Energizer 515 User manual

Energizer 515 User manual
Paradigm®
515 and 715 Infusion Pumps
User Guide
© 2005, Medtronic MiniMed. All rights reserved.
This product is covered by U.S. Patent Nos. 6,551,276 and 6,554,798. Other U.S. and/or foreign patents may be pending.
Paradigm®, Quick-serter®, Quick-set®, Silhouette®, and Sof-set®, are registered trademarks of Medtronic MiniMed.
CareLink™, Bolus Wizard™, Dual Wave™, Easy Bolus™, Paradigm Link™, ParadigmPAL™, and Square Wave™ are trademarks of
Medtronic MiniMed.
BD Logic™ is a trademarks of Becton, Dickinson and Company.
The Link™ is a trademark of Becton, Dickinson and Company (Canada only).
Energizer® is a registered trademark of Eveready Battery Company.
Glucagon Emergency Kit® is a registered trademark of Eli Lilly and Company.
REF MMT-515
MMT-715
6025020-015 110805
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
Help Line 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 Chapter 9, “Troubleshooting” for more details regarding what to do if
your pump displays an error alarm or other alert message.
Please contact our 24-Hour Help Line at 1-800-MINIMED (1-800-646-4633) to report any error alarms or
other problems that occur with your pump.
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Contents
Glossary .............................................................. xvii
Your personal information .......................................... xxiii
Basal rate ............................................................................................... xxiii
Carb ratios (meal bolus information) ............................................................. xxiv
Chapter 1 Introduction .................................................1
Availability ................................................................................................. 1
Assistance .................................................................................................. 1
Emergency kit ............................................................................................. 2
Disposables ................................................................................................. 3
Accessories ................................................................................................. 3
Download pump and meter data ...................................................................... 4
ParadigmPAL ............................................................................................... 5
How to wear your pump ................................................................................. 5
How to use this guide .................................................................................... 6
User safety ................................................................................................. 7
Indications ............................................................................................. 7
Contraindications ..................................................................................... 7
Warnings ............................................................................................... 7
Reservoir and infusion sets ...................................................................... 7
X-rays, MRIs and CT scans ........................................................................ 7
Precautions ............................................................................................ 8
Avoid extreme temperatures .................................................................... 8
Infusion sets and sites ............................................................................ 8
Notice ....................................................................................................... 9
Insulin pump and RF accessories ................................................................... 9
Chapter 2 The basics ................................................ 11
Your pump ...............................................................................................
Install battery ...........................................................................................
Pump buttons ............................................................................................
The pump screen .......................................................................................
Contents
11
12
14
15
v
HOME screen ............................................................................................. 15
Screen icons ..........................................................................................15
Battery .............................................................................................15
Time display .......................................................................................16
Reservoir volume .................................................................................16
Alert and alarm icons ............................................................................16
Scroll bar ..............................................................................................16
Screen backlight .....................................................................................17
Beep/vibrate ............................................................................................. 17
Operating modes ........................................................................................ 17
Menus ..................................................................................................... 19
STATUS screen .......................................................................................... 20
If you remove your pump ............................................................................. 21
Pump settings ........................................................................................21
Insulin ..................................................................................................21
Chapter 3 Basic programming ........................................ 23
Setting the time and date ............................................................................. 23
Bolus insulin delivery types .......................................................................... 24
Normal bolus .........................................................................................24
Review your bolus deliveries ......................................................................... 29
Bolus details ..........................................................................................30
Maximum bolus limit ................................................................................... 31
BG reminder ............................................................................................. 32
Basal ....................................................................................................... 33
Start and stop times .................................................................................33
Your basal settings ..................................................................................34
Basal programming and delivery ..................................................................34
Basal review ..........................................................................................36
Current basal delivery ...........................................................................36
Daily basal rate(s) ................................................................................36
Max basal rate ........................................................................................... 38
Stopping your pump .................................................................................... 39
Resume pump delivery ................................................................................ 40
vi
Contents
Chapter 4 Starting on insulin ........................................ 43
Prepare your pump for use ........................................................................... 43
Filling the reservoir .................................................................................... 44
Changing your infusion set ............................................................................ 46
Removing the reservoir .............................................................................46
Rewinding your pump ...............................................................................47
Inserting the reservoir in your pump .............................................................48
Manual prime .........................................................................................49
Insert the infusion set ...............................................................................50
Quick-set infusion set (with Quick-serter®) .................................................51
Connecting Quick-set .......................................................................54
Disconnecting Quick-set ...................................................................54
Fixed prime ...........................................................................................55
Prime history ............................................................................................ 55
Record keeping for diabetes management ........................................................ 56
Determining your pump settings .................................................................... 56
Using your daily journal ............................................................................... 57
Chapter 5 Using the Bolus Wizard feature ......................... 59
What is it? ................................................................................................ 59
Information you need .................................................................................. 59
Food entry ............................................................................................59
Your blood glucose (BG) reading ..................................................................59
Your personal Bolus Wizard feature settings ....................................................59
How the Bolus Wizard feature works ............................................................... 62
More about the Bolus Wizard feature ............................................................63
About high or low blood glucose levels .......................................................63
About maximum delivery .......................................................................63
About active insulin ..............................................................................64
How to program the Bolus Wizard feature ........................................................ 66
Bolus Wizard feature on/off .......................................................................66
Carb units .............................................................................................67
Carb/Exch ratios .....................................................................................67
BG (blood glucose) units ............................................................................69
Insulin sensitivity ....................................................................................69
BG (blood glucose) target range ...................................................................70
Active insulin time ...................................................................................72
Contents
vii
Review your Bolus Wizard feature settings ....................................................... 73
Meter option ............................................................................................. 73
Meter rules ............................................................................................74
Add, delete, review meter IDs .....................................................................74
Normal bolus using Bolus Wizard feature .......................................................... 76
Bolus Wizard feature examples ...................................................................... 78
Chapter 6 Optimizing pump therapy ................................. 83
Square Wave and Dual Wave boluses ............................................................... 83
Dual/Square Wave bolus on-off ...................................................................84
Square Wave or Dual Wave bolus without Bolus Wizard feature .............................84
Using the Bolus Wizard feature for a Square Wave or Dual Wave bolus .....................89
Easy bolus ................................................................................................ 91
Easy bolus setup .....................................................................................91
Step value setup ..................................................................................92
Delivering an Easy bolus ............................................................................92
Basal patterns ........................................................................................... 95
Patterns on/off ......................................................................................95
Program a pattern ...................................................................................96
Select a pattern ......................................................................................97
Temp (temporary) basal rates ....................................................................... 99
How does temp basal work? ........................................................................99
Temp basal types .................................................................................. 100
Insulin rate ...................................................................................... 100
Percent of basal ................................................................................ 101
Selecting temp basal type ........................................................................ 103
Delivering a temp basal ........................................................................... 103
Verifying temp basal delivery .................................................................... 104
Canceling a temp basal ........................................................................... 105
Chapter 7 Insulin pump therapy follow-up ......................... 107
Recommended follow-up .............................................................................107
Everyday ............................................................................................ 107
Every month ........................................................................................ 107
Every 3 months ..................................................................................... 107
Laboratory tests .................................................................................... 108
Every visit ........................................................................................... 108
Annually ............................................................................................. 108
viii Contents
Chapter 8 Utilities .................................................. 109
Alarm review ...........................................................................................109
Alarm details ....................................................................................... 109
Setting your alert type ...............................................................................109
Auto-off ..................................................................................................110
Low resv alert (Low reservoir warning) ...........................................................110
Review daily insulin totals ...........................................................................112
Pump data management .......................................................................... 113
Days to average ................................................................................. 115
Personal reminders ....................................................................................116
Alarm clock ......................................................................................... 116
Remote control option ................................................................................117
Turn on remote control option .................................................................. 118
Add, delete, review remote control IDs ....................................................... 118
Block feature ...........................................................................................119
Turn block on ....................................................................................... 119
Lock keypad feature ..................................................................................121
To lock keypad ..................................................................................... 121
To unlock keypad .................................................................................. 121
Selftest ...................................................................................................121
User settings ............................................................................................123
Saving pump settings .............................................................................. 123
Restoring pump settings .......................................................................... 124
Clear settings ....................................................................................... 125
History ............................................................................................... 126
Language setting .......................................................................................127
Chapter 9 Troubleshooting .......................................... 129
My pump has a no delivery alarm... ............................................................ 129
What happens if I leave the battery out too long? ........................................... 130
Why doesn’t my pump battery last very long? ................................................ 130
What is a CHECK SETTINGS alarm? .............................................................. 130
My screen appears distorted ..................................................................... 131
I cannot get out of the priming loop ............................................................ 131
The pump is asking me to rewind ............................................................... 131
My bolus stopped .................................................................................. 132
My pump buttons are not acting right during a bolus ........................................ 132
My pump won’t display my blood glucose reading from my meter ........................ 132
Contents ix
I dropped my pump ................................................................................ 133
I submerged my pump in water .................................................................. 133
I cannot get to the User Settings menu ........................................................ 134
Alert conditions ........................................................................................134
What to do .......................................................................................... 134
Low reservoir alert ............................................................................. 135
Low battery alert ............................................................................... 135
Alarms ....................................................................................................135
What to do .......................................................................................... 136
Alarm conditions .......................................................................................137
A (Alarm) ............................................................................................ 137
Auto off ............................................................................................. 137
Batt out limit ....................................................................................... 137
Bolus stopped ....................................................................................... 137
Button error ........................................................................................ 138
Check settings ...................................................................................... 138
E (Error) ............................................................................................. 138
Empty reservoir .................................................................................... 138
Failed batt test .................................................................................... 138
Is priming complete? .............................................................................. 139
Max delivery ........................................................................................ 139
Motor error ......................................................................................... 139
No delivery .......................................................................................... 139
No reservoir ......................................................................................... 139
Off no power ....................................................................................... 140
Reset ................................................................................................. 140
Weak Battery ....................................................................................... 140
Chapter 10 Pump maintenance ...................................... 141
Battery ...................................................................................................141
Storage ...................................................................................................141
Cleaning your pump ...................................................................................142
Chapter 11 Pump specifications .................................... 143
Alarms and error messages ..........................................................................143
Alarm history ...........................................................................................143
Backlight .................................................................................................143
Basal ......................................................................................................143
x
Contents
BG (blood glucose) target ............................................................................144
Bolus delivery ..........................................................................................144
Bolus history ............................................................................................144
Bolus units ..............................................................................................144
Bolus Wizard feature ..................................................................................144
Carb ratios ..............................................................................................144
Carb units ...............................................................................................144
Daily totals ..............................................................................................144
Default screen ..........................................................................................144
Pump motor .............................................................................................145
Dual Wave bolus .......................................................................................145
Easy bolus ...............................................................................................145
Infusion pressure ......................................................................................145
(Insulin) sensitivity ....................................................................................145
Low resv (reservoir) warning ........................................................................145
Meter value .............................................................................................146
Normal bolus ............................................................................................146
Occlusion detection ...................................................................................146
Percent temp basal ....................................................................................146
Power supply ...........................................................................................146
Prime function .........................................................................................146
Prime history ...........................................................................................146
Program safety checks ................................................................................147
Pump size ...............................................................................................147
Pump weight ............................................................................................147
Remote control .........................................................................................147
Reservoir ................................................................................................147
Square Wave bolus ....................................................................................147
Temporary (temp) basal rate ........................................................................147
Time and date screen .................................................................................147
Status screen ...........................................................................................148
Bolus Wizard feature specifications ...............................................................150
Bolus Wizard feature examples .................................................................. 152
Default (factory) settings ............................................................................154
Icon table ................................................................................................157
Index ................................................................. 159
Contents
xi
xii
Contents
Practice lessons and examples
Bolus examples
Meal bolus
Normal meal bolus using the exchange system ..................................................25
Bolus practice .........................................................................................26
Normal meal bolus practice using exchanges ....................................................26
Normal meal bolus using carbohydrate counting ................................................26
Correction bolus
Meal bolus, correction bolus and insulin sensitivity ............................................27
Practice: Meal bolus .................................................................................28
Max bolus
Example 1: Max bolus ................................................................................31
Example 2: Max bolus ................................................................................31
Basal examples
Basal programming
Practice: Basal programming .......................................................................35
Max basal
Example 1: Max Basal ................................................................................38
Example 2: Max Basal ................................................................................38
Suspend/Resume examples
Example: Suspend function .........................................................................40
Practice: Suspend function .........................................................................41
Practice: Resume basal delivery after a suspend ...............................................41
xiii
Bolus Wizard feature examples
Example 1: BG on target (normal BG) and no active insulin ...................................78
Example 2: BG above target (high BG) and no active insulin ..................................79
Example 3: Blood glucose below target (low BG) and no active insulin .....................79
Example 4: Blood glucose above target (high BG) with active insulin .......................80
Example 5: Blood glucose below target (low BG) with active insulin ........................81
Square Wave bolus examples
Example 1: Use of a Square Wave bolus while eating a meal high in fat ....................86
Example 2: Square Wave bolus, (gastroparesis) .................................................86
Dual Wave bolus examples
Your turn: Square Wave bolus practice ...........................................................87
Example 1: Set a Dual Wave bolus for a barbecue style dinner ...............................87
Example 2: Set a Dual Wave bolus for correcting elevated BG before a meal ..............88
Your turn: Dual Wave bolus practice ..............................................................88
Easy bolus examples
Example #1: Easy bolus ..............................................................................94
Your turn: Easy bolus practice .....................................................................94
Basal patterns examples
Example 1: Basal patterns ..........................................................................98
Example 2: Basal patterns ..........................................................................98
Your turn ...............................................................................................98
Example 1: Temp Basal for a decreased temporary basal rate ............................. 105
Temp Basal examples
Example 2: Temp Basal for an increased temporary basal rate ............................. 106
Your turn ............................................................................................. 106
Block examples
Example 1: Block ................................................................................... 120
Example 2: Block ................................................................................... 120
xiv
Glossary
A
Accept - Pressing the ACT button to approve the
selection or setting.
Active insulin - 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 - The feature you can use like any
alarm clock. You can set the pump to send you
an alarm at certain times of the day as
reminders. For example, you can set the pump
to send you an alarm every four hours to remind
you to check your blood glucose level.
ALARM HISTORY screen - The screen that
displays the last twelve alarms or errors that
have occurred on your pump.
Alert - An audible ‘beep’ or vibration from the
pump to notify you that the pump needs
attention soon. You may need to replace a low
battery, or the pump may be sending you a
reminder of something (for example, that you
need to check your blood glucose level). An
alert does not affect insulin delivery.
Attention mode - The 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
the
button is pressed or in combination with
the
button 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 - The screen that shows
the basal insulin delivery rates programmed in
the pump. This includes the total amount of
insulin delivered by the pump every 24 hours at
each delivery rate.
BG - (Blood glucose) The main sugar that your
body makes from food (especially
carbohydrates). Glucose is the major source of
energy for your body and is carried in the
bloodstream.
BG (blood glucose) reminder - The feature that
you can use to remind you to check your blood
glucose level after a bolus insulin dose.
Glossary xvii
BG (blood glucose) target range - The range of
your normal or desirable blood glucose levels.
You can set up the pump so that you receive an
alarm when your blood glucose level is below or
above your target range.
BG (blood glucose) units - Blood glucose unit of
measure (mg/dL or mmol/L).
Block - The feature that restricts access to all
programming except suspend, selftest and the
delivery of a bolus with the remote control.
Bolus - A dose of insulin given in addition to your
base (basal) insulin dose to bring your blood
glucose level down to your target range. The
two basic types of bolus insulin doses are
‘correction’ boluses (see page xviii), and ‘food’
boluses (see page xix).
BOLUS HISTORY screen - The screen that
shows the last twenty-four (24) boluses
delivered by your pump.
Bolus Wizard® feature - A feature of the pump
that automatically calculates the amount of
insulin you need bring your blood glucose level
back down to your target range.
C
Carb ratio - (Carbohydrate ratio) 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.
xviii Glossary
CH - (Carbohydrate) A source of energy in food.
Most carbohydrates are sugars and starches that
your body turns into glucose for energy. After
you eat carbohydrates, your blood glucose rises.
Correction bolus - A type of bolus insulin dose
given to bring your blood glucose level back
down to your blood glucose target range when
your blood glucose is unexpectedly higher than
your target range, and the rise in blood glucose
is not related to eating. The amount of insulin
that is needed is called the “corr bolus
amount” and is calculated using this formula:
[blood glucose] – [blood glucose target) = X.
X ÷ (corr bolus factor) = corr bolus amount
Correction bolus factor - How much 1.0 unit of
insulin will lower your blood glucose level. This
information is used to calculate the amount of
bolus insulin you need when your blood glucose
is above your blood glucose target range. (See
“Correction bolus.”)
D
Daily totals - Shows the total insulin delivered
(basal and bolus) in the last 24-hours. Maximum
records: 14 days
DKA - (Diabetic Ketoacidosis) A complication of
diabetes mellitus that is caused by the
accumulation of fat metabolism by-products
(ketones). This happens when glucose is not
available as fuel in the body. DKA is also
referred to as ketoacidosis or diabetic coma.
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 needed 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 - To fill (prime) the cannula with
insulin. This is done after you insert the infusion
set into your body and remove the introducer
needle.
Food bolus - A type of bolus insulin dose given
before meals or snacks to keep your blood
glucose level from going above your target
range. The amount of insulin needed is
calculated using your insulin sensitivity
(page xix), the amount of active insulin in your
body (page xvii), the amount of carbohydrates
in the meal or snack, and how much your
current blood glucose levels is above your
target range.
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 - To push and keep pressure on a pump
button.
I
Idle - The pump is at the HOME screen.
Ins sensitivity - (Insulin sensitivity) The amount
that your blood glucose level is reduced by one
unit of insulin.
K
Kilopascal (kPa) - A unit of measurement for
quantifying force. Used to measure atmospheric
pressure. Equivalent to 10,000 dynes per square
centimeter.
Glossary xix
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 blood glucose
readings from the Paradigm Link meter.
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” on page xxi).
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 can deliver at one time
(set by the user).
Max basal rate - The maximum amount of basal
insulin that the pump will deliver at one time
(set by the user).
xx Glossary
Meter - The Paradigm Link Blood Glucose Monitor
Powered by BD Logic™ Technology (Paradigm Link
meter). Your pump can be programmed to
receive your blood glucose readings from this
meter.
Meter option - Feature that allows the pump to
receive blood glucose readings from the
Paradigm Link meter.
N
Normal mode - Regular operating mode. No
special features are active, no alert or alarm
conditions exist. Insulin delivery is normal
during this mode.
Normal bolus - One of three types of bolus insulin
deliveries where all the insulin is delivered at
once. This is usually used to bring your blood
glucose level back down to your blood glucose
target range when you are fasting, and the high
blood glucose is unexpected. The other types of
bolus insulin deliveries are Dual Wave (see
page xix), and Square Wave (see page xxi).
Now portion- The “Normal” portion of a Dual
Wave bolus. The now portion is delivered all at
once, followed by the Square portion.
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.
Press - To push and release a pump button.
Prime - To fill (prime) the cannula with insulin.
This can be done automatically by the pump (a
“Fixed prime”), or manually (a “Manual prime.”
See Fixed prime (page xix) or Manual prime
(page xx).
PSI - Pound-force per square inch.
R
Resume - Continue basal insulin delivery after the
pump is suspended.
Rewind - The pump drive moves back to its
starting position to prepare the pump for a new
reservoir.
RF - (Radio frequency)
S
Scroll - Press the up or down arrow buttons to
move through the screen text.
Select - Pressing the up or down arrow buttons to
highlight a desired screen item.
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” on page xx.)
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 - The screen that 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
Special mode - Operating mode that indicates
one or more special functions is active or a
condition exists that requires attention.
Glossary xxi
xxii Glossary
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, “Using the
Bolus Wizard feature” for information on the Bolus Wizard feature.
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
xxiii
Pattern A
Basal rate
Start time
number
#1
midnight
#2
#3
(additional basal rates)
#4
#5
#6
#7
#8
Pattern B
Basal rate
(units per hour)
Basal rate
Start time
number
#1
midnight
#2
#3
(additional basal rates)
#4
#5
#6
#7
#8
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.
xxiv
When
breakfast
lunch
dinner
snacks
Basal rate
(units per hour)
Start time
(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 the amount of bolus insulin you need.
Availability
The pump and accompanying products are available from Medtronic MiniMed and authorized
distributors.
Assistance
Medtronic MiniMed provides a 24-hour
Product Help Line for assistance. The Help Line
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 Help Line or your local Medtronic
MiniMed office, please have your pump and
serial number available. The phone number for
the 24-hour Product Help Line is also on the
back of your pump.
Department
Telephone number
24-hour Product Help Line
(calls within the United
States)
800.646.4633
(800.M i n i M e d )
24-hour Product Help Line
(calls outside the United
States)
818.576.5555
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
“User safety” on page 7 for more information on pump safety. Your emergency kit should include these
items:
➠
Fast-acting glucose tablets
➠
Paradigm Quick Reference 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 body. Usually, you
need to wait at least 8 hours after an injection before using the Bolus Wizard
feature to calculate your active insulin. The actual amount of time you need to
wait depends on your active insulin setting (see “About active insulin” on
page 64 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 515 pump is intended for use with a 176-unit Paradigm reservoir (MMT-326). The
715 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: Your pump can be used with the optional Paradigm Link™ Blood Glucose Monitor powered by
BD Logic™ Technology. You can program your pump to automatically receive your blood glucose
readings from this meter.
Remote control: The optional Paradigm remote control can be used with the pump to deliver
normal boluses and suspend the pump from a distant location. (This User Guide provides
programming instructions for the remote control. See the remote control User Guide for operating
instructions.
To order supplies, call 800-646-4633 (1-800-MiniMed) or 818-362-5958 (outside U.S.)
www.minimed.com
Introduction 3
Download pump and meter data
The Medtronic CareLink™ Therapy Management System for Diabetes Web site is designed to help you
take information from all of your diabetes management tools—your insulin pump, blood glucose meters,
and logbook—and organize it into easy-to-read charts, graphs, and tables.
These reports can help you and your healthcare professional discover trends and other information
that can lead to improved therapy management for greater control of your diabetes.
Reports show you data gathered from your pump, meter, plus information you enter directly into
the system. Examples of reports you can create include:
Pump operation, such as alarm settings and maximum allowed bolus amount
➠
Insulin delivery rates, types, and times
➠
Blood glucose reading levels and times
➠
Bolus Wizard or online logbook entry data.
Reports display in PDF format, which you can view online, print out, and download and save to your
computer.
You can share your reports with your healthcare professional. They can use report results to
determine if and how your treatment regimen should be adjusted.
The logbook feature allows you to keep track of facts such as:
➠
Carbohydrates eaten,
➠
Exercise activity,
➠
Urine ketone results,
➠
HbA1c results, and
➠
Infusion set changes.
This data from your logbook is used in the reports you create. For instance, you can see how your
carbohydrate intake compares to blood glucose levels for the same day or time. You can also use your
logbook as an online diary of your diabetes management.
The CareLink system is accessed through a Web site at http://carelink.minimed.com. From there,
you can follow the on-screen instructions and help.
➠
NOTE - Medtronic CareLink™ Therapy Management System for Diabetes is not available in all
locations.
4 Chapter: 1
ParadigmPAL
With ParadigmPAL™ you can do the following with your pump settings:
➠ See your pump settings on your PC screen.
➠ Backup, or save, pump settings to diskette or the hard drive of your PC.
➠ Quickly change your pump settings in case your healthcare professional needs to make a
change to your pump therapy.
➠ Print copies of your pump settings for your records.
How to wear your pump
There are a different ways to wear your pump. Medtronic MiniMed has accessories that can hide,
protect, and add to the convenience of wearing a pump. See the accessories catalog or the website
(www.minimed.com) for more information.
➠
Holster: Used to wear the pump on your belt.
➠
Pump clip: Used 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.
Introduction 5
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. See 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 pump button
“Hold”
To push and keep pressure on the pump button
“Select”
To choose an item in a list on the pump screen using the
“Exit the menus”
To leave the current pump menu and return to the HOME screen by pressing
the ESC button until the HOME screen appears
Pump Buttons
Always bold and uppercase (for example, ESC, ACT)
/
buttons
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 damage 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.
6 Chapter: 1
User safety
Indications
The Paradigm 515/715 pump system is indicated for the continuous delivery of insulin, at set and
variable rates, for the management of diabetes mellitus in persons requiring insulin.
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 compatible 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.
Introduction 7
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 blood glucose 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.
8 Chapter: 1
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, Paradigm Link meter, 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 blood glucose reading to the pump while on an aircraft.
Manually enter your blood glucose levels.
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 Product Help Line.
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/Paradigm Link meter
➠ Increase the separation between the insulin pump/remote control/Paradigm Link meter and the
device that is receiving/emitting interference
The Paradigm Link meter transmits 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. See Chapter 9, “Troubleshooting” to
correct interference problems you may have.
If you have questions, please contact the Medtronic MiniMed 24-hour Product Help Line.
Introduction 9
10 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
battery
compartment
reservoir
window
tubing
connector
ESC
ESC
ACT
ACT
buttons
reservoir
compartment
The basics
11
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” alarms may
sound. If a “weak battery” alarm happens, 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
[(-) symbol] going in first. Check the label on the back
of the pump to make sure the battery is inserted
correctly.
Battery cap
Battery
NOTE - Do not use batteries that have been in cold storage (i.e., in the refrigerator or your car in
the winter).
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:
12 Chapter: 2
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.
one half-turn
one half-turn
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 very 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 Product Help Line.
6 Check to make sure the time and date are correct. If this is the first battery installed, or if more
than 5 minutes have passed since you removed the battery, you will be prompted to check the time
and date. See “Setting the time and date” on page 23 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
13
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.
Opens the pump 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. Backs
out of unintentional menu selections
if the ACT button has not been
pressed yet.
EXPRESS BOLUS button: Short-cut
to the SET BOLUS MENU or Bolus
Wizard screen to set up a 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.
14 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 Product Help Line.
HOME screen
in the HOME screen, the area
below the icons is blank.
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.
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 meaning of the icons are described below.
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. So if you only have one
segment left you want to make sure you have a new battery
available.
At least 75% left
Battery
Indicator
icons
Low battery
The basics
15
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 23.
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 until you reach the Low Reservoir point. This allows you to
be aware of how much insulin you have left in your pump. Check your
STATUS screen to view the number of units left in the reservoir.
NOTE - If using the Paradigm 715, your reservoir icon will only
appear full if using a filled 300 unit Paradigm reservoir.
75 to 100
percent left
Reservoir
Volume
Indicator
icons
Empty
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 135 and “Alarm conditions” on page 137.
Alert icon
Alarm icon
Scroll bar
If there is more text than the screen can show, a scroll
bar appears in the right side of the screen. Press
to
view any additional text.
16 Chapter: 2
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. See “Setting your alert type” on page 109 for
setup instructions.
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 and no alerts exist.
Normal Mode
The basics
17
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
➠
Dual or Square Wave bolus
delivery
➠
Basal pattern A or B is active
➠
Special Mode
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
the 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. See “Alarm conditions” on page 137 for alarm conditions that will trigger the
Attention mode. See “Stopping your pump” on page 39 to learn about Suspend mode.
18 Chapter: 2
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 functions for bolus deliveries. The
button allows
direct access to the BOLUS MENU or to the Bolus Wizard feature without having to navigate through
the menus. See Chapter 3, “Basic programming” for the manual bolus information, or to
Chapter 5, “Using the Bolus Wizard feature” for delivering bolus insulin using the Bolus Wizard
feature.
SUSPEND - Stops all current insulin deliveries (basal, bolus and fixed prime). See “Stopping your
pump” on page 39 for more information.
BASAL MENU - Contains the functions to setup and deliver your basal. See Chapter 3, “Basic
programming” for more information.
PRIME MENU - Contains the functions required to change your reservoir and fill the infusion set with
insulin. See “Changing your infusion set” on page 46 for more information.
UTILITIES MENU - Contains features for your safety and convenience. See Chapter 8, “Utilities”
for more information.
The basics
19
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 exit the STATUS screen, press ESC until the STATUS screen disappears.
/
to scroll and view all of the information.
The screen includes information about:
➠
recent insulin deliveries (basal and
bolus)
➠
reservoir status
➠
special features that are turned on
➠
battery status
NOTE - Only check your pump status (press
ESC) when you are not programming your
pump. If you press ESC during
programming, you will cancel the settings
you are trying to enter.
➠
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 515
VER X.XX X.X
time and date
Sample
STATUS screen
See Chapter 11, “Pump specifications” for a complete list of the information that is available in the
STATUS screen.
20 Chapter: 2
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 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 an 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.
The basics
21
22 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.
Main > Utilities > Time/Date
TIME/DATE SETUP
2 Select 12-Hour Setup or 24-Hour Setup and
press ACT.
12 Hour Setup
24 Hour Setup
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.
Minutes
SET MINUTES
9:00A
Year
Month
SET YEAR
SET MONTH
2004
Change the
Change the year.
minutes. Press ACT. Press ACT.
Day
SET DAY
01
01
Change the month. Change the day.
Press ACT.
Press ACT.
For 12-hour setups,
press
until
/
the correct A (am) or
P (pm) appears.
Basic programming
23
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 insulin delivery types
This section provides information on the basic bolus insulin delivery types and instructions on using
the Express bolus feature for giving yourself a ‘Normal’ bolus insulin delivery.
A bolus insulin delivery is a dose of insulin given in addition to your base (basal) insulin to bring your
blood glucose down to your target range. A bolus insulin delivery can be used when:
➠
You are fasting and you notice an unexpected rise in your blood glucose.
➠
Before a meal or a snack and you want to prevent your blood glucose from rising above your target
range.
There are three bolus insulin delivery types: normal, Square Wave, and Dual Wave.The normal bolus
insulin delivery is described below. For information about Square Wave and Dual Wave boluses, see
Chapter 6, “Optimizing pump therapy.”)
Normal bolus
For this type of insulin delivery, all of the bolus insulin is given all at once (all of the insulin in the
dose is given at one time). Normal bolus deliveries can be used to cover an expected rise in your blood
glucose caused by eating a meal or snack, or to correct an unexpected rise in blood glucose.
During a Normal bolus, most pump features are disabled until after all the bolus insulin has been
delivered. The Suspend function and the STATUS screen, however, are always available.
The following instructions are for a Normal bolus when the Bolus Wizard feature is turned off.
from the menu, or
1 Go to the BOLUS
MENU.
Main > Bolus
Select Set Bolus and
press ACT. Go to
Step 2.
24 Chapter: 3
using the EXPRESS BOLUS button
BOLUS MENU
Set
Set Bolus
Bolus
Bolus History
Bolus Wizard Setup
Max Bolus
Dual/Square Bolus
Easy Bolus
BG Reminder
Press the
button. Go to Step 2.
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
If the BOLUS TYPE screen
appears: (Dual/Square
Wave is on) Select Normal
Bolus and press ACT. Go
to Step 3.
SET BOLUS*
0.0
U
/
BOLUS TYPE
Normal Bolus
Square Wave Bolus
Dual Wave Bolus
SET BOLUS*
2.5
U
ACT
* “SET NORMAL BOLUS” will
show if Dual/Square option is on.
NOTE - If you have the BG Reminder feature 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 “BG reminder” on page 32 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
BOLUS DELIVERY
11:53A
U
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
Fred has been taught that he needs to take 1 unit of insulin for every carbohydrate exchange that he
eats (every milk, every starch or every 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
25
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.
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).
26 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 mmol/L). Jason knows that his blood glucose
level is above his high blood glucose target and will need more insulin before he eats.
Jason's healthcare professional has determined the following for him:
High blood glucose target:
Insulin sensitivity:
1
110 mg/dL (6.1 mmol/L)
30 mg/dL (1.7 mmol/L)
3b
Jason determines that he will need a correction bolus of 3.0 units insulin to lower his elevated blood
glucose. The 3.0 correction bolus will lower his current blood glucose of 200 mg/dL (11 mmol/L) down
to his high blood glucose target of 110 mg/dL (6.1 mmol/L).
elevated blood glucose:
200 - 110 = 90 mg/dL (11 - 6.1 = 5 mmol/L)
correction bolus:
90 / 30 (insulin sensitivity) = 3.0 units
(He will add this 3.0 correction bolus to the 4.0 units of insulin that he will need for his meal bolus.
Jason will take a total bolus of 7.0 units.)
1. Insulin sensitivity should equal the amount (in mg/dL or mmol/L) that blood glucose will be lowered after
taking 1 unit of insulin.
To determine insulin sensitivity, divide 1700 by Total Daily Dose (TDD2) of Insulin. The answer is your
“Correction Factor” (1700 Rule). As always, consult with your healthcare professional for guidance.
2. TDD = Total amount of basal and bolus insulin delivered in a 24-hour day.
Basic programming
27
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 blood glucose _________.
You will take ________ unit(s) of insulin to correct your high blood glucose.
Your total bolus (meal bolus plus correction bolus) is _________.
28 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. See “Bolus details” on page 30 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 blood glucose values
that the Bolus Wizard feature used to calculate the
boluses.
2 Follow the instructions in “Bolus details” on page 30
to see the details for any of these boluses.
(with the Bolus
Wizard feature)
BOLUS HISTORY
Last 12:48P 0.7N
05SEP 01:05P 0.2N
05SEP 06:30P 4.8S
BOLUS HISTORY
Last 12:48P 0.7N
CH: 13 BG: 150
05SEP 01:05P 0.2N
date
carb value
blood glucose
(BG) value
time
amount/type
N = Normal
S = Square Wave
D = Dual Wave
DN = Normal part of Dual Wave bolus
DS = Square part of Dual Wave bolus
Basic programming
29
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 you are using the feature)
To see the details for any bolus, do these
(without the Bolus
steps:
Wizard feature)
➠
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.
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
BOLUS DETAIL
Normal
Type:
4.0U
User Entry:
0.7U
Stopped at:
Bolus Wizard:
Est total:
Food intake:
(Meter) BG:
Food:
Correction:
Active Ins:
Est time:
(delivery completed)
(values shown are
for example only)
(delivery stopped)
BOLUS DETAIL
Normal
Type:
Delivered:
4.0U
30 Chapter: 3
If the Bolus Wizard
feature calculated your
bolus, this information
will also appear in the
BOLUS DETAIL screen.
4.0U
45gr
160
3.0U
2.0U
1.0U
12:03P
Maximum bolus limit
The maximum bolus (max bolus) is a safety feature that you can use to set a limit on the amount of
insulin that can be delivered in a single bolus. The factory setting is 10.0 units. You can reset the limit
to anywhere between 0.0 units up to 25.0 units. It is important to discuss this feature with your
healthcare professional to determine your maximum bolus limit.
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
31
BG reminder
When you deliver a bolus you may want to check your blood glucose afterwards. The BG reminder is
an optional feature that you can use to have the pump send you a reminder you to check your blood
glucose after a bolus. You can set the pump to remind you with an audible ‘beep’ or by vibrating. Your
pump is set at the factory with this feature turned off. If the BG reminder feature is turned on when
you are programming your pump, you will be asked to set the amount of time between the bolus insulin
delivery and the reminder. This amount of time is called the ‘BG Reminder Duration.’ The amount of
time you set 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 feature
is now enabled (turned on). Exit the menus.
BG REMINDER SETUP
Off
On
Now, the next time you program a bolus, your pump will ask
you for the amount of time after your bolus before you want to
be reminded to check your blood glucose.
NOTE - If you press ESC when the BG Reminder Duration
BG REMINDER DURATION
2:00
(flashing)
screen 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
32 Chapter: 3
Your pump will beep or vibrate
and the message “CHECK
BG” will appear on the screen.
Your pump will continue to
beep or vibrate periodically
until you clear the reminder
(ESC, ACT).
U100
STATUS
BG Reminder in 0:18h
Battery: Normal
Tues 08 MAR 2004
The STATUS screen will show
the amount of time remaining
before the BG reminder
notice will happen. In this
example, the BG reminder
notice will happen 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
* 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.
■ 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.
Basic programming
33
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 0.00 U/H. This will ensure that the insulin delivery records in your pump are accurate. See “If
you remove your pump” on page 21 for more information.
Basal programming and delivery
To set your basal rates, do these steps:
(If using patterns, you will
first select the basal you
want, then the SET BASAL
RATE 1 screen will appear.)
NOTE - You cannot make changes to your
basal rate settings while a percent (%)
temp basal is active.
1 Go to the BASAL MENU.
BASAL MENU
ACT
Set/Edit Temp Basal
Set/Edit Basal
Basal Review
Main > Basal
EDIT BASAL
Standard
Pattern A
Pattern B
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 24hour 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 data. Your daily basal rate is
now programmed. It will deliver daily from
12:00A to 12:00A.
c. Exit the menus.
34 Chapter: 3
4.40U
0.00U
-.- -U
U
_
H
rate 1 (flashing) press
to set
/
ACT
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.
SET START TIME 2
- -: - -
_. _ _
U
H
ACT
SET BASAL RATE 2
7:30A
_. _ _
U
H
ACT
start time (flashing)
to set
/
rate (flashing)
/
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.).
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.
_. _ _
NOTE - When you have finished programming your pump you can save your
U
H
ESC
settings. See “User settings” on page 123 for instructions.
BASAL RATE
Current Rate 0.60U/H
Started #1 12:00A
24 Hr. Total
14.40U
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
35
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 515
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 basal insulin rate(s).
1 Go to the BASAL MENU. Select Basal Review and
press ACT.
Main > Basal
36 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.
BASAL REVIEW
Standard
Pattern A
Pattern B
16.80 U
24.50 U
19.60 U
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.
(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
37
Max basal rate
Maximum 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 (maximum) 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 rate 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 maximum basal rate will be
flashing.
2
Change the rate and press ACT. 3
Main > Basal > Max Basal Rate
Your maximum
basal rate is now
set. Exit the
menus.
MAX BASAL RATE
x
MAX BASAL RATE
2.
U
00 H
15.
U
00 H‘
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 Maximum 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 Maximum Basal to 3.0 units per hour to accommodate his needs.
38 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.
SUSPEND will flash. Press 3
ACT to stop your pump.
ACT
SUSPEND
ACT
MAIN MENU
Bolus
Suspend
Basal
Press ACT to Stop Pump
(flashing)
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
NOTE - Press ESC to view the STATUS screen
and verify your pump is suspended.
STATUS
U100
Suspended at 01:05P
Last Bolus N 3.8U
7:58A 22 FEB
Basic programming
39
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).
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
Stopped at 1:05P
RESUME
ACT - Restart Basal
ACT
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.
40 Chapter: 3
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 you will continue to receive your basal insulin.
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?
_______.
Practice:
Resume basal delivery after a suspend
1 Make sure you are NOT connected to your pump while practicing.
2 Give a 3.0 unit bolus now. While it is delivering, suspend the bolus.
Check here if you were able to suspend the bolus.
3 Now restart the pump.
Check here if you were able to restart the pump.
Basic programming
41
42 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 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
Paradigm reservoir Instructions for Use document (provided with the
reservoir)
Paradigm infusion set
Starting on insulin 43
Filling the reservoir
WARNING: Your pump will not accurately deliver insulin if air bubbles are in the
reservoir or the infusion set. To prevent this, take care to remove air
bubbles when filling your reservoir.
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.
44 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 While holding 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 completely fill the
reservoir.
10 Put the tubing connector on the reservoir. Turn it
clockwise to secure.
“CLICK”
Starting on insulin 45
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 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 1/2-turn counter
clockwise, then pull the reservoir and connector out
from the pump.
tubing connector
1/2 turn counter-clockwise
4 Safely dispose of the used reservoir and infusion set items.
5 You must now rewind your pump as described in “Rewinding your pump” on page 47.
46 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 or the pump returns
to the HOME screen the PRIMING STOPPED
screen will appear which guides you back to the
priming screens. Once you start a rewind, you
cannot cancel it.
REWIND
Disconnect from Body
Press ACT to Rewind
PRIMING STOPPED
Continue Priming
Rewind Pump
Status Screen
ACT
REWINDING
Wait for notification
ESC PREPARING TO PRIME
Disconnect from Body
Insert/Lock Reservoir
ACT Hold ACT to Prime
ACT
time out
(HOME screen)
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 “Manual prime” on page 49.
If you are not practicing, continue to “Inserting the reservoir in your pump” on page 48.
Starting on insulin 47
Inserting the reservoir in your pump
If your reservoir is already inserted in your pump, continue to “Manual prime” on page 49.
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
1/2-turn clockwise until the connector is
seated. The tubing connector should be
aligned horizontally with the pump case as
shown here.
tubing connector
ESC
ACT
4 Attach the activity guard, if desired.
5 You must now do a manual prime as described in the next section.
48 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.
ACT
PREPARING TO PRIME
Disconnect from Body
Insert/Lock Reservoir
Hold ACT to Prime
The pump may automatically return to the HOME
screen while you install the reservoir. Press ACT to
return to the PREPARING TO PRIME screen.
(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
U
done
0.3
ACT
(hold)
3 While you hold ACT, the
pump will beep again 6 times
as the screen begins counting
the prime units being used.
ATTENTION: If you release the
ACT button:
a. Press ACT. The Manual Prime
screen appears.
b. Press ACT again to continue
the prime sequence (screen
shows where you left off), or
Press ESC to rewind.
4 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.
Starting on insulin 49
WARNING:
Your pump will not accurately deliver insulin if there are air bubbles in the
infusion set. Take care to remove any air bubbles during the manual prime.
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.
a. 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
➠
and 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 “Fixed prime” on page 55.
®
50 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
Starting on insulin 51
8
7
9
52 Chapter: 4
10
11
12
13
Starting on insulin 53
Connecting Quick-set
If you inserted a new reservoir, you should have already done a manual prime. A manual prime is
always done to fill the infusion set tubing with insulin after you rewind your pump and insert the
reservoir. If you are changing your infusion set without changing your reservoir, do a fixed prime to
fill the tubing. See “Fixed prime” on page 55 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.
Infusion set
Infusion set connected
Connector part
Disconnecting Quick-set
The Quick-set allows you the freedom to temporarily disconnect from your pump without removing the
infusion set from your body.
Squeeze the side grips of the connector part
with your fingers.
Side grips
54 Chapter: 4
Remove the connector from the site.
Fixed prime
A fixed prime fills the soft cannula with insulin and is required after the infusion set is inserted into
your body. Additionally, a fixed prime is required if you disconnect your quick release and you need to
reprime the infusion set or if you change your infusion set without changing the reservoir.
NOTE - Prime amounts depend on the type of infusion set you are using. See 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
ACT
Fixed Prime
Rewind
Prime History
3 In the FIXED PRIME screen,
enter the amount of insulin
for your type of infusion set,
then press 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.
ACT
FIXED PRIME
PRIME DELIVERY
6:26P
3U
0.
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.
M
manual
prime
2 Select Prime History
and press ACT.
PRIME MENU
Fixed Prime
Rewind
Prime History
ACT
PRIME HISTORY
01JAN 12:05p 22.5M
03JAN 01:15p 0.5F
03JAN 01:17p 1.2M
F
fixed
prime
4 Scroll through the list of prime
deliveries. The “F” at the end of
the text line indicates a fixed
prime.
An “M” indicates a manual prime.
Exit the menus.
Starting on insulin 55
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.
56 Chapter: 4
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.
Starting on insulin 57
58 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 (BG) reading
You need to know your blood glucose levels. When using
the Bolus Wizard feature, the pump can work with the
Paradigm Link Blood Glucose Monitor Powered by BD Logic
Technology (Paradigm Link meter) to automatically receive
your blood glucose readings. The section “Meter option” on
page 73 has more information. If you are not using this
meter, you will manually enter your blood glucose levels.
Blood glucose
(BG) readings
Paradigm Link
Meter
Your personal Bolus Wizard feature settings
In addition to your blood glucose readings and/or your food entry, the Bolus Wizard feature uses
personal settings that you program into the pump. (See “How to program the Bolus Wizard feature” on
page 66 for instructions.)
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
➠ blood glucose target range
➠ active insulin time (hours)
➠
Using the Bolus Wizard feature 59
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 per 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 per exchange
NOTE - Your carb ratios may vary throughout the day.
Your pump allows you to program up to eight (8)
different carb ratios.
BG units: (how you measure your blood glucose)
Insulin sensitivity:
This ratio is used for your correction bolus calculations.
This ratio is the BG units reduced by 1.0 units of insulin.
range:
(mg/dL)
10 - 400
(mmol/L)
0.5 - 22.2
NOTE - Your insulin sensitivity may vary throughout the
day. Your pump allows you to program up to eight (8)
different insulin sensitivities.
60 Chapter: 5
#8: _________
_____ mg/dL or _____ mmol/L
BG units reduced / 1
start time
unit of insulin
#1: _________
(midnight)
#2: _________
#3: _________
(additional settings, if needed)
#4: _________
#5: _________
#6: _________
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:
(mg/dL)
60 - 250
(mmol/L)
3.3 - 13.9
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 64). 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 61
How the Bolus Wizard feature works
If you are going to eat and you want the Bolus Wizard feature to estimate your food bolus:
1 Enter your blood glucose reading.
➠
automatically from the Paradigm Link meter (refer to “Meter option” on page 73)
or
➠
manually by selecting the
button.
2 Enter your food amount in carbs or exchanges.
3 The Bolus Wizard feature will calculate an estimated food bolus for you. An ESTIMATE DETAILS
screen will appear with your estimated total food bolus amount.
NOTE - If you are using the Paradigm Link meter, you can program your pump to automatically
receive your meter readings. The Bolus Wizard feature will use the blood glucose readings when
calculating your bolus amount. See “Meter option” on page 73 for instructions. If you are not using
this meter, you will manually enter your blood glucose levels.
62 Chapter: 5
More about the Bolus Wizard feature
About high or low blood glucose levels
If your blood glucose is less than 60 mg/dL (3.3 mmol/L), or
more than 250 mg/dL (13.9 mmol/L), the Bolus Wizard screen
will notify you and give you 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
The 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
ACT
to cancel
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 63
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
ESTIMATE DETAILS
If there is no
4.0U
Est total:
for you, based on your active insulin time, and subtracts the
active insulin,
Food intake: 45gr
this will show
appropriate amount when your blood glucose is above your target
160
(Meter) BG:
“N/A”
3.0U
Food:
range. The details will appear in the ESTIMATE DETAILS screen
2.0U
Correction:
during the bolus programming steps.
1.0U
Active Ins:
ACT to proceed,
Your Paradigm pump is shipped from the factory with an
ESC to back up
active insulin time setting of six hours, which most closely
(values shown are
matches the published scientific data. If your healthcare
for example only)
professional prescribes a different time for you, the active insulin
time setting can be adjusted in one-hour increments from two to
eight hours.
You can always choose to override the suggested Bolus Wizard feature estimate and manually enter
a different amount.
64 Chapter: 5
For more details about active insulin, see “Bolus Wizard feature specifications” on page 150.
Active Insulin Curve
100%
90%
8 Hour
7 Hour
80%
6 Hour
5 Hour
70%
% Insulin Remaining
4 Hour
3 Hour
60%
2 Hour
50%
40%
30%
20%
10%
0%
0
1
2
3
4
5
6
7
8
9
Time (hours)
Graph adapted from Mudaliar and colleagues, Diabetes Care, Volume 22, Number 9 September 1999, page 1501
CAUTION:
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. Usually, you must wait at least 8 hours
after an injection before using on your Bolus Wizard feature to calculate
your active insulin. The actual length of time you need to wait depends
on your active insulin setting in the Bolus Wizard feature. See “About
active insulin” on page 64 for more information.
Using the Bolus Wizard feature 65
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 given below. 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:
66 Chapter: 5
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
Carb units
The carb unit setting lets the pump know which way to count your carbohydrates (grams or
exchanges). See the “Bolus Wizard feature settings” table on page 60 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 Carb
Units:
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
Carb Units: grams
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.)
using exchanges
using grams
EDIT SETTINGS
Wizard:
On
Carb Units: grams
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
Using the Bolus Wizard feature 67
NOTE - Carb ratio values are normally between 5–50 grams/u or
WARNING
A carb ratio of XX
is valid but outside
the usual range of
5-50.*
ESC to correct,
ACT to continue
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
using grams
time for the next
SET START TIME 2
ratio and press
_: _
grams
ACT.
/U
__
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
“BG (blood glucose) units” on page 69.
68 Chapter: 5
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
Carb Units: grams
Carb Ratios:
->
BG (blood glucose) units
You can select mg/dL or mmol/L as your BG units (unit of 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.
8 Select mg/dL or
mmol/L and press ACT.
9 The screen will return to the
EDIT SETTINGS screen to set
your insulin sensitivity next.
BLOOD GLUCOSE UNITS
EDIT SETTINGS
Carb Units: grams
Carb Ratios:- >
BG Units:- - -
mg/dL
mmol/L
EDIT SETTINGS
--Sensitivity:
--BG Target:
Active Ins Time: - - -
Insulin sensitivity
Your insulin sensitivity is the amount your blood glucose level is reduced by one unit of insulin. This
value (amount) is used to calculate a suggested bolus insulin dose to correct your blood glucose level
when it is above your target range. Correcting your blood glucose brings it down to your target range.
Since insulin sensitivity amount can change throughout the day, your pump lets you enter up to eight
(8) different insulin sensitivity settings. Your healthcare professional may have you enter only one or
two insulin sensitivity settings when you first start using the Bolus Wizard feature. Record your settings
in the “Bolus Wizard feature settings” table (see page 60).
Insulin sensitivity amounts are normally between 20 – 100 mg/dL (or 1.1 – 5.6 mmol/L). If your
amount 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 amount 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.
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
Using the Bolus Wizard feature 69
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.
INS SENSITIVITY 2*
7:30A
mg/dL
50
per unit insulin
c. Repeat steps a and b
to set more values.
(flashing) set, then press ACT
d. Press ESC when you
are done.
* 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 range setting allows you to set your
blood glucose target range. Because your target 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 blood glucose level is above your
BG target range, the Bolus Wizard feature will
calculate a correction dose. If your current blood
glucose level is below the BG target range, the Bolus
Wizard feature will calculate a negative correction
and subtract it from your food bolus.
70 Chapter: 5
Glucose Concentration
BG (blood glucose) target range
(mmol/L)
22.2
(mg/dL)
400
13.9
250
5.5
100
3.8
70
Target Range
Correct down to upper limit
(mg/dL)
100
(mmol/L)
5.5
Correct up to the lower limit
(mg/dL)
70
(mmol/L)
3.8
NOTE - Pumps are sent from the factory with a BG target range of 90-140 mg/dL (5.0-7.8
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 the normal range.
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
first BG Target
Range
(flashing)
100 - 100
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
_-_
To set more than one BG Target:
a. Set the start time
for the next BG
target range and
press ACT.
SET START TIME 2*
_: _
--(flashing) set, then press
ACT
(flashing)
press ESC
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.
TARGET RANGE 2*
7:30A
mg/dL
100 - 100
(flashing) set, then press
ACT
* Depending on how many
targets you set, this
number can be 2 through 8.
Using the Bolus Wizard feature 71
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. See “About active insulin” on page 64
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.
ACTIVE INS TIME
6
hr
(flashing) set, then press
ACT
3 The screen will return to
the EDIT SETTINGS screen
where you can see the
new setting.
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.
72 Chapter: 5
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 > 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.
Meter option
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
Blood glucose
(BG) Readings
You can set up your pump to automatically receive your
blood glucose readings from the Paradigm Link meter. This
meter 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.
Pump
Programming your Paradigm Link meter ID, links your pump
to the meter. If you do not “link” the meter to your pump, Paradigm Link
meter
you will enter your blood glucose readings manually. Each
Paradigm Link meter has its own unique ID. You can link up
to three (3) meters to your pump.
When the pump is idle (at the HOME screen), it will beep or vibrate when it receives a blood glucose
reading from the Paradigm Link 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 meter ID is the serial number printed on the back of the Paradigm Link meter. See the User
Guide that came with your Paradigm Link meter for detailed information on how to use it.
Using the Bolus Wizard feature 73
Meter rules
If you want your pump to communicate with the Paradigm Link meter, the following conditions must
apply:
1 The meter option must be turned on and programmed. See “Meter option” on page 73 for
instructions.
2 Your pump must be within 4 feet (1.22 meters) of your Paradigm Link meter to receive blood glucose
readings.
3 The pump cannot have a LOW BATTERY alert condition.
4 When programming a bolus, the blood glucose measurement from the Paradigm Link meter will
appear as the default blood glucose value in 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 blood glucose readings to the pump while onboard aircraft.
Manually enter your BG.
CAUTION: The pump will not receive signals from the Paradigm Link meter while it has a “Low
Battery” 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 Paradigm Link meter.
If you are not sure that your Paradigm Link 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 Paradigm Link 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.
74 Chapter: 5
METER OPTION
Off
On
ACT
METER ID MENU
Add ID
Delete ID
Review ID
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.
DELETE METER ID
1 111111
2 222222
3------
REVIEW METER ID
1-----2 222222
3------
c. The selected ID is now
deleted.
DELETE METER ID
1-----2 222222
3------
METER ID MENU
Add ID
Delete ID
Review ID
3 Exit the menus when your are done.
Using the Bolus Wizard feature 75
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 blood glucose readings
from the Paradigm Link 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. See “Meter
option” on page 73 for instructions.
1 If you want a correction bolus, check your blood glucose 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 the Paradigm Link meter:
If you are using the Paradigm Link meter:
Enter your BG value. Press ACT and continue
to step 4.
The meter reading will
ENTER BG
flash on the pump screen.
meter
Press ACT to accept this
XXX mg/dL*
amount. (You can change
* or mmol/L
this BG value, if
necessary.) 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 blood glucose
level.
76 Chapter: 5
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 blood
glucose manually.
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.
grams*
* or exch
(flashing)
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
(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.
SET BOLUS
Estimate
4.0 U
ACT
to accept
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 32 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.
BOLUS DELIVERY
3:24P
NORMAL
0.1
U
Using the Bolus Wizard feature 77
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 (2.2 mmol/L) per unit of insulin
➠
BG Target:
90-120 mg/dL (5.0 - 6.7 mmol/L)
➠
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 150.
Example 1: Blood glucose within target range 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 Paradigm Link meter and his blood glucose reading of
120 mg/dl (6.7 mmol/L) 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+0
= 4 units
estimate = 4 units
78 Chapter: 5
= 4 units +
(correction)
Correction is 0 because the current blood
glucose reading is within his BG Target Range
Example 2: Blood glucose above target range and no active insulin
The next day, Michael wakes up before school. Before eating the same breakfast, he tests his blood
glucose with his Paradigm Link meter and finds it to be 200 mg/dL (11.1 mmol/L), which is above his
High BG target of 120 mg dL (6.7 mmol/L). His blood glucose 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: Blood glucose below target range and no active insulin
On another morning, Michael sits down before eating the same breakfast. He tests his blood glucose with
his Paradigm Link meter and finds it at 70 mg/dL (3.9 mmol/L), which is below his Low BG target of 90
mg/dL (5.0 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, the pump will suggest that he only take 3.5 unit of insulin.
(food estimate)
60g
15g/u
= 4 units
+ (correction)
70mg/dL - 90mg/dL
40mg/dL/u
=
-20mg/dL
40mg/dL
= -0.5 unit
= 4 + (-0.5)
= 3.5 unit
estimate = 3.5 unit
Using the Bolus Wizard feature 79
Example 4: Blood glucose above target range with active insulin
Michael is at school and wants to eat a snack in the late morning. He tests his blood glucose with his
Paradigm Link meter and finds it to at 200 mg/dl (11.1 mmol/L), which is above his High BG target of 120
mg/dL (6.7 mmol/L). 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
(correction)
= 4 units
+
200mg/dL - 120mg/dL -1.5 units (active insulin)= 2 - 1.5 = 0.5
40mg/dL/u
= 4 + 0.5
= 4.5 units
estimate = 4.5 units
80 Chapter: 5
Example 5: Blood glucose below target range with active insulin
Another day at school, Michael is getting ready to eat lunch. He tests his blood glucose with his Paradigm
Link meter and finds it at 70 mg/dL (3.9 mmol/L), which is below his Low BG target of 90 mg/dL (5.0
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.
(correction)
(food estimate)
60g
15g/u
= 4 units
+
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 blood glucose is below the Low BG target, an active insulin amount that is greater than the
correction estimate is not considered in the Bolus Wizard feature calculations.
Using the Bolus Wizard feature 81
82 Chapter: 5
Chapter: 6
Optimizing pump therapy
Square Wave and Dual Wave boluses
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 blood glucose too quickly. 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 self-test, 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.
This graphic shows: 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. Remainder delivered
evenly over time period
DUAL WAVE
BOLUS
Now
Portion
3
Square
Portion
TIME
Optimizing pump therapy
83
Dual/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
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.
84 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. Press ACT. Notice
the screen also shows the
percentage amount for each portion.
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 the BG Reminder feature turned on, a screen
SQUARE DURATION
Sq: 1.2U
0:30
displays allowing you to accept or modify the length of time after
this bolus before you are reminded to check your blood glucose.
6 The BOLUS DELIVERY screen will appear. The pump will beep or vibrate at the start and end of the
bolus. As the bolus is delivered, the screen will show the bolus type and amount until the total units
have been delivered.
Optimizing pump therapy
85
Example 1: Square Wave bolus Use of a Square Wave bolus while eating a meal high in fat
Conner loves pizza. When he was using insulin shots, he began to avoid pizza because he always had
high blood glucose readings several hours after eating this high fat meal. Now that Conner is using
the Paradigm pump, he can use the Square Wave bolus feature to help with this problem. With
frequent blood glucose testing and many pizza meals, he and his healthcare professional have
determined the length of time (duration) he needs to set his Square Wave bolus to prevent the high
blood sugars after eating pizza. He set it for 3-hours.
Example 2: Square Wave bolus (gastroparesis)
Lisa has had diabetes for many years. She has been diagnosed with gastroparesis, a condition of the
digestive system that slows down the emptying of food from her stomach. This makes her
carbohydrate digestion unpredictable. Because of this, Lisa has had a lot of trouble with blood
glucose control. It has been suggested to her that she use the Square Wave bolus feature before
meals to more evenly match her insulin with her carbohydrate digestion.
86 Chapter: 6
Your turn: 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-hours*.
(* This duration time is an example. As always, consult with your healthcare professional for
guidance.)
Check your 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? ________*
* 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.
Example 1: Dual Wave bolus
Set a Dual Wave bolus for a barbecue style dinner
Carol is going to a barbecue at a friend's house. Her meal consists of:
mixed green salad
fruit salad
a dinner roll and margarine
potato salad
baked beans
pork ribs with barbecue sauce.
She calculates her total carbohydrates and determines her total meal bolus amount. She knows that
she will need some insulin immediately for the fruit, barbecue sauce and dinner roll and some insulin
spread out over time for the high fat and high fiber content of the rest of the meal. Carol will
program her pump to deliver a Dual Wave bolus with ½ of the total bolus to be given immediately
and the other half over a 2- hour* duration.
(* This particular duration of time and bolus proportions is an example. As always, you should consult
with your healthcare professional for your individual needs.)
Optimizing pump therapy
87
Example 2: Dual Wave bolus Set a Dual Wave bolus for correcting elevated blood glucose before a meal
Marsha uses the Square Wave bolus for the majority of her meals. She tests her pre-meal blood
glucose and finds that it is above her target level. Marsha would like to correct her elevated blood
glucose before she eats. The Dual Wave bolus can be used to deliver some insulin now to help
correct her blood glucose elevation, and then deliver her Square Wave bolus to cover her meal.
Your turn:
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-hours*, and the other
half immediately
(* This duration of time and ratio is an example. As always, consult with your healthcare
professional for guidance.)
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? ________*
* 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.
88 Chapter: 6
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 blood glucose reading and/or the (carb or 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. See “Meter
option” on page 73 for instructions.
2 After you enter your blood glucose 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: 45gr
(Meter) BG:
160
Food:3.0U
Correction:2.0U
Active Ins:
1.0U
ACT to proceed,
ESC to back up
(using the Bolus
Wizard feature)
BOLUS EST: 4.0U
Normal Bolus
Square Wave Bolus
Dual Wave Bolus
ACT
(values shown are
for example only)
(without the Bolus
Wizard feature)
BOLUS TYPE
Normal Bolus
Square Wave Bolus
Dual Wave Bolus
ACT
NOTE - If you are using the Bolus Wizard
feature and it calculates that your bolus
includes a portion to correct your high blood
glucose, 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 blood glucose.
BOLUS EST: 4.0U
Normal Bolus
Dual Wave Bolus
Optimizing pump therapy
89
4 For a Square Wave bolus:
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.
b. In the next screen, notice the
screen shows the Normal
(Now) and Square portions of
the Dual Wave bolus. Press
ACT to accept the portions
suggested by the Bolus Wizard
feature, or press
to
/
SET DUAL BOLUS TOTAL
Estimate
4.0U
ACT
Now:
50%
Square:
50%
2.5U
1.5U
ACT
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.
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 the BG Reminder feature 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.
90 Chapter: 6
Square Duration
Sq: 1.2 u
0:30
ACT
6 Press ACT to accept and deliver the bolus. The BOLUS DELIVERY 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. If you want to see the
progress of the delivery, press ESC to see the status screen.
BOLUS DELIVERY
3:24P
NORMAL
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.
Optimizing pump therapy
91
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)
/
EASY BOLUS ENTRY
0. 5 U
ACT
BOLUS MENU
Dual/Square Bolus
Easy Bolus
BG Reminder
ESC
Delivering an Easy bolus
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.
92 Chapter: 6
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)
2 Press
the number of times needed for your bolus
amount. Watch the amount change on the screen with each
press. When your total bolus amount appears on the screen,
press ACT. The pump will vibrate or sound a different tone
for each
press. 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.
SET EASY BOLUS
1.0
U
ACT
BOLUS DELIVERY
1:32P
to accept
Normal
0.1U
ESC
to cancel
Optimizing pump therapy
93
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 “Setting your alert type” on page 109) 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.
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.
94 Chapter: 6
Your step level is
________.
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 shift)
➠
Extended periods of higher or lower activity
➠
Different schedules during the week
versus weekend
➠
Softball games every Saturday morning, etc.
➠
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:
➠
Pattern A/B:
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 dayto-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
ACT
Off
On
2 The screen will go back to the BASAL MENU. The patterns feature is now on. Exit the menus.
Optimizing pump therapy
95
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 - Be aware. 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.
Standard
Pattern A
Pattern B
16.80U
---.-- U
---.-- U
ACT
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.
SET BASAL RATE 1
rate
(flashing)
12:00A
_.-
A
NOTE - The first basal rate starts at midnight and cannot
-
U
H
H
indicates programming is for Pattern A
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.
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.
96 Chapter: 6
- -: - A
_.-
SET BASAL RATE 2
7:30A
-
set time
(flashing)
U
H
A
_.-
-
U
H
rate will flash after
you set the start time
5 After you press ESC, the BASAL RATE screen
appears. The screen will show:
➠ the
current basal pattern and basal rate,
➠ time
➠ the
it started, and
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
24-hour 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).
BASAL MENU
Set/Edit Temp Basal
Select Patterns
Set/Edit Basal
ACT
Optimizing pump therapy
97
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?
98 Chapter: 6
Temp (temporary) basal rates
The temp (temporary) basal rate feature is useful to manage blood glucose 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 the similar situations.
Optimizing pump therapy
99
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)
100
Chapter: 6
5:05 p.m.
(17:05)
12:00 a.m.
(00:00)
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).
Optimizing pump therapy
101
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)
Chapter: 6
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)
temp basal stop time
102
(120% x rate 3 = 2.34)
2.34 rounded down to
the next 0.05 increment
is 2.30 U/H
12:00 a.m.
(00:00)
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.
BASAL MENU
Main > Basal > Temp Basal Type
Max Basal Rate
Patterns
Temp Basal Type
Select Temp Basal Type and press ACT.
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 - Be aware. If your temp basal type is set to “Percent of Basal,”
BASAL MENU
Max Basal
Rate Patterns
Temp Basal Type
ESC
changes to your basal rate are not allowed until after temp basal is
completed or cancelled.
Delivering a temp basal
NOTE - A temp basal cannot exceed your programmed max basal rate.
1 Go to the BASAL MENU.
BASAL MENU
Main > Basal > Set/Edit Temp Basal
Set/Edit Temp
Basal Set/Edit
Basal Review
Select Set/Edit Temp Basal and press ACT.
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.
SET DURATION
Temp
3:00
ACT
Optimizing pump therapy
103
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
3:00P
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%
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.
104
Chapter: 6
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 2004
S/N# 000000
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.
Optimizing pump therapy
105
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?
106
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 your blood glucose 4 to 6 times a day and always before bed
Test before driving and have a fast-acting carbohydrate with you when you drive
If your blood glucose 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 blood glucose at least once during the month
Check 2-hour post-meal blood glucose for all meals on a given day
Every 3 months
➠
➠
➠
Visit your healthcare professional, even if you feel well and your blood glucose values are within
your target range
Review your blood glucose log and insulin pump settings with your healthcare professional
Make sure you have an HbA1c test done
Insulin pump therapy follow-up
107
Laboratory tests
➠
Test for HbA1c four or more times a year
Test for cholesterol, HDL, LDL, triglyceride yearly
➠
Test for microalbuminuria yearly
➠
Every visit
➠
➠
➠
Blood pressure check
Foot exam
Review goals for blood glucose, meal plan and exercise
Annually
➠
➠
➠
➠
➠
➠
➠
➠
➠
108
Dilated eye exam by a qualified opthalmologist
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)
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
“Alarm details” below. 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
109
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.
AUTO OFF DURATION
Main > Utilities > Alarm > Auto Off
2 Set the number of hours you want to set and press
ACT.
(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:
110
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.
Chapter: 8
For “Insulin units”:
Enter the number of units you want remaining
when the first warning will go off. Press ACT.
(flashing)
can be 5.0 – 50.0
WARNING UNITS
20
U
The pump will alarm first when the specified
units remain, then again when half that
remaining amount is used.
For “Time”:
Enter the amount of remaining time you want for
the first warning. Press ACT.
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” low resv warning types are intended
to let you know if you will have enough insulin while you are sleeping.
Utilities
111
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 amount of 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
112
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, blood glucose information, 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 select up to (up to 31 days). This is done in the DAYS
TO AVERAGE screen as explained in “Days to average” on page 115.
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 levels for the day
➠ total number of blood glucose values you entered into the
pump for the day
To view more data, press
DAILY TOTALS
Daily Average
Today
26.5U
Today
48.5U
ACT
27FEB BG AVG 128
BG Low/Hi 92/178
Number BGs
6
27FEB INSULIN 112.30U
Basal
60.20/54%
Bolus
52.10/46%
Carbs
253gr
27FEB BOLUS 52.10U
Food
36.50/70%
Corr
10.30/20%
Manual
5.30/10%
.
3 The INSULIN screen is displayed. This screen shows:
27FEB NUM BOLUS 8
Food/Corr
2/ 1
➠ total insulin delivered for the day
Food + Corr
1
Manual Bolus
4
➠ total Basal and Bolus insulin delivered for the day
➠ total percentage of each (Basal and Bolus) delivered for the
day
➠ total carbohydrates entered into the pump for the day (entered using the Bolus Wizard feature)
To view more data, press
.
4 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
Utilities
113
➠
total man (manual) bolus insulin delivered for the day and total percentage of manual boluses
delivered for the day
To view more data, press
.
5 The NUM BOLUS screen is displayed. This screen shows:
total
➠ total
➠ total
➠ total
➠
number of boluses delivered for the day
number of food only and correction only boluses delivered for the day
number of food plus correction boluses delivered for the day
number of manual boluses delivered for the day
To get back to the HOME screen, press
114
Chapter: 8
four times.
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.
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 the
and the
. 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
DAILY TOTALS
Daily Average
Today
26.5U
27Feb
48.5U
26Feb
54.5U
day marked
with an (*)
asterisk is
excluded from
the average.
12
ACT
AVG BG 128 mg/dL
BG Low/Hi 92/178
Number BGs
6.1
The flashing
number will be the
number of days
you have available
to average (up to
31 days).
AVG INS 112.30U
Basal 60.20/ 54%
Bolus 52.10/ 46%
Carbs
253gr
AVG BOLUS52.10U
Food
36.50/70%
Corr
10.30/20%
Manual 5.30/10%
.
4 The AVG INS (average insulin) screen is displayed.
NUM BOLUS
4.2
Food/Corr
2.1/1
This screen shows:
Food + Corr
1.1
Manual Bolus 1.0
➠ 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 previous 12 days
➠ the average total carbs entered into the pump per day (entered using the Bolus Wizard feature)
for the previous 12 days
To view more data, press
.
5 The AVG BOLUS screen is displayed. This screen shows:
➠ the average total bolus insulin delivered per day for the previous 12 days
Utilities
115
the total average percentage of bolus insulin delivered for the previous 12 days
➠ the average total correction bolus insulin delivered per day
➠ the total average percentage of bolus insulin delivered per day for the previous 12 days
➠ the average total manual bolus insulin delivered per day
➠
To view more data, press
.
6 The NUM BOLUS 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.
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.
1 Go to the ALARM OPTION screen.
116
Chapter: 8
12:40P
ALARM
CLOCK
Main > Utilities > Alarm Clock
2 Select On/Set.
Press ACT.
3 Select Add Alarm.
Press ACT.
ALARM CLOCK
ALARM OPTION
Off
On/Set
Add Alarm
Delete Alarm
Review Alarms
4 Use the
or
buttons to select the
hours (flashing). Press ACT. Use the
buttons again to select the minutes
(flashing). Press ACT.
ADD ALARM
(hours flashing)
12:00 (A)
ADD ALARM
(minutes flashing)
3:00 (A)
5 Repeat step 3 and step 4 to program additional alarm clock 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.
See 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
117
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
ACT
Off
On
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.
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Chapter: 8
REMOTE OPTION
Off
On
ACT
REMOTE ID MENU
Add ID
Delete ID
Review ID
Add
Select Add ID and press ACT.
Enter each of the six ID numbers.
Press ACT after each.
ADD REMOTE ID
Delete
Select Delete ID and press
ACT.
Select the remote ID that you
want to delete and press ACT.
DELETE REMOTE ID
1 111111
2 222222
3 ------
(flashing)
______
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
Select Review ID and press
ACT.
The programmed IDs will show
in the REVIEW REMOTE ID
screen.
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
The block allows you to prevent (block) people from changing pump setting that should not be
working with the pump s settings. This feature is an important safety feature, especially if the pump
user requires someone else to maintain complete control of pump operation. The factory setting for
this feature is off. When block is on, the remote control is used to deliver a bolus and suspend 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
ACT
Off
On
Utilities
119
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 Self-Test, 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.
120
Chapter: 8
Lock keypad feature
Lock keypad prevents accidental pump keypad presses. The only button you can press is the
to
view the STATUS screen. The remote control can be used to give a bolus or put the pump into Suspend.
To lock keypad
1 Go to the Lock Keypad screen
Main > Utilities > Lock Keypad
2 Select Utilities
3 Select Lock Keypad
Press ACT.
4 Press ACT to lock keypad.
Press ACT.
MAIN MENU
UTILITIES MENU
ACT
Basal
Prime
Utilities
Lock Keypad
Alarm
Daily Totals
ACT
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 the
same time.
button and the
button at the
KEYPAD
UNLOCKED
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 Product Help Line 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.
Utilities
121
1 Go to the UTILITIES MENU. Select Selftest and
press ACT.
MAIN MENU
ACT
Basal
Prime
Utilities
Main > Utilities > Selftest
2 As part of the selftests, the pump will do these
tests:
UTILITIES MENU
Meter Options
Remote Options
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.
b. Selftest:
The pump will count
down from 10.
c. Tone Test:
You should hear
beeps.
d. Vibrate Test:
You will feel
vibrations.
10
TONE TEST
3
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.
122
Chapter: 8
SELFTEST
VIBRATE TEST
1
TEST COMPLETE
User settings
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.
WARNING:
CAUTION:
Do not clear your pump settings while it is connected to
your body.
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.
Saving pump 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
123
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.
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
Restoring pump settings
Do these steps to restore the most recent pump settings you have saved to your pump.
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.)
124
Chapter: 8
Press ACT to restore
settings saved on
03/10/2004 at 04:15P
ESC to CANCEL
ACT
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.
SETTINGS RESTORED
User settings have been
restored.
PLEASE CHECK SETTINGS
ACT
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
Utilities
125
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
3:32A
RESET
Settings cleared
by user
Reprogram settings
ESC, ACT to clear
5 Reset the time and date as described in “Setting the time and date” on
page 23.
6 After you set the time and date, you must rewind your pump. See
“Rewinding your pump” on page 47 for instructions. Remember, all your
settings have been cleared and you must either restore or reprogram all
your settings.
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 ACT/ESC to exit the menu.
SETTINGS HISTORY
09:15A Restor
04:15P Save
10:03A Save
12:10P Restor
15MAR
10MAR
03MAR
12FEB
ESC/ACT
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Chapter: 8
Language setting
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
UTILITIES MENU
Selftest
User Settings
Language
ACT
LANGUAGE MENU
English
Espanol
Francais
3 The language setting is now changed. Exit the menus.
Utilities
127
128
Chapter: 8
Chapter: 9
Troubleshooting
This 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. Your pump is not
broken, but it has detected that something is preventing insulin from being delivered. 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 the 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 Product Help Line.
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).
Troubleshooting
129
7 Monitor your blood glucose closely.
8 If you followed these steps and you are still receiving a No Delivery alarm, call the 24-hour Product
Help Line.
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.
Why doesn’t my pump battery last very long?
A short battery life does not necessarily mean something is wrong with your pump.
➠
Battery life in your pump is variable and based on the conditions below. As a result, your battery
life will vary.
➠ The brand of battery you use (we recommend Energizer).
➠ The way the battery was stored and/or handled before use (avoid high or low temperatures).
➠ How you use your pump. For example: how often the buttons are pushed, the number of
alerts/alarms and set changes.
➠ How much insulin you are delivering.
➠ Use of some features. The backlight, vibrate, remote control and/or meter options decrease
battery life.
➠
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,
130
Chapter: 9
➠
or 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 the reservoir in the pump full?
➠ If no, place a full 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 “Manual prime” instructions on page 49 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
Product Help Line.
The pump is asking me to rewind
This is normal after any of the following:
1 any E-alarms,
2 the Clear Settings function,
3 or, a “No Delivery” Alarm (during the Prime sequence).
Troubleshooting
131
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 any button is 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 blood glucose reading from my meter
1 Make sure you are using the correct meter (Paradigm Link Blood Glucose Monitor Powered by BD
Logic Technology). 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.
8 If your pump still does not receive your blood glucose reading from the Paradigm Link meter, use the
up/down buttons to manually enter your blood glucose (in the ENTER BG screen).
132
Chapter: 9
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 Product Help Line 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.
Troubleshooting
133
I cannot get to the User Settings menu
If you do not hold down the
button while pressing ACT when you
have User Settings highlighted, you will see the following screen:
This feature is not
normally accessible. To
access, consult your
User Guide.
1 Go to the Utilities screen and highlight User Settings. Then, hold
down the
button and press ACT.
2 See “User settings” on page 123 for information about the menu
options.
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. The
alert message will also appear on the screen.
➠
➠
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.
134
Chapter: 9
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.
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 and the remote and Paradigm Link 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.
An alarm gradually becomes higher in pitch until you turn it off. 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
135
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.
136
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 Product Help Line for
assistance.
9:42A
Pump reset
Settings preserved
ESC, ACT to clear
Axx
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.
AUTO
Delivery stopped No OFF
11:17A
buttons pushed
during time limit
ESC, ACT to resume
delivery
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.
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
Troubleshooting
137
Button error
Occurs if a button has been continually pressed for more than 3
minutes.
10:05A
BUTTON
ERROR
Button pressed for
more than 3 min
ESC, ACT to clear
Check settings
When this alarm is active, you should check and/or reprogram your
pump settings, including the time/date.
8:35A
CHECK
SETTINGS
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 Product Help Line 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.
5:30A
Exx
Settings cleared
Reprogram settings
Call help-line
for assistance
ESC, ACT to clear
XX indicates the
error number
Empty reservoir
There is no insulin in the reservoir. Change the reservoir immediately.
3:36P
EMPTY
RESERVOIR
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.)
138
Chapter: 9
FAILED
BATT TEST
8:35A
Delivery stopped
Replace battery now
Use 1 AAA
ESC, ACT to clear
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.
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.
No delivery
Insulin delivery has stopped. This alarm occurs if your pump detects a
blockage.
IS PRIMING
COMPLETE?
Disconnect from body
See user guide
for instruction
ESC, ACT to clear
3:25P
MAX
DELIVERY
Exceeded 1 hour
max delivery
Check BG
ESC, ACT to clear
MOTOR
ERROR
3:25P
Delivery stopped
Disconnect set
ESC, ACT to clear
NO
DELIVERY
11:17A
Delivery stopped
Change entire set
Check BG
See user guide
to troubleshoot
ESC, ACT to clear
No reservoir
The reservoir is not inserted correctly or no reservoir has been inserted.
4:36P
NO
RESERVOIR
Delivery Stopped
Change reservoir set
ESC, ACT to clear
Troubleshooting
139
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
Reset
8:35A
RESET
The Reset alarm triggers when pump settings are cleared because of one
Settings cleared
of these reasons:
by user
Reprogram settings
➠
Pump settings were cleared (Clear Settings function) and settings have
ESC, ACT to clear
not been reprogrammed.
➠
A download attempt from the PC is incomplete. (The download function is applicable to the optional
software feature. See 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.
140
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. See “Install battery” on page 12 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
CAUTION:
➠
Paradigm Link meter
➠
Backlight
➠
Vibrate alert type setting
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. Install a new battery if the battery
was placed backwards in the pump.
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
141
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.
142
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
➠
The maximum records shown is 36
Backlight
➠
➠
Display type Liquid Crystal Display (LCD)
Time-out period is 30 seconds. The backlight will turn off when you do not push any buttons for 30
seconds or more.
Basal
Maximum patterns
delivery rate
3 patterns (with 48 delivery
rates for each pattern)
rate increments:
lowest possible rate:
highest possible rate:
factory maximum rate:
warning limits
0.05 units/hour
0.05 units/hour
35.0 units/hour
2.0 units/hour
lower limit:
upper limit:
less than 90 mg/dL
greater than 140 mg/dL
Pump specifications
143
BG (blood glucose) target
Maximum BG targets
range:
8
(mg/dL)
(mmol/L)
warning limits:
60 – 250
3.3 – 13.9
lower limit:
upper limit:
less than 90 mg/dL
greater than 140 mg/dL
Bolus delivery
Insulin delivered/stroke
Fluid delivered/stroke
Time between/delivery strokes
Delivery rate (per minute)
0.05u
0.5 µL
2 seconds
1.5u
Bolus history
Maximum records shown: 24
Bolus units
Increments: 0.1 units
Bolus Wizard feature
(See “Bolus Wizard feature examples” on page 152 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 ranges when using Bolus Wizard feature:
➠
➠
grams:
exchanges:
0 – 300 (increments: 1 gram)
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. If no buttons are pressed for 30 seconds (60 seconds for status type screens), the pump returns
to this screen.
144
Chapter: 11
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).
Easy bolus
Features programming using audible tones (or vibrate pulses) in user-defined 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 (pounds per square inch)
➠
94,46 kPa (Kilopascal)
(Insulin) sensitivity
Maximum settings:
factory setting:
range:
8
50 mg/dL (2.8 mmol/L) (mg/dL)
(mmol/L)
warning limits:
10 – 400 mg/dL
0.5 – 22.2 mmol/L
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)
Pump specifications
145
Meter value
The blood glucose measurement received from Paradigm Link meter. Appears in the ENTER BG screen during bolus
programming. Appears on the screen when the pump is idle at the HOME screen.
Maximum ID entries
expiration:
range:
3
12 minutes
(mg/dL)
(mmol/L)
warning limits:
20 – 600
1.1 – 33.3
less than 20 or greater than 100 mg/dL
less than 1.1 or greater than 5.6 mmol/L
Normal bolus
Range 0.1 – 25.0 units of insulin (limited by maximum bolus setting).
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.
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/hour)
2.2 hours
3.09 hours
4.47 hours
basal delivery (0.05 u/hour)
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 (Energizer brand recommended).
Prime function
➠
➠
➠
Fixed prime range0.1 – 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.
NOTE - 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)
146
Chapter: 11
Program safety checks
Maximum infusion with single fault condition: 0.0 ml.
Pump size
The dimensions of the pump are:
515 Pump:
(inches)
(cm)
2.0 x 3.0 (2.8 at the battery cap) x 0.77
5.0 x 7.6 (7.1 at the battery cap) x 2
715 Pump:
(inches)
(cm)
2.1 x 3.7 (3.5 at the battery cap) x 0.8
5.3 x 9.4 (8.9 at the battery cap) x 2.0
Pump weight
515 Pump:
approximately 100 grams (with battery installed)
715 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.
515 Pump:
up to 176 units of U100 insulin
715 Pump:
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/time
always appears on the top of the screen and in the status screen.
Pump specifications
147
Status screen
➠
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
➠
BG meter value: (most recent
BG value received)
(appears if BG meter is
enabled)
XXXmg/dL
time and date received
➠
BG Reminder:* (Only 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)
➠
Current date:
(always appears)
➠
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)
148
Chapter: 11
ON
date, time, units left, time left
➠
Standard basal delivery data:
(always appears)
➠
Status of pump
(i.e., Rewind, Suspended,
Low Reservoir, Set Time,
etc.)
➠
Time
(always appears)
current basal rate (basal 1, basal 2,
etc.)
*If all Reminders and Alarm Clock are enabled, only the reminder nearest to alarming will appear in the STATUS screen.
Pump specifications
149
Bolus Wizard feature specifications
There are three different formulas the Bolus Wizard feature uses to estimate a bolus, depending on
your current blood glucose:
correction estimate
food estimate
1 If current blood
glucose is greater than
your High Target BG
=
food
carb ratio
+
=
food
carb ratio
+
food estimate
3 If current BG is
between or = High or
Low Target BG
=
food
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
➠
150
Chapter: 11
– active insulin
correction estimate
food estimate
2 If current blood
glucose is less than your
Low Target BG
current BG – High BG Target
ESTIMATE DETAILS
Est total:
4.0U
Food intake:
45gr
(Meter) BG:
160
Food:3.0U Correction: 2.0U
Active Ins:
1.0U
ACT to proceed,
ESC to back up
(values
shown
are for
example
only)
Active Insulin Curve
100%
90%
8 Hour
80%
7 Hour
6 Hour
5 Hour
70%
% Insulin Remaining
4 Hour
3 Hour
60%
2 Hour
50%
40%
30%
20%
10%
0%
0
1
2
3
4
5
6
7
8
9
Time (hours)
Active insulin only reduces the correction portion of the estimate, not the food portion.
➠ For a current blood glucose 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 blood glucose that is below the low target, if the active insulin is more than the
correction estimate, the active insulin is not considered.
➠
Pump specifications
151
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 blood glucose.
(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 blood glucose of 200.
(correction)
(food estimate)
60g
30g/u
= 2 units
+
=2+2
= 4 units
estimate = 4 units
152
Chapter: 11
200mg/dL - 120mg/dL
40mg/dL/u
= 2 units
#3: No active insulin from previous bolus delivery. User inputs 60 grams of carbs and a blood glucose of 70.
(correction)
(food estimate)
60g
30g/u
= 2 units
+
70mg/dL - 90mg/dL
40mg/dL/u
=
-20mg/dL
40mg/dL
= -0.5 unit
= 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 blood glucose of 100.
(food estimate)
60g
30g/u
= 2 units
(correction)
+
Correction is 0 because the current blood glucose
reading is between the BG High and Low targets
=2+0
= 2 units
estimate = 2 units
#5: Previous bolus activity results in a calculation of 1.5 units unabsorbed (active) insulin. User inputs 60 grams of carbs
and a blood glucose of 200.
(correction)
(food estimate)
60g
30g/u
= 2 units
+
200mg/dL - 120mg/dL
40mg/dL/u
- 1.5 units (active insulin)
= 2 - 1.5 = 0.5 units
= 2 + 0.5
= 2.5 units
estimate = 2.5 units
Pump specifications
153
#6: Previous bolus activity results in a calculation of 3.5 units unabsorbed (active) insulin. User inputs 60 grams of carbs
and a blood glucose of 200.
(correction)
(food estimate)
60g
30g/u
= 2 units
+
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 estimate.
=2+0
= 2 units
estimate = 2 units
Default (factory) settings
Menu
Item
Default Setting
Bolus Wizard feature:
Off
Easy bolus:
On
Easy bolus step:
Bolus
Menu:
Basal
Menu:
154
Dual/Square bolus:
Maximum bolus:
0.1 u/h
Limits
Increments
maximum bolus setting
Off
10.0 u/h
0 - 25 u (per single
bolus)
BG reminder:
Off
0:00 - 5:00
0:30 (minutes)
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:
Chapter: 11
Warning
Limits
U/H
0.05u
max basal rate setting
0.05U/H (or
5%)
(basal rate =
0.0)
Menu
Item
Default Setting
Lock Keypad:
(Alarm) History:
Alert type:
Auto-off:
Low reservoir warning:
Utilities
Menu:
5 - 50 u; 2nd: @ 1\2
amount
(2:00 - 24:00; 2nd:
after 1:00)
20 u
(0:30 mins)
Warning
Limits
(no defaults)
audio, beep-med
Off
(20) insulin units
12 a.m. (midnight)
(Time/Date) Date:
1/1/04
12-hour
Off
Alarm clock:
Off
Remote option:
Off
Meter option:
Off
User Settings:
(no defaults)
Language:
Increments
Off
(Time/Date) Time:
(Time/Date) Time
format:
Block:
Limits
English
Pump specifications
155
Menu
Item
Default
Setting
Limits
Increments
Warning Limits
none
none
none
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
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
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
2 - 8 Hours
1 hour
Bolus Wizard feature Settings
carb units: grams
or
exchanges
ins to carb (or exch) ratio: 15 grams/u
or
1 unit/exch
(insulin) sensitivity: 50 mg/dL
or
2.8 mmol/L
BG target: 100- 100 mg/dL
or
5.6-5.6 mmol/L
Active Ins Time 6 Hours
156
Chapter: 11
Icon table
Do not reuse
Attention: See Instructions for Use
Method of sterilization using ethylene oxide
w
r
Date of manufacture (year - month)
Manufacturer
Batch code
LOT
Configuration
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
Country
Language of Instructions for Use
Recycle
Radio communication
Pump specifications
157
158
Chapter: 11
Index
Symbols
μL xxi
Numerics
24-hour Product Help Line 1
A
accept xvii
accessories,
activity guard 5
holster 5
leather case 5
meter 3
pump clip 5
remote control 3
ACT button 14
active insulin time, setting 72
active insulin,
definition xvii
information about 64
alarm clock feature xvii
ALARM HISTORY screen xvii, 109
alarm,
conditions 137
definition xvii
alarms,
’A’ alarm 137
’auto off’ 137
’batt out limit’ 137
’bolus stopped’ 137
’check settings’ 130, 138
’E’ (error) 138
’empty reservoir’ 138
’failed batt test’ 138
’max delivery exceeded’ 139
’no delivery’ 129
details 109
maximum number records in
history 143
responding to 135
reviewing 109
alert,
conditions 134
definition xvii
setting the type 109
types 109
alerts,
’low battery’ 135
’low reservoir’ 135
alerts, what to do 134
assistance
24-hour Product Help Line 1
Attention mode xvii, 18
auto-off feature 110
B
backlight time-out period 143
backlight,
definition xvii
described 17
basal delivery rate,
current 36
daily 36
maximum limit 38
setting 34
basal delivery,
factory maximum rate 143
highest possible rate 143
lower warning limit 143
lowest possible rate 143
maximum number of patterns 143
rate increments (steps) 143
stopping 39
upper warning limit 143
warning limits 143
Basal menu,
described 19
factory settings 154
basal rate,
definition xvii
patterns 95
standard xxiii
temp (temporary) feature 99
BASAL REVIEW screen xvii
battery,
compartment 11
installation 12
requirements 141
BG (blood glucose) reminder xvii
BG (blood glucose) target range,
definition xviii
setting 70
BG (blood glucose) units,
definition xviii
selecting 69
Index
159
BG (blood glucose),
definition xvii
block feature,
definition xviii
turning on 119
BLOCK OPTION screen 119
blood glucose (BG) target range,
mg/dL 144
mmol/L 144
blood glucose (BG) target warnings,
lower limit 144
upper limit 144
blood glucose (BG) targets,
maximum number of 144
blood glucose meter data,
and Carelink™ 4
downloading 4
bolus xviii
bolus deliveries,
history of 29
viewing details on 30
bolus delivery specifications,
amount of fluid delivered per
pump stroke 144
amount of insulin delivered per
pump stroke 144
time between pump strokes 144
units delivered per minute 144
bolus delivery stopped, what to do
132
BOLUS HISTORY screen xviii
bolus insulin delivery,
basic types 24
Dual Wave bolus (manually) 84
Dual Wave bolus (using Bolus
Wizard feature) 89
maximum limit 31
normal bolus (using Easy Bolus
feature) 92
160
Index
normal type,
described 24
procedure (Express Bolus
feature) 24
procedure (menu) 24
Square Wave bolus (manually) 84
Square Wave bolus (using Bolus
Wizard feature) 89
stopping 39
types,
Dual Wave 83
normal 83
Square Wave 83
Bolus menu,
described 19
factory settings 154
Bolus Wizard feature,
"Bolus Wizard is off" message 72
"Bolus Wizard setup is complete"
message 72
"Missing info" message 72
definition xviii
estimate details 30
How it works 62
information about 59
information needed to use 59
maximum bolus limit 63
on/off 66
review settings 73
settings,
BG units 60
Carb ratios 60
Carb units 60
Insulin sensitivity 60
specifications 150
What is it? 59
your blood glucose (BG) reading
59
your personal settings 59
Bolus Wizard feature, examples 152
Bolus Wizard feature, specifications
150
buttons,
ACT 14
Down 14
Easy Bolus 14
ESC 14
Express Bolus 14
Up 14
C
can’t get out of the priming loop,
what to do 131
carb ratio xviii
carb ratios,
calculating meal boluses xxiv
maximum number of settings 144
range (grams/u) 144
range (units/exch) 144
using exchanges as Carb units 67
using grams as Carb units 67
warning limits (grams/u) 144
warning limits (u/exch) 144
carb units,
definition xviii
food entry range (exchanges) 144
food entry range (grams) 144
information about 67
setting 67
CH (Carbohydrate) xviii
CHECK BG message 32
check settings alarm, what to do 130
child block feature 119
cleaning your pump 142
clearing factory settings 125
correction bolus factor xviii
correction bolus,
amount of insulin needed xviii
corr bolus amount xviii
definition xviii
formula for calculating xviii
procedure (Bolus Wizard feature)
77
D
DAILY TOTALS screen,
reviewing daily insulin totals 112
daily totals,
definition xviii
maximum number of records 144
default (factory) pump settings 154
display type (pump) 143
disposable parts 3
DKA (Diabetic Ketoacidosis) xviii
Down button 14
downloading,
blood glucose meter data 4
pump data 4
using Medtronic CareLink™
System 4
dropped my pump, what to do 133
Dual Wave bolus,
definition xix
information about 83
now portion 85
programming (manually) 84
programming (with Bolus Wizard
feature) 89
square portion 90
turning on-off 84
duration xix
E
Easy Bolus button 14
Easy bolus,
canceling 93
definition xix
delivering 92
step value 92
emergency kit 2
ESC button 14
using to cancel programming 20
Exch ratio xix
Express bolus xix
Express Bolus button 14
F
factory settings (pump) 154
fixed prime,
amount of insulin needed 55
definition xix
procedure 55
food bolus,
definition xix
how Bolus Wizard feature
estimates 62
procedure (Bolus Wizard feature)
77
food entry 59
G
Gastroparesis xix
Glossary xvii
H
HbA1c xix
HDL (High-density lipoprotein) xix
high blood glucose,
Bolus Wizard feature notice 63
history,
maximum number of alarm
records 143
maximum number of bolus
delivery records 144
maximum number of daily totals
records 144
maximum number of prime
records (fixed and manual) 146
user setting saves and restores
126
hold xix
HOME screen 15
I
idle xix
information needed to use Bolus
Wizard feature 59
infusion pressure, maximum 145
infusion set,
changing 46
infusion sets 3
installing the battery 12
insulin sensitivity,
definition xix
factory setting 145
information about 69
maximum number of settings 145
normal range 69
range (mg/dL) 145
range (mmol/L) 145
setting 69
warning limits (mg/dL) 145
warning limits (mmol/L) 145
Index
161
L
language setting 127
LDL (Low-density lipoprotein) xx
left the battery out too long, what to
do 130
Link xx
lock keypad feature 121
logbook feature data,
downloading 4
including in reports 4
types of 4
low battery alert 135
low battery,
affect on alerts 109
affect on remote control 118
affect on Selftest feature 121
affects on meter readings 74
low blood glucose,
Bolus Wizard feature notice 63
low reserve alert feature 110
low reserve alert types,
insulin units 111
time 111
low reservoir alert 135
Low resv warning xx
M
Main menu 19
manual bolus xx
MANUAL PRIME screen 49
manual prime,
definition xx
procedure 49
Max basal rate xx
Max bolus xx
maximum bolus limit 63
162
Index
maximum infusion pressure 145
maximum limit,
basal delivery rate 38
maximum meter ID entries 146
maximum number of alarm records in
history 143
maximum number of patterns,
basal delivery 143
maximum occlusion pressure 145
Medtronic CareLink™ Therapy
Management System 4
menus,
Basal 19
Bolus 19
Main 19
Prime 19
Utilities 19
meter blood glucose reading,
warning limits (mg/dL) 146
warning limits (mmol/L) 146
meter blood glucose readings,
expiration (minutes) 146
maximum ID entries 146
range (mg/dL) 146
range (mmol/L) 146
meter data, downloading 4
meter IDs,
adding 74
deleting 74
reviewing 74
METER OPTION screen 74
meter option,
definition xx
information about 73
rules 74
meter readings 62
modes,
Attention 18
Normal 17
Special 18
N
no delivery alarm, what to do 129
no display of blood glucose meter
readings, what to do 132
no User Settings menu, what to do
134
normal bolus xx
normal bolus range 146
normal bolus,
programming (Bolus Wizard
feature) 76
programming (without Bolus
Wizard feature) 24
Normal mode xx, 17
normal type bolus delivery,
using Bolus Wizard feature 76
now portion xx
O
occlusion detection,
maximum time before alarm 146
minimum time before alarm 146
typical time before alarm 146
occlusion pressure, maximum 145
options,
Dual/Square Wave bolus 83
Paradigm Link meter 73
ordering supplies,
phone number 3
web site (URL) 3
P
Paradigm Link meter 3, 59
ParadigmPAL,
managing your pump settings 5
pump setting reports 5
types of data you can manage 5
Pattern feature xx
pattern, standard xxi
patterns,
A and B 95
basal 95
programming a basal pattern 96
selecting a basal pattern 97
standard basal pattern 95
turning on/off 95
personal reminders 116
personal settings 59
plunger rod 44
press xxi
Prime menu 19
prime,
definition xxi
fill rate 146
fixed 55
fixed prime range 146
history 55
manual 49
manual prime limit 146
maximum number of records
(fixed and manual) 146
viewing history (fixed) 55
viewing history (manual) 55
PSI xxi
pump (reservoir) volume,
model 515 147
model 715 147
pump buttons 14
pump buttons not working right
during bolus, what to do 132
pump data, downloading 4
pump screen appears distorted,
what to do 131
pump screen,
language settings 127
pump settings,
clearing them 125
managing on your PC 5
managing using ParadigmPAL 5
restoring 124
saving 123
pump therapy follow-up,
recommendations 107
pump,
backlight time-out period 143
battery compartment 11
battery requirements 141
buttons 14
cleaning 142
default (factory) settings 154
display type 143
location of buttons 11
power supply 146
recommendations when
removing 21
screen 11, 15
size (model 515) 147
size (model 715) 147
storage requirements 141
weight (model 515) 147
weight (model 715) 147
R
radio frequency (RF) accessories,
use restrictions 9
radio frequency (RF) features,
and Paradigm Link meter 73
remote control 117
recommended therapy follow-up,
annual 108
daily 107
laboratory 108
monthly 107
quarterly (every three months)
107
reminder, alarm clock 116
remote control feature,
turning on 118
remote control IDs,
add, delete, review 118
removing your pump,
recommendations for alternate
insulin delivery method 21
recommendations for recording
pump settings 21
reports,
blood glucose meter data
downloads 4
examples of 4
pump data downloads 4
required items to start using your
pump,
infusion set 43
insulin 43
reservoir 43
reservoir Instructions for Use
document 43
reservoir for 515 pump (MMT-326) 3
reservoir for 715 pump (MMT-332) 3
reservoir volume,
515 pump (model MMT-326) 147
715 pump (model MMT-332) 147
Index
163
reservoir,
filling 44
inserting into your pump 48
low reservoir alert 110
plunger rod 44
removing the 46
transfer guard 44
tubing connector 11
restores,
history of 126
restoring your pump settings 124
Resume feature xxi
Rewind feature xxi
rewinding your pump 47
S
saves,
history of 126
saving your pump settings 123
screen,
language setting 127
scroll xxi
select xxi
Selftest 121, 133
Set bolus xxi
setting,
active insulin time 72
maximum bolus limit 31
Special mode,
definition xxi
information about 18
Square Wave bolus,
definition xxi
information about 83
programming without Bolus
Wizard feature 84
turning on-off 84
Square Wave portion xxi
164
Index
STATUS screen,
Alarm Clock 148
Auto-off 148
Basal pattern 148
Battery Status 148
BG meter value 148
BG Reminder 148
Block 148
Current date 148
Current temp basal 148
definition xxi
information about 20
Last bolus 148
Low Batt 148
Meter Off 148
Meter On 148
Pump model number 148
Remote On 148
Reservoir started 148
Serial number 148
Software version 148
Standard basal delivery 149
Status of pump 149
Time 149
step,
definition xxi
setting the value 92
storage requirements (pump) 141
storage temperature, pump 157
submerged my pump in water, what
to do 133
supplies, ordering 3
Suspend feature,
definition xxi
using to stop insulin delivery 39
Suspend menu 19
T
target range, blood glucose (BG) 144
Temp basal 134
temp basal,
canceling 105
definition xxi
delivering 103
rates 99
selecting the type 103
types (insulin rate) 100
types (percent of basal) 101
verifying delivery 104
terms and symbols 6
therapy follow-up,
recommendations 107
time and date, setting 23
time-out period (backlight) 143
transfer guard 44
troubleshooting,
alerts 134
bolus delivery has stopped 132
can’t get out of the priming loop
131
check settings alarm 130
dropped my pump 133
left the battery out too long 130
no delivery alarm 129
no display of blood glucose meter
readings 132
no User Settings menu 134
pump buttons not working right
during bolus 132
pump screen appears distorted
131
submerged my pump in water 133
U
Up button 14
user settings 123
Utilities menu,
described 19
factory settings 155
W
water resistance (pump) 133
Index
165
166
Index
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