.e. more than a day, set the
basal rate to 0.0U/H. This will ensure that the insulin delivery records in your pump are accurate.
Refer to the section, “If you remove your pump” in chapter 2 for more information.
Basal programming and delivery
To set your basal rates, do these steps:
NOTE - You cannot make changes to your
basal rate settings while a Percent (%)
temp basal is active.
1 Go to the BASAL MENU.
(If using patterns, you will first
select the basal you want, then
the SET BASAL RATE 1
screen will appear.)
BASAL MENU
ACT
Set/Edit Temp Basal
Set/Edit Basal
Basal Review
Main > Basal
EDIT BASAL
ACT
ACT
2 Select Set/Edit Basal and press ACT.
3 The SET BASAL RATE 1 screen will appear.
Enter your first basal rate amount and press ACT.
SET BASAL RATE 1
12:00A
0. 00
4 The start time for your first basal rate is midnight
(12:00A) and cannot be changed.
5 The screen will change to SET START TIME 2. If you
only need one basal rate for the entire 24-hour day
(12:00A to 12:00A), do these steps:
a. Press ACT or ESC without setting a start time.
b. The BASAL RATE screen will appear with your
basal rate information. Your daily basal rate
is now programmed.
c. Exit the menus.
32 Chapter 3
4.40U
0.00U
- .- -U
Standard
Pattern A
Pattern B
U
_
H
Rate 1 (flashing) press
/
ACT
to set
SET START TIME 2
BASAL RATE
--:--
Current Rate 0.45U/H
Started #1 - 12:00A
24 HR. Total 10.80U
_._ _
U
_
H
(flashing) Start time 2 Do not set.
Press ACT or ESC.
If you need to program more than one basal rate for the day, do these steps:
a. In the SET START TIME 2 screen, enter the
start time for the next rate and press ACT.
b. The SET BASAL RATE 2 screen will appear.
Enter the rate and press ACT.
c. Repeat steps a and b for each additional
basal rate. Each rate will have a different
number (i.e. Basal Rate 1, Rate 2, Rate 3,
etc.).
SET START TIME 2
--:--
_.__
U
H
ACT
Start time 2 (flashing)
Press
/
_. _ _
U
H
ACT
Rate 2 (flashing)
to set
Press
to set
d. After you program your last basal rate,
press ESC.
SET START TIME 3
--:--
/
_. _ _
e. The BASAL RATE screen will appear. Your basal rate(s) will now
deliver as programmed. Exit the menus.
U
H
ESC
NOTE - When you have finished programming your pump, you can save your
settings. Refer to “User settings” on page 117 for instructions.
WARNING:
SET BASAL RATE 2
7:30A
BASAL RATE
Current Rate
Started #1 24 Hr. Total
0.60U/H
12:00A
14.40U
Make sure you are NOT connected to your pump while practicing.
Practice: Basal programming
Make sure you are NOT connected to your pump while practicing.
Set a basal rate of 0.5 unit per hour.
Check here if you were able to set the basal rate:
What is the total basal insulin for 24-hours? ______ (answer: 12 units)
Basic programming 33
Basal review
Temporary basal information is only available in the STATUS screen.
Current basal delivery
The STATUS screen shows your current basal information.
standard
basal is the
current basal
STATUS
U100
Last Bolus N 3.8U
9.07A 11 JAN
Basal 1: 0.80 U/H
Units Left: 128.0U
Battery: Normal
Remote: On
Tue 11 JAN 2004
S/N #000000
Paradigm 522
Ver X.XX X.X
Daily basal rate(s)
The BASAL REVIEW screen shows your daily basal rates programmed for delivery from midnight to
midnight (12:00A to 12:00A). Compare your daily insulin deliveries to your blood glucose records to
help you and your healthcare professional identify your optimal daily insulin rate(s).
1 Go to the BASAL MENU. Select Basal Review and press
ACT.
Main > Basal > Basal Review
34 Chapter 3
BASAL MENU
Select Patterns
Set/Edit Basal
Basal Review
2 If you do not use patterns:
The delivery details for your
standard basal will appear.
STANDARD
16.80 U
0.60U/H
1.00U/H
0.80U/H
1) 12:00A
2) 11:30A
3) 12:00P
basal rate
start times
If you use patterns:
The screen will show the basal patterns.
The current basal pattern will be
highlighted. Select the pattern you want
to view. Press ACT.
(24-hour total)
The start time and
basal insulin
from 12:00A units for each
delivery rate in that
to 12:00A
basal
delivery rates
pattern will appear.
BASAL REVIEW
Standard
Pattern A
Pattern B
16.80 U
24.50 U
19.60 U
ACT
(24-hour total)
basal insulin from
12:00A to 12:00A)
24.50 U
PATTERN A
1) 12:00A
2.20U/H
2) 10:30A
1.80U/H
3) 6:30P
2.60U/H
basal rate start
times
basal
delivery rates
3 Exit the menus when you are done.
Basic programming 35
Max basal rate
Maximum (Max) basal rate is a safety limit for the amount of basal insulin that is able to be
delivered per hour. This maximum rate will apply to every basal rate that is set, including a
temporary basal. It is important to discuss what your Max basal rate should be with your healthcare
professional.
Once your basal rates have been set, you CANNOT set a maximum basal that is less than any of the
programmed basal rates or program a basal rate that is greater than your maximum basal rate—this
includes patterns and temporary basal rates. Your pump is sent from the factory with the maximum
basal set to two (2.0) units per hour.
To set your max basal rate, do these steps:
1
Go to the MAX BASAL RATE screen. The
Max basal rate will be flashing.
2
Change the rate and press ACT. 3
Main > Basal > Max Basal Rate
MAX BASAL RATE
2.
U
00 H
x
Your maximum
basal rate is now
set. Exit the
menus.
MAX BASAL RATE
15.
00 UH
ACT
(flashing)
Example 1: Max Basal
Helen has a very low insulin requirement. Her highest basal rate is only 0.4 units per hour. As a safety
measure, Helen's healthcare professional set her pump with a Max basal rate of 1.0 units per hour.
Example 2: Max Basal
Rusty needs large amounts of insulin to control his blood glucose levels. His new pump was delivered
from the factory with a Maximum Basal Rate of 2.0 units per hour, but he needs 2.8 units per hour in the
early morning. Rusty will reprogram his Max basal rate to 3.0 units per hour to accommodate his needs.
36 Chapter 3
Stopping your pump
You can stop your pump with the Suspend function. Suspend stops all insulin delivery including the
current basal and any bolus or prime deliveries that are in progress. While suspended, your pump will
not deliver insulin until you Resume your pump. When basal is resumed, the pump is taken out of the
Suspend mode.
The pump will beep or vibrate about every 15 minutes on the hour to remind you that it is not
delivering insulin. Example: You suspend your pump at 11:20AM. The pump will beep/vibrate at
11:30AM, 11:45AM, 12:00PM, and so on until you resume your pump (basal resumes).
NOTE - When suspended, your pump is in Attention mode (a solid circle). When in Suspend, you can
only resume your basal or view the STATUS screen. No other functions are available.
Do these steps to suspend your pump:
1 Select Suspend from 2
the MAIN MENU, and
press ACT.
MAIN MENU
Bolus
Suspend
Basal
ACT
SUSPEND will flash. Press 3
ACT to stop your pump.
SUSPEND
Press ACT to Stop Pump
(flashing)
NOTE - Press ESC once (three times if the Sensor
feature is ON) to view the STATUS screen and
verify that your pump is suspended.
ACT
The screen will show that the pump
is suspended and the time that it
stopped. After a few minutes, the
pump will default to the HOME
screen with a solid circle.
Stopped at 1:05P
SUSPEND
STATUS
U100
Suspended at 01:05P
Last Bolus N 3.8U
7:58A 22 FEB
Basic programming 37
Example:
Suspend function
1 Josh has been on a Medtronic MiniMed pump for several months. He is very active in soccer and
basketball. He and his healthcare professional have determined that he does not need his basal
insulin during his games, and that he is able to take the pump off for these short amounts of time.
Josh uses the “Suspend” feature on his pump to stop the basal insulin during the time that he is
disconnected from his pump. He will “Resume” delivery when he reconnects the pump.
2 Helen is ready to eat her lunch. She has just programmed her pump to deliver a meal bolus when
the phone rings. Helen wants to talk on the phone and not eat her lunch right away. She knows
that if she lets the bolus continue and she does not eat her lunch soon, she may be at risk for low
blood glucose. Helen “Suspends” delivery of her pump to stop the bolus, but then “Resumes”
delivery to restart her basal insulin. When she is off the phone and ready to eat, she checks her
STATUS screen to see how much insulin she received from the partially delivered bolus before she
suspended her pump. She will reprogram a new bolus for the remainder of her bolus amount.
WARNING: Make sure you are NOT connected to your pump while practicing.
Practice:
Suspend function
1 Make sure you are NOT connected to your pump while practicing.
Program your pump to deliver a Normal bolus of 3.0 units. Once the bolus begins, stop the bolus
by suspending your pump.
Remember, when you stop the bolus delivery with “Suspend,” ALL insulin delivery will stop.
2 Now, “Resume” delivery, so that your basal insulin will continue.
3 Check the STATUS screen.
4 How much insulin did the bolus deliver before you Suspended delivery? _______.
5 If you wanted to take the rest of the bolus later, how much would you take to equal 3.0 units?
_______.
38 Chapter 3
Resume pump delivery
When the pump is suspended, it defaults to the HOME screen with a solid circle.
Do these steps to resume your pump and basal delivery:
1. From any screen, press ACT until the RESUME screen appears. Press
ACT again.
2. Your pump will beep once, then the HOME screen will appear (with no
circle).
ACT
Stopped at 1:05P
RESUME
NOTE - A bolus or fixed prime that was stopped by Suspend will NOT
restart when you resume your pump. You must reprogram and activate
it to finish delivery.
ACT - Restart Basal
ACT
WARNING: Make sure you are NOT connected to your pump while practicing.
Practice:
Resume basal delivery after a suspend
Make sure you are NOT connected to your pump while practicing.
Give a 3.0 unit bolus now. While it is delivering, suspend the bolus.
Check here if you were able to suspend the bolus.
Now restart the pump.
Check here if you were able to restart the pump.
Basic programming 39
40 Chapter 3
Chapter 4
Starting on insulin
Prepare your pump for use
Before continuing with the steps in this chapter, we recommend that you watch your pump training
CD-ROM and complete your pump start training.
When you are done practicing and are ready to use your pump with insulin, you must:
1 Make sure the time and date are correct on your pump
2 Program your settings as instructed by your healthcare professional
3 Install the reservoir, and
4 Prime the infusion set
You will need these items:
➠
Pump
➠
Insulin
➠
Paradigm reservoir and user guide
➠
Paradigm infusion set and user guide
Starting on insulin 41
Filling the reservoir
WARNING: When filling the reservoir, take care to remove air bubbles.
1 Remove reservoir from package. Make sure
plunger rod is fully extended.
plunger
rod
2 Swab vial with alcohol.
3 Making sure you do not push down on the
plunger, press the transfer guard onto the vial.
reservoir
transfer
guard
4 Push down on the plunger to pressurize the vial.
42 Chapter 4
vial
5 While still holding the
plunger rod, flip the vial
over so the vial is up,
slowly pull down on the
plunger to fill the
reservoir.
6 Gently tap the side of the
reservoir to make any air
bubbles rise to the top of the
reservoir.
9 With the vial down, hold the transfer guard.
Turn the reservoir counter-clockwise then
pull straight up to remove it from the
transfer guard.
7 Slowly push up on the plunger
just enough to remove any air
bubbles from the reservoir.
8 Slowly pull down on the
plunger to fill the reservoir to
the number of units desired.
10 Place the tubing connector onto the reservoir.
Turn the connector clockwise pressing gently
against the reservoir until you feel it slide in.
Push in and continue turning until the reservoir
and the connector lock with a click.
“CLICK”
Starting on insulin 43
11 Tap the side of the
reservoir to remove any air
bubbles.
12 To purge air bubbles that
have risen to the top of the
reservoir, push up on the
plunger until you see insulin
in the tubing.
13 Without pulling, turn the
plunger rod counter-clockwise
to remove it from the
reservoir.
Changing your infusion set
Removing the reservoir
Each time you remove and replace a reservoir in your pump, you have to rewind and prime your
pump. Priming requires insulin.
1 Remove the entire infusion set from your body.
2 If attached, remove the activity guard.
3 Turn the tubing connector half-turn counter
clockwise, then pull the reservoir and connector
out from the pump.
tubing connetor
half-turn counter-clockwise
4 Safely dispose of the used reservoir and infusion set items in a sharp’s container.
5 You must now rewind your pump as described in the next section.
44 Chapter 4
Rewinding your pump
Before you continue, make sure the pump is NOT connected to your body.
WARNING: Make sure the infusion set is disconnected from your body before you rewind or prime
the pump. Never insert the reservoir into the pump while the tubing is connected to
your body. Doing so could result in an accidental infusion of insulin.
1 If you removed your reservoir and are replacing it, go to the REWIND screen.
Main > Prime > Rewind
2 In the REWIND screen, press ACT to start the rewind
process. The REWINDING screen will appear while
the pump rewinds.
3 After the pump rewinds the PREPARING TO PRIME
screen will appear.
NOTE - If you press ESC, the PRIMING
STOPPED screen displays. This screen guides
you back to the priming screens. Once you start
a rewind, you cannot cancel it.
REWIND
Disconnect from Body
Press ACT to Rewind
ACT
PRIMING STOPPED
Continue Priming
Rewind Pump
Status Screen
ESC
ACT
REWINDING
Wait for notification
PREPARING TO PRIME
Disconnect from Body
Insert/Lock Reservoir
Hold ACT to Prime
If you are practicing, do these steps:
a. Do NOT insert the reservoir in your pump. Make sure the shipping cap is installed in the
reservoir compartment.
b. Continue with the manual prime instructions described in the “Manual prime” section on
page 47.
If you are not practicing, continue to the next section, “Inserting the reservoir in your pump.”
Starting on insulin 45
Inserting the reservoir in your pump
If your reservoir is already inserted in your pump, continue to the next section, “Manual prime.”
You must do these steps in the order described. Your pump screen will show instructions to help you
with these steps. If you are practicing, do NOT insert the reservoir in your pump.
CAUTION: You must rewind your pump before installing a new reservoir. As part of the pump’s
function, it measures the reservoir volume. To ensure correct volume measurements,
your pump has been designed to require a rewind before you insert your reservoir.
1 If you are using the pump for the first time, remove the shipping cap from the reservoir
compartment.
WARNING: Do not insert the reservoir in the pump if you did not rewind. Doing so could result in
inaccurate insulin delivery.
Never insert the reservoir into the pump while the tubing is connected to your body.
Doing so could result in an accidental infusion of insulin.
2 Insert the reservoir into the top of the pump
case.
3 Turn the tubing connector approximately
half-turn clockwise until the connector is
seated. The tubing connector should be
aligned horizontally with the pump case as
shown here.
tubing connector
E
4 Attach the activity guard, if desired.
5 You must now do a manual prime as described in the next section.
46 Chapter 4
Manual prime
Manual prime fills the infusion set tubing with insulin before you attach it to the infusion site.
Manual prime is only available after you rewind your pump.
WARNING: Make sure the infusion set is disconnected from your body before you press ACT to
prime the pump. Never insert the reservoir into the pump while the tubing is
connected to your body. Doing so could result in an accidental infusion of insulin.
1 After you rewind your
pump, the PREPARING
TO PRIME screen will
appear.
PREPARING TO PRIME
Disconnect from Body
Insert/Lock Reservoir
Hold ACT to Prime
ACT (hold)
PREPARING TO PRIME
Hold ACT
DISCONNECT
ACT
(hold)
2 Press and hold ACT to start
the prime. The pump will
beep 6 times indicating the
prime has started.
PRIMING – HOLD ACT
ESC if
done
0.3
U
ACT
(hold)
3 While you hold ACT, the pump 4
will beep again 6 times as the
screen begins counting the prime
units being used.
PRIMING – HOLD ACT
ESC if
U
done
5.1
Continue to hold ACT until insulin
droplets form on the tip of the
infusion set needle, then release.
Be sure no bubbles are in the
tubing.
WARNING: If the PRIMING - HOLD ACT screen does not display, do NOT continue. Do NOT insert the
infusion set into your body. Please contact the 24 Hour HelpLine for assistance.
Take care to remove any air bubbles during the manual prime.
Starting on insulin 47
IS PRIMING
COMPLETE?
Disconnect from body
See user guide for
instruction.
ESC, ACT to clear
If your manual prime uses more than 30U insulin, the pump will ask you, “is
priming complete?” If you get this message, do these steps:
a. Make sure you are not connected to the pump.
b. Read the message on the screen, then press ESC, ACT to clear.
c. If your manual prime is complete (you see droplets on the tip of the infusion
set needle), press ESC and continue to step 5. If your manual prime is not
complete, press and hold ACT until priming is complete then continue to
step 5.
5 Press ESC. Your manual prime is complete.
6 You can now insert the infusion set into your body as described in the next section.
Insert the infusion set
WARNING:
While the infusion set is connected to your body, do not unscrew and retighten
the tubing connector on the reservoir.
After you complete all of the following, you will be ready to insert the infusion set into your body:
➠
Fill your reservoir
➠
Rewind your pump
➠
Insert the reservoir into pump
➠
Prime the pump (fill the infusion set with insulin)
It is important that you change your infusion set every 2-3 days. Medtronic MiniMed offers a number
of different infusion sets for your pump. Instructions for the Quick-set® begin on the next page as an
example. Always refer to the instructions that shipped with your infusion set. After your infusion set
is inserted, continue to the section “Fixed prime.”
48 Chapter 4
Quick-set infusion set (with Quick-serter®)
Always refer to the instructions that shipped with your infusion set.
1 Wash your hands.
2 Clean and dry the infusion
site.
3
4
5
6
7
8
9
Starting on insulin 49
10
11
12
13
Disconnecting Quick-set
The Quick-set allows you the freedom to temporarily disconnect from your pump without removing
the infusion set from your body.
Hold the side grips of the
connector part with your
fingers.
50 Chapter 4
Twist the connector counterclockwise.
Remove the connector from the
site.
Reconnecting Quick-set
A fixed prime is used before reconnecting the Quick-set to ensure that all air is removed from the
tubing. Refer to the section, “Fixed prime” on the next page for instructions.
Place the connector part (flat-side facing down) on the infusion set until it is fully seated. Do not
grip the connector part by the flat side-grips.
Starting on insulin 51
Fixed prime
A fixed prime fills the soft cannula with insulin and is required after the infusion set is inserted into
your body and the introducer needle is pulled out. Additionally, a fixed prime is required prior to
reconnecting the tubing to the infusion set to ensure that all air is removed from the tubing.
NOTE - Prime amounts depend on the type of infusion set you are using. Refer to your infusion set
instructions for your fixed prime amount.
1 Go to the PRIME MENU.
Main > Prime
2 Select Fixed Prime and
press ACT.
PRIME MENU
Fixed Prime
Rewind
Prime History
ACT
3 In the FIXED PRIME screen,
enter the amount for your
type of infusion set, then
press ACT.
FIXED PRIME
0.
3U
ACT
4 Once the prime begins, the PRIME
DELIVERY screen will count up the
units as they are delivered. A
“beep” will sound when priming is
complete.
PRIME DELIVERY
6:26P
0.2
U
Prime history
Do these steps to see a list of the delivered primes.
1 Go to the PRIME MENU.
Main > Prime
3 The PRIME HISTORY screen
will appear.
2 Select Prime History
and press ACT.
PRIME MENU
Fixed Prime
Rewind
Prime History
52 Chapter 4
ACT
M
manual
prime
PRIME HISTORY
01JAN 12:05p
22.5M
0.5F
03JAN 01:15p
03JAN 01:17p
1.2M
F
fixed
prime
4 Scroll through the list of prime
deliveries. “F” at the end of the
text line indicates a fixed prime.
“M” indicates a manual prime.
Exit the menus.
Record keeping for diabetes management
Now that you are using the pump with insulin, we will be asking you to test your blood glucose
regularly. The information from your blood glucose journal is your healthcare professional's only
method of making adjustments in your pump settings. It is important to test often and write down
your blood glucose readings, the food you eat, any exercise you perform and any other notes to
explain your blood glucose results.
You must test at the recommended times and any other time that you feel your blood glucose is
high or low. Be sure to include your meal boluses, correction boluses, the amount of carbohydrate
you eat, basal rate and any other information that will be helpful in assisting your healthcare
professional in adjusting your pump settings.
It is very important to look at your blood glucose readings as feedback regarding your diabetes
management, not as statements about you or your self-worth. Try not to have an emotional reaction
to the numbers and do not judge them too harshly. You will soon learn how to modify the numbers
easily and precisely through insulin pump therapy.
TEST AT LEAST 4-6 TIMES A DAY.
These are the recommended times to test to determine control:
➠
➠
➠
➠
➠
Overnight (occasionally, at approximately 2 - 3 AM)
Pre-breakfast (fasting)
Post-breakfast (approximately 2 hours after eating)
Pre-lunch
Post-lunch (approximately 2 hours after eating)
Pre-dinner
➠ Post-dinner
(approximately 2 hours after eating)
➠ Bedtime
➠ Before driving
➠
Determining your pump settings
Your healthcare professional will use your daily blood glucose journal records to program your
pump. It is very important to keep good records during the first weeks after you start on pump
therapy. Not only must you record your blood glucose readings, but it will be important to eat
regularly scheduled meals and to keep your activity as consistent as possible.
Until you and your healthcare professional determine the pump settings that will work best for you,
it is important to eat meals for which it is easy to count the carbohydrates. After your correct basal
rate is determined, you will be able to experiment with varied food choices and amounts.
After you and your healthcare professional are satisfied with your initial pump settings, you may
begin to experiment with different food choices, meal times and exercise schedules.
Starting on insulin 53
Using your daily journal
To use the daily journal that came with your pump, follow these easy steps:
1 Write the day and date in the spaces provided on the top of the page.
2 Find the time of the entry you are making. Test your blood glucose and enter the value in the space
labeled “blood glucose.”
3 If you are eating at this time, write the grams of carbohydrates in the space labeled
“carbohydrates.”
4 If you are taking a correction and/or meal bolus, record it in the space labeled “meal bolus” and/or
“correction bolus.” Even if you have added these together to take one bolus, write the separate
amounts in the corresponding spaces.
5 Record your basal rate in the space labeled “basal rate.” If you have more than one rate, be sure to
record the rate in the space corresponding to the correct time for each rate.
6 When you exercise, write the minutes in the space labeled “exercise.” If you test your urine
ketones, write the result in the space labeled “urine ketones.” Each time you test your ketones,
write the result even if it is negative.
7 Record the time you change your infusion set in the space labeled “set change.” This notation will
help you to evaluate any changes in your blood glucose readings due to changing your infusion set.
8 Record the food you eat in the “breakfast,” “lunch,” and “dinner” columns.
9 In the “notes” section, write down any information that may explain your blood glucose values or
diabetes management decisions. Use this section as you would a personal journal.
10 At the end of the journal, there are blood glucose graphs. To draw your blood glucose graph for the
day, find the time you tested and follow the line up until you reach the corresponding blood glucose
on the left. Once you find it, mark a dot on the graph that corresponds to the correct time and blood
glucose value. At the end of the day, connect the marks and draw your graph. This graph will be
helpful in looking at patterns in your blood glucose values from day to day.
54 Chapter 4
Chapter 5
Using the Bolus Wizard feature
What is it?
A feature that calculates an estimated bolus:
➠
To support your food intake
AND/OR
➠
To correct high blood glucose
Information you need
Food entry
You need to know how many exchanges or grams of carbohydrates you are going to eat. (You need
to know what foods contain carbohydrate and understand carbohydrate counting.)
Your blood glucose reading
You need to know your blood glucose, BG, reading.
When using the Bolus Wizard feature, the pump can
work with a linked meter that may have been included
with your pump to automatically receive your BG
reading. The section “Meter option” in this chapter has
more information. If you are not using this meter, you
will manually enter your BG.
BG
Readings
Linked
Meter
Pump
Your personal Bolus Wizard feature
settings
In addition to your BG reading and/or your food entry, the Bolus Wizard feature uses personal
settings that you program into the pump. (For instructions see “How to program the Bolus Wizard
feature.”)
Carb units (grams or exchanges)
➠ Carb (food) ratios(in carbohydrate
grams/unit of insulin or insulin units/carb
exchanges)
➠
BG units (mg/dL or mmol/L)
➠ Insulin sensitivity
➠ Target blood glucose range
➠ Active insulin time (hours)
➠
Using the Bolus Wizard feature 55
Get this information from your healthcare professional, and, for best results, talk to your
healthcare professional before making any changes. Keep a record of your settings in the “Bolus
Wizard feature settings” table on this page and the next page.
Bolus Wizard feature settings
Information
Carb units:
Carb ratios:
Bolus Wizard feature uses this for your food bolus
calculations.
If you count carbs:
this ratio is the amount of carbohydrate grams covered by
one (1) unit of insulin.
range:3 – 150 grams/unit
If you count exchanges:
this ratio is the amount of insulin you need to cover one
(carb) exchange.
Setting
_____ grams or ____ exchanges
start time
#1: _________
(midnight)
#2: _________
#3: _________
(additional settings, if needed)
#4: _________
#5: _________
#6: _________
#7: _________
range:0.1 – 5.0 units/exchanges
NOTE - Your carb ratios may vary throughout the day.
Your pump allows you to program up to eight (8)
different carb ratios.
#8: _________
BG units: (how you measure your BG)
Insulin sensitivity:
This ratio is used for your correction bolus calculations.
This ratio is the BG units reduced by 1.0 units of insulin.
_____ mg/dL or _____ mmol/L
BG units reduced /
start time
1 unit of insulin
#1: _________
(midnight)
range:10 – 400 mg/dL or 0.5 - 22.2 mmol/L
#2: _________
#3: _________
(additional settings, if needed)
#4: _________
#5: _________
#6: _________
NOTE - Your insulin sensitivity may vary throughout the
day. Your pump allows you to program up to eight (8)
different insulin sensitivities.
56 Chapter 5
Bolus Wizard feature settings
Information
BG target range:
If your current BG is above the BG Target Range, the Bolus
Wizard feature will calculate a correction dose. If your
current BG is below the BG Target Range, the Bolus Wizard
feature will calculate a negative correction and subtract it
from your food bolus.
Range: 60 – 250 mg/dL or 3.9 - 13.9 mmol/L
NOTE - Your pump will allow you to program up to eight
(8) different BG target ranges.
Active insulin time:
The Bolus Wizard feature uses this time to calculate the
active insulin in your system (see “About active insulin” on
page 60). Use your healthcare professional’s
recommendation for the active insulin time that best
represents the insulin type you use and your physiological
insulin absorption rate.
Setting
#1: ____-_____
(midnight)
#2: ____-_____
#3: ____-_____
(additional settings, if needed)
#4: ____-_____
#5: ____-_____
#6: ____-_____
#7: ____-_____
#8: ____-_____
Number of Hours: _________
Range: 2 – 8 hours
Using the Bolus Wizard feature 57
How the Bolus Wizard feature works
1 If you want your current blood glucose to be factored in, enter your BG reading.
➠ Automatically from your linked meter (refer to the section “Meter option”)
or
➠
Manually by selecting
.
2 If you are going to eat, enter your food amount in carbs or exchanges.
3 The Bolus Wizard feature will calculate a bolus for you. An ESTIMATE DETAILS screen will appear
with your estimated total bolus amount.
NOTE - If you are using a linked meter, you can program your pump to automatically receive your
meter readings. The Bolus Wizard feature will use the BG reading when calculating your bolus
amount. Refer to the section “Meter option” in this chapter for instructions.
58 Chapter 5
More about the Bolus Wizard feature
About high or low BG levels
If your BG is less than 70 mg/dL (3.9 mmol/L) or
more than 250 mg/dL (13.9 mmol/L), the Bolus
Wizard feature screen will notify you and give
instructions. Read the instructions and press ACT or
ESC to clear the message. You can continue
programming and deliver your bolus.
LOW BG
DO NOT BOLUS UNTIL BG
IS NORMAL.
Treat low BG.
Monitor BG.
HIGH BG
Check for occlusion
Check ketones.
Consider insulin
injection.
Monitor BG.
ACT or ESC
About maximum delivery
Bolus Wizard feature will not deliver more than the limit set for
your maximum bolus. If the Bolus Wizard feature calculates a bolus
amount that is larger than your max bolus limit setting, the
message, “MAX BOLUS EXCEEDED” will appear. If this happens, do
these steps:
1 In the MAX BOLUS EXCEEDED screen, press ACT to continue your
bolus programming. The estimate and maximum bolus amounts
will appear for your information. Continue to step 2.
If you do not want to continue, press ESC to cancel and the screen
will return to the ENTER BG screen.
2 In the EST: MAX screen, press ACT again to continue your bolus
programming. If desired, press ESC to cancel and the screen will
return to the ENTER BG screen.
MAX BOLUS
EXCEEDED
ESC
to cancel
ACT
EST: 30.0U
MAX: 25.0U
ENTER BG
---
mg/dL*
*or mmol/L
NOTE - Your pump will only deliver up to your maximum bolus limit setting. For example: The
Bolus Wizard feature estimate is 30 units and your max bolus limit is 25 units. When you press
ACT, your pump will only deliver 25 units, and will notify you that your bolus estimate exceeds
your max bolus.
Using the Bolus Wizard feature 59
About active insulin
Active insulin is the bolus insulin that has already been delivered to your body, but has not yet been
used. The Bolus Wizard feature considers your active insulin time setting in determining any active
insulin still in your body from prior boluses. This may help prevent hypoglycemia caused by over
correcting for high blood glucose.
The Bolus Wizard feature automatically tracks active insulin
for you, based on your active insulin time, and subtracts the
appropriate amount when your BG is above target. The details
will appear in the ESTIMATE DETAILS screen during the bolus
programming steps.
Your Paradigm pump is shipped from the factory with an
active insulin time setting of six hours, which most closely
matches the published scientific data. If your healthcare
professional prescribes a different time for you, the active
insulin time setting can be adjusted in one-hour increments
from two to eight hours.
ESTIMATE DETAILS
4.0U
Est total:
45gr
Food intake:
160
(Meter) BG:
3.0U
Food:
2.0U
Correction:
1.0U
Active Ins:
ACT to proceed, ESC to
back up
If there is no
BG entry,
Active Insulin
displays as
“N/A”
(values shown are
for example only)
You can always choose to override the suggested Bolus Wizard feature estimate and manually enter
a different amount.
For more details about active insulin, see “Bolus Wizard feature specifications” on page 141.
CAUTION:
60 Chapter 5
The Bolus Wizard feature cannot correctly determine the active insulin in your
system after you have taken a manual injection of insulin. The manual
injection will not be recorded by the pump so your active insulin amount will
be read as too little. You must generally wait at least 8 hours after an injection
before relying on your Bolus Wizard feature to calculate your active insulin.
But, the length of time you need to wait depends on your active insulin setting
in the Bolus Wizard feature. See “About active insulin” on page 60 for more
information.
How to program the Bolus Wizard feature
You need your personal settings from the Bolus Wizard feature settings table to setup the Bolus
Wizard feature. Your Bolus Wizard feature settings are programmed in the EDIT SETTINGS screen.
Main > Bolus > Bolus Wizard Setup > Edit Settings
Once the settings are programmed, you do not have to program them again unless the values
change. After you program one setting, the screen will automatically go to the next required setting.
After you program all your settings, review them as described in this section to make sure they are
set correctly.
Instructions for programming the Bolus Wizard feature settings are in the next paragraphs. Program
your settings in the order described to make sure you program all the settings.
Bolus Wizard feature On/Off
1 Go to the EDIT SETTINGS screen.
Bolus > Bolus Wizard Setup >
Edit Settings
3 Select On or Off and
press ACT.
2 Select Wizard and press ACT.
EDIT SETTINGS
Off
Wizard
Carb Units:
----BG Units:
ACT
WIZARD ON/OFF
Off
On
ACT
4 The EDIT SETTINGS
screen will appear.
Press ACT to program
your settings.
EDIT SETTINGS
Wizard:
On
Carb Units:
--BG Units:
---
ACT
Using the Bolus Wizard feature 61
Carb units
The carb unit setting lets the pump know which way to count your carbohydrates (grams or
exchanges). Refer to the “Bolus Wizard feature settings” table for your carb ratio settings.
NOTE - Any time you make changes to the carb units, you must also reprogram the carb ratios.
1 In the EDIT SETTINGS
screen, select Carb Units
and press ACT.
EDIT SETTINGS
Wizard:
On
Carb Units:
Carb Units:- - BG Units:
---
2 Select Grams or
Exchanges and press ACT.
3 The screen will return to
the EDIT SETTINGS screen
so you can set your carb
ratios next.
EDIT SETTINGS
Wizard:
On
grams
Carb Units:
Carb Ratios:
---
CARB UNITS
Grams
Exchanges
Carb/Exch ratios
If you use grams as your carb units: Carb ratio is the number of carb grams that are covered by one
unit of insulin.
If you use exchanges as your carb units: Carb ratio is the number of insulin units that are needed to
cover one (1.0) carb exchange.
Because this ratio may vary throughout the day, your pump allows you to set up to eight (8)
settings. Your healthcare professional may only have you program one or two carb ratios when you
first start using the Bolus Wizard feature.
4 In the EDIT SETTINGS screen, select
Carb Ratios and press ACT.
5 The screen will change to SET CARB
RATIO 1 (if you are using grams) or SET
EXCH RATIO 1 (if using exchanges).
Set your first ratio and press ACT. (The
start time for your first ratio is midnight
(12:00A) and cannot be changed.)
62 Chapter 5
using exchanges
using grams
EDIT SETTINGS
Wizard:
On
grams
Carb Units:
Carb Ratios:
---
EDIT SETTINGS
Wizard:
On
exch
Carb Units:
Carb Ratios:
--- ---
ACT
SET CARB RATIO 1
12:00A
grams
/U
15
ACT
(flashing)
set, then
press ACT
SET EXCH RATIO 1
12:00A
1.0
U/exch
WARNING
A carb ratio of XX is valid
but outside the usual
range of 5-50.*
ESC to correct,
ACT to continue
NOTE - Carb ratio values are normally between 5–50 grams/u or 0.3–
3.0 u/exch. If your ratio value is outside the range, this warning
message will appear on the screen. Press ESC to correct or ACT to
continue.
(* 0.3 - 3.0 for exch)
To set just one ratio:
a. Press ESC.
using grams
SET START TIME 2
_:_
grams
/U
__
(flashing)
using exchanges
SET START TIME 2
_:_
U/exch
__
(flashing)
To set more than one carb ratio:
a. Set the start time
using grams
for the next ratio SET START TIME 2
and press ACT.
_:_
__
b. Set the value for
the next ratio and
press ACT.
c. Repeat steps a
and b to set more
ratios.
d. Press ESC when
you are done.
6 The screen will return to the EDIT SETTINGS
screen. Set your BG Units as described in the
next section.
grams
/U
using exchanges
SET START TIME 2
_:_
U/exch
__
(flashing)
set then press ACT
SET CARB RATIO 2*
7:00A
grams
/U
__
SET EXCH RATIO 2*
7:00A
U/exch
__
* Depending on how many ratios you set,
this number can be 2 through 8.
EDIT SETTINGS
Wizard:
On
grams
Carb Units:
Carb Ratios:
->
Using the Bolus Wizard feature 63
BG units
You can select mg/dL or mmol/L as your Blood Glucose Unit (measurement type).
NOTE - If you make changes to your BG units setting, you must reprogram your insulin sensitivity
and BG targets.
7 In the EDIT SETTINGS
screen, select BG Units
and press ACT.
EDIT SETTINGS
Carb Units: grams
Carb Ratios:- >
BG Units:- - -
8 Select mg/dL or
mmol/L and press ACT.
BLOOD GLUCOSE UNITS
mg/dL
mmol/L
9 The screen will return to the
EDIT SETTINGS screen to set
your insulin sensitivity next.
EDIT SETTINGS
--Sensitivity:
--BG Target:
Active Ins Time:
---
Insulin sensitivity
Your insulin sensitivity is the amount your blood glucose (BG) level is reduced by one unit of insulin.
This value is used to calculate a suggested insulin dose to correct a high BG. Because this amount
may vary throughout the day, your pump lets you set up to eight (8) sensitivity settings. Your
healthcare professional may only have you program one or two insulin sensitivities when you first
start using the Bolus Wizard feature. Record your settings in the “Bolus Wizard feature settings”
table.
Insulin sensitivity values are normally between 20 – 100 mg/dL (or 1.1 – 5.6 mmol/L). If your value
is outside this range, a warning message will appear on the screen.
1 In the EDIT SETTINGS screen, select Sensitivity
and press ACT.
2 Enter the value for the first insulin sensitivity
setting and press ACT.
NOTE - The start time for your first insulin
sensitivity is midnight (12:00A) and cannot
be changed.
64 Chapter 5
EDIT SETTINGS
Carb Ratios:
--->
BG Units:
mg/dL
Sensitivity:
---
ACT
INS SENSITIVITY 1
12:00A
mg/dL
per unit insulin
__
(flashing) set, then
press ACT
3 The SET START TIME 2 screen will appear.
4 To set just one insulin sensitivity:
To set more than one insulin sensitivity:
Press ESC.
SET START TIME 2
_:_
___
mg/dL
per unit insulin
a. Set the start time for
the next insulin
sensitivity and press
ACT.
SET START TIME 2*
7:30A
___
mg/dL
per unit insulin
(flashing) set, then press ACT
(flashing)
b. Set the value for the
next insulin sensitivity
and press ACT.
c. Repeat steps a and b
to set more values.
d. Press ESC when you
are done.
INS SENSITIVITY 2*
7:30A
50
mg/dL
per unit insulin
(flashing) set, then press ACT
* Depending on how many
values you set, this number
can be 2 through 8.
5 The screen will return to the EDIT SETTINGS screen. You can now program your BG target(s).
The BG target setting allows you to set glucose
targets. Because your targets may vary throughout the
day, your pump allows you to set up to eight (8) BG
targets each day. If you want to set just one target
value instead of a range, set both the low and high
values to the same number.
If your current BG is above the BG Target Range, the
Bolus Wizard feature will calculate a correction dose.
If your current BG is below the BG Target Range, the
Bolus Wizard will calculate a negative correction and
subtract it from your food bolus.
Glucose Concentration
BG targets
(mmol/L)
22.2
(mg/dL)
400
13.9
250
5.6
100
3.8
70
Target Range
Correct down to upper limit
(mg/dL)
100
(mmol/L)
5.6
Correct up to the lower limit
(mg/dL)
70
(mmol/L)
3.8
NOTE - Pumps are sent from the factory with default BG target of 100 - 100 mg/dL (5.6-5.6
mmol/L). If you adjust your BG Targets outside of 90-140 mg/dL (5.0-7.8 mmol/L) the pump
screen displays a warning that the values are acceptable but outside normal range.
Using the Bolus Wizard feature 65
1 In the EDIT SETTINGS screen, select BG
Target and press ACT.
2 Enter the low end of your BG target range
and press ACT.Then enter the high end of
your BG target range and press ACT.
EDIT SETTINGS
mg/dL
BG Units:
Sensitivity:
->
BG Target:
---
ACT
TARGET RANGE 1
12:00A
mg/dL
100 - 100
first
BG Target
Range
(flashing)
NOTE - The start time for your first BG target range is midnight (12:00A or 00:00) and cannot
be changed.
3 The screen will display one of these messages:
4 To set just one BG Target:
a. Press ESC.
SET START TIME 2
_:_
mg/dL
_-_
(flashing)
press ESC
To set more than one BG Target:
a. Set the start time for
the next BG target
range and press ACT.
_ - _mg/dL
(flashing) set, then press
ACT
b. Set the low and high
values for the next BG
target range and
press ACT.
c. Repeat steps a and b
to set more BG target
ranges.
d. Press ESC when you
are done.
66 Chapter 5
SET START TIME 2*
_:_
TARGET RANGE 2*
_:_
mg/dL
100 - 100
(flashing) set, then press
ACT
*Depending on how many
targets you set, this number
can be 2 through 8.
Active insulin time
The active insulin time setting lets the pump know which active insulin time to use in calculating
the amount of active insulin to subtract before estimating a bolus. Refer to “About active insulin” on
page 60 for more information about this setting.
Your healthcare professional should determine the active insulin time that is best for you. To set
the time, take the following steps:
1 In the EDIT SETTINGS
screen, select Active
Ins Time and press
ACT.
EDIT SETTINGS
Sensitivity:
BG Target:
Active Ins Time:
Message
2 Set the number of hours for
the active insulin time and
press ACT.
3 The screen will return to
the EDIT SETTINGS screen
where you can see the
new setting.
ACTIVE INS TIME
->
->
---
6
hr
(flashing) set, then
press ACT
EDIT SETTINGS
Sensitivity:
->
BG Target:
->
Active Ins Time:
6
What it means
➠ “Bolus
Wizard setup is complete” ... Bolus Wizard feature is on and all settings are programmed.
➠ “Bolus
Wizard is off”................... Bolus Wizard feature is off.
➠ “Missing
Info” ........................... Bolus Wizard feature is on, but some of the settings are not
programmed.
This screen will show instructions and the missing
information.
You must program the missing information before you can
use the Bolus Wizard feature.
Using the Bolus Wizard feature 67
Review your Bolus Wizard feature settings
Check your Bolus Wizard feature settings in the REVIEW SETTINGS screen. If necessary, compare this
information with your information in the Bolus Wizard feature settings table.
Bolus > Bolus Wizard Setup > Review Settings
1 In the REVIEW SETTINGS screen, scroll through the text
to view your Bolus Wizard settings.
2 Exit the menus when you are done.
WIZARD SETUP
Edit Settings
Review Settings
ACT
REVIEW SETTINGS
On
Wizard
grams
Carb Units:
Carb Ratios:
15
12:00A
10
6:00A
mg/dL
BG Units:
Sensitivity:
30
12:00A
35
6:00A
BG Target:
90-120
12:00A
100-140
6:00A
Active Ins Time:
6
Meter option
You can set up your pump to automatically receive
your BG reading from a linked meter. This meter may
have been included with your pump and may not be
available in all countries. Check with your local
Medtronic MiniMed representative. Your pump is set at
the factory with the meter option turned off.
Programming your meter ID links your pump to the
meter. If you do not “link” the meter to your pump,
you will enter your BG readings manually. Each meter
has its own unique ID. You can link up to three (3)
meters to your pump.
BG
Readings
Linked
Meter
Pump
When the pump is idle (at the HOME screen), it will beep or vibrate when it receives a BG reading
from the meter. The reading will appear on the pump screen.
NOTE - The use of RF (radio frequency) devices with the pump reduces pump battery life.
You have to turn on the meter option to add, delete or review the meter ID(s) programmed in your
pump. The ID is the serial number printed on the back of the meter. See the user guide that came
with your meter for detailed information on how to use it.
68 Chapter 5
Meter rules
If you want your pump to communicate with the meter, the following conditions must apply:
1 The meter option must be turned on and programmed. Refer to the instructions in this section.
2 Your pump must be within 4 feet (1.2 meters) of your meter to receive the BG reading.
3 The pump cannot have a Low Battery alert condition.
4 When programming a bolus, the BG measurement from the meter will appear as the default BG
value on the ENTER BG screen. The pump will not display a reading that is older than 12 minutes on
the ENTER BG screen.
5 Make sure the pump’s Meter Option is set to Off while onboard aircraft.
6 Do not use the RF meter to send your BG readings to the pump while onboard aircraft. Manually
enter your BG.
CAUTION: The pump will not receive signals from the linked meter while it has a Low Battery
alert condition. To ensure the meter communicates with the pump, make sure the
pump does not have a low battery. (Replacing the low battery with a new battery will
restore meter-pump communication.)
Add, delete, review meter IDs
The meter programming screens are very similar to those for the remote control. Make sure to
select Meter Options (in the UTILITIES MENU) when programming your meter.
If you are not sure that your meter ID is entered in your pump, check the REVIEW METER ID screen.
You have to turn on the meter option to add, delete or review the meter ID(s) programmed in your
pump.
Main > Utilities > Meter Options
1 In the METER OPTION screen, select On and
press ACT. The METER ID MENU will appear.
METER OPTION
Off
On
ACT
METER ID MENU
Add ID
Delete ID
Review ID
Using the Bolus Wizard feature 69
2 Add, delete or review your meter ID(s) as desired.
Add
Delete
Review
a. Select Add ID and press
ACT.
a. Select Delete ID and
press ACT.
a. Select Review ID and
press ACT.
b. Use the up and down
arrow buttons to enter
each of the six ID
numbers. Press ACT after
each entry.
b. Select the meter ID that you
want to delete and press
ACT.
b. The programmed IDs will
show in the REVIEW
METER ID screen.
ADD METER ID
- - - - - - (flashing)
c. After you set the last
number of the ID, the
screen will return to the
METER ID MENU.
METER ID MENU
Add ID
Delete ID
Review ID
3 Exit the menus when your are done.
70 Chapter 5
DELETE METER ID
1 111111
2 222222
3------
c. The selected ID is now
deleted.
DELETE METER ID
1-----2 222222
3------
REVIEW METER ID
1-----2 222222
3------
Normal bolus using Bolus Wizard feature
After the Bolus Wizard feature is turned on and programmed, this feature can calculate an
estimate of insulin you need for your correction bolus and/or your food bolus. You have the option of
using the estimate or changing it as necessary. Additionally, your pump can receive your BG reading
from the meter, if they are linked.
Use
to deliver a Normal bolus at any time except during another Normal bolus. A Normal bolus
will temporarily interrupt a Square Wave or Dual Wave bolus that is delivering. After the Normal
bolus is finished, the Square Wave or Dual Wave bolus delivery will resume.
NOTE - If you want to use the pump-to-meter link, make sure the meter option is on. Refer to the
section “Meter option” for instructions.
1 If you want a correction bolus, check your BG with your BG meter and go to step 2. If you want to
bolus for food, go to step 2.
2 Press
on your pump, or go to the BOLUS MENU, select Use Bolus Wizard, and press ACT.
3 The ENTER BG screen will appear.
If you are NOT using a linked meter:
Enter your BG value. Press ACT and continue to
step 4.
If you are not entering a BG
and want to bolus for food,
select the dashes in the
ENTER BG screen. Press ACT
and continue to step 4.
ENTER BG
---
mg/dL*
* or mmol/L
NOTE - Selecting dashes in this screen will
make the Bolus Wizard feature calculate
the insulin needed for your food entry
without considering your BG level.
If you are using a linked meter:
The meter reading will flash
on the pump screen. Press
ACT to accept this amount.
(You can change this BG
value, if necessary.)
Continue to step 4.
ENTER BG
Meter
XXX mg/dL*
* or mmol/L
NOTE - You must program your bolus within 12
minutes of the pump receiving the reading from
the meter. If more than 12 minutes have
passed, the reading will no longer be available
from the screen and you must enter your BG
manually.
Using the Bolus Wizard feature 71
4 In the ENTER FOOD screen,
If this is a food bolus:
If this is a correction bolus:
Enter the food value you will Select 0 (zero) as the value and
eat and press ACT.
press ACT.
ENTER FOOD
45
ENTER FOOD
grams*
0
* or exch
(flashing)
5 Review the information in the ESTIMATE DETAILS screen.
Press ACT to continue to step 6. If you need to make any
changes, press ESC to return to the ENTER BG screen
(step 3) and make changes as necessary.
ESTIMATE DETAILS
Est total:
4.0U
Food intake:
45gr
(Meter) BG:
160
3.0U
Food:
2.0U
Correction:
1.0U
Active Ins:
ACT to proceed,
ESC to back up
SET BOLUS
Estimate
NOTE - If you have BG Reminder turned on, a screen
displays allowing you to accept or modify the length of
time after this bolus before you are reminded to check
your BG. See “BG reminder” on page 25 for information
about this feature.
7 The BOLUS DELIVERY screen appears. The pump will beep
or vibrate at the start and end of the bolus. As the bolus is
delivered, the screen shows the bolus type and amount
until the total units have been delivered. The screen then
defaults to the HOME screen.
72 Chapter 5
* or exch
(flashing)
(values shown are
for example only)
ESC
returns to the
ENTER BG screen
ACT
to continue
6 In the SET BOLUS screen, the estimated bolus amount
shows (flashing). Change the amount if desired. Press ACT
to accept and start delivery of the bolus.
grams*
4.0 U
ACT
to accept
BOLUS DELIVERY
3:24P
NORMAL
0.1
U
Bolus Wizard feature examples
For the scenarios that follow, Michael has his Bolus Wizard feature turned on with the following settings:
Carb ratio: 15 grams per unit of insulin
Insulin Sensitivity: 40 mg/dL per unit of insulin
BG Target: 90-120 mg/dL
Active Insulin Time: 6 hours
NOTE - If you want to see details of the formulas the Bolus Wizard feature uses to calculate
estimate boluses like the ones in the following examples, see “Bolus Wizard feature
specifications” on page 141.
Example 1: BG on target (normal BG) and no active insulin
Michael awakens in the morning before school and his mother has breakfast waiting for him. Before he
begins eating, he tests his blood glucose with his linked meter and his BG result of 120 mg/dL is
automatically sent to his pump.
He estimates that his meal consists of 60 grams of carbohydrates. When prompted by the Bolus Wizard
feature, he enters this amount in the ENTER FOOD screen. Based on his Bolus Wizard feature settings,
the pump will suggest that he take 4.0 units of insulin.
(food estimate)
60g
15g/u
= 4 units
+
(correction)
Correction is 0 because the current BG
reading is within the BG Target Range
=4+0
= 4 units
estimate = 4 units
Using the Bolus Wizard feature 73
Example 2: BG above target (high BG) and no active insulin
The next day, Michael wakes up before school. Before eating the same breakfast, he tests his BG with his
linked meter and finds it to be 200 mg/dL, which is above his target of 120 mg/dL. His BG reading is
automatically sent to his pump.
When prompted by the Bolus Wizard feature, he enters his carbohydrate amount of 60 grams in the
ENTER FOOD screen. Based on his settings, the pump will suggest that he take 6.0 units of insulin.
(food estimate)
60g
15g/u
= 4 units
+ (correction)
200mg/dL - 120mg/dL
40mg/dL/u
= 2 units
=4+2
= 6 units
estimate = 6 units
Example 3: BG below target (low BG) and no active insulin
On another morning, Michael sits down before eating the same breakfast. He tests his BG with his linked
meter and finds it at 70 mg/dL, which is below his Low BG target of 90 mg/dL. His reading is
automatically sent to his pump.
When prompted by the Bolus Wizard feature, he enters his carbohydrate amount of 60 grams in the
ENTER FOOD screen. Based on his settings, the pump will suggest that he only take 3.5 unit of insulin.
(food estimate)
= 4 + (-0.5)
= 3.5 unit
estimate = 3.5 unit
74 Chapter 5
60g
15g/u
= 4 units
+ (correction)
70mg/dL - 90mg/dL
40mg/dL/u
=
-20mg/dL
40mg/dL
= -0.5 unit
Example 4: BG above target (high BG) with active insulin
Michael is at school and wants to eat a snack in the late morning. He tests his BG with his linked meter
and finds it to be at 200 mg/dL, which is above his target of 120 mg/dL. He estimates that his snack
contains 60 grams of carbohydrate, so he enters 60 into the pump when prompted by the Bolus Wizard
feature. Based on his settings, and as a result of 1.5 units of active insulin, his pump will suggest that he
take 4.5 units.
(food estimate)
60g
15g/u
= 4 units
(correction)
+
200mg/dL - 120mg/dL -1.5 units (active insulin)= 2 - 1.5 = 0.5 units
40mg/dL/u
= 4 + 0.5
= 4.5 units
estimate = 4.5 units
Using the Bolus Wizard feature 75
Example 5: BG below target (low BG) with active insulin
Another day at school, Michael is getting ready to eat lunch. He tests his BG with his linked meter and
finds it at 70 mg/dL (3.9 mmol/L), which is below his Low BG target of 90 mg/dL (4.9 mmol/L). His
reading is automatically sent to his pump.
When prompted by the Bolus Wizard feature, he enters his carbohydrate amount of 60 grams in the
ENTER FOOD screen. Based on his settings, and despite 1.5 units of active insulin, his pump will suggest
that he take 3.5 units of insulin.
(food estimate)
60g
= 4 units
15g/u
+
(correction)
70mg/dL - 90mg/dL -20mg/dL
- 0 (active insulin*) = -0.5 unit
=
40mg/dL
40mg/dL/u
= 4 + (-0.5)
= 3.5 unit
estimate = 3.5 unit
*Note: When the current BG is below the target low BG, an active insulin amount that is greater than the correction estimate is not
considered in the Bolus Wizard feature calculations.
76 Chapter 5
Chapter 6
Optimizing pump therapy
Square Wave and Dual Wave bolus
Square Wave bolus delivers a bolus evenly over a period of time (30 minutes to 8-hours). This bolus
can be used for insulin delivery when you have eaten a long meal with extended snacking. It can also
be useful if you have delayed food digestion due to gastroparesis or meals high in fat. A Square Wave
bolus can be useful if a Normal bolus drops your BG too rapidly. Since the Square Wave portion
extends over a period of time, the insulin is more likely to be available to match your individual
needs.
NOTE - During delivery of a Square Wave bolus, you will not be able to do the following pump
functions: change the max bolus amount, disable or deliver Dual and Square Wave boluses, do a
fixed prime or rewind, change the active insulin time, run a selftest, or access the User Settings
menu. All other pump functions are still available during the Square Wave bolus.
Dual Wave bolus delivers a combination of an immediate Normal bolus followed by a Square Wave
bolus. The Square Wave portion is delivered evenly over a period of time. A Dual Wave bolus is useful
for meals with both rapidly and slowly absorbed carbohydrates. For example, a Dual Wave bolus
would be appropriate for fruit and crackers followed by pasta. The Dual Wave option meets both
immediate and extended insulin needs. A Dual Wave bolus is also useful for correcting elevated blood
glucose before a meal.
See the following graphic for a description of the different bolus types:
INSULIN
Entire bolus amount
delivered immediately
NORMAL
BOLUS
1
Bolus amount delivered evenly
over specified time period.
SQUARE WAVE
BOLUS
2
Part of the bolus amount delivered
immediately and the remainder
delivered evenly over time period
DUAL WAVE
BOLUS
Now
Portion
3
Square
Portion
TIME
Optimizing pump therapy 77
Dual Wave/Square Wave bolus On/Off
NOTE - It is important that you consult with your healthcare professional before using a Square
Wave or Dual Wave bolus. You should be familiar with the basic functions of your pump before
exploring these options.
To set up a Dual Wave or Square Wave bolus, you must first turn on the Dual/Square bolus option. If
the option is off, a Dual Wave or Square Wave bolus cannot be programmed or delivered.
1 Go to the DUAL/SQUARE OPTION screen.
Main > Bolus > Dual/Square Bolus
2 Select On and press ACT. The feature is now on. Exit the menus.
DUAL/SQUARE OPTION
Off
On
Square Wave or Dual Wave bolus without Bolus Wizard feature
NOTE - To deliver a Square Wave or Dual Wave bolus, the Dual/Square bolus option must be on.
1 Make sure the Dual/Square option is on.
2 Calculate your food and/or correction bolus amount.
3 Press
on your pump, or go to the BOLUS MENU and select Set Bolus (or Manual Bolus), then
press ACT.
4 The BOLUS TYPE (or MANUAL BOLUS TYPE) screen will appear.
78 Chapter 6
For a Square Wave bolus do these steps:
For a Dual Wave bolus do these steps:
a. Select Square Wave Bolus. Press ACT.
The SET SQUARE BOLUS screen will appear.
a. Select Dual Wave Bolus and press ACT. The
SET DUAL BOLUS TOTAL screen will appear.
b. Enter the desired amount
for the Square Wave
bolus units and press
ACT.
b. Enter the desired amount
for the total dual bolus
units. Press ACT.
c. Continue to step 5.
SET SQUARE BOLUS
1.2U
SET DUAL BOLUS TOTAL
1.2U
NOTE - The number of units you enter for
the SET DUAL BOLUS TOTAL is a total of
both the Normal and Square Wave bolus
units.
c. In the next screen, press
Now:
/
to change the
50%
Square:
normal (Now) and Square
50%
portions of the Dual Wave
bolus. Notice the screen
also shows the percentage
amount for each portion. Press ACT.
0.6U
0.6U
ACT
d. Continue to step 5.
5 The SQUARE DURATION screen will appear. Enter the amount of time you want
the Square Wave bolus to last and press ACT.
NOTE - If you have BG Reminder turned on, a screen displays allowing you
to accept or modify the length of time after this bolus before you are
reminded to check your BG.
SQUARE DURATION
Sq: 1.2U
0:30
6 The BOLUS DELIVERY screen will appear. The pump will beep or vibrate at the start and end of the
bolus. During bolus delivery, the pump will return to the HOME screen. An open circle will appear
indicating that your pump is in Special mode.
Optimizing pump therapy 79
Square Wave bolus practice
Your target pre-meal blood glucose range is ______ to _______.
Check your pre-meal blood glucose. Are you within your target? _____ If yes, continue. If no, wait to
try the following test until your pre-meal blood glucose is within your target range:
TEST:
Choose a meal that is high in fat (e.g. hot dogs, pizza, cheese enchiladas). Determine your
meal bolus amount. Set the Square Wave bolus to deliver the determined amount of insulin
over 2-hours1.
Check your BG (blood glucose) and record:Pre-meal ________
1 hour post meal ________
2 hours post meal ________
3 hours post meal ________
4 hours post meal ________
Did your blood glucose return to your pre-meal target within 4 hours post meal? ________2
1
This duration of time and ratio is an example. As always, consult with your healthcare professional for guidance.
If you answered YES, then repeat this test with the same meal on another day to verify your results. If you answered NO, discuss this
with your healthcare professional for guidance.
2
80 Chapter 6
Dual Wave bolus practice
Can you think of any meals where this feature would help you with blood glucose control?
Your target pre-meal blood glucose range is ______ to _______
Check your pre-meal blood glucose. Are you within your target? _____ If yes, continue. If no, try this
test when your pre-meal blood glucose is within your target range:
TEST:
Choose a meal that has a combination of both rapidly absorbed and slowly absorbed
carbohydrates. Determine your meal bolus amount. Set the Dual Wave bolus to deliver the
determined amount of insulin. Program your pump to deliver ½ over 2-hours1, and the other
half immediately.
Check blood glucose and record:
Pre-meal________
1 hour post meal________
2 hours post meal________
3 hours post meal________
4 hours post meal________
Did your blood glucose return to your pre-meal target within 4 hours post meal? ________2
1This
duration of time and ratio is an example. As always, consult with your healthcare professional for guidance.
If you answered YES, repeat this test with the same meal on another day to verify results. If you answered NO, discuss this with your
healthcare professional for guidance.
2
Optimizing pump therapy 81
Using the Bolus Wizard feature for a Square Wave or Dual Wave bolus
If you are using the Bolus Wizard feature to calculate your Square Wave or Dual Wave bolus
amounts, you will be prompted to enter your BG reading and/or the carb/exchange units you will
eat. The Bolus Wizard feature will use this input to calculate your suggested correction and/or food
bolus amount. If you do not want to use the Bolus Wizard feature estimate, you can change it, if
desired.
1 The Bolus Wizard feature must be turned on and the settings must be programmed. Also, make sure
the dual/square option is turned on.
NOTE - If you want to use the pump-to-meter link, make sure the meter option is on. Refer to
the section “Meter option” for instructions.
2 After you enter your BG and/or food entry, review the
information in the ESTIMATE DETAILS screen. Press ACT to
continue to step 3. If you need to make any changes, press
ESC to return to the ENTER BG screen and make changes as
necessary.
3 In the next screen, select Square Wave Bolus
or Dual Wave Bolus as desired and press ACT.
ESTIMATE DETAILS
Est total:
4.0U
Food intake: 15gr
(Meter) BG:
227
Food:3.0U
Correction:2.5U
Active Ins:
1.5U
ACT to proceed,
ESC to back up
(using the Bolus Wizard
feature)
(without the Bolus
Wizard feature)
BOLUS EST: 4.0U
Normal Bolus
Square Wave Bolus
Dual Wave Bolus
BOLUS TYPE
Normal Bolus
Square Wave Bolus
Dual Wave Bolus
ACT
ACT
NOTE - If you are using the Bolus Wizard
feature and it calculates that your bolus includes a portion to
correct your high BG, the Square Wave bolus will not be
available. This helps you to select a bolus type (Normal or Dual
Wave) that has an immediate delivery option to cover your high
BG.
82 Chapter 6
(values shown are
for example only)
BOLUS EST: 4.0U
Normal Bolus
Dual Wave Bolus
4 For a Square Wave bolus do these steps:
For a Dual Wave bolus do these steps:
The SET SQUARE BOLUS screen will appear.
NOTE - The number of units you program for the
Change the amount if desired. Press ACT to
SET DUAL BOLUS TOTAL is a total of both the
accept.
Normal and Square Wave bolus units.
SET SQUARE BOLUS
Estimate
4.0U
ACT
a. The SET DUAL BOLUS TOTAL
screen will appear. Change
the amount if desired. Press
ACT to accept.
SET DUAL BOLUS TOTAL
Estimate
4.0U
ACT
b. In the next screen, notice the
Now:
screen shows the Normal
2.5U
62%
(Now) and Square portions of Square:
1.5U
38%
the Dual Wave bolus. Press
ACT
ACT to accept the portions
suggested by the Bolus Wizard
feature, or press
to change these
/
portions then press ACT.
NOTE - The Bolus Wizard feature recommends
splitting the food portion of your bolus 50/50
between the Square and Now portions. The entire
correction amount is always recommended to the
Now portion. In this example the Now portion
consists of half of the food insulin plus the
correction amount less the active insulin
(1.5U+2.5U-1.5U). This gives 2.5U or 62% of total
insulin of 4.0U. The Square portion consists of the
other half of the food insulin (1.5U) which is 38%
of total insulin of 4.0U.
5 The SQUARE DURATION screen will appear. Enter the amount of time you want
the Square Wave bolus to last and press ACT.
Square Duration
Sq: 1.2 u
0:30
ACT
Optimizing pump therapy 83
NOTE - If you have BG Reminder turned on, a screen displays allowing you to accept or modify
the length of time after this bolus before you are reminded to check your BG.
6 Press ACT to accept and deliver the bolus. The BOLUS DELIVERY screen
appears.The pump beeps or vibrates at the start and end of the bolus. Shortly
after bolus delivery begins, the screen defaults to the HOME screen. An open
circle will appear indicating that your pump is in Special mode. If you want to
see the progress of the delivery, press ESC to see the STATUS screen.
BOLUS DELIVERY
3:24P
Square
0.1U
ACT
Easy bolus
The EASY BOLUS button
allows a quick way to deliver a Normal bolus. You will pre-set the
settings for this feature in the EASY BOLUS OPTION screen in the BOLUS MENU. Your pump is sent from
the factory with the Easy Bolus feature set to on. If you do not want to use Easy Bolus, turn it off.
After you set up Easy Bolus, with each
press, you can increase the Normal bolus amount by a
fixed amount, called a “step.” Before you can deliver an Easy Bolus, you must set the amount in the
EASY BOLUS ENTRY screen. This amount equals the number of units of insulin for each step. The
maximum number of steps can equal up to your maximum bolus limit.
NOTE - When using vibrate mode, EASY BOLUS is limited to 20 steps or maximum bolus,
whichever comes first.
Once you set your step amount, you can program your Easy Bolus. When you are in the HOME
screen, each time you press
the Easy Bolus amount increases by one “step.” You will hear a beep
or feel a vibration for each step increase. Each beep is a different tone. This makes it easy for you to
count the beeps while you are programming your Easy Bolus.
Easy bolus setup
1 Go to the EASY BOLUS OPTION screen.
Main > Bolus > Easy Bolus
Select On/Set and press ACT. If you do not
want to use Easy Bolus, select Off and press
ACT.
EASY BOLUS OPTION
Off
On/Set
NOTE - If you are using the remote control, the Easy Bolus must be set to on.
84 Chapter 6
Step value setup
You can set the step value from 0.1 to 2.0 units (factory setting: 0.1). Set the step to a number that
is convenient to use and easy to multiply.
Example:
2.0 unit Easy bolus with a step
amount set at 0.5 units
Total # Steps = 4
Total # Button Presses = 4
4
1 Step = 0.5 units
3
1 Step = 0.5 units
2
1 Step = 0.5 units
1
0
1 Step = 0.5 units
0
0.5
1.0
1.5
2
Total # Units
2 In the EASY BOLUS ENTRY screen, the “step”
value will appear flashing. Change the value
and press ACT (The step value is the
increment you will use for your Easy bolus.)
3 The screen will return to the BOLUS MENU.
Your step amount is now programmed and
Easy Bolus is ready to use. Exit the menus.
EASY BOLUS ENTRY
0.1 U
(flashing)
Deliver Easy Bolus
/
EASY BOLUS ENTRY
0. 5 U
ACT
BOLUS MENU
Dual/Square Bolus
Easy Bolus
BG Reminder
ESC
Practice using the Easy Bolus feature while looking at the pump screen as you count the beeps.
After you are familiar with Easy Bolus, you can use the audible tones for bolus delivery without
having to look at the screen.
NOTE - Easy bolus only works from the HOME screen.
1 From the HOME screen, press
. The SET EASY BOLUS
screen will appear. The single “step” value will be flashing.
SET EASY BOLUS
0.1
U
(flashing)
Optimizing pump therapy 85
2 Press
the number of times needed for your bolus amount.
Watch the amount change on the screen with each press. The
pump will vibrate or sound a different tone for each
press. When your total bolus amount appears on the screen,
press ACT. Listen/feel to count the steps without looking at
the screen.
SET EASY BOLUS
x 10
1.0
U
ACT
For example: You need to deliver a 1.0 unit bolus, and your step size is set to 0.1. Each time you
press
, the units increase by the “step” amount. To deliver 1.0 units, you need
to press the
button 10 times. (10 X 0.1 = 1.0) The screen will show 1.0 units.
NOTE - Pressing
or ESC will cancel the Easy bolus. For your safety you cannot use the
to select the Easy Bolus values.
3 If this amount is correct, press ACT to start the
Easy Bolus delivery. The BOLUS DELIVERY
screen will show the units being delivered.
When the total bolus is finished, the pump will
beep or vibrate.
If this amount is wrong, press ESC or
to
start over. The pump will return to the HOME
screen.
86 Chapter 6
SET EASY BOLUS
1.0
U
ACT
to accept
ESC
to cancel
BOLUS DELIVERY
1:32P
Normal
U
0.1
Example 1: Easy bolus
Alexander is a busy executive with an accounting firm. He wears his Paradigm pump on his belt and
does not want to take it off to give himself a bolus. Alex can easily reach down and feel for the Easy
Bolus button
to give a bolus.
He previously programmed his pump to deliver an Easy Bolus in steps of 0.5 unit increments. From
the HOME screen, with each press of the
track of the number of button presses.
, the pump will sound a different tone so he can keep
He wants to give himself 2.0 units for a snack, so he will press
4 times (4 presses x 0.5
units/press = 2.0 units) and then press the ACT button. The pump counts back 4 beeps because he
pressed
4 times. He simply presses ACT to confirm the amount, and his pump delivers the 2.0
units.
When Alexander wants to be more discrete, or does not want his pump to beep in an important
meeting, he can set the pump to “vibrate” mode (see section. “Alert types”) and feel for vibrations
rather than listening for the tones.
Your turn: Easy bolus practice
The factory default setting for the Easy Bolus feature is 0.1 unit steps. You
can change the step level as necessary to a value that is more convenient for
you to use and easier to multiply.
Give your next bolus by using the Easy Bolus feature on your pump.
Your step level is
________.
How many units did you give? _______
How many tones did you count? _______
It might be a good idea to look at your pump's screen to see the bolus
amount as well as counting the steps the first few times you try this until
you become familiar and comfortable with the feature.
Optimizing pump therapy 87
Basal patterns
The Basal Patterns feature is optional for pump users. You can set your pump to deliver a standard
basal and two additional basal patterns to meet your individual daily, weekly, or monthly needs. Keep
a paper copy of your programmed patterns with you at all times in case you need to reprogram your
pump. To select and use pattern A or pattern B, the patterns option must be on and programmed.
Basal patterns are useful to establish different sets of basal rates to match different needs such as:
Changes in time of sleep (for example, work ➠ Extended periods of higher or lower activity
shift)
➠ Different schedules during the week versus
➠ Softball games every Saturday morning, etc.
weekend
➠ Menses
➠
NOTE - You may want to explore this option after you become familiar with the basic pump
functions. It is important that you consult your healthcare professional before using a pattern
other than your standard pattern.
➠
➠
Standard pattern: Your normal basal that supports your usual day-to-day activity. When the
Patterns feature is off, the pump uses your standard basal pattern.
Basal pattern that supports activity levels that are not a part of your dayPattern A/B:
to-day routine, but are normal in your lifestyle. Such activities could be a
sport that you do once a week or a change in your sleep pattern over the
weekend.
Patterns on/off
Your pump is set at the factory with the basal patterns feature turned off. After you turn on
patterns, you still have to program and select a pattern (A or B), as described in the next sections,
before the patterns feature is active. If you turn off the patterns feature, your pump will
automatically select your standard basal pattern.
1 Go to the PATTERNS OPTION screen.
Main > Basal > Patterns
Select On or Off and press ACT.
PATTERNS OPTION
Off
On
ACT
2 The screen will go back to the BASAL MENU. The patterns feature is now on. Exit the menus.
88 Chapter 6
Program a pattern
Your pump will keep your pattern settings even when the Patterns option is turned off. The
patterns feature must be on to program a basal pattern.
NOTE - When you make changes to a pattern, the pump will use that pattern as the current basal.
Make sure the basal you want is selected in the SELECT PATTERNS screen.
Do these steps to program your patterns:
1 Go to the EDIT BASAL screen.
EDIT BASAL
Main > Basal > Set/Edit Basal
2 Select the basal pattern you want to program and press ACT.
Notice that the open circle for special mode now appears in
the icon bar on the top of your screen.
3 The SET BASAL RATE 1 screen will appear. The basal rate will
flash indicating that it can be changed. Set your first rate and
press ACT.
Standard
Pattern A
Pattern B
ACT
SET BASAL RATE 1
12:00A
A
NOTE - The first basal rate starts at midnight and cannot be
changed.
4 The SET START TIME 2 screen will appear. The start
time will flash. If you want to use the same rate for
the whole day, press ESC and go to step 5.
16.80U
---.-- U
---.-- U
_.-
-
rate
(flashing)
U
H
indicates programming is for Pattern A
SET START TIME 2
--:--
_.-
A
If you want to program more rates, do these steps:
-
U
H
time
(flashing)
a. Set the start time for this rate and press ACT.
b. The rate will start flashing. Set the rate and press
ACT.
c. Repeat steps a and b for each additional rate you
want to program for that pattern. Each rate will
have a different number (RATE 2, RATE 3, etc.).
Press ESC when you are done. Continue to step 5.
--:-A
_.-
-
set time
(flashing)
SET BASAL RATE 2
7:30A
U
H
A
_.-
-
U
H
rate will flash after
you set the start time
Optimizing pump therapy 89
5 After you press ESC, the BASAL RATE screen
appears. The screen will show:
➠ Current
➠ Time
basal pattern and basal rate
it started
➠ 24-hour
indicates
Pattern A is the
active pattern
BASAL RATE A
Current Rate 0.80 U/H
Started #1 - 12:00A
24 Hr. Total 19.20
basal total
Select a pattern
Before you try to select a pattern to be active, make sure the Patterns feature is on. After your
standard pattern and/or pattern A or B are set, do these steps to select a pattern to be the active
one:
1 Go to the SELECT PATTERN screen.
Main > Basal > Select Patterns
2 Select the desired pattern, press ACT.
SELECT PATTERN
Standard
16.80U
Pattern A 19.60U
19.60 U
Pattern B
- -. - -
this pattern is not
programmed
3 The screen will return to the BASAL MENU. Your basal
pattern is now active. Exit the menus.
NOTE - If pattern A or B is active, the pump is in
“Special mode” (an open circle appears at the top of
the screen).
90 Chapter 6
BASAL MENU
Set/Edit Temp Basal
lSelect Patterns
Set/Edit Basal
ACT
Example 1:
Basal patterns
Ken has had his insulin pump for about a month. He tests his blood glucose 4 - 6 times a day and
records his results in his logbook. He is happy with his glucose control during the week but on the
weekends, he noticed that he has to eat more food to prevent his blood glucose from running too
low.
Ken has realized that during the week while he is at work, he is very inactive and sits at a desk most
of the time. On the weekends, though, he is busy with yard work, running errands and playing with
his kids. He determines that he needs to have lower basal settings to receive less insulin during
active times, such as his weekend.
He can use the Basal Patterns feature to support his weekend change in activity. During the week,
he can set his pump to deliver in the standard setting, and on Saturday morning, he can switch over
to Pattern A, which he can set with lower basal rates for the weekend. On Monday morning, he can
return his pump to the Standard setting for his weekday insulin needs.
Example 2:
Basal patterns
Cynthia has had diabetes for about 12 years and has been on her Paradigm pump for several weeks.
Every Monday, Wednesday and Friday, Cynthia goes on a 2-mile walk in the morning. To prevent
hypoglycemia on these days, she uses the patterns feature. For those days, she simply switches over
to Pattern A, which she has programmed with a lower set of basal rates. Before she learned to use
the patterns feature, she would have to eat more food throughout the day to keep her blood glucose
at a safe level. Cynthia has also noticed that a few days prior to menstruation, her blood glucose
levels seem to rise, requiring more insulin. She has programmed Pattern B on her Paradigm pump
with higher basal rates for this time. For her usual schedule, she uses the standard basal pattern.
Your turn:
Can you think of situations where you might require different basal rate settings on different days?
Optimizing pump therapy 91
Temp basal rates
The temp basal rate feature is useful to manage BG levels during unusual short-term activities or
conditions. These conditions could be an illness or unplanned physical activity that is not part of your
daily routine.
A temporary basal rate allows an immediate short-term change to your basal insulin for a specified
period of time (30 minutes to 24-hours). This rate can be up to your maximum basal rate setting. It
offers an easy way to immediately meet short-term insulin needs for temporary activities or
situations. When your blood glucose is temporarily high or low, a temp basal rate allows you to set a
temporarily higher or lower basal to accommodate your blood glucose.
NOTE - Temp Basal is useful for a temporary condition or period of increased or decreased
activity (i.e. a cold or physical activity) that is not usually part of your lifestyle. For ongoing
periods of increased or decreased activity, the patterns feature may be more suitable.
How does temp basal work?
During a temp basal delivery, all other basal programming is temporarily overridden. After the
temp basal delivery is completed, your pump will return to the programmed basal. A temp basal is
delivered only once and does not repeat. If you want another temp basal, you must program the
temp basal again. This feature may be useful to temporarily increase or decrease basal insulin during
illness, exercise or similar situations.
92 Chapter 6
Temp basal types
Based on your preference, you can select either Percent of Basal or Insulin Rate.
Insulin rate
Insulin rate is a fixed basal in units per
hour (U/H). This temp basal type is
independent of your current basal. When
you select Insulin rate (U/H) for your
temp basal type, your pump will deliver
the fixed amount you have set for the
duration as set. The amount of your temp
basal insulin rate can be set up to your
maximum basal rate setting.
If you make changes to your normal basal
rate, your U/H temp basal is not affected
and will continue to deliver as
programmed.
NOTE - Temp Basal rate cannot exceed
maximum basal rate.
temp basal settings
temp basal type: Insulin rate (U/H)
duration: 4:00 hours (1:05p - 5:05p)
rate: 3.50 U/H
3.50 U/H
temp basal rate
3.50 U/H
1.50 U/H
(rate 1)
2.55 U/H
(rate 2)
7:00. a.m.
(07:00)
1.95 U/H
(rate 3)
3:00 p.m.
(15:00)
1:05 p.m.
(13:05)
12:00 a.m.
(00:00)
5:05 p.m.
(17:05)
Optimizing pump therapy 93
Percent of basal
The temp basal type is dependent on your current basal rates. Percent temp basal is a percentage
increase or decrease of your current basal (0 - 200 percent limited to your maximum basal rate
setting).
The maximum percent limit is based on the largest basal rate segment with your programmed temp
basal rate time.
For example: It is 6:00AM and your current basal rate is 1.50 U/H. You want to set a temp basal
rate of 130 percent for seven (7) hours. The maximum percent temp basal rate you can set is 125
percent. Anything larger would make #2 segment exceed your maximum basal setting of 2.0 U/H.
Your current basal rates:
Your maximum basal rate setting: 2.0 U/H
Segment #1: 12:00A
1.50 U/H
Segment #2: 11:00A
1.60 U/H (largest)
Segment #3: 4:00P
1.30 U/H
If your current basal changes (i.e. from rate 1 to rate 2), your percent temp basal amount will also
change. The pump will deliver the percentage for the duration that you have set.
You cannot make changes to your normal basal rate while a percent temp basal is active. You must
either wait until the temp basal is finished or cancel the temp basal in order to reprogram your
normal basal rate setting(s).
94 Chapter 6
NOTE - The pump delivers basal amounts in 0.05 U/H increments. Because of this, your temp basal
amount will be rounded down to the next 0.05 U/H increment.
temp basal settings
temp basal type: Percent of basal
duration: 4 hours (1:05p - 5:05p)
rate: 120 percent (%)
(120% x rate 2 = 3.06)
3.06 rounded down to
the next 0.05 increment
is 3.05 U/H
1.50 U/H
(rate 1)
7:00a.m.
(07:00)
temp basal start time
3.05
U/H
2.55 U/H
(rate 2)
(120% x rate 3 = 2.34)
2.34 rounded down to
the next 0.05 increment
is 2.30 U/H
2.30
U/H
1.95 U/H
(rate 3)
3:00 p.m.
(15:00)
1:05 p.m.
5:05 p.m.
(13:05)
(17:05)
12:00 a.m.
(00:00)
temp basal stop time
Optimizing pump therapy 95
Selecting temp basal type
Your pump will remember the temp basal type setting. Once the type is set, you do not have to set
it again. To select a temp basal type, do these steps:
1 Go to the BASAL MENU.
Main > Basal > Temp Basal Type
Select Temp Basal Type and press ACT.
BASAL MENU
Max Basal
Rate Patterns
Temp Basal Type
ACT
2 The SET TEMP BASAL AS screen will appear. Select Insulin Rate or
Percent of Basal and press ACT.
SET TEMP BASAL AS
Insulin Rate <U/H>
Percent of Basal
ACT
3 The screen will return to the BASAL MENU. The temp basal type is now set.
Exit the menus.
NOTE - If your temp basal type is set to “Percent of Basal,” changes to
your basal rate are not allowed until after temp basal is completed or
cancelled.
BASAL MENU
Max Basal
Rate Patterns
Temp Basal Type
ESC
Deliver a temp basal
NOTE - A temp basal cannot exceed your programmed max basal rate.
1 Go to the BASAL MENU.
Main > Basal > Set/Edit Temp Basal
Select Set/Edit Temp Basal and press ACT.
BASAL MENU
Set/Edit Temp
Basal Set/Edit
Basal Basal Review
ACT
2 The SET DURATION screen will appear. The duration* will flash. Enter the
desired minutes or hours (30 minutes to 24-hours), then press ACT.
NOTE - * Duration is the amount of time it will take for the pump to
deliver the temporary basal.
96 Chapter 6
SET DURATION
Temp
3:00
ACT
3 In the SET TEMP BASAL screen, the temporary
basal rate will flash. Enter your temp basal rate,
then press ACT.
OR
SET TEMP BASAL U/H
3:00P
0.05
U
60%
H
appears if
Temp Basal Type is set
to “Insulin rate (U/H)”
4 The BASAL MENU will appear.
Your temp basal is now set and
delivering. Exit the menus.
SET TEMP BASAL %
3:00P
appears if
Temp Basal Type is set
to “Percent of basal”
BASAL MENU
Set/Edit Temp Basal
Cancel Temp Basal
Select Patterns
pump is in Special mode
during a temp basal
Verifying temp basal delivery
Temporary basal information is
available in the STATUS screen only.
During a temporary (temp) basal, the
pump is in Special mode (an open circle
appears). This open circle will remind
you that a temp basal is active.
Additionally, your pump will
beep/vibrate three times every hour
during delivery. During delivery, the
STATUS screen will show the current
temp basal information.
indicates a U/H temp basal of
0.6 units per hour is now active
temp basal delivery
will last 30 minutes
time remaining before temp
basal delivery is finished
regular programmed
basal rate that will resume after the
temp basal delivery is finished
STATUS
U100
Tmp Basal 0.60 U/H
Duration 0:30
Time left 0:22
Last Bolus N 3.8U
9:07A 11 JAN
Basal 1: 0.80 U/H
Reservoir Started:
09JAN, 6:03P
Units left: 128U
Time left: 24 Hours
Battery: Normal
Tue 11 JAN 2005
S/N# 000000
Optimizing pump therapy 97
Canceling a temp basal
Use the cancel temp basal function in the BASAL MENU to cancel a temporary basal. This function
immediately stops the temp basal and resumes the regular programmed basal delivery. To cancel a
temp basal, do these steps:
1 Go to the BASAL MENU.
Main > Basal > Cancel Temp Basal
2 Select Cancel Temp Basal and press ACT to
accept.
BASAL MENU
Set/Edit Temp Basal
Cancel Temp Basal
Select Patterns
ACT
BASAL MENU
Set/Edit Temp Basal
Select Patterns
Set/Edit Basal
The screen will return to the BASAL MENU. Your temp basal is cancelled and the programmed basal
is now active again. Exit the menus.
Example 1:
Temp Basal for a decreased temporary basal rate
Ramon and his friends got together for an unplanned game of soccer. Before using the pump, he was
taking shots to manage his diabetes. Ramon experienced frequent low blood glucose reactions
sometimes during, and very often after, he played games with his friends. Now that he is using his
Paradigm pump, he can use the Temporary Basal Rate feature to help prevent low blood glucose. He
simply programs his pump to temporarily deliver less basal insulin during the time that he is playing,
and often for several hours after play, as well.
Ramon was able to determine how to set his Temporary Basal rates by frequent blood glucose
testing, both during and after activity, and recording his results. The first time he tried using the
pump, his healthcare professional advised him to program his pump to deliver ½ his usual basal rate
for the amount of time that he was playing and for an hour after he was done. He made small
adjustments of the temporary basal rate and the duration of time, each time he tried to use the
feature. After several different attempts with similar activity for the same amount of time, (such as
his soccer game that lasted 2 hours), he found a temporary basal rate that worked well for him.
98 Chapter 6
Example 2:
Temp Basal for an increased temporary basal rate
Gail has had a cold with a cough for a couple of days. Because she is not feeling well, she tests her
blood glucose more frequently. She finds that her blood glucose levels are running above target
range before meals and she has needed several correction boluses to keep her blood glucose levels
within her normal limits. Gail decides to use the Temporary Basal Rate to increase her basal rate
during the day today. As advised by her healthcare professional, she will continue to check her blood
glucose more frequently until she is feeling well.
Your turn:
Think of an activity where you might need to use a Temporary Basal Rate.
At what rate is your current basal rate running? ____________
What Temporary Basal Rate would you try using at this time? ___________________
How long will you be active?___________________
What duration will you set for the Temporary Basal Rate?________________
Test your blood glucose before and during activity and several times after as well. What are your
blood glucose results?
Pre- activity______________
During activity______________
1 hour after activity______________
Several hours after activity______________
What Temporary Basal Rate changes will you make for the next time you try this?
Optimizing pump therapy 99
100 Chapter 6
Chapter 7
Insulin pump therapy follow-up
We hope that you are now comfortable using the pump and your blood glucose values have
improved through insulin pump therapy. Diabetes management requires much more than blood
glucose control. You need to take care of your complete physical and mental health. This includes
seeking treatment for any condition both directly related to and not related to diabetes. The
following recommendations apply to general diabetes as well as insulin pump therapy follow-up.
Remember, your healthcare professional is your best resource for successful diabetes management.
Recommended follow-up
Everyday
➠
➠
➠
Check BG 4-6 times a day and always before bed
Test before driving and have a fast-acting carbohydrate with you when you drive
If your BG is above 250 mg/dl (13.9 mmol/L) twice in a row, take an injection and change the
infusion set
Every month
➠
➠
➠
Review DKA prevention guidelines
Check 3:00AM BG at least once during the month
Check 2-hour post-meal BG for all meals on a given day
Every 3 months
➠
➠
➠
Visit your healthcare professional, even if you feel well and check that your BG values are within
target range
Review your BG log and insulin pump settings with your healthcare professional
Make sure you have an HbA1c test done
Laboratory tests
➠
Test for HbA1c four or more times a year
➠
Test for cholesterol, HDL, LDL, triglyceride yearly
Insulin pump therapy follow-up 101
➠
Test for microalbuminuria yearly
Every visit
➠
➠
➠
Blood pressure check
Foot exam
Review goals for BG, meal plan and exercise
Annually
➠
➠
➠
➠
➠
➠
➠
➠
Dilated eye exam by a qualified ophthalmologist
Annual flu shot
Regular dental visits
Nerve function tests
EKG test over age 35
Prostate exam for men, breast exam for women
Diabetes education review
Replace Glucagon Emergency Kit (new prescription from healthcare professional)
102 Chapter 7
Chapter 8
Utilities
Alarm review
You can review alarms in the ALARM HISTORY screen. This screen shows up to 36 past alarms and/or
errors. You can also review the details for each alarm when you are in the ALARM HISTORY screen.
1 Go to the ALARM HISTORY screen.
Main > Utilities > Alarm > Alarm History
2 Scroll through your past alarms.
ALARM HISTORY
11OCT 10:35P LoRes
08OCT 04:08P ChkSet
05OCT 11:35A LoBat
3 If you want to review the details for an alarm, continue to the next
section, “Alarm details.” Exit the menus if you are done.
Alarm details
4 In the ALARM HISTORY screen, select the alarm you want to review
and press ACT. The details for that alarm will appear on the screen.
5 Press ESC to return to the ALARM HISTORY screen. Select another
alarm to review, or exit the menus if you are done.
LOW RESERVOIR
11OCT 10:35P
> 24-hours remaining
0.25 units remaining
Setting your alert type
You can select the type of alert your pump uses (for alarms, special conditions and programming).
You can select a vibrate (silent) alert, or an audible beep alert. There are three beep types: long,
medium and short tones. The factory setting for this feature is beep-medium.
The vibrate alert type is disabled if you use the block feature, and vibrate must be set again once
block is turned off. If your alert type is set to vibrate and you get a Low Battery alert, your pump will
use the beep alert type instead to conserve battery power.
NOTE - Vibrate uses more battery power than the beep alert type and may shorten battery life.
Utilities 103
1 Go to the ALERT TYPE screen.
Main > Utilities > Alarm > Alert Type
2 Select your alert type and press ACT. That alert type is now active.
Exit the menus.
ALERT TYPE
Beep Long
Beep Medium
Beep Short
Vibrate
Auto-off
The factory setting for this feature is off (set to 0 hours). This is a safety feature that stops insulin
delivery after a defined time period (from 1 to 24-hours). If the pump detects that no buttons have
been pressed for the selected amount of time, insulin delivery will stop and an alarm will sound. You
may choose to program this feature into your pump based on the numbers of hours that you usually
sleep at night. Discuss what uses and settings are best for you with your healthcare professional.
1 Go to the AUTO OFF DURATION screen.
Main > Utilities > Alarm > Auto Off
2 Set the number of hours you want to set and press ACT.
AUTO OFF DURATION
(flashing)
0 Hours
NOTE - If you do not want to use the Auto Off feature, make sure the hour is set to zero (0).
3 The screen will return to the ALARM MENU. The Auto Off feature is now set. Exit the menus.
Low resv alert (Low reservoir warning)
Allows you to program the pump to sound an alert before your reservoir is empty. You can select
one of these warning types:
A specified number of units that remain in the reservoir
➠
A specified maximum amount of time that remains before the reservoir will be empty
The factory setting for this feature is (20) insulin units.
➠
1 Go to the RESV WARNING TYPE screen.
Main > Utilities > Alarm > Low Resv Warning
2 Select Insulin Units or Time and press ACT.
WARNING:
104 Chapter 8
RESV WARNING TYPE
Insulin Units
Time
When the pump detects a low reservoir condition during a bolus or prime
delivery, the alert will go off after the delivery is finished. Make sure to
check the volume of your reservoir to ensure enough insulin is available.
For “Insulin units”:
For “Time”:
Enter the number of units you want remaining
when the first warning will go off. Press ACT.
Enter the amount of remaining time you
want for the first warning. Press ACT.
WARNING UNITS
20
U
(flashing)
can be 5.0 – 50.0
The pump will alarm first when the specified
units remain, then again when half that
remaining amount is used.
WARNING TIME
8:00
(flashing)
can be 2 –24
Hours
The pump will alarm first when the specified
time remains, then again one hour before
empty.
NOTE - If you use “time” as the low resv warning type and you deliver large boluses, the actual
time remaining could be less than the warning time. “Time” in low resv warning types is intended
to let you know if you will have enough insulin while you are sleeping.
Utilities 105
Review daily insulin totals
The DAILY TOTALS screen provides a day by day history of the total amount of insulin that delivered
for the past 31 days. This screen includes all bolus and basal amounts delivered midnight to midnight
for each of the past 31 days. The “Today” line in the DAILY TOTALS screen shows the amount of
insulin you delivered so far that day.
NOTE - The insulin used to prime your pump is not included in the DAILY TOTALS screen. This
amount is counted separately and shown in the PRIME HISTORY screen.
➠
Why should I review my daily totals?
Comparing your daily insulin deliveries to your blood glucose records helps you and your healthcare
professional identify your optimal daily insulin rate(s).
➠
What is included in the daily totals?
Daily totals include all basal and bolus insulin deliveries, but they do not include insulin used for
priming your pump. Each total reflects all basal and bolus insulin delivered for that day.
NOTE - If an asterisk (*) is displayed next to a total, that means the day for which the total is
being reported was not a full day. Anything, such as a time or date change, that shortens a day
an hour and twelve minutes or more will cause the asterisk to display.
➠
Where is the daily totals screen?
DAILY TOTALS
Main > Utilities > Daily Totals
Daily Average
Today
26.5U
09Nov
48.5U
08Nov
54.5U
date
106 Chapter 8
Daily Average
(total) basal and bolus deliveries
Pump data management
The pump data management feature allows you and your healthcare
professional to view and manage your basal and bolus insulin delivery,
BG data, and food intake with averages up to 31 days. You can view
the details of each day individually. You can also average the data
over a specified time period that you have selected up to (up to 31
days). This is done in the DAYS TO AVERAGE screen as explained in the
next section.
To view the details of one day:
1 Select a date and press ACT. The following example shows the
details for February 27th.
Main > Utilities > Daily Totals > 27 FEB 48.5U
2 The BG AVG (Blood Glucose Average) screen is displayed. This
screen shows:
➠ Your average blood glucose for the day.
➠ Your high and low blood glucose for the day.
➠ Total number of blood glucose values you entered into the pump
for the day. To view more data, press
.
3 The SEN AVG (sensor average) screen is displayed. This screen
shows:
➠
An average of all sensor glucose readings received from the sensor
during the selected day. The readings are in the selected blood
glucose units (mg/dL or mmol/L).
The first line displays the lowest and the highest sensor reading
received during the selected day.
➠ The number of sensor calibrations (fingerstick blood glucose
readings from a meter entered into the pump) during the selected
day.
➠
DAILY TOTALS
Daily Average
Today
26.5U
Today
48.5U
ACT
27FEB BG AVG 135
BG Low/Hi 92/176
Number BGs
6
27FEB SEN AVG 135
Sen Low/Hi
92/178
Sen Cal/Data
6/288
27FEB INSULIN 48.5U
Basal
20.00/41%
Bolus
28.50/59%
Carbs
253gr
27FEB BOLUS 28.50U
Food
14.50/51%
Corr
12.00/42%
Manual
2.00/7%
27FEB NUM BOLUS 8
Food/Corr
2/ 1
Food + Corr
1
Manual Bolus
4
4 The INSULIN screen is displayed. This screen shows:
➠ Total insulin delivered for the day.
➠ Total Basal and Bolus insulin delivered for the day.
➠ Total percentage of each (Basal and Bolus) delivered for the day.
Utilities 107
➠
Total carbohydrates entered into the pump for the day (entered into the Bolus Wizard feature).
To view more data, press
.
5 The BOLUS screen is displayed. This screen shows:
➠ Total bolus insulin delivered for the day
➠ Total food bolus insulin delivered for the day and total percentage of food bolus insulin delivered
for the day
➠ Total Corr (correction) bolus insulin delivered for the day and total percentage of corr bolus
insulin delivered for the day
➠ Total man (manual) bolus insulin delivered for the day and total percentage of manual boluses
delivered for the day. To view more data, press
.
6 The NUM BOLUS (number of boluses) screen is displayed. This screen shows:
➠ Total number of boluses delivered for the day
➠ Total number of food only and correction only boluses delivered for the day
➠ Total number of food plus correction boluses delivered for the day
➠ Total number of manual boluses delivered for the day
To get back to the HOME screen, press
four times.
108 Chapter 8
Days to average
The DAYS TO AVERAGE screen allows you to
choose the number of days to average. This
example shows the previous 12 days as the number
of days to be averaged.
1 Select Daily Average and press ACT.
DAILY TOTALS
Daily Average
Today
26.5U
27Feb
48.5U
26Feb
54.5U
ACT
DAYS TO AVERAGE
Main > Utilities > Daily Totals > Daily
Average
2 The DAYS TO AVERAGE screen is displayed.
Select the number of days you want to average
by pressing
and
. Press ACT.
3 The AVG BG screen is displayed. This screen
shows:
The average of all blood glucose values
entered into the pump for the previous 12
days.
➠ The average high and low blood glucose
values for the previous 12 days.
➠ The average number of blood glucose values
entered into the pump per day for the
previous 12 days. To view more data,
press
.
➠
NOTE - Any
day marked
with an (*)
asterisk is
excluded from
the average.
12
ACT
AVG BG 128 mg/dL
BG Low/Hi 113/178
Number BGs
6.1
The flashing
number will be the
number of days
you have available
to average (up to
31 days).
SEN AVG
130
Sen Low/Hi 80/201
Sen Cal/Data 6/288
(continued on next page)
4 The SEN AVG (sensor average) screen is displayed. This screen shows:
➠ An average of all sensor glucose readings received from the sensor during the previous 12 days.
The readings are in the selected blood glucose units (mg/dL or mmol/L).
➠ The first line displays the lowest and the highest sensor reading received during the previous 12
days.
➠ The number of sensor calibrations (fingerstick blood glucose readings from a meter entered into
the pump) during the previous 12 days.
Utilities 109
5 The AVG INSULIN (average insulin) screen is displayed. This screen shows:
➠ The average total insulin delivered per day
for the previous 12 days.
➠ The average total basal and bolus insulin
delivered and total percentage of basal and
bolus insulin delivered per day for the
AVG INS 112.30U
previous 12 days.
Basal 60.20/ 54%
➠
The average total carbs entered into the
pump per day (entered into the Bolus Wizard
feature) for the previous 12 days. To view
more data, press
.
Bolus
Carbs
52.10/ 46%
253gr
AVG BOLUS52.10U
Food
36.50/70%
6 The AVG BOLUS screen is displayed. This screen
Corr
10.30/20%
shows:
Manual 5.30/10%
➠ The average total bolus insulin delivered per
day for the previous 12 days.
➠ The average total food bolus insulin
delivered per day for the previous 12 days
NUM BOLUS
4.2
Food/Corr
2.1/1
and the total average percentage of bolus
Food + Corr
1.1
insulin delivered for the previous 12 days.
Manual Bolus 1.0
➠ The average total correction bolus insulin
delivered per day and the total average
percentage of bolus insulin delivered per day
for the previous 12 days.
➠ The average total manual bolus insulin delivered per day and the total average percentage of
bolus insulin delivered per day for the previous 12 days. To view more data, press
.
7 The NUM BOLUS (number of boluses) screen is displayed. This screen shows:
➠ The average total number of boluses delivered per day for the previous 12 days.
➠ The average total number of food only boluses delivered per day for the previous 12 days.
➠ The average total number of correction only boluses delivered per day for the previous 12 days.
➠ The average total number of food plus correction boluses delivered per day for the previous 12
days.
The average total number of manual boluses delivered per day for the previous 12 days.
To get back to the HOME screen, press
four times.
➠
110 Chapter 8
Personal reminders
Alarm clock
The alarm clock is a feature that allows you to set daily reminders for
various events (8 max). The factory setting for this feature is off. The
alarm clock can be useful to remind you when to check your blood
glucose, eat, bolus, etc. When the alarm clock goes off, the message,
“ALARM CLOCK” will appear.
12:40P
ALARM
CLOCK
1 Go to the ALARM OPTION screen.
Main > Utilities > Alarm Clock
2 Select On/Set.
Press ACT.
3 Select Add Alarm.
Press ACT.
Enter the minutes (flashing). Press ACT.
ALARM CLOCK
ALARM OPTION
Off
On/Set
4 Enter the hour (flashing). Press ACT.
Add Alarm
Delete Alarm
Review Alarms
ADD ALARM
_ _: _ _ (A)
(flashing)
5 Repeat step 4 to program additional alarm times. Exit the menus when you are done.
Remote control option
The factory setting for this feature is off. You may want to explore the remote option after you
have become completely familiar with the basic functions of your pump. It is important that you
consult with your healthcare professional before using this feature. Remote controls can be
purchased from Medtronic MiniMed.
Refer to the remote control user guide for operating instructions.
NOTE - The use of RF (radio frequency) devices with the pump reduces battery life.
To use the remote control, these pump settings must be programmed:
➠
Remote Options = On
➠
Remote control ID code entered in pump (code is on back of remote)
➠
Easy Bolus = On
Utilities 111
Turn on remote control option
WARNING:
If there is a Low Battery condition, the pump will not receive signals from the
remote. To ensure the pump communicates with the remote control, make sure
the pump does not have a low battery. (Replacing the low battery with a new
battery will restore remote control function.)
1 Go to the REMOTE OPTION screen. Select On and
press ACT.
Main > Utilities > Remote Options
REMOTE OPTION
Off
On
ACT
REMOTE ID MENU
Add ID
Delete ID
Review ID
2 The REMOTE ID MENU screen will appear. Add, delete
or review your remote ID as described in the next
section. Exit the menus if you are done.
Add, delete, review remote control IDs
Each remote control has its own unique ID. Up to three (3) different remote control IDs can be
programmed in your pump. The remote control programming screens are very similar to those for the
meter. Make sure to select Remote Options (in the UTILITIES MENU) when programming your remote
control.
If you are not sure that your remote control ID is entered in your pump, check the REVIEW REMOTE
ID screen. You have to turn on the remote option to add, delete or review the remote control ID(s)
programmed in your pump.
1 In the REMOTE OPTION screen, select On and press ACT.
The REMOTE ID MENU will appear.
2 Add, delete or review your remote ID(s) as desired.
NOTE - The remote control RF ID code is on the back
of the remote control.
112 Chapter 8
REMOTE OPTION
Off
On
ACT
REMOTE ID MENU
Add ID
Delete ID
Review ID
Add
Delete
Select Add ID and press ACT.
Enter each of the six ID numbers.
Press ACT after each.
ADD REMOTE ID
(flashing)
Review
Select Review ID and press
Select Delete ID and press ACT.
ACT.
Select the remote ID that you
The programmed IDs will show
want to delete and press ACT.
in the REVIEW REMOTE ID
screen.
DELETE REMOTE ID
1 111111
2 222222
3 ------
______
After you set the last number of
the ID, the screen will return to
the REMOTE ID MENU.
The selected ID is now deleted.
REVIEW REMOTE ID
1 -----2 222222
3 ------
REMOTE ID MENU
Add ID
Delete ID
Review ID
3 Exit the menus when your are done.
Block feature
Block restricts access to pump programming. The factory setting for this feature is off. Block is an
important safety feature if the pump user requires someone else to maintain complete control of
pump operation. When Block is on, the remote control is used to deliver a bolus and suspend/resume
the pump. Direct pump programming is limited to Suspend, Block, and Selftest. You can, however,
still view status-type screens (STATUS, BOLUS and PRIME HISTORY, BASAL REVIEW, DAILY TOTALS,
etc.). Discuss what uses and settings are best for you with your healthcare professional. (You can
order the remote control from Medtronic MiniMed.)
Turn Block on
NOTE - The vibrate alert-type is disabled when Block is on.
1 Go to the BLOCK OPTION screen.
Main > Utilities > Block
2 Select On and press ACT. The HOME screen will
appear with an open circle. The Block option is now
on and the pump is in Special mode. Exit the menus.
BLOCK OPTION
Off
On
ACT
Utilities 113
Example 1: Block
Nicholas is a very active toddler who wears a Paradigm pump. His parents don't want to worry that
he will play with the pump and accidentally change his programmed settings. They simply activated
the Block feature, and now, except for the Suspend and Selftest, no other features are active when
using the pump buttons. When Nicholas needs a bolus, his parents and caregivers simply program it
with the Remote Control.
Example 2: Block
Oscar is an elderly man with diabetes who needs assistance with all of his daily living activities. He
needs his caregiver or family member to help him with his pump as well. To be sure that Oscar does
not change any pump settings, his family programmed his Paradigm pump with the Block feature
turned on. They use the Remote Control to give him his boluses when he needs them.
114 Chapter 8
Lock keypad feature
Lock keypad prevents accidental pump keypad presses. The only button you can press is
to
view the STATUS screen. The remote control can be used to give a bolus or put the pump into
Suspend.
A locked kepad is automatically unlocked during the following:
Battery insertion
Alarms
Alerts
➠
➠
➠
To lock keypad
1 Go to the Lock Keypad screen
Main > Utilities > Lock Keypad
2 Select Utilities
Press ACT.
MAIN MENU
3 Select Lock Keypad
Press ACT.
ACT
Basal
Prime
Utilities
UTILITIES MENU
Lock Keypad
Alarm
Daily Totals
ACT
4 Press ACT to lock keypad.
Press ACT to Lockout
Keypad
Press ESC to Cancel
ACT
KEYPAD LOCKED
To unlock, press B and
UP keys at the same
time
To unlock keypad
1 Press
and
at the same time.
KEYPAD
UNLOCKED
Utilities 115
Selftest
Selftest is a safety utility that allows you to check if your pump is operating properly. This selfdiagnostic feature can be used for maintenance or to check your pump if it operates unusually.
During selftest, your pump will automatically run internal tests, including a check for proper
operation of the beep and vibrate modes. The selftest is additional to the routine tests that run
independently while the pump operates.
Contact the Medtronic MiniMed 24 Hour HelpLine if any of the tests do not occur as described here.
NOTE - If the pump detects a condition such as low battery, the selftest will not finish. A message
will appear to show the condition that caused the test to stop.
1 Go to the UTILITIES MENU. Select Selftest and
press ACT.
MAIN MENU
Basal
Prime
Utilities
Main > Utilities > Selftest
2 As part of the selftests, the pump will do these
tests:
ACT
UTILITIES MENU
Remote Options
Block
Selftest
NOTE - Periodically, you will hear beeps as different mechanisms in the pump are being tested.
a. Screen Test:
The screen will appear
all black as shown
here.
c. Tone Test:
You should hear beeps.
TONE TEST
3
b. Selftest:
The pump will count
down from 10.
SELFTEST
d. Vibrate Test:
You will feel
vibrations.
VIBRATE TEST
3 After the selftest is finished, TEST COMPLETE will
appear on the screen. The screen will return to the
UTILITIES MENU, then to the HOME screen.
116 Chapter 8
TEST COMPLETE
10
1
User settings
WARNING: Do not clear your pump settings while it is connected to your body.
The user settings function allows you to save, restore, and clear all pump settings. You can also
view a listing of the dates and times of all recent user settings operations you have done. The Save
Settings feature lets you keep a set of pump settings that you can restore to your pump if it is
cleared or you need to go back to these settings for any reason.
When you clear your pump, the pump settings are restored to the factory defaults, and you must
either use Restore Settings, if you have saved a set of pump settings, or reprogram all your settings
before you can use your pump again. The pump does not clear the internal pump memory.
CAUTION: Do not clear your pump settings unless directed by your healthcare professional or a
Medtronic MiniMed representative. If you clear your pump settings, it will be necessary
to reprogram all your personal pump settings as directed by your healthcare
professional. Additionally, you will have to rewind your pump.
Save settings
Do these steps to save your current pump settings:
1 Go to the UTILITIES screen and highlight User Settings. Then,
hold down
and press ACT.
Main > Utilities > User Settings
UTILITIES MENU
Selftest
User Settings
Language
ACT
2 The USER SETTINGS screen is displayed with Save Settings
highlighted. Press ACT.
USER SETTINGS
Save Settings
Clear Settings
History
ACT
Utilities 117
3 If this is the first time you have saved pump settings, go to step 4.
If you have previously saved pump settings, a message displays,
indicating the date of your last pump settings save. Read the
instructions on the screen then press ACT to save your current
settings (or press ESC to cancel the save).
4 The SETTINGS SAVED message displays to confirm that your
current pump settings have been saved. Exit the menus.
Restore settings
Do these steps to restore the most recent pump settings you have
saved to your pump.
Press ACT to over
write settings saved
20APR2004 at 9:41A
ESC to CANCEL
ACT
SETTINGS SAVED
User settings have
been saved
920APR2004 at 9:43A
ESC/ACT
NOTE - Regardless of the basal pattern you saved or the current one, Restore Settings always
sets patterns to Standard.
1 Go to the UTILITIES screen and select User Settings. Then, hold
down
and press ACT.
Main > Utilities > User Settings
UTILITIES MENU
Selftest
User Settings
Language
ACT
2 The USER SETTINGS screen is displayed. Select Restore Settings
and press ACT.
USER SETTINGS
Save Settings
Restore Settings
Clear Settings
ACT
3 A message displays, giving you the option of restoring the pump
settings that were saved on the given date and erasing the ones
currently on your pump. Read the instructions on the screen then
press ACT to restore the settings. (You can press ESC to cancel the
restore.)
Press ACT to restore
settings saved on
03/10/2004 at 04:15P
ESC to CANCEL
4 The SETTINGS RESTORED message displays to confirm that your
current pump settings have been replaced with the pump settings
you had saved on the given date. Exit the menus and check your
pump settings to verify the restore.
User settings have been
restored.
ACT
SETTINGS RESTORED
PLEASE CHECK SETTINGS
ACT
118 Chapter 8
Clear settings
Take the following steps only if you want to clear your pump to factory default settings.
WARNING: Do not clear your pump settings while it is connected to your body.
CAUTION: Do not clear your pump settings unless directed by your healthcare professional or a
Medtronic MiniMed representative. If you clear your pump settings, it will be necessary
to reprogram all your personal pump settings as directed by your healthcare
professional. Additionally, you will have to rewind your pump.
1 Go to the UTILITIES screen and select User Settings. Then, hold down
Main > Utilities > User Settings
and press ACT.
UTILITIES MENU
Selftest
User Settings
Language
ACT
2 The USER SETTINGS screen is displayed. Select Clear Settings and press
ACT.
USER SETTINGS
Save Settings
Restore Settings
Clear Settings
ACT
3 A CONFIRM message displays, giving you the option of clearing your
pump settings or not. Select YES and press ACT to clear the settings.
(You can press ESC to cancel.)
CONFIRM
No
Yes
ACT
4 You will see a RESET screen, and then the pump will go through
various screens while it restarts. After the pump clears all of your
settings, the screen will go to the TIME/DATE SETUP screen.
5 Reset the time and date as described in “Setting the time and date”
on page 21.
3:32A
RESET
Settings cleared
by user
Reprogram settings
ESC, ACT to clear
6 After you set the time and date, you must rewind your pump. Refer to
“Rewinding your pump” on page 45 for instructions. Remember, all your settings have been cleared
and you must either restore or reprogram all your settings.
Utilities 119
History
If you want to view a listing of the dates and times of all recent User Settings operations you have
done on your pump, such as saves and restores, take the following steps:
1 Go to the UTILITIES screen and select User Settings. Then, hold
down
and press ACT.
Main > Utilities > User Settings
UTILITIES MENU
Selftest
User Settings
Language
ACT
2 The USER SETTINGS screen is displayed. Select History and press
ACT.
USER SETTINGS
Restore Settings
Clear Settings
History
ACT
3 The SETTINGS HISTORY screen displays, giving you a list of all the
dates and times of your most recent User Setting operations. Use
the scroll bar to view the entire history. When you are done
looking at the history, press ESC to exit the menu.
SETTINGS HISTORY
09:15A Restor
04:15P Save
10:03A Save
12:10P Restor
15MAR
10MAR
03MAR
12FEB
Language setting
ESC
The language shown on the pump screens can be changed. Some
languages will not be available on all pumps. To change the language for your pump, do these steps:
1 Go to the UTILITIES screen, select Language and press
ACT.
Main > Utilities > Language
2 The LANGUAGE MENU Screen is displayed. Select your
language and press ACT.
3 The language setting is now changed. Exit the menus.
120 Chapter 8
UTILITIES MENU
Selftest
User Settings
Language
ACT
LANGUAGE MENU
English
Espanol
Francais
Chapter 9
Troubleshooting
This Troubleshooting chapter is designed to help you understand the messages that your pump is
giving you when you get an alarm or an alert message. The procedures in the beginning of this
chapter are to be used when you get specific alarms or cover a likely condition that might happen. A
list of alarms is provided at the end of this chapter.
NOTE - It is recommended that you read your warranty statement included with your pump for
information on what is covered during your warranty period.
My pump has a no delivery alarm...
When a “No Delivery” alarm occurs, it means the pump is working correctly but it has detected
that something is preventing insulin from being delivered. Your pump is not broken. Do the following
steps:
1 Check your blood glucose and take an injection if needed.
2 Make sure that there is insulin in your reservoir and the tubing is not kinked. If these are all right, go
to step 5.
3 If necessary, unkink tubing. Clear the alarm by pressing ESC and ACT. A screen will appear with two
choices: Resume and Rewind. Select Resume.
4 If the reservoir is empty, clear the alarm by pressing ESC and ACT. Select Rewind and change your
reservoir and infusion set per the instructions in chapter 4, “Starting on insulin.”
5 Continue troubleshooting by disconnecting at the quick-disconnect, and set a 10 unit Fixed Prime.
6 Does insulin come out of the needle at the quick-disconnect?
a. If yes, change your entire infusion set per the instructions in chapter 4, “Starting on insulin.”
If NO insulin comes out of the needle at the quick-disconnect, or you receive another No
Delivery alarm, call the 24 Hour HelpLine.
b. Your pump remembers the last fixed prime you deliver, so make sure to set your fixed prime
amount back to your usual setting. To do this, deliver another fixed prime in your normal
amount (the amount specified in your infusion set instructions).
7 Monitor your blood glucose closely.
Troubleshooting 121
8 If you followed these steps and you are still receiving a No Delivery alarm, call the 24 Hour HelpLine.
What happens if I leave the battery out too long?
If you leave the battery out too long (more than five minutes), you may receive a BATT OUT LIMIT alarm
message when you install the new battery. Do the following steps:
1 Set your pump clock to the correct time, date, and year.
2 Check to make sure that all your settings, such as basal rate, are set as desired. If need be, reapply
your last saved settings to the pump by using the Restore Settings option under User Settings in the
UTILITIES MENU as described in chapter 8 (you can only use this option if you have previously saved
your pump settings).
3 Check the ALARM HISTORY screen and the STATUS screen for any alarms and/or alerts that may still
need attention.
If you leave the battery out for more than three or four days, you may receive an A17 alarm and several
A47 alarms when you install a new battery. Do the following steps:
1 Clear all A17 and A47 alarms.
2 Set your pump clock to the correct time, date and year.
3 Check to make sure that all your settings, such as basal rate are set as desired. If need be, reapply
your last saved settings to the pump by using the Restore Settings option under User Settings in the
UTILITIES MENU as described in chapter 8 (you can only use this option if you have previously saved
your pump settings).
4 Check the ALARM HISTORY screen and the STATUS screen for any alarms and/or alerts.
Why doesn’t my pump battery last very long?
A short battery life does not mean that something is wrong with your pump. Battery life in your pump is
variable and based on the conditions below:
➠
The brand of battery you use (we recommend Energizer).
➠
The storage and /or handling of the battery before use (avoid high or low temperatures).
➠
The usage of pump in cold temperatures; this may shorten the battery life.
➠
The usage of your pump, such as how often the buttons are pushed, the number of alerts/alarms
and set changes.
➠
➠
The amount of insulin the pump is delivering.
The usage of some features. The backlight, vibrate, remote control and/or meter options decrease
battery life.
122 Chapter 9
What is a CHECK SETTINGS alarm?
This alarm occurs after an E alarm or after you clear your pump. It is advising you to make sure that all
your settings are correct. A CHECK SETTINGS alarm occurs after any of these actions:
➠
All user settings were cleared (set back to their defaults) because there was an E-error alarm.
➠
The “Clear Settings” function was performed.
➠
After you rewind when practicing without a reservoir when your first get your pump. In this case, it
is just a reminder to make sure all your settings are programmed before you begin using the pump
with insulin.
My screen appears distorted
The screen may appear distorted or have a “rainbow” appearance if you are wearing polarized
sunglasses, are in bright sunlight, or in extreme high or low temperatures. If your screen appears
distorted:
➠
Take off your sunglasses.
➠
Move into the shade.
➠
Make sure your pump is not in direct heat (i.e., next to a heater) or cold (worn on the outside of
your clothing on a very cold day).
Do not return the pump: this is a normal property of this type of screen on any device.
I cannot get out of the priming loop
1 Is there a filled reservoir in the pump?
➠ If no, place a filled reservoir or shipping cap in the pump.
➠ If yes, make sure you are disconnected from the pump.
2 Hold the ACT button until the second set of beeps and the numbers appear on the screen.
➠ If yes, your pump is okay, go to step 4 in the section “Manual prime” in chapter 4 to finish the
manual prime.
➠ If you did not hear a second set of beeps or numbers did not appear on the screen, change your
infusion set and repeat this step.
3 If you still do not hear the beeps and see the numbers count up on the screen, call the
24 Hour HelpLine.
Troubleshooting 123
The pump is asking me to rewind
This is normal after any of the following:
1 Any E-alarms
2 Clear Settings function
3 No Delivery Alarm (during the Prime sequence)
My bolus stopped
The Bolus Stopped error can occur if the battery cap is loose or the pump was bumped or dropped
during a bolus. It can also happen if the pump receives a static shock. As a safety measure, the pump
stops the bolus when this happens.
1 If you dropped your pump, visually inspect it to make sure that it is not damaged in any way.
2 Review your bolus history and reprogram the remaining bolus, if needed.
My pump buttons are not acting right during a bolus
If the
,
or
buttons are pressed and held down while a bolus is being delivered, the
screen will freeze on that amount. Once the button is released, the units will ramp up to the amount
delivered so far. Pressing and holding down the button will not stop the delivery of a bolus.
My pump won’t display my BG reading from my meter
1 Make sure that you are using the correct linked meter. Your pump will communicate with this meter
only.
2 Make sure your meter is on (set to “snd”) and working correctly.
3 Make sure the meter option in your pump is set to On and you have set the meter ID number
correctly on the pump.
4 Make sure your pump does not have a Low Battery alert condition.
5 Make sure the meter is within 4 feet (1.2 meters) of the pump without anything in between such as
another person, a wall, etc.
6 Make sure there is no RF (radio frequency) interference from other electronic devices that could
prevent communication. These devices can include some cell phones, cordless phones, televisions,
computers, radios, other Paradigm pumps meters and pump remote controls. To restore
communication, simply move away from these other types of devices, or turn them off.
7 Your pump will not show another reading. Make sure the pump is idle and the HOME screen is blank.
124 Chapter 9
8 If your pump still does not receive your BG reading from the linked meter, use the up/down buttons
to manually enter your BG (in the ENTER BG screen).
I dropped my pump
Take care to protect your pump from being dropped.
1 Check that all connections are still tightly in place.
2 Check the LCD, keypad and pump case for cracks or damage.
3 Check infusion set, including the tubing connector and tubing for cracks or damage.
4 Review the status screen, basal rates and other pump settings.
5 Perform the Selftest procedure located in the UTILITIES MENU.
6 Call the Medtronic MiniMed 24 Hour HelpLine for assistance.
I submerged my pump in water
Your pump is designed to resist accidental contact with water. Do not submerge in water during
bathing, swimming, or other water activities.
1 Pat the outside of the case until dry.
2 Open the reservoir compartment and check the compartment and reservoir for water. If wet, dry it
completely within ten (10) minutes of exposure to water. Exposure to liquids, including water or
insulin can corrode the mechanism.
3 Dry the reservoir completely—do NOT place a wet reservoir in the pump.
4 Do not use hot air to dry your pump. This may damage your pump's internal electronics.
5 Check the battery compartment and the battery—if wet, let them dry completely before using the
pump.
6 Perform a selftest.
I cannot get to the User Settings menu
If you do not hold down
while pressing ACT when you have User
Settings highlighted, you will see the following screen:
1 Go to the UTILITIES screen and highlight User Settings. Then, hold down
and press ACT.
This feature is not
normally accessible. To
access, consult your
User Guide.
2 See “User settings” on page 117 for information about the menu options.
Troubleshooting 125
Alert conditions
Your pump has a sophisticated network of safety checks and systems. If
it detects an unusual condition that requires your immediate attention, it
will beep or vibrate periodically to alert you. The pump will go into
Special mode (an open circle will display), and the backlight will
illuminate.
➠
➠
Dual Wave or Square Wave bolus
delivery
➠
Pattern A or B is active
➠
Temp basal delivery
➠
Low reservoir
➠
Block feature is on
➠
Low battery
Why are alerts important?
Your pump monitors activities and will alert you if a Special mode is active. Some alerts are a normal
part of pump therapy, such as an active temporary basal. There are alerts that indicate a condition
that is outside normal pump activity. For example, your pump notifies you with an alert when you
need to replace the reservoir (LOW RESERVOIR) or replace your pump battery (LOW BATTERY).
What to do
When your pump beeps or vibrates notifying you that an alert condition exists:
1 Read and follow the instructions on the screen. Press ESC, ACT to silence an alert.
2 Check the STATUS screen to determine what caused the alert.
3 If the condition is due to a low battery, replace the battery.
4 If the condition is due to a low reservoir, monitor the reservoir volume frequently and change the
reservoir when appropriate. Make sure you have a new reservoir, infusion set and vial of insulin with
you.
Low reservoir alert
You can program the pump to sound an alert when either a specified
number of units remains or a specified amount of time remains before the
reservoir will be empty.
126 Chapter 9
3:36P
LOW
RESERVOIR
ESC, ACT to clear
Low Battery alert
If you get this alert, DO NOT go to sleep without replacing the battery.
The backlight, Remote control and meter functions are disabled during a
Low Battery condition. If the alert type is set to “vibrate,” the pump will
change to the audio alert “beep-medium.” Clear (ESC, ACT) this alert
before you replace your battery.
10:09A
LOW
BATTERY
Replace battery now
Use 1 AAA
ESC, ACT to clear
Alarms
Your pump has a sophisticated network of safety checks and systems. If
the safety network detects anything unusual, your pump notifies you of conditions that require your
immediate attention. The backlight illuminates the pump screen and the alarm/alert message
displays on the screen.
NOTE - The STATUS screen shows any alarms and alerts that are active.
➠
Why are alarms important?
Your pump monitors activities and notifies you if there is an unusual
pump status or your attention is required. When an attention alarm is
active, INSULIN DELIVERY IS STOPPED and immediate operator
interaction is required.
If the vibrate mode is on, all alarms and alerts start as vibrations and
then change to beeps. For your safety, if there is no response after ten
(10) minutes, the beeps change to a siren. The siren continues every
minute until the alarm is cleared.
when a solid circle
appears, follow the
instructions on the screen.
Troubleshooting 127
What to do
When an alarm is triggered, the pump goes into Attention mode and an alarm message shows on the
screen. The pump then defaults to the HOME screen. Do these steps when you get an alarm:
1 View the alarm:
From the HOME screen, press any button to see the alarm message.
(any button)
2 Read all of the alarm text. There are instructions on how to fix the
alarm condition. (Press
to read more text, if available.)
ALARM
MESSAGE
/
3 Clear the alarm:
Press ESC then ACT after you read the alarm instructions.
Alarm description and
instructions show here.
ESC, ACT
4 The HOME screen appears.
5 Follow the instructions that appeared with the alarm to fix the alarm
condition.
6 Check your settings (i.e., time/date, basal, etc.) to make sure they are
correct.
128 Chapter 9
Alarm conditions
Alarms put the pump in “Attention” mode.
A (Alarm)
This alarm shows an “A” followed by two numbers. A-alarms cause all
insulin delivery to stop. Your pump settings are retained. If this alarm
repeats often, call the Medtronic MiniMed 24 Hour HelpLine for assistance.
Axx
9:42A
Pump reset
Settings preserved
ESC, ACT to clear
XX indicates the
alarm number
Auto off
Alerts you that no buttons were pressed during the time limit you set for
the AUTO OFF DURATION feature, and so insulin delivery has been stopped.
Batt out limit
Occurs if the battery has been out of the pump for more than five minutes.
Verify that the pump time and date are correct. If not correct, go to the
UTILITIES MENU and reset the date and time.
Bolus stopped
If this alarm occurs, it is very important to check bolus history to review how
much of the bolus was actually delivered. If necessary, reprogram a bolus
with the amount not yet delivered.
Button error
This error occurs if a button has been continually pressed for more than 3
minutes.
AUTO
OFF
11:17A
Delivery stopped
No buttons pushed
during time limit
ESC, ACT to resume
delivery
12:00A
BATT
OUT LIMIT
Batt change
too slow
ESC, ACT to clear
8:35A
BOLUS
STOPPED
Loose battery cap?
Pump dropped or
bumped?
Check bolus history,
Reprogram bolus
if required
ESC, ACT to clear
10:05A
BUTTON
ERROR
Button pressed for more than
3 min
ESC, ACT to clear
Troubleshooting 129
Check settings
When this alarm is active, you should check and/or reprogram your pump
settings, including the time/date.
CHECK
SETTINGS
8:35A
Delivery stopped
Reprogram settings
ESC, ACT to clear
E (Error)
After receiving this alarm, note the error number then call the Medtronic
MiniMed 24 Hour HelpLine for assistance. An error alarm will show an “E”
followed by two numbers. E-alarms cause all insulin delivery to stop, the
pump resets, and all your settings are cleared.
Empty reservoir
There is no insulin in the reservoir. Change the reservoir immediately.
5:30A
Exx
Settings cleared
Reprogram settings
Call help-line
for assistance
ESC, ACT to clear
XX indicates the error
number
EMPTY
RESERVOIR
3:36P
Delivery stopped
Change reservoir
ESC, ACT to clear
Failed batt test
The pump tests the voltage of each battery installed. This test ensures a
battery with low voltage is not used. If the battery does not have enough
voltage, this alarm will occur. The pump will not function and the battery
must be replaced. (Always make sure that you install a NEW battery into the
pump.)
Is priming complete?
If you manually prime your pump with more than 30u insulin, this message
appears. Press ESC, ACT to clear the message. If manual prime is complete,
press ESC. If the manual prime is not complete, press and hold ACT until
manual prime is complete.
FAILED
BATT TEST
Delivery stopped
8:35A
Replace battery now
Use 1 AAA
ESC, ACT to clear
IS PRIMING
COMPLETE?
Disconnect from body
See user guide
for instruction
ESC, ACT to clear
130 Chapter 9
Max delivery
This alarm alerts you when you have taken more insulin than expected based
on maximum bolus and maximum basal rates.
Motor error
Insulin delivery has stopped. This alarm occurs if your pump detects a motor
error.
3:25P
MAX
DELIVERY
Exceeded 1 hour
max delivery
Check BG
ESC, ACT to clear
MOTOR
ERROR
Delivery stopped
3:25P
Disconnect set
ESC, ACT to clear
No delivery
Insulin delivery has stopped. This alarm occurs if your pump detects a
blockage.
No reservoir
The reservoir is not inserted correctly or no reservoir has been inserted.
NO
DELIVERY
Delivery stopped
11:17A
Change entire set
Check BG
See user guide
to troubleshoot
ESC, ACT to clear
4:36P
NO
RESERVOIR
Delivery Stopped
Change reservoir set
ESC, ACT to clear
Off no power
The battery is dead. Replace battery immediately. Follow the directions on
the screen. Check to make sure that the time is correct on the screen. Reset
the time if necessary.
OFF
NO POWER
04:42
0% battery life
Delivery stopped
Replace battery now
Use 1 AAA
ESC, ACT to clear
Troubleshooting 131
Reset
The Reset alarm triggers when pump settings are cleared because of one of
these reasons:
➠
➠
Pump settings were cleared (Clear Settings function) and settings have not been
reprogrammed.
8:35A
RESET
Settings cleared
by user
Reprogram settings
ESC, ACT to clear
A download attempt from the PC is incomplete. (The download function is
applicable to the optional software feature. Refer to the software user guide for
more information.)
Weak Battery
The pump tests the voltage of each battery installed. If the battery voltage is
less than full strength, this alarm may occur. The pump will operate normally,
but the battery life will be shorter than expected.
Always make sure to install a NEW battery in the pump.
132 Chapter 9
11:17A
WEAK
BATTERY
Shorter battery
life expected
ESC, ACT to clear
Chapter 10
Pump maintenance
It is recommended that you read your warranty statement included with your pump for information
about what is covered during your warranty period.
Battery
The Paradigm pump uses a AAA battery. As a safety measure, Medtronic MiniMed has designed the
pump to only accept a NEW battery. If you insert a used battery, the “Failed batt test” alarm may be
triggered. Refer to the section “Install battery” in chapter 2 for instructions.
The use of cold batteries causes erratic pump behavior. To prevent this, do not use batteries that
have been in cold storage (i.e., in the refrigerator or your car in the winter). It takes several hours
for these batteries to warm to room temperature.
Certain features on the pump use a lot of battery power. Your battery will need to be replaced
more frequently if you use these features:
➠
Remote control
➠
A linked meter
➠
Backlight
➠
Vibrate alert type setting
CAUTION: It is recommended that you use a AAA Energizer battery. Do not use a rechargeable or
carbon zinc battery in the pump. Do not remove the battery unless you are changing
your battery (installing a NEW battery). Replace it within five (5) minutes. If not
replaced within five (5) minutes, the screen may display an alarm message. Follow the
instructions in the message and make sure the time and date are set correctly. Check
that the battery is inserted correctly. If the battery has been installed backwards,
remove the battery and install it properly.
Storage
If you have to remove and store your pump, it is recommended that you store it with the battery in
place. Keep a record of your current basal rates. To preserve battery life, reset the basal rates to 0
(zero), turn off the remote and meter options, and set the Auto-off to dashes or zeroes.
Pump maintenance 133
Cleaning your pump
1 Use only a damp cloth and mild detergent mixed with water to clean the outside of your pump.
2 Rinse the pump with a clean cloth, dampened with clean water.
3 Dry with a clean cloth.
4 Never use organic solvents, such as lighter fluid, nail polish remover, or paint thinner to clean your
pump.
5 Keep the reservoir compartment and battery compartment dry and away from moisture.
6 Do not use any lubricants with your pump.
7 Use a 70 percent alcohol wipe to disinfect your pump.
134 Chapter 10
Chapter 11
Pump specifications
This section provides detailed information on specifications related to your pump. The safety features of your
pump are individually listed and described.
Alarms and error messages
Indicators: audible tone (beep) or vibration (silent)
All alarms and errors show messages on the pump’s screen and provide instructions on what to do. Unresolved
alarms will escalate to siren mode for added safety.
Alarm history
Maximum records shown: 36
Backlight
LCD (Liquid Crystal Display) type
Time-out: 30 seconds
Basal
Delivery: 0.05 – 35 units/hour (maximum units: 35/hour)
Factory maximum setting: 2.0 units/hour
Increments: 0.05 units
3 patterns maximum, each with 48 rates
BG target
Maximum targets: 8
range:60 – 250 mg/dL
(3.3 – 13.9 mmol/L)
warning limits:less than 90 or greater than 140 mg/dL
(less than 5.0 or greater than 7.8 mmol/L)
Bolus delivery
Insulin delivered/stroke Fluid delivered/stroke Time between/delivery strokes
Delivery rate (per minute)
0.05u
1.5u
0.5 µL
2 seconds
Bolus history
Maximum records shown: 24
Pump specifications 135
Bolus units
Increments: 0.1 units
Bolus Wizard feature
(see end of this section for information)
Carb ratios
Maximum ratio settings:
range:
warning limits:
8
3 – 150 grams/u
0.1 – 5.0 u/exch
less than 5 or greater than 50 grams/u
less than 0.3 or greater than 3.0 u/exch
Carb units
The food entry when using Bolus Wizard feature
grams:
0 – 300 (increments: 1 gram)
exchanges: 0.0 – 20 (increments: 0.5 exch)
Daily totals
Maximum records shown: 31 days of data, maximum display: 999.95 units/day. Accuracy: +0/–0.05 units
Default screen
The HOME screen. For most screens, if no buttons are pressed for 30 seconds, the pump returns to this screen.
Pump motor
The pump motor has a unique, patented design with an integrated safety check system. The system delivers in
precise increments.
Dual Wave bolus
Delivers a Normal bolus followed by a Square Wave bolus (limited by maximum bolus).
136 Chapter 11
Easy bolus
Features programming using audible tones (or vibrate pulses) in user-determined increments. Beep mode range: 0
to maximum bolus; Vibrate mode range: 0 to 20 steps or maximum bolus, whichever comes first.
Default step increment: 0.1 unit
Step size < maximum bolus.
Adjustable step size: 0.1 to 2.0 units per step.
Accessible from the remote control or pump buttons.
Infusion pressure
Maximum infusion pressure and occlusion pressure: 13.7 PSI (94,46 kPa).
Insulin sensitivity
Maximum settings: 8
Factory default: 50 mg/dL (2.8 mmol/L)
Range:10 – 400 mg/dL
(0.5 – 13.9 mmol/L)
Warning limits:less than 20 or greater than 100 mg/dL
(less than 1.1 or greater than 5.6 mmol/L)
Low resv (reservoir) warning
Values are based on displayed amount, not actual amount.
Time:
2 – 24-hours, and
@ 1:00 hour before empty
08:00 hours (default when time is
selected)
Units:
5 – 50 units, and
@ 1/2 amount remaining
20 units (factory default)
Meter value
The BG measurement received from the linked meter. Appears in the ENTER BG screen during bolus programming.
Appears on the screen when the pump is idle at the HOME screen.
Expiration: 12 minutes;
Range: 20 – 600 mg/dL (1.1 - 33.3mmol/L)
Maximum meter ID entries: 3
Normal bolus
Range 0.1 – 25.0 units of insulin (limited by maximum bolus setting).
Pump specifications 137
Occlusion detection
When occlusion is detected, the “no delivery alarm” will occur. The occlusion alarm is triggered by an average of
2.77 units of “missed” insulin. This table shows occlusion detection for 3 different situations when using U100
insulin.
522/722
Rate
Minimum time
before alarm
Typical time
before alarm
Maximum time
before alarm
bolus delivery (1.5 u/minute)
92 seconds
116 seconds
162 seconds
basal delivery (1.0 u/h)
2.2 hours
3.09 hours
4.47 hours
basal delivery (0.05 u/h)
37.4 hours
59.2 hours
87 hours
Percent temp basal
Default value: 100% of basal programming
Power supply
The pump is powered by a standard 1.5 V AAA alkaline battery, size E92, type LR03 (Energizer brand
recommended).
Prime function
Fixed prime: 0.1 – 25.0 units (limited by maximum bolus).
Manual prime limit: warning at 30 units, then at each 10 units thereafter.
Fill rate: 1 to 5 units/second.
Prime insulin is not counted in daily totals but is recorded separately in the prime history.
Prime history
Maximum records shown: 20 (manual and fixed)
Program safety checks
Maximum infusion with single fault condition: 0.0 units
138 Chapter 11
Pump size
The dimensions of the pump are approximately:
522 Pump:
2.0 x 3.0 (2.8 at the battery cap) x 0.75 inches
[5.1 x 7.6 (7.1 at the battery cap) x 2.0 cm]
722 Pump:
2.0 x 3.7 (3.5 at the battery cap) x 0.75 inches
[5.1 x 9.4 (8.9 at the battery cap) x 2.0 cm.]
Pump weight
522 and 722 pump: 522 pump approximately 100 grams (with battery installed), 722 pump approximately 108
grams (with battery installed).
Remote control
Uses radio signals to allow users to program Normal boluses or to suspend/resume their pumps.
Reservoir
The user-filled reservoir is made from impact-resistant, insulin-compatible polypropylene.
522 Pump volume: up to 176 units of U100 insulin
722 Pump volume: up to 300 units of U100 insulin
Square Wave bolus
Delivers bolus insulin over a duration of 30 minutes up to 8 hours (limited by the max bolus setting).
Temporary (temp) basal rate
Allows you to temporarily change the current basal rate for a duration of 30 minutes up to 24-hours (limited by
maximum basal setting). The temp basal rate can be set to either Percent of basal or Insulin rate.
Time and date screen
12-hour or 24-hour formats. Pump users set the time/date, including the year, month and day. The date is
included in the STATUS screen information. Time always appears on the top of the screen.
Pump specifications 139
Status screen
Item
When
What
➠ Alarm Clock:*
Appears if scheduled to alarm
Time set is displayed
➠ Auto-off:
Appears if enabled
X HR
➠ Basal pattern information:
If active
Pattern A or B
➠ Battery Status:
Always appears
Normal, Low, Off
Appears if BG meter is enabled
XX.Xmg/dL
time and date received
If enabled
Time remaining before BG reminder is
set to go off H:MM h
(if less than 1 hour, 0:XXh where XX is
minutes remaining)
➠ Block:
If active
ON
➠ Current date:
Always appears
➠ BG meter value:
(most recent BG value received)
➠ BG Reminder:*
➠ Current temp basal information:
If active
Rate (units per hour), duration, time
remaining
➠ Last bolus information:
Type and units delivered
Delivery time and date
‘S’-Square, ‘N’-Normal, ‘D’-Dual
➠ Meter Off, Low Batt:
Appears if enabled but battery is low or empty
➠ Meter On:
Appears if enabled
➠ Pump model number:
Always appears
➠ Remote On:
Appears if enabled
➠ Reservoir started:
Always appears
➠ Serial number:
Always appears
➠ Software version:
Always appears
➠ Standard basal delivery data:
Always appears
Date, time, units left, time left
Current basal rate (basal 1, basal 2,
etc.)
➠ Status of pump
i.e., Rewind, Suspended, Low Reservoir, Set Time, etc.
➠ Time
Always appears
*If all Reminders and Alarm Clock are enabled, only the reminder nearest to alarming will appear in the STATUS screen.
140 Chapter 11
Bolus Wizard feature specifications
There are three different formulas the Bolus Wizard feature uses to estimate a bolus, depending on your current
BG:
1 If current BG
is greater than
your High
Target BG
correction estimate
food estimate
=
food
carb ratio
+
=
food
carb ratio
food estimate
3 If current BG
is between or =
High or Low
food
=
Target BG
carb ratio
insulin sensitivity
+
current BG - Low BG Target
insulin sensitivity
correction estimate
+
0
Notes:
If a Dual Wave bolus is less than the estimate due to the max
bolus limit or a user change, the square (sq) portion is reduced
first.
➠ Based on the Active Insulin Time setting you choose, the pump
keeps track of how much insulin is still active in your body. This
prevents “stacking” of insulin, and lowers the chances of
hypoglycemia.
➠ Active Insulin Curves
➠
– active insulin
correction estimate
food estimate
2 If current BG
is less than
your Low
Target BG
current BG – High BG Target
ESTIMATE DETAILS
Est total:
Food intake:
(Meter) BG:
Food:
Correction:
Active Ins:
4.0U
45gr
160
3.0U
2.0U
1.0U
(values
shown
are for
example
only)
ACT to proceed,
ESC to back up
Pump specifications 141
Active Insulin
Insulin Curve
Curve
100%
90%
88 Hour
Hour
77 Hour
Hour
66 Hour
Hour
80%
55 Hour
Hour
44 Hour
Hour
33 Hour
Hour
%%Insulin
Remaining
Insulin Remaining
70%
60%
22 Hour
Hour
50%
40%
30%
20%
10%
0%
0
1
2
3
4
5
6
7
8
9
Time
Time(hours)
(hours)
Graph adapted from Mudaliar and colleagues, Diabetes Care, Volume 22, Number 9 September 1999, page 1501
Active insulin only reduces the correction portion of the estimate, not the food portion.
➠ For a current BG that is above the high target, if the active insulin is more than the correction
estimate, the correction portion of the estimate is changed to zero (0).
➠ For a current BG that is below the low target, if the active insulin is more than the correction
estimate, the active insulin is not considered.
➠
142 Chapter 11
Bolus Wizard feature examples
Settings:
➠
Carb ratio: 30 grams/unit
➠
Insulin Sensitivity: 40 mg/dL/unit
➠
BG Target: 90-120 mg/dL
➠
Active Insulin Time: 6 Hours
#1: No active insulin from previous bolus delivery. User inputs 60 grams of carbs and does not enter BG.
(food estimate)
60g
30g/u
= 2 units
estimate = 2 units
#2: No active insulin from previous bolus delivery. User inputs 60 grams of carbs and a BG of 200.
(food estimate)
60g
30g/u
= 2 units
+
(correction)
200mg/dL - 120mg/dL
= 2 units
40mg/dL/u
=2+2
= 4 units
estimate = 4 units
#3: No active insulin from previous bolus delivery. User inputs 60 grams of carbs and a BG of 70.
(food estimate)
60g
30g/u
= 2 units
+
(correction)
70mg/dL - 90mg/dL -20mg/dL
=
= -0.5 unit
40mg/dL/u
40mg/dL
= 2 + (-0.5)
= 1.5 unit
estimate = 1.5 unit
#4: No active insulin from previous bolus delivery. User inputs 60 grams of carbs and a BG of 100.
(food estimate)
60g
30g/u
= 2 units
+
(correction)
Correction is 0 because the current BG
reading is between the BG High and Low
=2+0
= 2 unit
estimate = 2 unit
Pump specifications 143
#5: Previous bolus activity results in a calculation of 1.5 units unabsorbed (active) insulin.
User inputs 60 grams of carbs and a BG of 200.
(correction)
(food estimate)
60g
30g/u
= 2 units
+ 200mg/dL - 120mg/dL
- 1.5 units (active insulin)
40mg/dL/u
= 2 - 1.5 = 0.5 units
= 2 + 0.5
= 2.5 unit
estimate = 2.5 unit
#6: Previous bolus activity results in a calculation of 3.5 units unabsorbed (active) insulin.
User inputs 60 grams of carbs and a BG of 200.
(food estimate)
60g
30g/u
= 2 units
(correction)
+
200mg/dL - 120mg/dL
40mg/dL/u
- 3.5 units (active insulin) = 2 - 3.5 = -1.5 units*
* This negative number indicates that active insulin is sufficient to
cover the correction that is needed. Thus, correction will be 0
units. Active insulin does not reduce the food portion of the
=2+0
= 2 unit
estimate = 2 unit
144 Chapter 11
Default settings
Menu
Bolus
Menu:
Item
Default
Setting
Bolus Wizard feature:
Off
Easy bolus:
On
Easy bolus step:
Dual/Square bolus:
Maximum bolus:
Basal
Menu:
0.1 u/h
Increments
maximum bolus setting
Off
10.0 u/h
0 - 25 u (per single bolus)
BG reminder:
Off
0:00 - 5:00
0:30
Patterns:
Off
0.00 - 35.00 u/h
0.05u
Maximum basal rate:
2.0 u/h
Basal rate:
0.0 u/h
Temp basal type:
Lock Keypad:
U/H
(no defaults)
Alert type:
audio, beepmed
max basal rate setting
0.05U/H (or
1%)
5 - 50 u; 2nd: @ 1\2
amount
(2:00 - 24:00; 2nd: after
1:00)
20 u
(0:30)
Off
Low reservoir warning:
(20) insulin
units
(Time/Date) Time:
12 a.m.
(midnight)
(Time/Date) Date:
1/1/04
(Time/Date) Time
format:
Block:
0.05u
Off
(Alarm) History:
Auto-off:
Utilities
Menu:
Limits
12-hour
Off
Alarm clock:
Off
Remote option:
Off
Meter option:
Off
User Settings: (no defaults)
Language: English
Pump specifications 145
Menu
Item
Default
Setting
Bolus Wizard feature Settings
carb units:
ins to carb (or exch)
ratio:
Limits
Increments
Warning
Limits
grams or
exchanges
none
none
none
15 grams/u or
1 units/exch
3 - 150g/u or
0.1 - 5.0 u/exch
1 g/u or
0.1 u/exch
5 - 50 g/u or
0.3 - 3.0 u/exch
50 mg/dL or
2.8 mmol/L
10 - 400 mg/dL or
0.5 - 22.2 mmol/L
1 mg/dL or
0.1 mmol/L
20 - 100 mg/dL
or
1.1 - 5.6
mmol/L
100- 100 mg/dL
or
5.6-5.6 mmol/L
60 - 250 mg/dL or
3.3- 13.9 mmol/L
1 mg/dL or
0.1 mmol/L
90 - 140 mg/dL
or
5.0 - 7.8
mmol/L
6 Hours
2 - 8 Hours
1 hour
(insulin) sensitivity:
BG target:
Active Ins Time
146 Chapter 11
Icon table
Do not reuse:
Attention: See Instructions for Use
w
Date of manufacture (year - month):
Batch code:
LOT
Use by: (year - month)
Catalogue number:
REF
Device serial number:
SN
Storage temperature range:
Fragile product:
Type BF equipment:
(Protection from electrical shock)
Conforms to IEC60601-1 sub-clause 44.6
and IEC60529 standard.
Recycle:
Radio communication:
Pump specifications 147
148 Chapter 11
Glossary
A
Accept - Pressing the ACT button to approve the
selection or setting.
Active insulin - Bolus insulin that has been
delivered to your body, but has not yet been
used.
Alarm - Audible or vibrating (silent) notice that
indicates the pump is in Attention mode and
immediate attention is required. Alarms are
prefixed in the alarm history with the letter A.
Alarm clock - Feature you can set to go off at
specified times of the day.
ALARM HISTORY - Screen that displays the last
36 alarms/errors that have occurred on your
pump.
Alert - Audible or vibrating (silent) indicator that
notifies you the pump needs attention soon or
that you should be reminded of something.
Insulin delivery continues as programmed.
Attention mode - Operating mode that stops all
current insulin delivery. This mode indicates an
alarm or condition exists that requires
immediate attention.
B
Backlight - Pump screen light. Turns on whenever
is pressed or is pressed in combination with
if not on the HOME screen. The backlight
also appears during an alarm (except LOW
BATT).
Basal rate - The pump setting that provides a
continuous infusion of insulin to keep the blood
glucose stable between meals and during the
night. Basal insulin mimics pancreatic insulin
delivery which meets all the body’s non-food
related insulin needs.
BASAL REVIEW screen - Shows the basal rates
programmed in the pump, with the 24-hour
total for each rate.
BG - Blood Glucose
BG reminder - Feature that you can set to remind
you to check your blood glucose after a bolus.
BG target - normal blood glucose level
BG unit - blood glucose unit of measure (mg/dL
or mmol/L)
Block - Feature that restricts access to all
programming except suspend, selftest and the
delivery of a bolus with the remote control.
Glossary 149
Bolus - A dose of insulin given to cover an
expected rise in blood glucose (such as the rise
after a meal) or to lower a high blood glucose
down to target range.
BOLUS HISTORY - This screen displays the last
twenty-four (24) boluses delivered by your
pump.
Bolus Wizard feature - Calculates the bolus
amount based on personal information of the
pump user.
C
Carb ratio - (Carbohydrate ratio). Used when
counting carbohydrates in grams. The amount of
carbohydrates covered by one unit of insulin.
(Also see exch ratio.)
Carb units - The food entry when using the Bolus
Wizard feature. Entered as (carbohydrate)
grams or exchanges.
Cannula - A short, thin, and flexible tubing at the
end of an infusion set that is inserted into the
subcutaneous tissue to deliver insulin.
CH - Carbohydrate
Correction bolus - The amount of insulin needed
to return a high blood glucose level back down
to target range.
Correction bolus factor - How much 1.0 unit of
insulin will lower your blood glucose. This factor
is used to calculate a correction bolus amount
when your blood sugar is high.
(BG level) – (BG target) = X.
X ÷ (corr bolus factor) = corr bolus amount
150 Glossary
D
Daily totals - Shows the total insulin delivered
(basal and bolus) in the last 24-hours. Maximum
records: 14 days
DKA - Diabetic Ketoacidosis
Dual Wave bolus - Combination of a Normal
bolus that is delivered immediately, then
followed by a Square Wave bolus. The Square
Wave portion is delivered evenly over a period
of time.
Duration - Amount of time it takes to administer
a bolus or basal delivery. Also, length of time
for an action or condition.
E
Easy bolus - Method of delivery for a Normal
bolus using the Easy Bolus button
.
Exch ratio - (Exchange ratio) Used when
counting carbohydrates as exchanges. The
amount of insulin required to cover one (1)
carbohydrate exchange. (Also see carb ratio.)
Express bolus - Method of delivery for any bolus
type using the express bolus button
.
F
Fixed prime - Fills the cannula with insulin. This
is done after you insert the infusion set into
your body and remove the introducer needle.
Food bolus - A dose of insulin given to cover the
expected rise in blood glucose that occurs after
eating.
G
Gastroparesis - A condition of the digestive
system that slows down the emptying of food
from the stomach.
H
HbA1c - Glycosylated hemoglobin
HDL - High-density lipoprotein
A complex of lipids and proteins in
approximately equal amounts that functions as
a transporter of cholesterol in the blood.
Hold - Press and continue to press a pump button.
I
Idle - The pump is at the HOME screen.
Infusion set - Flexible tubing with a reservoir
connector and an infusion site. This tubing
delivers insulin from the pump to the body.
Infusion site - The end of the infusion set held to
the body with a tape. It consists of a cannula and
an introducer needle.
Insulin sensitivity - The amount by which your
blood glucose (BG) level is reduced by one unit
of insulin. (Bolus Wizard feature data)
Introducer needle - This needle allows the
insertion of a cannula or a sensor into the
subcutaneous tissue. It is removed and discarded
after insertion leaving only the cannula or the
sensor in the body.
K
Kilopascal - A unit of measurement for
quantifying force. Used to measure atmospheric
pressure. Equivalent to 10,000 dynes per square
centimeter.
L
LDL - Low-density lipoprotein
A complex of lipids and proteins, with greater
amounts of lipid than protein, that transports
cholesterol in the blood.
Link - To turn on and setup the meter option that
allows the pump to receive BG readings from a
meter that communicates with your pump.
Low resv warning - Programmable warning that
notifies you with an alert when either a
specified number of units remain in the
reservoir or a specified amount of time remains
before the reservoir will be empty.
M
Manual bolus - Selectable item available in the
BOLUS MENU when the Bolus Wizard feature is
active. One method of programming a bolus
without the Bolus Wizard feature. (see “Set
bolus”)
Manual prime - Fills the infusion set tubing with
insulin before you insert the set into your body.
(This function is available after a rewind)
Max bolus - The maximum amount of bolus
insulin that the pump will deliver at one time.
(set by the user)
Glossary 151
Max basal rate - The maximum amount of basal
insulin that the pump will deliver at one time.
(set by the user)
Meter - The Paradigm Link Blood Glucose Monitor
Powered by BD Logic™ Technology (Paradigm Link
meter). Your pump can be programmed to
receive your BG readings from this meter.
Meter option - Feature that allows the pump to
receive BG readings from the Paradigm Link
meter.
N
Press - To push and release a button.
Prime - (see fixed prime or manual prime)
PSI - Pound-force per square inch
R
Reservoir - The syringe that holds insulin.
Resume - Restarts basal delivery after the pump
is suspended.
Rewind - The pump drive moves back to its
starting position to prepare the pump for a new
reservoir.
Normal mode - Regular operating mode. No
special features are active, no alert or alarm
conditions exist. Insulin delivery is normal
during this mode.
RF - Radio frequency
Normal bolus - An immediate delivery of a
specified unit amount of insulin.
Scroll - Press the up or down arrow buttons to
move through the screen text.
Now portion- The “Normal” portion of a Dual
Wave bolus. The now portion delivers
immediately and is then followed by the Square
portion.
Select - Pressing the up or down arrow buttons to
highlight a desired screen item.
P
Pattern feature - Extended pump feature that
allows you to program optional basals (Pattern
A, Pattern B) that support activities that are not
a part of your day-to-day routine, but are usual
in your lifestyle. Such activities could be a sport
that you do once a week or a change in your
sleep pattern over the weekend.
Pattern, standard - Your normal basal that
supports your usual day-to-day activity. When
the Patterns feature is off, the pump uses your
standard (basal) pattern.
152 Glossary
S
Set bolus - Selectable item available in the
BOLUS MENU when the Bolus Wizard feature is
inactive. One method of programming a bolus
without the Bolus Wizard feature. (See Manual
bolus.)
Special mode - Operating mode that indicates
one or more special functions is active or a
condition exists that requires attention.
Square Wave bolus - Immediate bolus delivered
evenly over a specified time period (30 minutes
to 8 hours).
Square Wave portion - (Sq) The second part of a
Dual Wave bolus. The Square Wave portion
delivers evenly over a period of time after the
NOW portion delivers.
Status screen - Displays the current operations
of the pump, including active functions, the
most recent basal and bolus deliveries,
reservoir information, and battery condition.
Step - Measurement of insulin that you set and
use for Easy Bolus delivery.
Suspend - Function that stops all insulin delivery.
Any current bolus and/or prime deliveries are
cancelled. The basal delivery is paused until
restarted.
T
Temp - Temporary
Temp basal - (Tmp basal) Temporary one-time
basal insulin with a specified amount and
duration. Used to support insulin needs for
special activities or conditions that are not part
of the normal daily routine.
U
µL - microliter
Glossary 153
154 Glossary
Index
A
accessories 3
accessories,
activity guard 4
holster 4
meter 3
pump clip 4
remote control 3
active insulin 60
Active insulin time,
setting 67
alarm clock 111
Alarm conditions 129
ALARM HISTORY screen 103
Alarm types,
A- alarm 129
auto off 129
batt out limit 129
bolus stopped 129
check settings 123, 130
E- (error) 130
empty reservoir 130
failed batt test 130
max delivery 131
no delivery 121
Alarms,
Alarm details 103
responding to 127
review 103
alert type,
Setting your 103
alerts,
for alert conditions,
low battery alert 127
low reservoir alert 126
assistance
24-hour Product Help Line 1
Attention mode 17
auto-off 104
B
backlight 15, 149
basal delivery, current 34
BASAL MENU 18
basal rate,
daily 34
maximum 36
patterns 88
programming 32
standard xi
stop delivery of 37
temp 92
battery 133, 138
Install 10
pump 122
beep/vibrate, alert type 15
BG reminder 30
BG targets 65
BG units 64
Block feature,
Turn on 113
BLOCK OPTION screen 113
bolus
basic 22
details 28
history 27
manual 78
maximum limit 29
stop delivery of 37
bolus delivery, methods for normal
Bolus Wizard 71
Easy Bolus 85
express bolus 22
from the menu 22
remote control 3
BOLUS MENU 17
bolus types,
Dual Wave 77
Normal 22
Square Wave 77
Bolus Wizard 1, 55
Bolus Wizard,
"Bolus Wizard is off" message 67
"Bolus Wizard setup is complete"
message 67
"Missing info" message 67
estimate details 28
maximum delivery 59
on/off 61
review settings 68
settings,
BG units 56
Carb ratios 56
Carb units 56
Insulin sensitivity 56
specifications 141
What is it? 55
Index 155
your BG reading 55
your personal settings 55
Bolus Wizard, How it works 58
buttons, pump 9, 12
C
Carb ratios xii
Carb ratios,
exchanges 62
grams 62
Carb units 62
Charger 3
CHECK BG message 30
Child block 113
cleaning the pump 134
Clear settings 119
correction bolus 22, 71, 72
D
DAILY TOTALS screen,
Review 106
default settings 145
disposables 3
Dual Wave bolus programming,
with Bolus Wizard 82
without Bolus Wizard 78
dual/square option,
on-off 78
E
Easy 84
Easy bolus 84
Easy bolus,
cancel 86
deliver an 85
step value 85
156 Index
emergency kit 2
ESC 5, 12
ESC, cancels programming 19
express bolus button 12
F
fixed prime amounts 52
food bolus 22, 56, 71, 72
food entry 55, 71
G
Glossary 149
H
high BG levels,
Bolus Wizard and 59
History 120
HOME screen 13
I
infusion set 41
infusion set,
changing your 44
infusion sets 3
Insulin sensitivity 64
L
Language setting 120
Lock keypad feature 115
low battery alert 127
low battery,
affects remote control 112
affects selftest 116
affects your alert type 103
low BG levels,
Bolus Wizard and 59
low reservoir alert 126
Low resv alert feature 104
Low resv alert types,
Insulin units 105
Time 105
M
MAIN MENU 17
MANUAL PRIME screen 47
maximum bolus limit 29
menus 17
meter 55
meter IDs,
add, delete, review 69
meter option 68
rules 69
METER OPTION screen 69
meter readings 58
modes,
Attention 17
Normal 16
Special 16
N
no delivery 121
Normal 71
Normal bolus programming,
without Bolus Wizard 22
Normal mode 16
Now 83
Now portion,
of the Dual Wave bolus 79, 83
P
Patterns,
basal 88
on/off 88
pattern A, B 88
Program a basal pattern 89
Select a basal pattern 90
standard basal pattern 88
Personal reminders 111
personal settings 55
practicing 45
PRIME MENU 18
prime,
fixed 52
history 52
manual 47
pump,
battery compartment 9
buttons 9, 12
if you remove your 20
screen 9, 13
using in water 125
R
Reminder, alarm clock 111
remote control 3
remote control IDs,
add, delete, review 112
Remote control option,
turn on 112
removing your pump 20
reservoir,
filling the 42
Inserting in your pump 46
low reservoir alert 104
plunger rod 42
removing the 44
transfer guard 42
tubing connector 9
reservoirs 3
Restore settings 118
rewinding your pump 45
rewinding your pump,
during practice 45
RF features,
remote control 111
use on aircraft 8
S
Save settings 117
scroll bar 13
Selftest 116, 125
Sensor function 18
Special mode 16
Square portion,
of the Dual Wave bolus 83
Square Wave bolus programming,
with Bolus Wizard 82
without Bolus Wizard 78
STATUS screen 19
Step value setup 85
storage temperature, pump 147
supplies, ordering 4
Suspend function 17, 37
rates 92
Selecting type 96
verify delivery 97
terms and symbols 5
Tester 3
therapy follow-up,
Recommended 101
time and date, setting 21
Transmitter
tester 3
U
User settings 117
Utilities 103
UTILITIES MENU 18
T
Temp basal 126
temp basal types,
Insulin rate 93
Percent of basal 94
Temp basal,
Canceling a 98
Deliver a 96
Index 157
158 Index
6025250-011C
112106
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