User manual | Minimed Paradigm ® Insulin Pump

INSULIN PUMP
User Guide
Paradigm®
515 and 715 Insulin Pumps
User Guide
©2008 Medtronic MiniMed, Inc. All rights reserved.
This product is covered by U.S. Patent Nos. 6,551,276; 6,554,798; 6,872,200; 6,936,029; 6,979,326; 6,997,920 and 7,025,743.
Other U.S. and/or foreign patents may be pending.
Bolus Wizard®, Dual Wave®, Guardian®, Guardian RT®, Paradigm®, Paradigm Link®, Quick-serter®, Quick-set®, Sof-set®, and
Square Wave® are registered trademarks of Medtronic MiniMed, Inc.
CareLink™ Personal and Easy Bolus™ are trademarks of Medtronic MiniMed, Inc.
Energizer® is a registered trademark of Eveready Battery Company.
Glucagon Emergency Kit® is a registered trademark of Eli Lilly and Company.
6025020-017 050808
REF MMT-515 MMT-715
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 insulin 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 Selftest from the pump's Utilities Menu. If you believe that water has entered
your pump or you observe any other possible pump malfunction, please check your blood glucose, treat high blood
glucose (if necessary) with an injection and contact our 24 Hour HelpLine at 1-800-MINIMED (1-800-646-4633) for
further assistance. Symptoms of high blood glucose include fatigue, excessive thirst and nausea. You should always
contact your healthcare professional if you experience excessively high or low blood glucose levels, or if you have
any questions about your care.
Electrostatic Discharge
Although your Paradigm pump is designed to be unaffected by typical levels of electrostatic discharge (ESD), very
high levels of ESD can result in a reset of the pump's software with an associated pump error alarm. In most cases,
exposure to high levels of ESD will trigger the pump's A-13 alarm although, under certain circumstances, high level
ESD exposure can cause A-44, Bolus Stopped or Max Delivery alarms. High levels of ESD are more likely in situations
where the relative humidity is very low, such as inside a heated building during the winter in areas where it is cold
outside.
If your pump experiences an A-13 or other error alarm, press the ESC and ACT buttons to clear the alarm. If you
are unable to clear the alarm by pressing ESC and ACT, you may need to remove and replace the pump's battery to
clear the alarm. After clearing the alarm, you should always verify that your pump is set to the correct date and
time and that all other settings (basal rate, max basal and bolus limits, etc.) are programmed to the desired values,
since the software reset could erase your previously programmed settings. Please see the Alarms and Alerts section
of this User Guide for more details regarding what to do if your pump displays an error alarm or other alert message.
Please contact our 24 Hour HelpLine 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
Chapter 1: Introduction .......................................................................... 1
Assistance .......................................................................................................... 1
Emergency kit ...................................................................................................... 2
Consumables ........................................................................................................ 3
Accessories .......................................................................................................... 4
How to wear your pump .......................................................................................... 4
How to use this guide .............................................................................................. 5
User safety .......................................................................................................... 6
Indications ...................................................................................................... 6
Pump ........................................................................................................ 6
Contraindications .............................................................................................. 6
Warnings ........................................................................................................ 6
Reservoir and infusion sets .............................................................................. 6
Magnetic fields ............................................................................................ 6
X-rays, MRIs and CT scans ................................................................................ 7
Precautions .................................................................................................... 7
Avoid extreme temperatures ............................................................................ 7
Infusion sets and sites .................................................................................... 7
Notice ................................................................................................................ 7
Insulin pump and RF accessories ............................................................................ 7
RF interference from other devices ........................................................................ 8
Chapter 2: Introduction to pump therapy .................................................... 11
Theory of insulin pump therapy ................................................................................ 11
Understanding pump therapy ......................................... ......................................... 12
Basal rate ...................................................................................................... 12
Meal bolus .................................................. .................................................. 12
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Gram counting ............................................. ............................................. 12
Exchange counting ...................................................................................... 12
BG targets .................................................................................................... 12
Insulin sensitivity ............................................................................................ 13
Active Insulin .................................................................................................. 13
Blood glucose and A1C testing .................................................................................. 13
BG testing .................................................. .................................................. 13
A1C ............................................................................................................ 13
Low blood glucose (hypoglycemia) ............................................................................ 15
Hypoglycemia protocol: the rule of 15 ................................. ................................. 15
High blood glucose (hyperglycemia) .......................................................................... 16
Hyperglycemia protocol .................................................................................... 16
Diabetes ketoacidosis (DKA) .................................................................................... 17
Preventing DKA .............................................................................................. 17
Sick day management ............................................................................................ 18
Sick day protocol ............................................................................................ 18
Sick day supplies .............................................. .............................................. 19
Nutrition ............................................................................................................ 19
Carbohydrate counting ...................................................................................... 19
Carbohydrate gram counting .......................................................................... 19
Carbohydrate exchange system ................................... ................................... 20
Reading a food label ........................................................................................ 20
Fat and blood glucose ...................................................................................... 21
Protein and blood glucose .................................................................................. 22
Other things that affect blood glucose ................................. ................................. 22
Healthy eating habits ........................................................................................ 22
Exercise ............................................................................................................ 23
Chapter 3: The basics ............................................................................ 25
Your pump .................................................... .................................................... 25
Install battery .................................................................................................... 26
Pump buttons ...................................................................................................... 28
The pump screen .................................................................................................. 29
HOME screen ...................................................................................................... 29
Screen icons .................................................................................................. 29
Battery .................................................................................................... 29
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Contents
Time display .............................................................................................. 30
Reservoir volume ........................................................................................ 30
Alert and alarm icons .................................................................................. 30
Scroll bar ...................................................................................................... 30
Screen backlight .............................................................................................. 31
Beep/vibrate ...................................................................................................... 31
Operating modes .................................................................................................. 31
Normal mode .................................................................................................. 31
Special mode .................................................................................................. 31
Attention mode .............................................................................................. 32
Menus .............................................................................................................. 32
MAIN MENU .................................................................................................... 32
BOLUS MENU .................................................................................................. 33
SUSPEND ...................................................................................................... 33
BASAL MENU .................................................................................................. 33
PRIME MENU .................................................................................................. 33
UTILITIES MENU .............................................................................................. 33
STATUS screen .................................................................................................... 33
If you remove your pump ........................................................................................ 34
Chapter 4: Basic programming ................................................................ 35
Setting the time and date ...................................................................................... 35
Selecting the language .......................................................................................... 36
Bolus ................................................................................................................ 37
Setting the Normal Bolus .................................................................................... 37
Review your bolus deliveries .................................................................................... 40
Bolus details .................................................................................................. 41
Maximum bolus limit ............................................................................................ 43
BG reminder ...................................................................................................... 43
Basal ................................................................................................................ 44
Start and stop times ........................................................................................ 44
Your basal settings .......................................................................................... 45
Basal programming and delivery ...................................................................... 45
Current basal delivery ...................................................................................... 46
Daily basal rate(s) ...................................................................................... 47
Setting the Max basal rate ...................................................................................... 48
Contents
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Stopping your pump .............................................................................................. 49
Resume pump delivery .......................................................................................... 50
Chapter 5: Starting on insulin .................................................................. 53
Prepare your pump for use ...................................................................................... 53
Filling the reservoir .............................................................................................. 54
Changing your infusion set ...................................................................................... 56
Removing the reservoir .................................................................................... 56
Rewinding your pump ...................................................................................... 57
Inserting the reservoir in your pump .................................................................... 57
Manual prime ................................................................................................ 59
Inserting the infusion set .................................................................................... 59
Quick-set infusion set (with Quick-serter®) ............................................................ 62
Fixed prime .................................................................................................. 63
Prime history .................................................................................................. 64
Disconnecting Quick-set .................................................................................... 64
Reconnecting Quick-set .................................................................................... 65
Record keeping for diabetes management .................................................................... 65
Determining your pump settings .............................................................................. 66
Chapter 6: Using the Bolus Wizard feature .................................................. 67
What is it? .......................................................................................................... 67
Carbohydrate counting ...................................................................................... 67
Your blood glucose reading ................................................................................ 67
Your personal Bolus Wizard feature settings ............................................................ 68
How the Bolus Wizard feature works .......................................................................... 71
Bolus Wizard warnings ...................................................................................... 71
High or low blood glucose levels .................................................................... 71
About maximum delivery .............................................................................. 71
How to program the Bolus Wizard feature .................................................................... 72
Turning on the Bolus Wizard feature .................................................................... 72
Selecting the Carb units .................................................................................... 72
Setting the Carb/Exch ratios .............................................................................. 73
Setting the BG units ........................................................................................ 73
Insulin sensitivity ............................................................................................ 74
Setting the BG targets ...................................................................................... 75
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About active insulin .......................................................................................... 76
Active insulin time .......................................................................................... 76
Review your Bolus Wizard feature settings .................................................................. 77
Meter option ...................................................................................................... 77
Meter rules ................................................. ................................................. 78
Add, delete, review meter IDs ............................................................................ 78
Normal bolus using Bolus Wizard feature .................................................................... 79
Bolus Wizard feature examples ................................................................................ 80
Chapter 7: Optimizing pump therapy ........................................................ 87
Square Wave and Dual Wave bolus ............................................................................ 87
Turning on the Dual Wave/Square Wave option ........................................................ 88
Square Wave or Dual Wave bolus without Bolus Wizard feature .................................... 88
Using the Bolus Wizard feature for a Square Wave or Dual Wave bolus ............................ 91
Easy bolus .......................................................................................................... 93
Easy bolus setup .............................................................................................. 93
Step value setup ............................................................................................ 94
Delivering Easy Bolus ........................................... ........................................... 94
Basal patterns .................................................................................................... 96
Turning on the patterns .................................................................................... 96
Programming a pattern .................................................................................... 97
Select a pattern .............................................. .............................................. 97
Temp basal rates .................................................................................................. 99
How does temp basal work? ................................................................................ 99
Temp basal types ............................................................................................ 99
Insulin rate (U/H) ...................................................................................... 99
Percent of basal ........................................................................................ 101
Chapter 8: Utilities ............................................................................ 107
Alarm review ....................................................................................................
Setting your alert type ........................................................................................
Auto-off ..........................................................................................................
LOW RESV WARNING (Low reservoir warning) ..............................................................
Review daily insulin totals ....................................................................................
Pump data management ......................................................................................
Meter blood glucose information ........................................................................
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Personal reminders .............................................................................................. 112
Alarm clock ................................................................................................ 112
Remote control option .......................................................................................... 113
Turn on remote control option .......................................................................... 113
Add, delete, review remote control IDs ................................................................ 114
Block feature .................................................................................................... 114
Turning block on .......................................................................................... 114
Lock keypad feature ............................................................................................ 115
Locking the keypad ........................................................................................ 115
Unlocking the keypad ...................................................................................... 116
Selftest ............................................................................................................ 116
User settings .................................................................................................... 117
Saving the settings ........................................................................................ 117
Restoring the settings .................................................................................... 117
Clearing the settings ...................................................................................... 118
History ...................................................................................................... 119
Chapter 9: Therapy software ................................................................ 121
CareLink Personal™ .............................................................................................. 121
Reports ...................................................................................................... 121
Logbook ...................................................................................................... 122
Chapter 10: Insulin pump therapy follow-up .............................................. 123
Recommended follow-up ...................................................................................... 123
Everyday ...................................................................................................... 123
Every month ................................................................................................ 123
Every 3 months .............................................................................................. 123
Laboratory tests ............................................................................................ 124
Every visit .................................................................................................... 124
Annually ...................................................................................................... 124
Chapter 11: Troubleshooting and alarms .................................................. 125
My pump has a NO DELIVERY alarm .......................................................................... 125
What happens if I leave the pump battery out too long? ................................................ 126
Why doesn't my pump battery last very long? .............................................................. 126
What is a CHECK SETTINGS alarm? ............................................................................ 127
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Contents
My screen appears distorted .................................................................................. 127
I cannot get out of the priming loop ........................................................................ 127
The pump is asking me to rewind ............................................................................ 128
My bolus stopped ................................................................................................ 128
My pump buttons are not acting right during a bolus ...................................................... 128
My pump will not display my blood glucose reading from my meter .................................... 128
I dropped my pump ............................................................................................ 129
I submerged my pump in water .............................................................................. 129
I cannot get to the User Settings screen .................................................................... 129
Alert conditions .................................................................................................. 130
What to do .................................................................................................. 131
LOW RESERVOIR ALERT .............................................................................. 131
LOW BATTERY ALERT .................................................................................. 131
Alarms ............................................................................................................ 131
What to do .................................................................................................. 132
Alarm conditions ................................................................................................ 132
A (ALARM) .................................................................................................. 132
AUTO OFF .................................................................................................. 133
BATT OUT LIMIT ............................................................................................ 133
BOLUS STOPPED ............................................................................................ 133
BUTTON ERROR .............................................................................................. 133
CHECK SETTINGS .......................................................................................... 133
E (ERROR) .................................................................................................. 133
EMPTY RESERVOIR .......................................................................................... 133
FAILED BATT TEST ........................................................................................ 134
MAX DELIVERY .............................................................................................. 134
MOTOR ERROR .............................................................................................. 134
NO DELIVERY ................................................................................................ 134
NO RESERVOIR .............................................................................................. 134
OFF NO POWER .............................................................................................. 134
RESET ........................................................................................................ 134
WEAK BATTERY .............................................................................................. 135
Chapter 12: Pump maintenance .............................................................. 137
Battery ............................................................................................................ 137
Storage ............................................................................................................ 138
Contents
xi
Cleaning your pump ............................................................................................ 138
Chapter 13: Pump specifications .............................. .............................. 139
Alarms and error messages .................................................................................... 139
Alarm history .................................................. .................................................. 139
Audio frequency ................................................ ................................................ 139
Backlight .......................................................................................................... 139
Basal ....................................................... ....................................................... 140
BG target .................................................... .................................................... 140
Bolus delivery .................................................................................................... 140
Bolus history ...................................................................................................... 140
Bolus units ........................................................................................................ 140
Bolus Wizard feature ............................................................................................ 140
Carb ratios ........................................................................................................ 141
Carb units ........................................................................................................ 141
Daily totals ................................................... ................................................... 141
Default screen ................................................. ................................................. 141
Delivery accuracy ............................................... ............................................... 142
Pump motor ...................................................................................................... 142
Dual Wave bolus ................................................ ................................................ 142
Easy bolus ........................................................................................................ 143
Infusion pressure ................................................................................................ 143
Insulin sensitivity ................................................................................................ 143
Low resv (reservoir) warning .................................................................................. 144
Meter value ...................................................................................................... 144
Normal bolus .................................................. .................................................. 144
Occlusion detection .............................................. .............................................. 144
Percent temp basal .............................................. .............................................. 145
Power supply .................................................. .................................................. 145
Prime function ................................................. ................................................. 145
Prime history .................................................. .................................................. 145
Program safety checks .......................................................................................... 145
Pump size .................................................... .................................................... 145
Pump weight .................................................. .................................................. 146
Remote control .................................................................................................. 146
Reservoir .......................................................................................................... 146
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Contents
Square Wave bolus .............................................................................................. 146
Temporary (temp) basal rate .................................................................................. 146
Time and date screen .......................................................................................... 146
Environmental conditions ...................................................................................... 146
Status screen .................................................................................................... 147
Bolus Wizard feature specifications .......................................................................... 148
Bolus Wizard feature examples .............................................................................. 151
Insulin delivery default settings .............................................................................. 154
Bolus Wizard feature default settings ........................................................................ 156
Icon table ........................................................................................................ 157
Warranty .......................................................................................................... 158
Glossary ............................................................................................ 159
Index ................................................................................................ 165
Contents
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Contents
1
Introduction
Thank you for choosing Medtronic Diabetes (legally known as Medtronic MiniMed, Inc.) 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 Medtronic MiniMed
Paradigm® pump. We strongly recommend that you work closely with your healthcare professional for a safe and
complete pump start.
Assistance
Medtronic Diabetes provides a 24 Hour HelpLine for assistance. The HelpLine is staffed with technicians who are
trained in the set-up and operation of the pump and are able to answer pump-related questions. When calling the
HelpLine or your local Medtronic Diabetes office, please have your pump and serial number available. The phone
number for the 24 Hour HelpLine is also on the back of your pump.
Department
Telephone number
24 Hour HelpLine (calls within the United States)
800.646.4633 (800.MiniMed)
24 Hour HelpLine (calls outside the United States)
+1.818.576.5555
Web site
www.medtronicdiabetes.com
Introduction
1
Emergency kit
Keep an emergency kit with you at all times to make sure that you always have necessary supplies. Inform a family
member, co-worker, and/or friend where this emergency kit is kept. Please refer to the User safety section in this
chapter for more information on pump safety. Your emergency kit should include these items:
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Fast-acting glucose tablets
Blood glucose monitoring supplies
Urine ketone monitoring supplies
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Extra Paradigm® compatible infusion set and Paradigm reservoir
Insulin syringe and fast-acting insulin (with dosage instructions from your healthcare professional)
Paradigm Quick Reference Card
Dressing and adhesive
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Glucagon Emergency Kit®
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Extra AAA alkaline batteries (Energizer® brand is recommended)
CAUTION: If you give yourself insulin by using a syringe, the Bolus Wizard feature will not be able to correctly
determine the active insulin in your system. Consult with your healthcare professional on how long you need
to wait after a manual injection before you can rely on the active insulin calculation of your Bolus Wizard
feature.
2
Introduction
Consumables
The pumps use disposable reservoirs and infusion sets for insulin delivery. Installation instructions for Paradigm
reservoir and Paradigm compatible infusion sets are provided in the Starting on insulin chapter.
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Reservoirs — The 515 pump is only used with the 176-unit Paradigm reservoir (MMT-326A). The 715 pump can
be used with either the 300-unit Paradigm reservoir (MMT-332A) or the 176-unit reservoir, depending on your
insulin needs.
Infusion sets — Medtronic Diabetes provides a variety of Paradigm compatible 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 compatible infusion sets manufactured or distributed by
Medtronic Diabetes. We recommend using Medtronic Diabetes 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.
Introduction
3
Accessories
Meter — Your pump can be used with an optional blood glucose meter powered by MWT1 technology (where
or if available). MWT1 is the wireless Radio Frequency (RF) technology that is used to transmit information from
the meter to the pump. You can program your pump to automatically receive your BG reading from this meter.
All meters referenced in this user guide are blood glucose meters supported by MWT1 technology.
Remote control — The optional Paradigm remote control can be used with the pump to deliver normal boluses
and suspend/resume the pump from a distant location. (This User Guide provides programming instructions for
the remote control. Refer to the remote control User Guide for operating instructions.)
CareLink USB Upload Device — The Medtronic Diabetes CareLink USB is used to download the Paradigm 515
or 715 pump data to the diabetes management software using a USB port on your computer.
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•
•
To order supplies, call 800-646-4633 (1-800-MiniMed), +1-818-362-5958 (outside U.S.), refer to the contacts list at
the beginning of this user guide, or visit our web site at www.medtronicdiabetes.com.
How to wear your pump
There are different ways to wear your pump. Medtronic Diabetes has optional accessories that can hide, protect,
and add to the convenience of wearing a pump. Refer to the accessories catalog or the website
(www.medtronicdiabetes.com) for more information.
Holster — To wear the pump on your belt.
Pump clip — To wear the pump underneath your clothing.
Activity guard — If you are active in sports, or you are a child, use the guard to protect the pump from
disconnecting.
Leather case — Fine leather lined with nylon. Styling complements business and formal wear. Velcro flap
provides easy access for programming. Wear it vertically with the built-in belt clip.
•
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4
Introduction
How to use this guide
NOTE:
This user guide shows sample screens only. Your pump screens may be slightly different.
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For step-by-step instructions, refer to the appropriate sections in this guide. Refer to the Glossary for definitions
of terms and functions. The terms and symbols used in this guide are in the table below.
Meaning
Conventions
Press
to push and release the button
Hold
to push and keep pressure on the button
Select
to press
Exit the menus
press ESC until the HOME screen appears
Pump Buttons
always bold and uppercase; for example, ESC, ACT
Screen and menu names
always uppercase; for example, MAIN MENU, REWIND screen
Menu selections
always bold; for example, 24-Hour Setup, On, Off
Flashing (blinking) screen item
you can change the value for that item with the
NOTE and TIP
additional helpful information
CAUTION
warns of a potential hazard which, if not avoided, may result in minor or
moderate injury to the equipment
WARNING
notifies you of a potential hazard which, if not avoided, could result in death
or serious injury. It may also describe potential serious adverse reactions and
safety hazards
or
to highlight a screen item you want to select
or
buttons
when a step instructs you to go to a certain screen, the path to that screen
is shown. For example:
Go to the ALARM MENU.
Go to the...screen.
Main > Utilities > Alarm
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3
From the MAIN MENU, select Utilities and press ACT.
In the UTILITIES MENU, select Alarm and press ACT.
The ALARM MENU appears.
Introduction
5
User safety
Indications
Pump
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 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 Diabetes Paradigm
reservoir and Paradigm compatible infusion sets are specifically designed for use with the pump. Do not modify
your Paradigm reservoir or Paradigm compatible 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.
Magnetic fields
Do not use pump cases that have a magnetic clasp.
Do not expose your insulin pump to MRI equipment or other devices that generate very strong magnetic fields. The
magnetic fields in the immediate vicinity of these devices can damage the part of the pump’s motor that regulates
insulin delivery, possibly resulting in over-delivery and severe hypoglycemia.
Your pump must be removed and kept outside the room during magnetic resonance imaging (MRI) procedures.
If your pump is inadvertently exposed to a strong magnetic field, discontinue use and contact our 24 Hour HelpLine
for further assistance.
6
Introduction
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 before entering a room containing any of this equipment.
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.
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
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1
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3
Avoid exposure of your pump and remote control to temperatures above 108°F (42°C) or below 34°F (1°C).
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.
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.
Notice
CAUTION: Any changes or modifications to the devices not expressly approved by Medtronic Diabetes could
void your ability to operate the equipment.
Insulin pump and RF accessories
The pump, 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.
Introduction
7
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:
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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 our 24 Hour HelpLine.
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/ meter
• Increase the separation between the insulin pump/remote control/meter and the device that is receiving/
emitting interference
The meter sends information to the pump using radio frequency. If other devices that use radio frequency are
in use, such as cell phones, cordless phones and wireless networks, they may prevent communication between
the pump and the meter. This interference will not cause any incorrect data to be sent and will not cause any
harm to your pump or meter. Moving away from or turning off these other devices may allow communication.
Refer to the Troubleshooting and alarms chapter to correct interference problems you may have.
If you have questions, please contact our 24 Hour HelpLine.
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2
RF interference from other devices
Common consumer electronic devices that transmit in the same frequency band used by the optional RF glucose
meters may prevent the pump from receiving the glucose information sent by those meters. Most cellular (mobile)
phones and 900 MHz cordless phones, when transmitting or receiving, may interrupt RF glucose meter-pump
communication. It is likely that other devices operating in similar frequency ranges will have a similar effect. This
interference, however, will not cause any incorrect data to be sent and will not cause any harm to your RF glucose
meter.
Communication problems can usually be resolved by:
•
ensuring that there is less than 6 feet (1.8 meters) between the pump and the RF glucose meter;
8
Introduction
•
•
turning off or moving away from other RF transmitting devices; or
reorienting or relocating the RF glucose meter or pump, or both.
Communications problems may also occur due to cellular telephone interference. Testing conducted with several
different cellular telephones indicates that, while a glucose value is being transmitted, using a cell phone within
12 inches (31 cm) of receiving devices, transmitters or RF glucose meters can interfere with reception of the
transmitted values. In the event of such interference, normal communication can be re-established by:
•
•
turning the cell phone off; or
keeping the cell phone at least 12 inches away from the pump or glucose meter when a glucose measurement
is being transmitted.
If you have questions, please contact your local Medtronic Diabetes representative.
Introduction
9
10
Introduction
Introduction to pump therapy
2
Theory of insulin pump therapy
Insulin pumps deliver insulin closer to the way the human pancreas delivers insulin than any other method of treating
diabetes.
All people, with or without diabetes, need background insulin for normal functions of the body without food. They
also need a dose of insulin on demand - when food is eaten. People without diabetes can trust that their pancreas
will produce this insulin for them. People with diabetes need to take insulin in a way that is most like the way a
pancreas produces it.
Most people with diabetes who take more than one daily injection, use long-acting insulin. This takes care of their
background insulin needs. They take fast-acting insulin for food. When using an insulin pump, only fast-acting insulin
is used. You control when and at what rate your insulin is delivered.
Insulin pump therapy allows you to set a basal rate, or background insulin. This is delivered all throughout the day
and night for normal body function without food. When you exercise, you can reduce the basal rate so that your
blood glucose (BG) does not drop too low. When you are sick or have an infection, you can increase the basal rate.
This will keep your BG from going up too high.
Insulin pump therapy allows you to give a bolus, or dose of insulin on demand - when you eat. You can also increase
or decrease your meal bolus based on the foods you choose to eat. A bolus may also be used to lower an elevated
BG. This is called a correction bolus.
The Paradigm pump also contains an optional feature called the Bolus Wizard. This does the math for the required
bolus amount based on your personal settings. The Bolus Wizard will use your BG reading, carbohydrate intake, and
active insulin when coming up with your bolus amount.
Remember, the pump uses only fast-acting insulin. This means you will not need to follow as rigid a schedule as
you did before. There is no long-acting insulin telling you when you should eat or when you will need more insulin.
Introduction to pump therapy
11
Sound exciting? It is exciting because not only can you manage your blood glucose more easily, your lifestyle can
be easier too.
As long as you are ready to learn how to use the pump, the pump can work for you.
Understanding pump therapy
If you are new to pump therapy, you will need the following data from your healthcare professional. Gather this
before going to your pump start appointment. If you are unsure, contact your healthcare professional or pump
trainer for guidance.
Basal rate
Basal insulin is needed to maintain your target glucose values when you are not eating. Your pump allows up to 48
basal rates to be programmed. Your healthcare professional may only have you program one or two basal rates
when you start pump therapy.
Meal bolus
Deliver a meal bolus before eating carbohydrates. Your insulin to carbohydrate ratio is the amount of insulin
required to cover a given number of carbohydrates or exchanges. This ratio gives you an idea of how much of an
insulin bolus you should take when eating carbohydrates.
Gram counting
1.0 unit of insulin for __________ grams of carbohydrate
Or
Exchange counting
__________ units of insulin for each carbohydrate exchange
BG targets
The Bolus Wizard will use your BG targets to calculate a correction dose. Keeping your BG within target range is
key to living well with diabetes. Your healthcare professional should help you decide these targets.
12
Introduction to pump therapy
Insulin sensitivity
Insulin sensitivity is used to decide a correction bolus for a high BG. This is how much your blood glucose will be
dropped with 1 unit of insulin.
1 unit of insulin will lower BG __________ mmol/L (mg/dL).
Active Insulin
Active insulin is the bolus insulin that has already been delivered to your body, but has not yet been used. The pump
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.
Blood glucose and A1C testing
When you check your blood glucose with a meter, you measure blood glucose at the moment you perform the test.
This number gives you key feedback for making present and day-to-day adjustments in your diabetes management.
The A1C test, done at your doctor's, shows you your average blood glucose over the last 60 to 90 days. Both blood
glucose and A1C testing are necessary for good diabetes management.
BG testing
With any insulin therapy, you must monitor your blood glucose 4 to 6 times a day. With insulin pump therapy, blood
glucose testing gives you correct feedback. It also allows you to make prompt changes based on the results. It alerts
you to high blood glucose readings that need changing. It allows you to adjust your insulin to carbohydrate ratio for
certain foods. Your pump only uses fast-acting insulin; as a result, you have no long-acting insulin as a back-up.
Therefore, if your insulin delivery is disrupted on pump therapy, your blood glucose can go dangerously high fairly
fast. This can happen much faster than it could when you were using daily injections with long-acting insulin. Blood
glucose testing is needed to alert you to high blood glucose so you can prevent diabetic ketoacidosis (DKA).
A1C
A1C testing also plays a key part in diabetes management. Sustained high BG levels can cause serious long-term
problems. These problems may be prevented and/or delayed if you maintain your blood glucose levels close to
normal. The best measure of your overall blood glucose is the A1C test. It has been proven that an A1C level of 7.0
or less greatly reduces the risk of problems from diabetes. But, any reduction in A1C is a plus. ADA Clinical Practice
Recommendations state that your A1C should be tested at least every 3 months by your healthcare professional.
Introduction to pump therapy
13
Your healthcare professional will rely on the results of your blood glucose tests to make changes in your pump
settings. The results of your A1C tests are used to assess your overall blood glucose control.
If you are on pump therapy, you must test your BG at least:
•
•
•
•
•
Upon waking up
Before each meal
At bedtime
If you feel nauseous
One hour after any BG above 250 mg/dL (13.9 mmol/L)
Below are target guidelines from the American Diabetes Association for adults with diabetes. Consult your
healthcare professional to find out what your targets should be.
Summary of recommendations for adults with diabetes mellitus
Glycemic control A1C
<7.0 percent
Preprandial plasma glucose (before meals)
90-130 mg/dL (5.0-7.2 mmol/L)
Peak postprandial plasma glucose (1-2 hours after meals)
<180 mg/dL (<10.0 mmol/L)
Correlation between A1C level and blood glucose levels
Mean plasma glucose
A1C (percent)
mg/dL
mmol/L
6
135
7.5
7
170
9.5
8
205
11.5
9
240
13.5
10
275
15.5
11
310
17.5
12
345
19.5
American Diabetes Association. Diabetes Care. “Tests of Glycemia in Diabetes.” & “Standards of Medical Care.”
Vol. 31, Supplement 1, January 2008. S18.
14
Introduction to pump therapy
Low blood glucose (hypoglycemia)
Low blood glucose can occur while using the pump for the same reasons it can while using daily injections.
Not enough food
Too much insulin
More exercise than usual
Drinking alcoholic beverages
As you know, you cannot always avoid low blood glucose. It is important that you create a routine to follow when
your BG is low. If you have a routine, you will have something ready to treat a low BG. This makes it less likely you
will over-treat and cause your blood glucose to go up too much.
It is best to use something that you can always carry with you. Choose a food that is all carbohydrate because it
will be fast acting. Avoid using high fat foods such as chocolate. They will not work fast enough, and you may also
end up over-treating your lows. When treating hypoglycemia, start with 15 grams of fast acting carbohydrates. Do
not keep eating until you feel better. Eat the required amount and stop. The feelings will pass and you will be
grateful that you did not overdo it.
Some people with diabetes know when their blood glucose is low and some do not. If you are not aware of
hypoglycemia, it is important to test your blood glucose more often. Everyone with diabetes should test before
driving a car to assure safety on the road. Blood glucose should be above 100 mg/dL (5.6 mmol/L) before driving
and at bedtime.
Tip: We suggest that you use glucose tablets to treat a low. These tablets contain a known, pre-measured amount
of carbohydrate, and are in handy packages that you can carry in your pocket, purse, or car.
ಘ
Hypoglycemia protocol: the rule of 15
If blood glucose is 70 mg/dL (3.9 mmol/L) or below:
•
•
•
•
Eat 15 grams of fast acting carbohydrate
Check BG again in 15 minutes; if not above 70 mg/dL (3.9 mmol/L), repeat treatment
Check BG again in 15 minutes; if still not above 70 mg/dL (3.9 mmol/L), repeat treatment again.
Contact your healthcare professional
Introduction to pump therapy
15
These items have 15 grams of fast acting carbohydrates:
•
•
Glucose tablets (three, 5-gram tablets or four, 4-gram tablets)
4 oz. of juice or soda (not diet)
•
•
6-7 Life Savers® (hard candies)
1 tablespoon of table sugar or honey
High blood glucose (hyperglycemia)
High blood glucose can occur while using the pump for the same reasons it can while using daily injections. It can
also occur for reasons that are unique to insulin pump therapy.
Too much food,
Not enough insulin,
Loss of insulin strength,
Disruption of insulin delivery from the pump.
The goal of treating hyperglycemia is to prevent Diabetic Ketoacidosis (DKA) and delay or prevent diabetes problems
due to high blood glucose over a lengthy period of time.
If for any reason you are not getting the proper amount of insulin, your blood glucose rises quickly. This can occur
with insulin pump therapy from the disruption of insulin delivery. This happens from the infusion set coming out,
clogs, or leaks, or insulin not being absorbed right.
Since the pump only delivers fast-acting insulin, hyperglycemia can occur rapidly. Your healthcare professional will
give you data needed for you to determine your correction bolus. This correction dose is based on your insulin
sensitivity.
It is vital that you know these guidelines in the hyperglycemia protocol.
Hyperglycemia protocol
If one blood glucose reading is above 250 mg/dL (13.9 mmol/L):
•
•
Take a correction bolus right away
Test BG in one hour
16
Introduction to pump therapy
If the second blood glucose is above 250 mg/dL (13.9 mmol/L):
•
•
•
•
•
•
Take an insulin injection by syringe (not through the pump). The amount should be the same as if you were
taking a correction bolus.
Change the entire infusion set system (new reservoir, infusion set, and cannula). Consider changing the insulin
vial if you believe that the insulin is no longer stable.
Check urine for ketones and call your healthcare professional if ketones are present.
Drink liquid with no calories every 30 minutes (for example: 8 oz. diet ginger ale, broth, water).
Test blood glucose every 2 hours and keep taking correction insulin until blood glucose reaches target.
Call your healthcare professional if your blood glucose and urine ketones remain high or you are unable to drink.
Treating hyperglycemia from illness or infection through insulin pump therapy will be discussed on the following
pages.
Diabetes ketoacidosis (DKA)
DKA results from untreated hyperglycemia. DKA is a serious medical problem that needs treatment right away. The
insulin pump therapy uses only fast-acting insulin, so DKA can occur rapidly if insulin delivery is disrupted. It is
important that you understand these guidelines.
Preventing DKA
If you have nausea or vomiting, immediately check your blood glucose and ketones. If your blood glucose is above
250 mg/dL (13.9 mmol/L) and/or ketones are present:
•
•
•
•
•
•
•
Take an injection of fast-acting or regular-acting insulin with a syringe (not through the pump). The amount
should be the same as if you were taking a correction bolus. If ketones are present, more insulin may be needed.
Contact your healthcare professional for guidelines for insulin doses especially when ketones are present.
Change the entire infusion set system (new reservoir, infusion set, and cannula). Consider changing the insulin
vial if you believe that the insulin is no longer stable.
Call your healthcare professional.
Troubleshoot the pump. If help is needed, please call our 24 Hour HelpLine for assistance.
Drink liquids with no calories every 30 minutes (for example: 8 oz. diet ginger ale, broth, water).
Check your blood glucose and ketones in one hour.
Continue to take insulin as discussed with your healthcare professional.
Introduction to pump therapy
17
•
•
•
Call your healthcare professional right away if your blood glucose and ketones are not decreasing, or you cannot
drink fluids.
Continue to test blood glucose and ketones. Continue to take correction insulin injections as told until your
blood glucose reaches your target level.
If your blood glucose is less than 200 mg/dL (11.1 mmol/L) and ketones are present, drink liquids with calories.
Some examples of caloric fluids are juice and non-diet soda. Also, extra insulin may be needed. Contact your
healthcare professional for guidelines for insulin doses when ketones are present.
Tip: You should have a meter, glucose strips, and ketones strips handy at all times. This way you are always ready
to test your blood glucose and ketones.
ಘ
Sick day management
Managing diabetes during an illness or infection requires frequent blood glucose and urine
ketone testing. Illness and infection put extra stress on the body and often raise blood
glucose. The insulin pump allows you to make changes. It lets you quickly and easily respond
to blood glucose changes due to illness and infection.
Even if you are not able to eat, you need insulin. Depending on blood glucose testing, you
may or may not need to adjust your basal insulin to cover your needs. You may also need
to take frequent correction boluses during illness.
Sick day protocol
•
•
•
•
•
•
Test your blood glucose every 2 hours, 24 hours a day.
Check urine ketones every time you urinate.
If you are throwing up and/or have ketones, you must call your healthcare professional.
They will give you the proper treatment with fluids and insulin to avoid DKA.
Consult your healthcare professional about taking more insulin if your blood glucose is 250 mg/dL (13.9 mmol/
L) or higher. Also take more insulin when ketones are fair or large.
Keep exact records of your blood glucose values, ketones, medication, temperature and all other signs.
Keep in mind that you need more insulin and fluids when there are urine ketones. This is true even if your
blood glucose is within your target range.
18
Introduction to pump therapy
Sick day supplies
You should have the supplies listed below in the house at all times, and carry them with you when you travel:
•
•
•
•
•
•
Fluids that have sugar (regular soda, juice, jello) to replace solid food.
Sugar-free liquids (diet drinks, bouillon, water) for replacing lost fluids.
Thermometer.
Sugar free medicine for fever, cough, congestion, nausea and vomiting.
Extra blood glucose and ketone strips.
Glucagon emergency kit in case of severe hypoglycemia. This can be used if you cannot eat or are unconscious.
Caring for your diabetes when you are sick is worthwhile and can be a challenge. If you are too sick to watch your
diabetes carefully, ask a friend or family member to help. If there is no one to help you, ask your healthcare
professional for help.
Nutrition
Good nutrition and making healthy choices are important for everyone. Additionally, for those with diabetes, it is
more important to know the nutrient content in food, and how the nutrients affect blood glucose.
Carbohydrates have the most effect on blood glucose, notably within a few hours of being eaten. Counting
carbohydrates allows you to match your insulin dose to the food you are eating. This is your insulin to carbohydrate
ratio. Although fat and protein can affect your blood glucose when eaten in large amounts, carbohydrates affect
blood glucose the most.
Consult with your healthcare professional for your personal nutritional guidelines.
Carbohydrate counting
With insulin pump therapy, you must take a bolus for the carbohydrates you eat. You need to count the
carbohydrates you plan to eat to see how much insulin to take.
There are two basic methods to count carbohydrates, and in truth, they are very much alike. Many people use parts
of both of the two methods.
Carbohydrate gram counting
With this method, you add up the exact number of grams of carbohydrate in each meal. Food labels, food list and
meal planning books are great tools for carbohydrate gram counting.
Introduction to pump therapy
19
Carbohydrate exchange system
This method uses food groups called exchange groups. One exchange with carbohydrate has about 15 grams of
carbohydrate.
1 bread exchange
1 fruit exchange
1 milk exchange
15 grams carbohydrate
15 grams carbohydrate
12 to 15 grams carbohydrate
Foods with carbohydrates include:
•
•
•
•
starches and starchy vegetables
fruits and fruit juices
milk and milk products
sugars and foods with sugar
Facts on the nutrition labels on packaged food will help you to figure how much carbohydrate is in a certain food.
There are a number of paperback books that list the grams of carbohydrates in many foods. These books are very
helpful when you are eating foods without labels or are eating out. Also, if you know the exchange system, you can
count carbohydrate exchanges.
Your healthcare professional will give you an insulin to carbohydrate ratio at the start. This will be a place to begin.
It may need to be changed based on the results of your blood glucose readings after you eat.
Determining your meal bolus based on carbohydrate counting is not an exact science. Sometimes it takes trial and
error to come up with the correct meal bolus for certain foods. If you are not sure how some foods affect your blood
glucose, test your blood glucose 2 hours after eating. If your reading is too high or too low, adjust your meal bolus
the next time you make that food choice.
As you start to learn carbohydrate counting, try to assess the carbohydrates in the food you are eating. Then look
at the food labels to see how close you are.
Reading a food label
Use the Serving Size and Total Carbohydrates information on the food label to determine how many total grams of
carbohydrate you will be eating. Then, use the insulin to carbohydrate ratio prescribed by your healthcare
professional. This allows you to figure out how much insulin to take for the foods you eat.
The food label below shows 12 grams of carbohydrates for each 1 piece serving. If your carbohydrate ratio is 1 unit
of insulin for every 12 grams of carbohydrate, you would need 1 unit of insulin for each 1 piece serving of this food.
20
Introduction to pump therapy
Nutrition Facts
Serving Size 1 piece (20g)
Serving per Container 22
Amount Per Serving:
Calories: 50
Fat Calories: 0
Total Fat 0g
Sodium 0g
Total Carbohydrates 12g
Sugars 11g
Protein 0g
Fat and blood glucose
Although fat does not have carbohydrate, it may affect your blood glucose level. Your blood glucose can be normal
2 hours after a meal with high fat foods. However, 4-6 hours later your blood glucose will increase. That is because
the fat slows down the rate the carbohydrates are absorbed in that meal.
Foods with fat include:
•
margarine
•
oils
•
mayonnaise
•
salad dressing
•
nuts
•
fried foods
•
butter
•
sour cream
•
whole milk
•
cream cheese
•
bacon
•
high fat meats
Doctors and health experts suggest that all people, with or without diabetes, eat less total fat—namely less
saturated fat. If you have high cholesterol or are trying to lose weight, it is key to limit the amount of fat you eat
per day.
There are bolus type options available on your pump that can be helpful in handling the rare high-fat meal. Before
using bolus type options, you should be at ease using basic pump features and consult with your healthcare
professional.
Introduction to pump therapy
21
Protein and blood glucose
Protein has little effect on blood glucose when eaten in moderate amounts, and normally does not require any
insulin.
Sources of protein include:
•
meat
•
fish
•
poultry
•
eggs
•
cheese
•
peanut butter
•
tofu
•
dried beans
•
dried peas
Protein needs are the same for people with and without diabetes, unless kidney disease is present. Most people eat
more protein than they need. Protein does not need to be part of every meal. In general, five to seven ounces a
day is enough. If you have high cholesterol or are trying to lose weight, eat leaner proteins such as chicken and fish.
Other things that affect blood glucose
Fiber may slow down the rise in blood glucose after a meal. Fiber grams are not absorbed. They can be subtracted
from the Total Carbohydrate amount for foods or meals with more than 5 grams of fiber. Fiber is an important part
of a healthy diet. Suggestions for fiber intake are the same for people with and without diabetes.
Sodium (salt) has no effect on blood glucose. Moderate sodium intake is suggested for people with or without
diabetes. If you have high blood pressure or are affected by sodium, limit the amount of sodium in your diet.
Alcohol can cause low blood glucose by slowing down the release of glucose from the liver. This glucose release
keeps blood glucose in target between meals. Therefore, food should be eaten while having a drink with alcohol.
The carbohydrate content of different types of alcohol can be found in carbohydrate counting books. Consult your
healthcare professional for guidelines on bolusing for alcohol.
Vitamins and minerals have no effect on blood glucose.
Healthy eating habits
Insulin pump therapy gives you the choice of when, what and how much to eat without impacting blood glucose
control. This gives you the flexibility to sleep-in, postpone or skip meals, and eat snacks—the same as people who
do not have diabetes. Be careful to not abuse this freedom and compromise your nutritional health. All people need
to make healthy food choices to be mentally and physically healthy.
It is not an exact science to figure your meal bolus based on carbohydrate counting. Sometimes it takes trial and
error to figure the correct meal bolus for certain foods. If you are unsure how certain foods will effect your blood
22
Introduction to pump therapy
glucose, test your blood glucose 2 hours after you eat. Keep records of foods that you eat on regular basis. Note
the bolus amounts and post-prandial readings for each entry. If your reading is too high or too low, adjust your meal
bolus the next time you make that food choice.
Exercise
Your body needs insulin and carbohydrate to provide cells with energy during exercise. How much insulin and
carbohydrates you need varies with the types of exercise and with how often you exercise. Using an insulin pump
during exercise allows you to reduce your basal rate instead of eating extra carbohydrate. Before, you needed to
eat extra carbohydrate to make up for the glucose lowering effect exercise often has on blood glucose. It takes
trial and error to get the balance right.
The body needs insulin during exercise. Therefore, it is not suggested that you stop the pump unless the exercise
is for a short amount of time (1 hour or less). If you need to remove the pump for more than 1 hour, refer to the
If you remove your pump section in the The basics chapter.
If you do an exercise that on average lowers your blood glucose, you can use the temporary basal rate feature. You
can use this feature to lower the amount of insulin delivered and reduce the risk of hypoglycemia. You may also
choose to change your basal rate pattern for the days you exercise.
It takes a period of time to determine how much to adjust your basal rate during exercise. Record your blood glucose
before, during and after exercise to figure the proper reduction in your basal rate. Record any carbohydrates that
you have eaten during the exercise period. There is no magic formula that will tell you just what to do. You have
to test often to figure out the basal rate that you need during exercise.
Introduction to pump therapy
23
24
Introduction to pump therapy
3
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.
battery
compartment
screen
tubing
connector
ESC
reservoir
window
ACT
ESC
buttons
ACT
reservoir
compartment
The basics
25
Install battery
CAUTION: Do not use a rechargeable or carbon zinc battery in your pump. For best results use a new Energizer
AAA alkaline battery, size E92, type LR03.
Medtronic Diabetes designed the pump to only accept a NEW battery. As a safety measure, if you install a battery
that does not have full power, the WEAK BATTERY or FAILED BATT TEST alarm may sound. If you receive a WEAK
BATTERY alarm, respond to the alarm and continue. The pump will still operate normally, but with a decreased
battery life. The pump uses one AAA alkaline battery.
ಘ
1
ಘ
2
ಘ
3
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.
Use the edge of a coin to remove the battery cap. Turn the cap in a counter-clockwise direction.
battery
Remove the old battery and dispose of it per the
disposable requirements of your state or country.
battery cap
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.
NOTE: Do not use batteries that have been in
cold storage (i.e., in the refrigerator or your car in the winter).
ಘ
ಘ
4
Place the battery cap in the pump and tighten so the slot
is aligned horizontally with the pump as shown here:
one half-turn
CAUTION: Do NOT over-tighten the battery cap. You
should not turn the cap more than four half turns. If you
over-tighten the cap you may not be able to remove it,
and you can damage your pump.
one half-turn
26
The basics
ಘ
5
ಘ
6
ಘ
7
While the pump turns on, it will show one or more screens until the
HOME screen appears.
If the HOME screen does not appear, do these steps:
a. Check that the battery is inserted correctly. If the battery has been
HOME screen
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 our 24 Hour HelpLine.
Check to make sure the time and date are correct. If more than 5 minutes have passed since you removed the
battery, you will be prompted to check the time and date. Refer to the Setting the time and date section in
the Basic programming chapter for programming instructions.
Press ESC to view the STATUS screen, making sure no alarms are active. If an alarm is active, follow the
instructions on the screen.
The basics
27
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
ESC
button
From the HOME screen
EASY BOLUS™ button-Shortcut to
set and deliver an Easy Bolus.
ACT
button
DOWN
button
From the menus and programming screens
Increases / decreases the value of a flashing item. Scrolls up and
down the items in a list.
Turns the backlight on/off from
Accepts a selected menu item or activates a selected setting.
the HOME screen.
Opens the MAIN MENU.
Returns to previous screen or exits the menu. 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 to set up any bolus.
Press simultaneously with
to turn on backlight when in the menus or
use as a Shift button by pressing it in combination with another button
to access certain features.
28
The basics
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, contact our 24 Hour HelpLine.
ಘ
HOME screen
The HOME screen serves as the starting point to access the programming
screens. When no buttons are pressed for about 30 seconds, the pump returns
to this screen.
When you press ACT from the HOME screen, the MAIN MENU will appear.
When the pump is on, the following icons always appear across the top of the screen: reservoir volume icon, the
time (12 or 24 hr), and the battery icon. If these do not appear, the pump is not operating.
Screen icons
There are various icons that appear at the top of your pump screen, like the time, battery and reservoir icons
mentioned above. The next sections describe what the icons mean.
Battery
The battery icon tells you how much usable life is left in your battery. There are four
segments in the icon. Each segment represents approximately 25 percent of the usable
battery life you have left until you reach Low Battery point. So if you only have one
segment left you want to make sure you have a new battery available.
At least 75% left
Low battery
The basics
29
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 the Setting the time and date section
in the Basic programming chapter.
24-Hr
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. This allows you to be aware of how much insulin you have
left in your pump. Refer to your STATUS screen to view the number of units left in the
reservoir.
75 to 100% left
NOTE:
Less than 25% left
For the Paradigm 715, your reservoir icon will only appear full if using a filled
300 unit Paradigm reservoir. The icon will not appear full if you use the 176 unit Paradigm
reservoir.
ಘ
Alert and alarm icons
An open circle (alert) or a solid 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 the Troubleshooting and alarms chapter.
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
any additional text.
30
The basics
to view
Screen backlight
When you press
from the HOME screen, the light on the screen turns on or off. During programming, the backlight
can be turned on by pressing the
and the
together. The light will stay on while you are pressing any of the
pump buttons. It will stay on as long as the current screen is active.
To conserve your battery, the backlight will turn off automatically while the pump is vibrating. After the vibration
is finished, the light will turn back on. The backlight cannot be turned on in a Low Battery condition.
Beep/vibrate
Your pump will beep or vibrate to indicate activity. Refer to the Setting your alert type section in the Utilities
chapter 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.
Normal mode
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.
Special mode
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
The basics
31
•
•
•
•
•
Block feature is on
Dual or Square Wave bolus delivery
Basal pattern A or B is active
Temporary basal delivery
Alert Silence is active
Attention mode
CAUTION: When the pump is in Attention mode (showing a solid circle alarm), all insulin deliveries are stopped.
Indicates insulin delivery has stopped. This can mean that the pump is in
Suspend mode. It can also mean an alarm is active or an alarm condition exists
that needs immediate attention for insulin delivery to resume. A solid circle
appears at the top of the screen and the pump will beep periodically until either
the pump is taken out of Suspend mode or the condition is cleared. The screen will show text describing the condition
that put the pump in Attention mode. For example, if the reservoir is empty, EMPTY RESERVOIR will appear on the
screen.
When the pump is in Attention mode, it will beep/vibrate periodically to remind you of the condition. The beep/
vibrate frequency varies depending on the condition that put the pump in Attention mode. Refer to the Alarm
conditions section in the Troubleshooting and alarms chapter for alarm conditions that will trigger the Attention
mode. See the Stopping your pump section in the Basic programming chapter to learn about Suspend mode.
Menus
The MAIN MENU is the highest level menu. There are submenus, functions, status and programming screens in the
lower menu levels. The menus are described in the following paragraphs.
TIP:
If a screen item is flashing (blinking), during programming, press
or
to change the value.
ಘ
MAIN MENU
Highest menu level in the menu system. When you press ACT from the HOME screen, the MAIN MENU will appear.
32
The basics
BOLUS MENU
Contains the settings and functions for bolus deliveries. The
button allows direct access to MANUAL BOLUS or
to the BOLUS WIZARD feature without having to navigate through the menus. Refer to the Basic programming
chapter for the manual bolus information or to the Using the Bolus Wizard feature chapter for bolusing using the
Bolus Wizard feature.
SUSPEND
Stops all current insulin deliveries (basal, bolus and fixed prime). Refer to the Stopping your pump section in the
Basic programming chapter for the manual bolus information or to the Using the Bolus Wizard feature for more
information.
BASAL MENU
Contains the functions to setup and deliver your basal. Refer to the Basal section in the Basic programming chapter
for more information.
PRIME MENU
Contains the functions to change your reservoir and fill the infusion set with insulin. Refer to the Changing your
infusion set section in the Starting on insulin chapter for more information.
UTILITIES MENU
Contains features for your safety and convenience. Refer to the Utilities chapter for more information.
STATUS screen
The STATUS screen shows information about what your pump is doing. 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.
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.
or
to scroll and view all of the information.
The basics
33
The screen includes information about:
•
•
•
•
•
•
•
•
Recent insulin deliveries (basal and bolus)
The amount of active insulin, if any
Special features that are turned on
Last alarm/alert that was cleared within 24 hours
Most recent BG meter reading received within 24 hours
Reservoir status
Battery status
Time and date
Refer to the Pump Specifications chapter for a complete list of the information that is available in the STATUS
screen.
If you remove your pump
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 do the following: Keep a record of your current basal rates and use the Save Settings
feature (see the Utilities chapter). 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.
•
•
•
Store your pump with the battery in place
Keep a record of your current basal rates and use the Save Settings feature (see the Saving the settings section
of the Utilities chapter).
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.
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 hour without taking insulin. If you remove your pump for
more than one hour, you will have to use another way to take your insulin, such as injections of fast-acting insulin,
or reconnecting your pump to take boluses. Take the injection or bolus approximately every four hours. Calculate
the amount of insulin to take based on the total of your basal insulin in four 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.
34
The basics
4
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).
ಘ
1
Go to the TIME/DATE SETUP screen.
Main > Utilities > Time/Date
ಘ
2
ಘ
3
ಘ
4
Select 12-Hour Setup or 24-Hour Setup and press ACT.
Press ACT again to change the settings.
Change each of the settings as follows:
a. Hour
Change the hour. Press ACT.
For 12-hour setups, press
or
until the correct A (am) or P (pm)
appears.
b. Minutes
Change the minutes. Press ACT.
Basic programming
35
c.
Year
Change the year. Press ACT.
d. Month
Change the month. Press ACT.
e. Day
Change the day. Press ACT.
ಘ
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.
Selecting the language
The language shown on the pump screens can be changed. Some languages will not be available on all pumps. Before
you can select another language, you need to set the time using the English screens. Refer to the previous section.
ಗ
To change the language for your pump:
ಘ
1 Go to the LANGUAGE MENU screen.
Main > Utilities > Language
ಘ
2
ಘ
3
Select your language, then press ACT.
The language setting is now changed. Exit the menus.
36
Basic programming
Bolus
There are three bolus types: Normal, Square Wave®, and Dual Wave®. This section gives instructions for a Normal
bolus using the express bolus button and navigating through the menus. (For information about Square Wave and
Dual Wave boluses, refer to the Optimizing pump therapy chapter.)
The Normal bolus delivers an immediate food or correction bolus. It can be delivered at any time except during
another Normal bolus. During a Normal bolus, most pump features are disabled until after all the bolus has been
delivered. The suspend function and the STATUS screen, however, are always available.
Setting the Normal Bolus
Normal bolus can be used to cover the carbohydrate in a meal or snack and/or to correct a blood glucose that is
higher than your blood glucose target.
ಗ
The following instructions are for a Normal bolus when the Bolus Wizard feature is turned off.
ಘ
1 Go to the BOLUS MENU.
Main > Bolus
Select Set Bolus and press ACT. Go to step 2.
You can also use the
ಘ
2
ಘ
3
EXPRESS BOLUS button to get to step 2. Press
from your HOME screen.
a. If the SET BOLUS screen appears: (Dual/Square option is off) Go to step 3.
b. If the BOLUS TYPE screen appears: (Dual/Square Wave is on) Select Normal Bolus and press ACT. Go to
step 3.
The SET BOLUS screen (or SET NORMAL BOLUS screen if the Dual/Square option is on) appears with 0.0 unit
bolus amount flashing.
Enter your bolus amount and press ACT.
NOTE: If you have BG Reminder turned On, a screen displays allowing you to accept or modify the length of
time after this bolus before you are reminded to check your blood glucose. See the BG reminder section of
this chapter for information about this feature.
ಘ
ಘ
4
The BOLUS DELIVERY screen appears and the Normal bolus starts. The pump will beep/vibrate at the start of
the bolus. As the bolus delivers, the amount shown on the screen will increase until the entire bolus has been
delivered. 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.
Basic programming
37
Normal meal bolus using the exchange system
Normal bolus can be used to cover the carbohydrate in a meal or snack and to correct a blood glucose that is
higher than the target that was chosen for you.
Fred has been taught that he needs to take 1 unit of insulin for every carbohydrate exchange that he eats (every
milk, 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.
Bolus practice:
Going through the menus, program a 2.0 unit Normal bolus now.
NOTE: Make sure that you are
Check here if you were able to program it.
not connected to your pump
while practicing.
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.
38
Basic programming
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
1/2 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).
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.
Basic programming
39
Meal bolus, correction bolus and insulin sensitivity
Jason is ready to eat his breakfast. He has calculated that he will need 4.0 units for his food.
He tests his blood glucose and finds that it is 200 mg/dL (11.1 mmol/L). Jason knows that his blood glucose level
is above his blood glucose target and will need additional insulin before he eats.
Jason's healthcare professional has determined the following for him:
Target BG: 110 mg/dL (6.1 mmol/L)
Insulin sensitivity1: 36 mg/dL (2.0 mmol/L)
Jason determines that he will need a correction bolus of 2.5 units insulin to lower his elevated blood glucose.
The 2.5 correction bolus will lower his current blood glucose of 200 mg/dL (11.1 mmol/L) to his target of 110
mg/dL (6.1 mmol/L).
•
elevated blood glucose: 200 î 110 = 90 mg/dL (11.1 î 6.1 = 5 mmol/L)
•
correction bolus: 90 / 36 mg/dL (insulin sensitivity) (5.0 / 2.0 mmol/L) = 2.5 units
(He will add this 2.5 correction bolus to the 4.0 units of insulin that he will need for his meal bolus. Jason will
take a total bolus of 6.5 units.)
1. Insulin sensitivity is the amount (in mmol/L or mg/dL) by which blood glucose will be lowered after taking 1
unit of insulin. Consult with your healthcare professional to determine your insulin sensitivity.
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 level.
Your total bolus (meal bolus plus correction bolus) is _________.
Review your bolus deliveries
You can view a list of your bolus deliveries in the BOLUS HISTORY screen. This screen shows a list of the dates,
times, units, and types for your last 24 boluses. This feature is helpful for record keeping or to check if you bolused
for your last meal.
If a bolus was stopped before delivery was complete, the BOLUS HISTORY screen will show only the amount actually
delivered. Refer to the Bolus details section for instructions about viewing bolus details.
40
Basic programming
Do the following steps to view the BOLUS HISTORY screen:
ಘ Go to the BOLUS HISTORY
1
screen and scroll through
the bolus deliveries.
(with the Bolus Wizard feature)
Main > Bolus > Bolus
History
ಘ
2
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.
Refer to the instructions in
the Bolus details section,
to see the details for any
of these boluses.
Bolus details
date
carb value
BG value
time
amount/type
N = Normal
S = Square Wave
DN = Normal part of dual wave bolus
DS = Square part of dual wave bolus
You can view the details of any
of the deliveries in the BOLUS HISTORY screen. The details include:
•
•
•
•
bolus types: normal, square, and dual
programmed bolus amount
delivered bolus amount
Bolus Wizard feature information (if used)
ಗ
Basic programming
41
To see the details of any
bolus, do these steps:
ಘ
1 In the BOLUS HISTORY
screen, select the bolus
that you want to review and
press ACT.
ಘ The details for that bolus
2
will appear on the screen.
Scroll through the details.
ಘ Exit when you are done.
3
Without the Bolus Wizard feature
With the Bolus Wizard feature
delivery is active
If the Bolus Wizard feature
calculated your bolus, more
information will appear in the
BOLUS DETAIL screen.
delivery stopped
delivery completed
42
Basic programming
Press the down key to see the
details
Maximum bolus limit
The maximum bolus (max bolus) is a safety feature that limits the amount of insulin that can be delivered in a single
bolus. The factory setting is 10.0 units. You can specify the limit from 0.0 to 25.0 units. It is important to discuss
this feature with your healthcare professional to determine your maximum bolus amount.
To set the maximum bolus limit, do these steps:
ಘ
1 Go to the MAX BOLUS SETUP screen.
Main > Bolus > Max Bolus
ಘ
2
ಘ
3
Set your maximum bolus limit and press ACT.
Your maximum bolus is set. Exit the menus.
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 35.0 units so he can take more insulin when he needs to.
BG reminder
After you deliver a bolus you may want to check your blood glucose. The BG Reminder is an optional feature that
makes the pump beep or vibrate to remind you to check your blood glucose after a bolus. However, this reminder
is not available after an Easy Bolus. Your pump is set at the factory with the BG Reminder feature turned off.
When setting a bolus, if the BG Reminder is on, your pump will ask you to set up the BG Reminder Duration. This
sets how long after bolus delivery you will be reminded to check your BG. This time can be from 30 minutes to 5
hours, or NONE. The BG Reminder is not available after an Easy Bolus.
ಘ
1
Go to the BG REMINDER SETUP screen.
Main > Bolus > BG Reminder
Basic programming
43
ಘ
2
Select On and press ACT. The BG Reminder is now enabled. Exit the menus.
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.
When the BG Reminder goes off, your pump will beep or vibrate and the message CHECK BG will appear on the
screen. Your pump will beep or vibrate periodically until it is cleared (ESC, ACT).
When you set a BG Reminder after a bolus, the STATUS screen will show
the amount of time remaining before the reminder will go off. Here,
the STATUS screen indicates BG Reminder will go off in 18 minutes.
Basal
Basal insulin is required to maintain your target glucose values when you are not eating. Your healthcare professional
will calculate this rate for you. Your basal insulin accounts 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 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. For basal rate 1, the start time is midnight (12:00 a.m. or 00:00) and cannot be
changed. See below for a sample graph of basal rates.
44
Basic programming
12:00 AM
Basal Rate 1
start time
The start and stop times of basal rates for this example are:
•
•
•
•
12:00 a.m. (00:00) to 3:00 a.m. (3:00) for basal rate 1
3:00 a.m. (3:00) to 7:00 a.m. (7:00) for basal rate 2
7:00 a.m. (7:00) to 9:00 p.m. (21:00) for basal rate 3
9:00 p.m. (21:00) to 12:00 a.m. (00:00) for basal rate 4
e
rat
rat
e
4
3:00 AM
Basal Rate 2
start time
1
rate 2
If you need one basal insulin that starts before midnight and
stops after midnight, you need to set up two basal rates.
These basal rates have the same rate but different start and
stop times. For example, in this graph a basal rate is needed
from 9:00 p.m to 3:00 a.m. (21:00 to 3:00) at one rate. Basal
rate 1 always starts at midnight and should be set to end at
3:00 a.m. (3:00). After setting basal rates 2 and 3, rate 4 is
set from 9:00 p.m. (21:00) to midnight at the same rate as
basal rate 1. This gives continuous basal insulin from 9:00 p.m
to 3:00 a.m. (21:00 to 3:00) at one rate.
9:00 PM
Basal Rate 4
start time
24 hours
7:00 AM
Basal Rate 3
start time
rate 3
You cannot set a start time for one basal rate to overlap the next basal rate. The addition of a new basal rate will
erase any basal rates that follow.
For best results, setting or changing your basal rate(s) should be discussed with your healthcare professional.
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. Refer to the If you remove your
pump section in the The basics chapter for more information.
Basal programming and delivery
NOTE:
You cannot make changes to your basal rate settings while a percent temp basal is active.
ಘ
ಗ
Basic programming
45
To set your basal rates:
ಘ1 Go to the SET BASAL RATE 1 screen.
Main > Basal > Set/Edit Basal
ಘ2
ಘ3
ಘ4
ಘ5
ಘ6
ಘ7
ಘ8
ಘ9
ಘ
10
The SET BASAL RATE 1 screen flashes the basal rate in U/H.
Enter your first basal rate amount and press ACT.
The start time for your first basal rate is midnight (00:00 or 12:00A) and cannot be changed.
The SET START TIME 2 screen appears. The dashes under the screen name flash. The first basal rate is now set.
If you do not need a second basal rate for the day, press ESC. If you need to set up a second basal rate for the
day, follow steps 5 and 6.
In the SET START TIME 2 screen, enter the start time for the next rate.
Press ACT. The SET BASAL RATE 2 screen appears. Enter the rate.
Press ACT. The SET START TIME 3 screen appears. The second basal rate is now set. If you do not need to set
up any more basal rates for the day, press ESC and skip to step 9. If you need to set up more basal rates, follow
steps 5 and 6 for each basal rate.
After you program your last basal rate, press ESC.
The BASAL RATE screen will appear. Your basal rate(s) will now deliver as programmed. Exit the menus.
When you have finished programming your pump, you can save your settings. Refer to the User Settings section
in the Utilities chapter for instructions.
Current basal delivery
The STATUS screen shows your current basal information.
46
Basic programming
current basal
Daily basal rate(s)
The BASAL REVIEW screen shows your daily basal rates programmed for delivery from midnight to midnight. 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).
ಗ
To review your basal rates, do these steps:
ಘ
1 Go to the BASAL MENU screen.
Main > Basal
ಘ
2
ಘ
3
Select Basal Review and press ACT.
If you do not use patterns, the STANDARD
screen appears.
The delivery details for your standard basal
will appear.
(24-hour total)
basal insulin
basal rate
start times
basal
delivery rates
Basic programming
47
If you use patterns, the BASAL REVIEW
screen appears.
The current basal pattern will be
highlighted. Select the pattern you want to
view. Press ACT.
The delivery details for that pattern will
appear.
(24-hour total)
basal insulin
basal rate
start times
basal
delivery rates
ಘ
4
Exit the menus when you are done.
Setting the Max basal rate
Maximum (max) basal rate is a safety limit for the amount of basal insulin that is able to be delivered per hour.
Your pump is sent from the factory with the max basal set to two (2.0) units per hour. It is important to determine
your max basal rates with your healthcare professional. This safety feature will not allow you to program any basal
rates, including patterns and temporary basal rates, that are greater than the max basal rate.
If you are setting your max basal rate after your basal rates have been set, you cannot set a max basal that is less
than any of the programmed basal rates.
To set your max basal rate, do these steps:
ಘ Go to the MAX BASAL RATE screen. The maximum basal rate will be flashing.
1
Main > Basal > Max Basal Rate
ಘ
2
ಘ
3
Change the rate and press ACT.
Your maximum basal rate is now set. Exit the menus.
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.
48
Basic programming
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.
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 you resume your pump, the basal delivery will continue.
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 11:20 AM. The pump will beep/vibrate at 11:30 AM, 11:45 AM, 12:00 PM, and
so on until you resume your pump (basal resumes).
When suspended, your pump is in Attention mode with a solid circle showing on the pump. When in Suspend, you
can only resume your basal or view the STATUS screen. No other functions are available.
To suspend the pump:
ಘ Select Suspend from the MAIN MENU, and press ACT.
1
Main > Suspend
ಘ
2
ಘ
3
SUSPEND will flash on your screen. Press ACT to stop your pump.
The screen will show that the pump is suspended and the time that it stopped. After less than one minute, the
pump will return to the HOME screen with a solid circle.
You can verify on your pump STATUS screen that your pump is suspended.
Basic programming
49
Resume pump delivery
When the pump is suspended, it defaults to the HOME screen with a solid circle.
To resume your pump and basal delivery, do these steps:
ಘ
1 From any screen, press ACT until the RESUME screen appears. Press
ACT again.
ಘ
2 Your pump will beep once, then the HOME screen will appear without
the solid 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.
ಘ
Example:
Suspend function
Helen is ready to eat her lunch. She has just programmed her pump to deliver a meal bolus when the phone rings.
Helen wants to talk on the phone and not eat her lunch right away. She knows that if she lets the bolus continue
and she does not eat her lunch soon, she may be at risk for low blood glucose. Helen suspends delivery of her
pump to stop the bolus, but then resumes delivery to restart her basal insulin. When she is off the phone and
ready to eat, she checks her STATUS screen to see how much insulin she received from the partially delivered
bolus before she suspended her pump. She will reprogram a new bolus for the remainder of her bolus amount.
Practice:
Suspend function
1
2
3
4
5
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.
Now, RESUME delivery, so that your basal insulin will continue.
Check the STATUS screen.
How much insulin did the bolus deliver before you Suspended delivery? _______.
If you wanted to take the rest of the bolus later, how much would you take to equal 3.0 units? _______.
50
Basic programming
Practice:
Resume basal delivery after a suspend
Make sure you are NOT connected to your pump while practicing.
1 Give a 3.0 unit bolus now. While it is delivering, suspend the bolus.
2 Check here if you were able to suspend the bolus.
3
4
Now restart the pump.
Check here if you were able to restart the pump.
Basic programming
51
52
Basic programming
5
Starting on insulin
The Paradigm pump is intended for use with U100 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 make sure the time and date are
correct on your pump. You must also program your settings as instructed by your healthcare professional.
You will need these items:
•
•
•
•
Pump
Insulin (U100)
Paradigm reservoir and user guide
Paradigm compatible infusion set and user guide
Starting on insulin
53
Filling the reservoir
WARNING: Using cold insulin can cause air bubbles in the reservoir and tubing. If your insulin is stored in the
refrigerator, allow it to reach room temperature before filling your reservoir. When filling the reservoir, take
care to remove air bubbles.
CAUTION: Insulin comes in different vial types, depending on your country. If your vial is different than the
one described in the User Guide, consult with your healthcare professional on how to fill 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
vial
4
Push down on the plunger to pressurize the vial.
54
Starting on insulin
5 While still holding the
plunger rod, flip the vial
over so the vial is up, slowly
pull down on the plunger to
fill the reservoir.
6 Gently tap the side of the reservoir to
make any air bubbles rise to the top of the
reservoir.
9 With the vial down, hold the transfer guard. Turn
the reservoir counter-clockwise, then pull straight up
to remove it from the transfer guard.
7 Slowly push up on the plunger just
enough to remove any air bubbles
from the reservoir.
8 Slowly pull down on the plunger
to fill the reservoir to the number of
units desired.
10 Place the tubing connector onto the reservoir.
Turn the connector clockwise, pressing gently against
the reservoir until you feel it slide in. Push in and continue turning until the reservoir and the connector lock
with a click.
“Click”
Starting on insulin
55
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 your pump, and fill the infusion
set with insulin.
ಘ
1 Remove the entire infusion set from your body.
ಘ If attached, remove the activity guard.
2
ಘ Turn the tubing connector half-turn counter
tubing connector
3
half-turn counter-clockwise
clockwise, then pull the reservoir and connector out
from the pump.
ಘ Safely dispose of the used reservoir and infusion set
4
item in a sharp's container.
ಘ You must now rewind your pump as described in the
5
next section.
56
Starting on insulin
Rewinding your pump
Before you continue, make sure the infusion set is NOT connected to your body and the reservoir is NOT in the
pump.
WARNING: Make sure the infusion set is disconnected from your body before you rewind your pump or fill the
infusion set tubing. 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.
ಘ
1
If you removed your reservoir and are replacing it, go to the REWIND screen.
Main > Prime > Rewind
ಘ
2
ಘ
3
In the REWIND screen, press ACT to start the rewind process. The REWINDING screen will appear while the
pump rewinds.
After the pump rewinds the PREPARING TO PRIME screen will appear.
If you are practicing:
a. Do NOT insert the reservoir in your pump. Make sure the red shipping cap is installed in the reservoir
compartment as shipped.
b. Press ACT, then continue with the manual prime instructions described in the Manual prime section of this
chapter.
If you are not practicing, continue to the next section to insert the reservoir in your pump.
Inserting the reservoir in your pump
If your reservoir is already inserted in your pump, continue to the next section.
You must do these steps in the order described. 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
calculates the reservoir volume. To ensure correct volume calculations, your pump has been designed to
require a rewind before you insert your reservoir.
Starting on insulin
57
ಘ
1
If you are using the pump for the first time, remove the red 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.
Insert the reservoir into the top of the pump case.
ಘ
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.
ESC
ಘ
2
tubing connector
ಘ
4
ಘ
5
Attach the activity guard, if desired.
You must now do a manual prime as described in the next section.
58
Starting on insulin
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 that 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.
ಘ
1
ಘ
2
ಘ
3
ಘ
4
After you rewind your pump, the PREPARING TO PRIME screen appears.
The pump may automatically return to the HOME screen while you install the reservoir. Press ACT to return to
the PREPARING TO PRIME screen.
Press and hold ACT to start the prime. The pump will beep six times when the prime starts.
While you hold ACT, the pump will again beep six times when the screen begins counting the prime units being
used.
Continue to hold ACT until insulin droplets form on the tip of the infusion set needle, then release. Make sure
there are no bubbles in the tubing.
WARNING: If the PRIMING-HOLD ACT screen does not display, do NOT insert the infusion set in your body.
Please contact your local representative for assistance.
ಘ
5
ಘ
6
If your manual prime uses more than 30U insulin, the pump will show the following screen: IS PRIMING
COMPLETE? When you get this message, do the following:
1 Make sure you are not connected to the pump.
2 Read the message on the screen, then press ESC, ACT to clear.
3 If your manual prime is complete (you see droplets on the tip of the infusion set needle), press ESC and
continue to step 5.
Press ESC. Your manual prime is complete.
You can now insert the infusion set into your body as described in the next section.
Inserting the infusion set
WARNING: While the infusion set is connected to your body, do not unscrew and retighten the tubing connector
on the reservoir.
Starting on insulin
59
After you complete all of the following, you will be ready to insert the infusion set into your body:
•
•
•
•
fill your reservoir
rewind your pump
insert the reservoir into pump
and fill the infusion set with insulin
Shown here are the best body areas (shaded) for infusion set insertion. Avoid the 2-inch (5.0 cm) area around the
navel.
It is important that you change your infusion set every 2–3 days. Be sure to rotate the infusion sites so that they do
not become overused. The abdominal area is the most common site for set insertions because absorption is very
consistent. To keep abdominal sites healthy, some people find it helpful to use a visual scheme to help them rotate
their infusion sites in an organized way. Here are two commonly used methods. For maximum effectiveness, use
both methods, alternating between them:
•
Visualize an imaginary clock drawn on your abdomen surrounding your belly button. Rotate
infusion sites by starting at 12 o’clock and then rotating the site clockwise to 3 o’clock, 6
o’clock, etc.
60
Starting on insulin
•
Imagine a letter M or a letter W on either side of your belly button. Start at the end
of one letter and proceed through the letter, rotating to each intersection in turn.
Medtronic Diabetes 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, see the next section to prime your pump.
Starting on insulin
61
Quick-set infusion set (with Quick-serter®)
Always refer to the instructions that shipped with your infusion set.
1
2 Clean the infusion site. Let it
air dry.
3
4
5
6
7
8
9
Wash your hands.
62
Starting on insulin
10
11
12
13
Fixed prime
A fixed prime fills the soft cannula with insulin and is required after the infusion set is inserted into your body and
the introducer needle removed. The prime amount depends on your infusion set type, so read your infusion set
instructions for the fixed prime amount. A fixed prime is also required before reconnecting the tubing to the infusion
set to make sure that all air is removed from the tubing.
ಘ
1
Go to the PRIME MENU screen.
Main > Prime
ಘ
2
ಘ
3
ಘ
4
Select Fixed Prime and press ACT.
In the FIXED PRIME screen, enter the insulin amount for your infusion set type, then press ACT.
After the prime begins, the PRIME DELIVERY screen will count the units as they are delivered. The pump will
beep after priming is complete.
Starting on insulin
63
Prime history
Do these steps to see a list of the delivered primes.
ಘ
1 Go to the PRIME HISTORY.
Main > Prime > Prime History
ಘ
2
Scroll through the list of prime deliveries. The letter F at the end of the text line indicates a fixed prime.
The letter M indicates a manual prime. Exit the menus.
Disconnecting Quick-set
The Quick-set allows you the freedom to temporarily disconnect from your pump without removing the infusion set
from your body.
1 Hold the side grips of the connector part with your fingers.
64
2 Twist the connector counterclockwise.
Starting on insulin
3 Remove the connector from the
site.
Reconnecting Quick-set
A fixed prime is used before reconnecting the infusion set to your body to ensure that insulin has filled the infusion
set. See the instructions in this chapter.
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.
1
2
3
Record keeping for diabetes management
Now that you are using the pump, 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.
Starting on insulin
65
These are the recommended times to test to determine control:
•
•
•
•
•
•
•
•
•
Overnight (occasionally, at approximately 2 - 3:00 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.
66
Starting on insulin
Using the Bolus Wizard feature
6
What is it?
Bolus Wizard is a feature that calculates an estimated bolus to support your food intake or to correct high blood
glucose. You need the following information:
Carbohydrate counting
You need to know how which foods contain carbohydrates and how to count these.
Your blood glucose reading
BG readings
You need to know your blood glucose (BG) reading.
When using the Bolus Wizard feature, the pump can
Meter
work with blood glucose meter powered by MWT1
technology to automatically receive your blood
glucose reading. MWT1 is the wireless RF technology
that is used to transmit information from the meter to the pump. You can program your pump to automatically
receive your BG reading from this meter. All meters referenced in this user guide are blood glucose meters supported
by MWT1 technology. The Meter option section in this chapter has more information. If you are not using this meter,
you will manually enter your blood glucose.
Using the Bolus Wizard feature
67
Your personal Bolus Wizard feature settings
In addition to your blood glucose reading and/or your food entry, the Bolus Wizard feature uses personal settings
that you program into the pump. (For instructions see the How to program the Bolus Wizard feature section in the
Using the Bolus Wizard feature chapter.)
•
•
•
•
•
•
carb units (grams or exchanges)
carb ratios (in carbohydrate grams/unit of insulin or insulin units/carb exchanges)
BG units (mg/dL or mmol/L)
insulin sensitivity
target blood glucose range
active insulin time (hours)
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 following Bolus Wizard feature settings table:
Bolus Wizard feature settings
Information
Setting
Carb units:
_____ grams or ____ exchanges
Carb ratios:
Bolus Wizard feature uses this for your food bolus calculations.
#1: __________
If you count carbs:
this ratio is the amount of carbohydrate grams covered by one (1) unit
of insulin.
range: 3 - 150 grams/unit
If you count exchanges:
this ratio is the amount of insulin you need to cover one (carb) exchange.
range: 0.1 - 5.0 units/exchange
#2: __________
start time
(midnight)
#3: __________
(additional settings, if
needed)
#4: __________
#5: __________
#6: __________
#7: __________
NOTE: Your carb ratios may vary throughout the day. Your pump
allows you to program up to eight (8) different carb ratios.
#8: __________
BG units: (how you measure your blood glucose)
_____ mg/dL or _____ mmol/L
68
Using the Bolus Wizard feature
Information
Setting
Insulin sensitivity:
This ratio is used for your correction bolus calculations.
BG units reduced /
1 unit of insulin
This ratio is the BG units reduced by 1.0 unit of insulin.
#1: __________
range: 10 - 400 mg/dL or 0.5 - 22.2 mmol/L
#2: __________
NOTE:
#3: __________
(additional settings, if
needed)
Your insulin sensitivity may vary throughout the day. Your
pump allows you to program up to eight different insulin sensitivities.
start time
(midnight)
#4: __________
#5: __________
#6: __________
#7: __________
#8: __________
BG target range:
If your current blood glucose is above the BG Target Range, the Bolus
Wizard feature will calculate a correction dose. If your current blood
glucose is below the BG Target Range, the Bolus Wizard feature will
calculate a negative correction and subtract it from your food bolus.
#1: __________
range: 60 - 250 mg/dL or 3.3 - 13.9 mmol/L
#4: __________
NOTE:
#5: __________
Your pump will allow you to program up to eight different
BG target ranges.
(midnight)
#2: __________
#3: __________
(additional settings, if
needed)
#6: __________
#7: __________
#8: __________
Active insulin time:
The Bolus Wizard feature uses this time to calculate the active insulin
in your system. 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.
Number of Hours: _____
Using the Bolus Wizard feature
69
Information
range: 2-8 hours
70
Using the Bolus Wizard feature
Setting
How the Bolus Wizard feature works
ಘ
1
If you want your current blood glucose to be factored in, enter your BG Reading.
• automatically from the meter (refer to the Meter option section of this chapter);
or
•
ಘ
2
ಘ
3
manually by selecting the
button.
If you are going to eat, enter your food amount in grams or exchanges.
The Bolus Wizard feature will calculate a bolus for you. An ESTIMATE DETAILS screen will appear with your
estimated total bolus amount.
Bolus Wizard warnings
High or low blood glucose levels
If your blood glucose in the ENTER BG screen is not in the range of 70 to 250 mg/dL (3.9 to 13.9 mmol/L), the Bolus
Wizard feature will give you a warning. Either a LOW BG or HIGH BG screen appears. Read the instructions, then
press ACT or ESC to clear the message. You can then continue programming to deliver your bolus.
About maximum delivery
Bolus Wizard feature will not deliver more than the limit set for your maximum bolus. If the Bolus Wizard feature
calculates a bolus amount that is larger than your max bolus limit setting, the message, MAX BOLUS EXCEEDED will
appear. If this happens, do these steps:
ಘ
1
ಘ
2
ಘ
3
ಘ
4
ಘ
5
In the MAX BOLUS EXCEEDED screen, press ACT to continue your bolus programming. The EST : MAX screen
appears with the estimated and maximum bolus amounts. Continue to the next step.
If you do not want to continue, press ESC to cancel and the screen will return to the ENTER BG screen.
In the EST : MAX screen, press ACT again to continue your bolus programming.
The SET BOLUS screen appears with the maximum bolus amount flashing. Enter the bolus amount. This amount
cannot be more than the max bolus amount. Press ACT.
The BOLUS DELIVERY screen appears showing the insulin units being delivered.
The pump will beep/vibrate after it has completed the insulin delivery.
Using the Bolus Wizard feature
71
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.
0DLQ!%ROXV!%ROXV:L]DUG6HWXS!(GLW6HWWLQJV
Once the settings are programmed, you do not have to program them again unless the values change. After you
program one setting, the screen will automatically go to the next required setting. After you program all your
settings, review them as described in this section to make sure they are set correctly.
Instructions for programming the Bolus Wizard feature settings are in the next paragraphs. Program your settings
in the order described to make sure you program all the settings. If you have not completed setting up all of the
required settings, MISSING INFO screen appears. It lists the required settings for this feature. You must program the
listed settings before you can use the Bolus Wizard feature.
Turning on the Bolus Wizard feature
ಘ
1
Go to the EDIT SETTINGS screen.
Main > Bolus > Bolus Wizard Setup > Edit Settings
ಘ
2
ಘ
3
ಘ
4
The EDIT SETTINGS screen appears with Wizard: Off selected. Press ACT.
The WIZARD ON/OFF screen appears. Select On, then press ACT.
The EDIT SETTINGS screen appears, showing that the wizard is now turned on. You are now ready to select your
carb units.
Selecting the Carb units
The carb unit setting lets the pump know which way to count your carbohydrates (grams or exchanges). Any time
you make changes to the carb units, you must also reprogram the carb ratios. Refer to the Bolus Wizard feature
settings table in this chapter for your carb ratio settings.
ಘ
1
Make sure the EDIT SETTINGS screen is open.
Main > Bolus > Bolus Wizard Setup > Edit Settings
ಘ
2
ಘ
3
ಘ
4
Select Carb Units, then press ACT.
The CARB UNITS screen appears. Select Grams or Exchanges, then press ACT.
The EDIT SETTINGS screen shows the carb units you selected. You are now ready to set your carb/exchange
ratios.
72
Using the Bolus Wizard feature
Setting the Carb/Exch ratios
Your pump allows you to set up to eight Carb/Exch ratios because this ratio may vary throughout the day. Your
healthcare professional may only have you program one or two carb ratios when you first start using the Bolus Wizard
feature.
ಘ1
Make sure the EDIT SETTINGS screen is open.
Main > Bolus > Bolus Wizard Setup > Edit Settings
ಘ2
ಘ3
ಘ4
ಘ5
ಘ6
ಘ7
ಘ8
ಘ9
ಘ
10
Select Carb Ratios, then press ACT.
The SET CARB RATIO 1 (if you are using grams) or SET EXCH RATIO 1 (if using exchanges) screen appears. The
default ratio flashes on the screen.
Set your first ratio, then press ACT. Carb ratio values are normally between 5-50 grams/u or 0.3-3.0 u/exch.
If your ratio value is outside the range, a warning message will appear on the screen. This message warns that
the entered carb ratio is valid but outside the usual range. Press ESC to correct or ACT to continue.
The start time for your first ratio is midnight and cannot be changed.
The SET START TIME 2 screen appears. The dashes under the screen name flash. The first Carb Ratio or Exchange
Ratio is now set.
If you do not need a second ratio, press ESC and skip to the next section. If you need to set up another ratio,
follow steps 6 through 9.
In the SET START TIME 2 screen, enter the time of the day you want this ratio to become active.
Press ACT. The SET CARB RATIO 2 screen appears.
The default ratio flashes. Select your ratio.
Press ACT. The SET START TIME 3 screen appears. The second carb or exchange ratio is now set.
If you do not need to set up any more ratios, press ESC. If you need to set up more ratios, repeat steps 6 through
9 above for each ratio.
You are now ready to set up the BG units.
Setting the BG units
You can select mmol/L or mg/dL as your Blood Glucose Unit (measurement type). If you make changes to your BG
settings, you must reprogram your insulin sensitivity and BG targets.
ಘ
1
Make sure the EDIT SETTINGS screen is open.
Main > Bolus > Bolus Wizard Setup > Edit Settings
ಘ
2
Select BG Units, then press ACT.
Using the Bolus Wizard feature
73
ಘ
3
ಘ
4
The BLOOD GLUCOSE UNITS screen displays. Select mmol/L or mg/dL, then press ACT.
The EDIT SETTINGS screen shows the BG units you selected. You are now ready to set your insulin sensitivity.
Insulin sensitivity
Your insulin sensitivity is the amount your blood glucose (BG) level is reduced by one unit of insulin. This value is
used to calculate a suggested insulin dose to correct a high BG. Because this sensitivity may vary throughout the
day, your pump lets you set up to eight sensitivity settings. Your healthcare professional may only have you program
one or two insulin sensitivities when you first start using the Bolus Wizard feature. Record your settings in the Bolus
Wizard feature settings table in this chapter.
Insulin sensitivity values are normally between 20 - 100 mg/dL (1.1 - 5.6 mmol/L). If your value is outside this range,
a warning message will appear on the screen.
ಘ1
Make sure the EDIT SETTINGS screen is open.
Main > Bolus > Bolus Wizard Setup > Edit Settings
ಘ2
ಘ3
ಘ4
ಘ5
ಘ6
ಘ7
ಘ8
ಘ9
ಘ
10
Select Sensitivity, then press ACT.
The INS SENSITIVITY 1 screen appears. The default sensitivity value flashes on the screen.
Set the value for your first insulin sensitivity setting, then press ACT.
The start time for your first insulin sensitivity is midnight and cannot be changed.
The SET START TIME 2 screen appears. The dashes under the screen name flash. The first insulin sensitivity is
now set.
If you do not need a second insulin sensitivity, press ESC and skip to the next section. If you need to set up
another insulin sensitivity, follow steps 6 through 9.
In the SET START TIME 2 screen enter the time of the day you want this insulin sensitivity to become active.
Press ACT. The INS SENSITIVITY 2 screen appears.
The default sensitivity value flashes. Select the value for this insulin sensitivity.
Press ACT. The SET START TIME 3 screen appears. The second insulin sensitivity is now set.
If you do not need to set up any more insulin sensitivities, press ESC. If you need to set up more insulin
sensitivities, repeat steps 6 through 9 above for each insulin sensitivity.
You are now ready to set up the BG target.
74
Using the Bolus Wizard feature
Glucose Concentration
Setting the BG targets
The BG Target setting allows you to set glucose
targets. The Bolus Wizard will use these targets to
calculate a correction dose. Because your targets
may vary throughout the day, your pump allows you
to set up to eight 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.
mmol/L
22.2
mg/dL
400
13.9
250
5.6
100
3.8
70
If your current BG is above the BG Target range, the
Bolus Wizard feature may calculate a correction
dose. A correction dose will be enough insulin to bring
your BG down to your current high end of the BG
Target
Target range. If your current BG is below the BG
Target range, the Bolus Wizard may calculate a
negative correction and subtract it from your food
bolus. This will bring your BG to the low end of your BG Target range.
Range
Correct down to the upper
limit of 100 mg/dL
Correct up to the lower limit
of 70 mgl/dL
Pumps are sent from the factory with default BG target range of 100-100 mg/dL (5.6-5.6 mmol/L).
ಘ1
Make sure the EDIT SETTINGS screen is open.
Main > Bolus > Bolus Wizard Setup > Edit Settings
ಘ2
ಘ3
ಘ4
ಘ5
ಘ6
Select BG Target, then press ACT.
The TARGET RANGE 1 screen appears. The low end of your BG target range flashes on the screen.
Set the BG target, then press ACT.
The high end of your BG target range flashes on the screen. Enter the BG target, then press ACT.
The start time for your first BG target is midnight and cannot be changed.
a. If you adjust your BG Targets outside of 90-140 mg/dL (5.0-7.8 mmol/L), the pump screen displays a warning
that the values are acceptable but outside normal range. Press ESC to change your BG target or press
ACT to set this range.
b. If your BG target is within 90-140 mg/dL (5.0-7.8 mmol/L), the SET START TIME 2 screen appears. The
dashes under the screen name flash. The first BG target range is now set.
If you do not need a second BG target range, press ESC and skip to the next section. If you need to set up
another BG target range, follow steps 7 through 11.
Using the Bolus Wizard feature
75
ಘ7
ಘ8
ಘ9
ಘ
10
ಘ
11
ಘ
12
In the SET START TIME 2 screen enter the time of the day you want this BG target range to become active.
Press ACT. The TARGET RANGE 2 screen appears.
The low end of your BG target range flashes on the screen. Set the BG target, then press ACT.
The high end of your BG target range flashes on the screen. Enter the BG target, then press ACT.
The SET START TIME 3 screen appears. The second BG target range is now set.
If you do not need to set up any more BG target ranges, press ESC. If you need to set up more BG target ranges,
repeat steps 7 through 11 above for each one.
You are now ready to set up the Active insulin time.
About active insulin
Active insulin is the bolus insulin that has already been delivered to your body, but has not yet been used. The pump
considers your active insulin time setting in determining any active insulin still in your body from prior boluses. This
may help prevent hypoglycemia caused by over-correcting for high blood glucose.
The Bolus Wizard feature automatically tracks active insulin for you, based on your active insulin time, and subtracts
the appropriate amount when your blood glucose is above your target range. The details will appear in the ESTIMATE
DETAILS screen during the bolus programming steps.
Your Paradigm pump is shipped from the factory with an active insulin time setting of six hours, which most closely
matches the published scientific data. If your healthcare professional prescribes a different time for you, the active
insulin time setting can be adjusted in the Bolus Wizard menu in one-hour increments from two to eight hours.
For more details about active insulin, see the Bolus Wizard feature specifications section in the Pump specifications
chapter.
CAUTION: If you give yourself insulin by using a syringe, the Bolus Wizard feature will not be able to correctly
determine the active insulin in your system. Consult with your healthcare professional on how long you need
to wait after a manual injection before you can rely on the active insulin calculation of your Bolus Wizard
feature.
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. Your healthcare professional should determine the active insulin
time that is best for you.
ಗ
76
Using the Bolus Wizard feature
To set the Active insulin time, do the following steps:
ಘ
1 Make sure the EDIT SETTINGS screen is open.
Main > Bolus > Bolus Wizard Setup > Edit Settings
ಘ
2
ಘ
3
ಘ
4
ಘ
5
Select Active Ins Time, then press ACT.
The ACTIVE INS TIME screen appears. The default time of six hours flashes on the screen.
Set the number of hours for the active insulin time, then press ACT.
The EDIT SETTINGS screen shows the new Active insulin time setting. You have now completed the Bolus Wizard
setup. Press ESC or wait to see the message: Bolus Wizard setup is complete.
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.
ಘ
1
Go to the REVIEW SETTINGS screen.
Main > Bolus > Bolus Wizard Setup > Review Settings
ಘ
2
ಘ
3
Scroll through the text to view your Bolus Wizard settings.
Exit the menus when you are done.
Meter option
BG readings
You can set up your pump to automatically receive
your blood glucose reading from the linked meter.
Meter
This meter may not be available in all countries.
Check with your local Medtronic Diabetes
representative. Your pump is set at the factory with
the meter option turned off. Programming your meter ID links your pump to the meter. If you do not link the meter
to your pump, you will enter your blood glucose readings manually. Each meter has its own unique ID. You can link
up to three 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 meter. The reading will appear on the pump screen.
NOTE:
The use of RF (radio frequency) devices with the pump reduces pump battery life.
ಘ
Using the Bolus Wizard feature
77
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 meter. See the user guide that came with your meter for detailed
information on how to use it.
Meter rules
If you want your pump to communicate with the meter, the following conditions must apply:
ಘ
1 The meter option must be turned on and programmed. Refer to the instructions in this section.
ಘ Your pump must be within 4 feet (1.2 meters) of your meter to receive the blood glucose reading.
2
ಘ The pump cannot have a LOW BATTERY alert condition.
3
ಘ When programming a bolus, the blood glucose measurement from the meter will appear as the default blood
4
glucose value on the ENTER BG screen. The pump will not display a reading that is older than 12 minutes on
the ENTER BG screen.
ಘ
5 Do not use the RF meter to send your blood glucose readings to the pump while onboard aircraft. Manually
enter your blood glucose.
CAUTION: The pump will not receive signals from the 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 Meters in the
DEVICE OPTIONS screen when programming your meter.
If you are not sure that your meter ID is entered in your pump, check the REVIEW METER ID screen.
You have to turn on the meter option to add, delete, or review the meter ID(s) programmed in your pump.
ಘ
1
Go to the METER OPTION screen.
Main > Utilities > Meter Options
ಘ
2
ಘ
3
Select On, then press ACT. The METER ID MENU appears.
Add, delete or review your meter ID(s) as desired.
Adding meter IDs
a. Select Add ID, then press ACT.
78
Using the Bolus Wizard feature
b. Use the up and down arrow buttons to enter each of the six ID characters. Press ACT after each entry.
c. After you set the last character of the ID, the screen will return to the METER ID MENU.
Deleting meter IDs
a. Select Delete ID, then press ACT.
b. Select the meter ID that you want to delete and press ACT.
c. The selected ID is now deleted.
Reviewing meter IDs
a. Select Review ID, then press ACT.
b. The programmed IDs will show in the REVIEW METER ID screen.
ಘ
4
Exit the menus when you are done.
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 reading from the meter, if they are linked.
Use the
button to deliver a Normal bolus at any time except during another Normal bolus. A Normal bolus will
temporarily interrupt a Square Wave or Dual Wave bolus that is delivering. After the Normal bolus is finished, the
Square Wave or Dual Wave bolus delivery will resume.
NOTE:
If you want to use the pump-to-meter link, make sure the meter option is on. Refer to the Meter
option section in this chapter for instructions.
ಘ
ಘ
1
If you want a correction bolus, check your blood glucose with your blood glucose meter and go to step 2. If you
want to bolus for food, go to step 2.
ಘ
2
Press
ಘ
3
The ENTER BG screen will appear.
a. If you are NOT using the meter:
Enter your blood glucose value. Press ACT and continue to step 4.
on your pump, or go to the BOLUS MENU, select Use Bolus Wizard, and press ACT.
Using the Bolus Wizard feature
79
If you are not entering a blood glucose and want to bolus for food, select the dashes in the ENTER BG screen.
The Bolus Wizard feature will calculate the insulin needed for your food entry without considering your
blood glucose level. Press ACT and continue to step 4.
b. If you are using the meter, your pump checks if the entered BG is within your target range.
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.
ಘ
ಘ
4
ಘ
5
ಘ
6
Press ACT to accept the Blood glucose value. You can change this blood glucose value, if necessary, then
press ACT. Continue to step 4.
The ENTER FOOD screen appears.
a. If this is a food bolus, enter the food value you will eat, then press ACT.
b. If this is a correction bolus, select 0 (zero) as the value, then press ACT.
The ESTIMATE DETAILS screen appears. Review the information in this screen. If you need to make any changes,
press ESC to return to the ENTER BG screen (step 3) and make changes as necessary.
Press ACT In the ESTIMATE DETAILS screen. The SET BOLUS screen appears with the estimated bolus amount
flashing. Change the amount if desired. Press ACT to accept and start delivery of the bolus.
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 the BG reminder section in the Basic
programming chapter for information about this feature.
ಘ
ಘ
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 returns to the HOME screen.
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 - 6.6 mmol/L)
Active Insulin Time: 6 hours
80
Using the Bolus Wizard feature
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 the Bolus Wizard feature specifications section in the Pump
specifications chapter.
ಘ
Example 1: Blood glucose on target (normal blood glucose) 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 meter and his blood glucose result of 120 mg/dL (6.6 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)
60 g
= 4 units
15 g/u
(correction estimate)
Correction is 0 because the
current blood glucose reading
is within the BG Target Range.
+
bolus estimate
=4+0
= 4 units
Using the Bolus Wizard feature
81
Example 2: Blood glucose above target (high blood glucose) and no active insulin
The next day, Michael wakes up before school. Before eating the same breakfast, he tests his blood glucose with
his meter and finds it to be 200 mg/dL (11.1 mmol/L), which is above his target of 120 mg/dL (6.6 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)
(correction estimate)
60 g
= 4 units
15 g/u
+
11.1 mmol/L - 6.6 mmol/L = 2 units
2.2 mmol/L/u
200 mg/dL - 120 mg/dL = 2 units
40 mg/dL/u
bolus estimate
82
=4+2
= 6 units
Using the Bolus Wizard feature
Example 3: Blood glucose below target (low blood glucose) and no active insulin
On another morning, Michael sits down before eating the same breakfast. He tests his blood glucose with his
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)
(correction estimate)
60 g
= 4 units
15 g/u
+
3.9 mmol/L - 5.0 mmol/L = -0.5 units
2.2 mmol/L/u
70 mg/dL - 90 mg/dL
40 mg/dL/u
bolus estimate
= -0.5 units
= 4 + (-0.5)
= 3.5 units
Using the Bolus Wizard feature
83
Example 4: Blood glucose above target (high blood glucose) with active insulin
Michael is at school and wants to eat a snack in the late morning. He tests his blood glucose with his meter and
finds it to at 200 mg/dL (11.1 mmol/L), which is above his target of 120 mg/dL (6.6 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)
(correction estimate)
60 g
= 4 units
15 g/u
+
bolus estimate
84
11.1 mmol/L - 6.6 mmol/L - 1.5 units (active insulin)
2.2 mmol/L/u
= 0.5 units
200 mg/dL - 120 mg/dL - 1.5 units (active insulin)
40 mg/dL/u
= 0.5 units
= 4 + 0.5
= 4.5 units
Using the Bolus Wizard feature
Example 5: Blood glucose below target (low blood glucose) with active insulin
Another day at school, Michael is getting ready to eat lunch. He tests his blood glucose with his 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.
(food estimate)
(correction estimate)
60 g
= 4 units
15 g/u
+
3.9 mmol/L - 5.0 mmol/L - 0* units (active insulin)
2.2 mmol/L/u
70 mg/dL - 90 mg/dL
40 mg/dL/u
bolus estimate
- 0* units (active insulin)
= -0.5 units
= -0.5 units
= 4 + (-0.5)
= 3.5 units
NOTE:
*When the current blood glucose is below the target low blood glucose, the active insulin amount is
not considered in the Bolus Wizard feature calculations.
Using the Bolus Wizard feature
85
86
Using the Bolus Wizard feature
7
Optimizing pump therapy
Square Wave and Dual Wave bolus
Square Wave bolus delivers a bolus evenly over a period of time (30 minutes to 8 hours). This bolus can be used
for insulin delivery when you have eaten a long meal with extended snacking. It can also be useful if you have
delayed food digestion due to gastroparesis or meals high in fat. A Square Wave bolus can be useful if a Normal
bolus drops your blood glucose too rapidly. Since the Square Wave portion extends over a period of time, the insulin
is more likely to be available to match your individual needs.
NOTE: During delivery of a Square Wave bolus, you will not be able to do the following pump functions: change
the max bolus amount, disable or deliver Dual and Square Wave boluses, rewind or do a fixed prime, change the
active insulin time, run a Selftest, or access the User Settings menu. All other pump functions are still available
during the Square Wave bolus.
ಘ
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.
Optimizing pump therapy
87
See the following graphic for a description of the different bolus types:
INSULIN
Entire bolus amount
delivered immediately.
NORMAL
BOLUS
Bolus amount delivered evenly
over specified time period.
SQUARE WAVE
BOLUS
1
2
Part of the bolus amount delivered
immediately and the remainder
delivered evenly over time period.
DUAL WAVE
BOLUS
Now
Portion
3
Square
Portion
TIME
Turning on the Dual Wave/Square Wave option
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.
ಗ
To set up a Dual Wave or Square Wave bolus, you must first turn on the dual/square bolus option.
ಘ Go to the DUAL/SQUARE OPTION screen.
1
Main > Bolus > Dual/Square Bolus
ಘ
2
Select On, then press ACT. The feature is now on. Exit the menus.
Square Wave or Dual Wave bolus without Bolus Wizard feature
ಘ
1
ಘ
2
ಘ
3
Make sure the dual/square option is on.
Calculate your food and/or correction bolus amount.
Go to the BOLUS TYPE screen.
Press
on your pump, or follow this path:
Main > Bolus > Set Bolus
88
Optimizing pump therapy
ಘ
4
ಘ
5
ಘ
6
For
a.
b.
c.
For
a.
b.
a Square Wave bolus, do these steps:
Select Square Wave Bolus, then press ACT. The SET SQUARE BOLUS screen appears.
Enter the desired amount for the Square Wave bolus units, then press ACT.
Continue to step 5.
a Dual Wave bolus, do these steps:
Select Dual Wave Bolus, then press ACT. The SET DUAL BOLUS TOTAL screen appears.
Enter the desired amount for the total dual bolus units. This amount is the total of Normal and Square Wave
bolus units. Press ACT.
c. The next screen flashes the amounts of Now (Normal) and Square Wave portions of the Dual Wave bolus.
or
to change the percentage/
The screen also shows the percentage amount of each portion. Press
number of units. Continue to step 5.
The SQUARE DURATION screen appears. Enter the amount of time you want the Square Wave bolus to last, then
press ACT.
If you have BG Reminder turned On, a screen displays. It allows you to accept or modify the length of time after
this bolus before you are reminded to check your blood glucose.
The BOLUS DELIVERY screen appears with an open circle indicating that your pump is in Special mode. The
pump beeps/vibrates at the start of the bolus. During bolus delivery, the pump will return to the HOME screen.
The pump beeps/vibrates at the end of the bolus and the open circle disappears.
Optimizing pump therapy
89
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 yes, then repeat this test with the same meal on another day to verify your results.
If no, discuss this with your healthcare professional for guidance.
90
Optimizing pump therapy
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 one-half 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 yes, repeat this test with the same meal on another day to verify results.
If no, discuss this with your healthcare professional for guidance.
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 (gram 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.
The Bolus Wizard feature must be turned on and the settings must be programmed (see the How to program the
Bolus Wizard feature section of the Using the Bolus Wizard chapter). Also, make sure the dual/square option is
turned on (see the Turning on the Dual Wave/Square Wave option of this chapter).
If you want to use the pump-to-meter link, make sure the meter option is on. Refer to the Meter option section of
the Using the Bolus Wizard feature chapter for instructions.
Optimizing pump therapy
91
ಘ
1
Go to the ENTER BG screen.
Press
on your pump, or use the following path:
Main > Bolus > Use Bolus Wizard
ಘ
2
ಘ
3
ಘ
4
ಘ
5
ಘ
6
ಘ
7
Enter your blood glucose value, then press ACT.
The ENTER FOOD screen appears. Enter your food, then press ACT.
The ESTIMATE DETAILS screen appears. Scroll down to review the information there. Press ACT to continue to
step 5.
If you need to make any changes, press ESC to return to the ENTER BG screen. Make changes as necessary.
The BOLUS EST screen appears with Normal Bolus, Square Wave Bolus, and Dual Wave Bolus options. If your
Bolus Wizard feature calculates that your bolus includes a portion to correct your high blood glucose, the Square
Wave Bolus option 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.
To set a Square Wave bolus, do these steps:
a. In the BOLUS EST screen, select Square Wave Bolus, then press ACT.
b. The SET SQUARE BOLUS screen flashes the estimated bolus amount. Change the amount if needed. Press
ACT to accept the bolus amount.
To set a Dual Wave bolus, do these steps:
a. The SET DUAL BOLUS TOTAL screen flashes the estimated bolus amount. This amount is the total of both
the Normal and Square Wave bolus units. Change the amount if needed. Press ACT to accept the bolus
amount.
b. The next screen flashes the amounts of Now (Normal) and Square portions of the Dual Wave bolus. The
screen also shows the percentage amount of each portion. Press ACT to accept the Bolus Wizard's suggested
or
to change these portions, then press ACT.
portions. You can also press
The Bolus Wizard feature recommends splitting the food portion of your bolus 50/50 between the Square
and Now portions. The entire correction amount is always recommended to the Now portion. In this example
the NOW portion consists of half of the food insulin plus the correction amount less the active insulin (1.5U
+ 2.5U - 1.5U). This gives 2.5U or 62% of total insulin of 4.0U. The Square portion consists of the
other half of the food insulin (1.5U), which is 38% of total insulin of 4.0U.
The SQUARE DURATION screen appears. Enter the amount of time you want the Square Wave bolus to last, then
press ACT.
If you have BG Reminder turned On, a screen displays. It allows you to accept or modify the length of time after
this bolus before you are reminded to check your blood glucose.
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Optimizing pump therapy
ಘ
8
Press ACT to accept and deliver the bolus. The BOLUS DELIVERY screen appears with an open circle indicating
that your pump is in Special Mode. The pump beeps/vibrates at the start of the bolus. During bolus delivery,
the pump returns to the HOME screen. If you want to see the progress of the delivery, press ESC to see the
STATUS screen. The pump beeps/vibrates at the end of the bolus, and the open circle disappears.
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. When using vibrate mode, EASY BOLUS is limited to 20 steps or maximum bolus, whichever
comes first.
After you set your step amount, you can program your Easy Bolus. When you are in the HOME screen, each time you
the Easy Bolus amount increases by one step. You will hear a beep or feel a vibration for each step increase.
press
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
ಘ
1
Go to the EASY BOLUS OPTION screen.
Main > Bolus > Easy Bolus
Select On/Set, then press ACT. If you do not want to use Easy Bolus, select Off and press ACT.
ಘ
NOTE:
If you are using the remote control, the Easy Bolus must be set to on.
Optimizing pump therapy
93
Step value setup
You can set the step value from 0.1 to 2.0 units, or to the set maximum bolus limit of less than 2.0 units (factory
setting: 0.1). Set the step to a number that is convenient to use and easy to multiply.
Total # Steps = 4
Total # Button Presses = 4
4
Example:
2.0 unit Easy bolus with a step
amount set at 0.5 units
1 Step = 0.5 units
3
1 Step = 0.5 units
2
1 Step = 0.5 units
1
1 Step = 0.5 units
0
0
0.5
1.0
1.5
2
Total # Units
ಘ
1
ಘ
2
The EASY BOLUS ENTRY screen flashes the step value. Change the value, then press ACT. The step value is the
increment you will use for your Easy bolus.
The screen will return to the BOLUS MENU. Your step amount is now programmed and Easy Bolus is ready to
use. Exit the menus.
Delivering Easy Bolus
Practice using the Easy Bolus feature while looking at the pump screen as you count the beeps. This feature only
works from the HOME screen. After you are familiar with Easy Bolus, you can use the audible tones for bolus delivery
without having to look at the screen.
ಘ
1
From the HOME screen, press
ಘ
2
Press
. The SET EASY BOLUS screen appears with the single step value flashing.
the number of times needed for your bolus amount. Watch the amount change on the screen with
each press. The pump will vibrate or sound a different tone for each
ಘ
3
press.
When your total bolus amount appears on the SET EASY BOLUS screen, press ACT. Listen/feel to count the steps
without looking at the screen.
94
Optimizing pump therapy
For example: You need to deliver a 2.0 unit bolus, and your step size is set to 0.5. Each time you press
units increase by the step amount of 0.5 units. To deliver 2.0 units, you need to press the
, the
button 4 times.
(4 X 0.5 = 2.0) The screen will show 2.0 units.
NOTE: For your safety, you cannot use the
to select the Easy Bolus values. Pressing
or ESC will cancel
the Easy bolus.
ಘ
ಘ
4
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.
Example 1: Easy bolus
Alexander is a busy executive with an accounting firm. He wears his Paradigm pump on his belt and does not
to
want to take it off to give himself a bolus. Alex can easily reach down and feel for the Easy Bolus button
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
, the pump will sound a different tone so he can keep track of the number of
button presses.
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 and feel for vibrations rather than listening for the tones. (See the Setting your
alert section of the Utilities chapter for details.)
Optimizing pump therapy
95
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? _______
Your step level is ________.
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.
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 turned on and programmed.
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.
ಘ
•
•
Standard pattern: Your normal basal that supports your usual day-to-day activity. When the Patterns feature
is off, the pump uses your standard basal pattern.
Pattern A/B: Basal pattern that supports activity levels that are not a part of your day-to-day routine, but are
normal in your lifestyle. Such activities could be a sport that you do once a week or a change in your sleep
pattern over the weekend, extended periods of higher or lower activity, or menses.
Turning on the patterns
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.
ಘ
1
Go to the PATTERNS OPTION screen.
Main > Basal > Patterns
ಘ
2
Select On, then press ACT. The patterns feature is now on. Exit the menus.
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Optimizing pump therapy
Programming a pattern
Your pump will keep your pattern settings even when the Patterns option is turned off. However, the patterns
feature must be on to program a basal pattern.
ಗ
To program your patterns, do these steps:
ಘ1 Go to the EDIT BASAL screen.
Main > Basal > Set/Edit Basal
ಘ2
ಘ3
ಘ4
ಘ5
ಘ6
ಘ7
ಘ8
ಘ9
ಘ
10
Select the basal pattern you want to program, then press ACT.
The SET BASAL RATE 1 screen appears. The basal rate flashes, indicating that it can be changed. Set your first
rate, then press ACT.
The start time for your first basal rate is midnight and cannot be changed.
The SET START TIME 2 screen appears. The dashes under the screen name flash. The first basal rate is now set.
If you want to use the same rate for the whole day, press ESC and skip to step 10. If you want to program
another basal rate, follow steps 5 through 8.
In the SET START TIME 2 screen enter the time of the day you want this basal rate to become active.
Press ACT. The SET BASAL RATE 2 screen appears.
The previously set basal rate or dashes flash on the screen. Select the value for this basal rate.
Press ACT. The SET START TIME 3 screen appears. The second basal rate is now set.
If you do not need to set up any more basal rates, press ESC. If you need to set up more basal rates, repeat
steps 5 through 8 above for each rate.
After you press ESC, the BASAL RATE screen appears. The screen will show:
• the current basal pattern and basal rate,
• time it started, and
• the 24-hour basal total.
After 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.
Select a pattern
Before you select a pattern to be active, make sure the Patterns feature is turned 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:
ಘ
1
Go to the SELECT PATTERN screen.
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97
Main > Basal > Select Patterns
ಘ
2
ಘ
3
Select the desired pattern, then press ACT.
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.
ಘ
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 3 kilometer 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.
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Optimizing pump therapy
Your turn:
Can you think of situations where you might require different basal rate settings on different days?
Temp basal rates
Temp basal should be used based on the guidance of your healthcare professional. This feature is useful to manage
blood glucose levels during unusual short-term activities or conditions. These conditions could be an illness or
physical activity.
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. For ongoing periods of increased or decreased activity, the patterns feature may be more
suitable.
How does temp basal work?
During a temp basal delivery, all other basal programming is temporarily overridden. After the temp basal delivery
is completed, your pump will return to the programmed basal. A temp basal is delivered only once and does not
repeat. If you want another temp basal, you must program the temp basal again. This feature may be useful to
temporarily increase or decrease basal insulin during illness, exercise or similar unusual situations.
Temp basal types
Based on your preference, you can select either Percent of Basal or Insulin Rate.
Insulin rate (U/H)
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.
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Temp Basal Settings
Temp basal type: Insulin rate (U/H)
Duration: 4 hours (1:05 p.m.-5:05 p.m.)
Rate: 1.25 U/H
1.25 U/H
temp basal rate
1.50 U/H
(rate 1)
2.55 U/H
(rate 2)
7:00 a.m.
(7:00)
1.25 1.25
U/H U/H
1.95 U/H
(rate 3)
1:05 p.m.
(13:05)
12:00 a.m.
(00:00)
3:00 p.m.
(15:00)
5:05 p.m.
(17:05)
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Optimizing pump therapy
Percent of basal
Unlike insulin rate, the percent of basal is dependent on your current basal rates. Percent temp basal is a percentage
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 6:00 AM and your current basal rate is 1.50 U/H. You want to set a temp basal rate of 130 percent
for seven 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: 00:00
1.50 U/H
Segment #2: 11:00
1.60 U/H (largest)
Segment #3: 16:00
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).
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.
ಘ
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101
Temp Basal Settings
Temp basal type: Percent of basal
Duration: 4 hours (1:05 p.m. - 5:05 p.m.)
Rate: 50%
(50% x rate 2 = 1.275)
1.275 rounded down to
the next 0.05 increment is
1.25 U/H
(50% x rate 3 = 0.975)
0.975 rounded down to
the next 0.05 increment
is 0.95 U/H
2.55 U/H
(rate 2)
1.50 U/H
(rate 1)
1.25 0.95
U/H U/H
7:00 a.m.
(07:00)
1:05 p.m.
(13:05)
1.95 U/H
(rate 3)
12:00 a.m.
(00:00)
temp basal start time
3:00 p.m.
(15:00)
5:05 p.m.
(17:05)
temp basal stop time
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Optimizing pump therapy
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:
ಘ
1
Go to the SET TEMP BASAL AS screen.
Main > Basal > Temp Basal Type
ಘ
2
ಘ
3
The SET TEMP BASAL AS screen appears. Select Insulin Rate (U/H) or Percent of Basal, then press ACT.
The screen will return to the BASAL SETUP screen. The temp basal type is now set. Exit the menus.
If you select Percent of Basal as your temp basal type, changes to your basal rate are not allowed until after
temp basal is completed or cancelled.
Delivering a temp basal
A temp basal cannot exceed your programmed max basal rate.
ಘ
1
Go to the BASAL MENU.
Main > Basal
ಘ
2
ಘ
3
ಘ
4
ಘ
5
Select Set/Edit Temp Basal, then press ACT.
The SET DURATION screen appears. The duration will flash. Duration is the amount of time it will take for the
pump to deliver the temporary basal. Enter the desired minutes or hours (30 minutes to 24-hours), then press
ACT.
If you have selected insulin rate as your temp basal type, the SET TEMP BASAL U/H screen appears. If you have
selected percent of basal as your temp basal type, the SET TEMP BASAL % screen appears. The temporary basal
rate will flash. Enter your temp basal rate, then press ACT.
The BASAL MENU screen appears with an open circle at the top of the screen. Your pump is in Special mode;
temp basal is now set and delivering. Exit the menus.
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103
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, go to the STATUS screen to see
the current temp basal information.
Canceling a temp basal
Temp Basal of
0.6 units per hour
is now active
Temp Basal delivery
will last 30 minutes
4 minutes remaining
before Temp Basal
delivery is finished
Press down button
to scroll
regular programmed
basal rate will
resume after the
Temp Basal delivery
is finished
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.
ಗ
To cancel a temp basal, do these steps:
ಘ
1 Go to the BASAL MENU.
Main > Basal
ಘ
2
Select Cancel Temp Basal, then press ACT.
The screen will return to the BASAL MENU. Your temp basal is cancelled and open circle has disappeared from
the top of the screen. The programmed basal is now active again. Exit the menus.
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Optimizing pump therapy
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 1/2 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.
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.
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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?
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Optimizing pump therapy
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.
ಘ
1
Go to the ALARM HISTORY screen.
Main > Utilities > Alarm > Alarm History
ಘ
2
ಘ
3
ಘ
4
Scroll through your past alarms.
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.
Press ESC to return to the ALARM HISTORY screen. Select another alarm to review, or exit the menus if you are
done.
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. Vibrate uses more battery power than the beep alert type and may shorten battery life. 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.
ಘ
1
Go to the ALERT TYPE screen.
Main > Utilities > Alarm > Alert Type
ಘ
2
Select your alert type and press ACT. That alert type is now active. Exit the menus.
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107
Auto-off
The factory setting for this feature is Off. 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
in Auto-off, 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.
ಘ
1
Go to the AUTO OFF DURATION screen.
Main > Utilities > Alarm > Auto Off
ಘ
2
ಘ
3
Set the number of hours you want to set and press ACT.
If you do not want to use the Auto Off feature, make sure the hour is set to zero (0).
The screen will return to the ALARM MENU. The Auto Off feature is now set. Exit the menus.
LOW RESV WARNING (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.
If you use TIME as the low reservoir warning type and you deliver large boluses, the actual time remaining could be
less than the warning time. The TIME low reservoir warning type is intended to let you know if you will have enough
insulin while you are sleeping.
ಘ
1
Go to the RESV WARNING TYPE screen.
Main > Utilities > Alarm > Low Resv Warning
ಘ
2
Select Insulin Units or Time and press ACT.
WARNING: 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.
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Utilities
a. For Insulin units:
In the WARNING UNITS screen enter the number of units you want remaining for the first warning, then
press ACT.
The pump will alarm first when the specified units remain, then again when half that remaining amount is
used.
b. For Time:
In the WARNING TIME screen enter the amount of remaining time you want the first warning, then press
ACT.
The pump will alarm first when the specified time remains, then again one hour before empty.
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.
The insulin used to prime your pump is not included in the DAILY TOTALS screen. This amount is counted separately
and shown in the PRIME HISTORY screen.
Question: Why should I review my daily totals?
Answer: Comparing your daily insulin deliveries to your blood glucose records helps you and your healthcare
professional identify your optimal daily insulin rate(s).
Question: What is included in the daily totals?
Answer: Daily totals include all basal and bolus insulin deliveries and meter blood glucose information for that day.
Pump data management
The pump data management feature allows you and your healthcare professional to view and manage your basal
and bolus insulin delivery, food intake, and BG data with averages. You can view the details of each day individually
or you can average the data over a specified number of days (up to 31 days).
•
•
Daily totals — The system automatically tracks certain types of information for you on a day-to-day basis. The
daily totals are the totals for a single day.
Averages — The system automatically calculates averages of certain types of information for you. There are
two basic types of averages:
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109
•
•
An average over a number of days (you select the number of days)
An average for a single day
The insulin delivery, food intake, and meter blood glucose information includes daily totals and averages, as
described in the following sections.
Meter blood glucose information
The meter blood glucose information is calculated by using all of the automatic and manual meter blood glucose
measurements that were received by the pump for the day, or number of days. This includes measurements that
were manually entered into the pump during that time.
To view data for a single day:
ಘ
1 Go to the DAILY TOTALS screen.
Main > Utilities > Daily Totals
ಘ
2
Select a date and press ACT.
The BG AVG (Blood Glucose Average) screen displays. 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
Press
ಘ
3
The
•
•
•
•
INSULIN screen displays. This screen shows:
total insulin delivered for the day
total Basal and Bolus insulin delivered for the day
total percentage of each (Basal and Bolus) delivered for the day
total carbohydrates entered into the pump for the day (entered using the Bolus Wizard feature)
Press
ಘ
4
to view more information.
to view more information.
The BOLUS screen displays. 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
110
Utilities
•
total man (manual) bolus insulin delivered for the day and total percentage of manual boluses delivered
for the day
Press
ಘ
5
to view more information.
The NUM BOLUS screen displays. This screen shows:
• total number of boluses delivered for the day
• total number of food only and correction only boluses delivered for the day
• total number of food plus correction boluses delivered for the day
• total number of manual boluses delivered for the day
To get back to the HOME screen, press
four times.
To view data over a number of days:
This procedure shows you how to view insulin delivery, food intake and meter blood glucose data for a selected
number of days.
ಘ Go to the DAILY TOTALS screen.
1
Main > Utilities > Daily Totals
The DAILY TOTALS screen shows Daily Average selected.
Press ACT.
ಘ
2
The DAYS TO AVERAGE screen displays. Select the number of days you want to average by pressing the
the
ಘ
3
. Press ACT.
The AVG BG screen displays. This screen shows:
• the average of all blood glucose values entered into the pump for the number of previous days you selected
•
the average high and low blood glucose values for the number of previous days you selected
•
the average number of blood glucose values entered into the pump per day for the number of previous
days you selected
Press
ಘ
4
and
to view more information.
The AVG INS (average insulin) screen displays. This screen shows:
• the average total insulin delivered per day for the number of previous days you selected
• the average total basal and bolus insulin delivered and total percentage of basal and bolus insulin delivered
per day for the number of previous days you selected
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111
•
the average total carbs entered into the pump per day (entered using the Bolus Wizard feature) for the
number of previous days you selected
Press
ಘ
5
The AVG BOLUS screen displays. This screen shows:
• the average total bolus insulin delivered per day for the number of previous days you selected
• the average total food bolus insulin delivered for the number of previous days you selected and the total
average percentage of bolus insulin delivered for the number of previous days you selected
• the average total correction bolus insulin delivered per day and the total average percentage of bolus
insulin delivered per day for the number of previous days you selected
• the average total manual bolus insulin delivered per day and the total average percentage of bolus insulin
delivered per day for the number of previous days you selected
Press
ಘ
6
to view more information.
to view more information.
The NUM BOLUS screen displays. This screen shows:
• the average total number of boluses delivered per day for the number of previous days you selected
• the average total number of food only boluses delivered per day for the number of previous days you
selected
• the average total number of correction only boluses delivered per day for the number of previous days you
selected
• the average total number of food plus correction boluses delivered per day for the number of previous days
you selected
• the average total number of manual boluses delivered per day for the number of previous days you selected
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. Press ESC, then ACT to clear the
reminder.
ಘ
1
Go to the ALARM OPTION screen.
112
Utilities
Main > Utilities > Alarm Clock
ಘ
2
ಘ
3
ಘ
4
ಘ
5
ಘ
6
Select On/Set. Press ACT.
Select Add Alarm. Press ACT.
Enter the hour (flashing). Press ACT.
Enter the minutes (flashing). Press ACT.
Repeat steps 3 through 5 to program additional alarm times. Exit the menus when you are done.
Remote control option
The factory setting for this feature is off. You may want to explore the remote option after you have become
completely familiar with the basic functions of your pump. It is important that you consult with your healthcare
professional before using this feature. Remote controls can be purchased from Medtronic Diabetes.
Refer to the remote control user guide for operating instructions.
NOTE:
The use of RF (radio frequency) devices with the pump reduces battery life.
ಘ
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
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.)
ಘ
1
Go to the REMOTE OPTION screen.
Main > Utilities > Remote Option
ಘ
2
ಘ
3
Select On, then press ACT.
The REMOTE ID MENU screen appears. Add, delete or review your remote ID as described in the next section.
Exit the menus if you are done.
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113
Add, delete, review remote control IDs
Each remote control has its own unique ID. Up to three 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
Remotes 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
must turn on the remote option to add, delete or review the remote control ID(s) programmed in your pump.
ಘ
1
ಘ
2
ಘ
3
ಘ
4
Adding a remote ID
a. Select Add ID, then press ACT.
b. Enter each of the six ID numbers found on the back of the remote control. Press ACT after each entry.
After you set the last number of the ID, the screen will return to the REMOTE ID MENU.
Deleting a remote ID
a. Select Delete ID, then press ACT.
b. Select the remote ID that you want to delete, then press ACT.
The selected ID is now deleted.
Reviewing remote IDs
a. Select Review ID, then press ACT.
b. The programmed IDs will show in the REVIEW REMOTE ID screen.
Exit the menus when you are done.
Block feature
Block restricts access to pump programming. The factory setting for this feature is off. Block is an important safety
feature if the pump user requires someone else to maintain complete control of pump operation. When block is on,
the remote control is used to deliver a bolus and suspend/resume the pump. Direct pump programming is limited
to suspend, block, and selftest. You can, however, still view status-type screens (STATUS, BOLUS, 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 Diabetes.)
Turning block on
NOTE:
ಘ
ಘ
1
The vibrate alert-type is disabled when block is on.
Go to the BLOCK OPTION screen.
114
Utilities
Main > Utilities > Block
ಘ
2
Select On, then 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.
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.
Lock keypad feature
Lock keypad prevents accidental pump keypad presses. You can only press the
the
to view the STATUS screen, and
button to turn on the backlight. The remote control can be used to give a bolus or put the pump into
Suspend.
A locked keypad is automatically unlocked during the following:
•
•
•
Battery insertion
Alarms
Alerts
Locking the keypad
ಘ
1
ಘ
2
Go to the UTILITIES MENU.
Select Lock Keypad, then press ACT.
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115
ಘ
3
Press ACT again to lock the keypad. The KEYPAD LOCKED screen appears with instructions on how to unlock
the keypad.
Unlocking the keypad
Press the
button and the
button at the same time. Keypad Unlocked screen appears.
Selftest
Selftest is a safety utility that allows you to check if your pump is operating properly. This self-diagnostic 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 our 24 Hour HelpLine if any of the tests do not occur as described here.
NOTE: If the pump detects a condition such as low battery, the selftest will not finish. A message will appear
to show the condition that caused the test to stop.
ಘ
ಘ
1
Go to the UTILITIES MENU.
Main > Utilities > Selftest
ಘ
2
ಘ
3
ಘ
4
Select Selftest, then press ACT.
Periodically, you will hear beeps as different mechanisms in the pump are being tested. As part of the selftest,
the pump will do these tests:
a. Screen Test:
The screen will appear all black.
b. Selftest:
The pump will count down from 10.
c. Tone Test:
You should hear beeps.
d. Vibrate Test:
You will feel vibrations.
After the selftest is finished, TEST COMPLETE screen appears. The screen will return to the UTILITIES MENU,
then to the HOME screen.
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Utilities
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: 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
Diabetes 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 the settings
Do these steps to save your current pump settings:
ಘ
1 Go to the UTILITIES MENU screen and select User Settings.
Main > Utilities > User Settings
ಘ
2
Hold down
ಘ
3
ಘ
4
The USER SETTINGS screen is displayed with Save Settings highlighted. Press ACT.
If this is the first time you have saved pump settings, go to step 5. 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. You can press ESC if you want to cancel the save.
The SETTINGS SAVED message displays to confirm that your current pump settings have been saved. Exit the
menus.
ಘ
5
and press ACT.
Restoring the settings
Do these steps to restore the most recent pump settings you have saved to your pump.
ಘ
1
Go to the UTILITIES MENU screen and select User Settings.
Main > Utilities > User Settings
Utilities
117
ಘ
2
Hold down
ಘ
3
ಘ
4
The USER SETTINGS screen is displayed. Select Restore Settings, then press ACT.
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 if you want to cancel the restore.
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.
ಘ
5
and press ACT.
Clearing the 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
Diabetes 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.
ಘ
1
Go to the UTILITIES MENU screen and select User Settings.
Main > Utilities > User Settings
ಘ
2
Hold down
ಘ
3
ಘ
4
The USER SETTINGS screen is displayed. Select Clear Settings, then press ACT.
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 if you want to cancel.
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.
Reset the time and date as described in Setting the time and date section of the Basic programming chapter.
After you set the time and date, you must rewind your pump. Refer to the Rewinding your pump section of the
Starting on insulin chapter for instructions. Remember, all your settings have been cleared and you must either
restore or reprogram all your settings.
ಘ
5
ಘ
6
ಘ
7
118
and press ACT.
Utilities
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:
ಘ
1 Go to the UTILITIES MENU screen and select User Settings.
Main > Utilities > User Settings
ಘ
2
Hold down
ಘ
3
ಘ
4
The USER SETTINGS screen is displayed. Select History, then press ACT.
The SETTINGS HISTORY screen displays, giving you a list of all the dates and times of your most recent User
Setting operations. Scroll down to view the entire history. When you are done looking at the history, press
ESC to exit the menu.
and press ACT.
Utilities
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Utilities
9
Therapy software
Medtronic provides software to optimize your pump use. Contact our 24 Hour HelpLine for more information.
CareLink Personal™
Your pump provides real-time glucose values so that you can track glucose concentration patterns and possibly
identify episodes of low and high blood glucose. It also stores glucose data so that it can be analyzed to track
patterns and/or downloaded to CareLink Personal for analysis of historical glucose values.
CareLink Personal is a web-based system designed to help you manage your diabetes. It has many key features:
•
•
•
•
•
It copies (uploads) data from your devices: insulin pump and supported blood glucose meters.
Device data is stored on a networked database.
There is an online logbook where you can record self-reported information, such as how many carbohydrates
you consumed.
Uploaded data and other information stored on the system can be viewed through several different types of
treatment reports.
Access to data and personal information on this system is secure.
Reports
Reports show you data gathered from your device(s), and from what you directly entered into the system. Examples
of the report data you can get 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 are displayed in PDF format. They can be viewed online, saved, or printed.
Therapy software
121
You can share your reports with your healthcare professional. These reports can help you and your healthcare
professional to discover trends and other information. This can lead to improved therapy management for greater
control.
Logbook
The logbook allows you to enter the following self-reported information:
•
•
•
•
•
Carbohydrates consumed
Exercise activity
Urine ketone results
HbA1c results
Infusion set changes
The data from your logbook is used in the reports you create. You can see how, for example, your carbohydrate
intake compares to blood glucose levels for the same day or time. You can also use it as an online diary of your
diabetes management.
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Therapy software
Insulin pump therapy follow-up
10
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 blood glucose 4–6 times a day and always before bed
Test before driving and have a fast-acting carbohydrate with you when you drive
If your 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 3:00 AM 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 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
123
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
•
•
•
•
•
•
•
•
Dilated eye exam by a qualified ophthalmologist
Annual flu shot
Regular dental visits
Nerve function tests
EKG test over age 35
Prostate exam for men, breast exam for women
Diabetes education review
Replace Glucagon Emergency Kit (new prescription from your healthcare professional)
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Insulin pump therapy follow-up
Troubleshooting and alarms
11
This Troubleshooting chapter is designed to help you understand the messages that your pump is giving you when
you get an alarm or an alert message. The procedures in the beginning of this chapter are to be used when you get
specific alarms or cover a likely condition that might happen. A list of alarms is provided at the end of this chapter.
NOTE: It is recommended that you read your warranty statement included with your pump for information on
what is covered during your warranty period.
ಘ
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:
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1
ಘ
2
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3
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4
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5
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6
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7
Check your blood glucose and take an injection if needed.
Make sure that there is insulin in your reservoir and the tubing is not kinked. If these are all right, go to
step 5.
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.
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 the Starting on insulin chapter.
Continue troubleshooting by disconnecting at the quick-disconnect, and set a 10 unit Fixed Prime.
Does insulin come out of the needle at the quick-disconnect?
a. If yes, change your entire infusion set per the instructions in the Starting on insulin chapter.
If NO insulin comes out of the needle at the quick-disconnect, or you receive another No Delivery alarm,
call our 24 Hour HelpLine.
b. Your pump remembers the last Fixed Prime amount that was delivered, so make sure to set your Fixed
Prime amount back to your usual setting. Remember to change your Fixed Prime amount from 10 units to
your infusion set amount.
Monitor your blood glucose closely.
Troubleshooting and alarms
125
ಘ
8
If you followed these steps and you are still receiving a No Delivery alarm, call our 24 Hour HelpLine.
What happens if I leave the pump battery out too long?
If you leave the pump 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:
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1
ಘ
2
ಘ
3
Set your pump clock to the correct time, date, and year.
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
(you can only use this option if you have previously saved your pump settings). See the Restoring the settings
section of the Utilities chapter.
Check the ALARM HISTORY screen and the STATUS screen for any alarms and/or alerts that may still need
attention.
If you leave the battery out for more than three or four days, you may receive an A17 and A47 alarms when you
install a new battery. Do the following steps:
ಘ
1
ಘ
2
ಘ
3
ಘ
4
Clear the A17 and A47 alarms.
Set your pump clock to the correct time, date and year.
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
(you can only use this option if you have previously saved your pump settings). See the Restoring the settings
section of the Utilities chapter.
Check the ALARM HISTORY screen and the STATUS screen for any alarms and/or alerts.
Why doesn't my pump battery last very long?
A short battery life does not mean that something is wrong with your pump. Battery life in your pump is variable
and based on the conditions below:
•
•
•
•
•
•
The brand of battery you use (we recommend Energizer).
The storage and/or handling of the battery before use (avoid high or low temperatures).
The usage of pump in cold temperatures; this may shorten the battery life.
The usage of your pump, such as how often the buttons are pushed, the number of alerts/alarms and set
changes.
The amount of insulin the pump is delivering.
The usage of some features. The backlight, vibrate, remote control and meter options decrease battery life.
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Troubleshooting and alarms
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,
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-like 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 (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
There are several causes of and resolutions to this problem:
ಘ
1
ಘ
2
ಘ
3
Is the reservoir pump full?
• If no, place a full reservoir or shipping cap in the pump.
• If yes, make sure you are disconnected from the pump.
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 section in the Starting on insulin chapter 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.
If you still do not hear the beeps and see the number count on the screen, call the helpline or your local
representative.
Troubleshooting and alarms
127
The pump is asking me to rewind
This is normal after any of the following:
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1
ಘ
2
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3
Any E-alarms,
The Clear Settings function,
Or, a NO DELIVERY Alarm (during the Prime sequence).
My bolus stopped
The Bolus Stopped error can occur if the battery cap is loose or the pump was bumped or dropped during a bolus.
It can also happen if the pump receives a static shock. As a safety measure, the pump stops the bolus when this
happens.
ಘ
1
ಘ
2
If you dropped your pump, visually inspect it to make sure that it is not damaged in any way.
Review your bolus history and reprogram the remaining bolus, if needed.
My pump buttons are not acting right during a bolus
If the
,
or
buttons are pressed and held down while a bolus is being delivered, the screen will freeze on
that amount. Once the button is released, the units will ramp up to the amount delivered so far. Pressing and
holding down the button will not stop the delivery of a bolus.
My pump will not display my blood glucose reading from my meter
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1
ಘ
2
ಘ
3
ಘ
4
ಘ
5
ಘ
6
Make sure you are using the correct meter (a blood glucose meter supported by MWT1 technology). Your pump
will communicate with this meter only.
Make sure your meter's RF (radio frequency) feature is on and working correctly.
Make sure the meter option in your pump is set to On and you have set the meter ID number correctly on the
pump.
Make sure your pump does not have a low battery alert condition.
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.
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,
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Troubleshooting and alarms
ಘ
7
ಘ
8
other Paradigm pumps, meters and pump remote controls. To restore communication, simply move away from
these other types of devices, or turn them off.
Your pump will not show another reading. Make sure the pump is idle and the HOME screen is blank.
If your pump still does not receive your blood glucose reading from the meter, use the up/down buttons to
manually enter your blood glucose (in the ENTER BG screen).
I dropped my pump
Take care to protect your pump from being dropped.
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1
ಘ
2
ಘ
3
ಘ
4
ಘ
5
ಘ
6
Check that all connections are still tightly in place.
Check the LCD, keypad and pump case for cracks or damage.
Check infusion set, including the tubing connector and tubing for cracks or damage.
Review the status screen, basal rates and other pump settings.
Perform the Selftest procedure located in the UTILITIES MENU.
Call our 24 Hour HelpLine for assistance.
I submerged my pump in water
Your pump is designed to resist accidental contact with water. Do not submerge in water during bathing, swimming,
or other water activities.
ಘ
1
ಘ
2
ಘ
3
ಘ
4
ಘ
5
ಘ
6
Pat the outside of the case until dry.
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.
Dry the reservoir completely—do NOT place a wet reservoir in the pump.
Do not use hot air to dry your pump. This may damage your pump's internal electronics.
Check the battery compartment and the battery—if wet, let them dry completely before using the pump.
Perform a selftest.
I cannot get to the User Settings screen
If you press ACT when you have User Settings highlighted, the following message appears: This feature is not
normally accessible. To access, consult your User Guide.
To get to the USER SETTINGS screen:
Troubleshooting and alarms
129
ಘ
1
Go to the UTILITIES MENU screen.
Main > Utilities
ಘ
2
Select User Settings. Hold down
ಘ
3
See the User Settings section of the Utilities chapter for information about the menu options.
and press ACT.
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 beeps or vibrates periodically to alert you. The pump goes into Special mode (an open
circle displays), and the backlight illuminates.
If you do not clear an alarm, the pump will not display any other alarms or alerts. Your pump behaves differently
if an alarm happens after an alert that has not been cleared. It will display an alarm before you clear the initial
alert. Alarms and alerts are displayed in the order of importance. When you clear the initial alarm, the pump displays
any alarms or alerts received after the first alarm in this order.
Check your pump and test your blood sugar. Follow the guidelines prescribed by your healthcare professional to
manage your diabetes as needed.
Example:
John's pump displays a BUTTON ERROR alarm, but he does not clear it. During the time that his pump displays
the BUTTON ERROR alarm, his pump receives a LOW RESERVOIR alert. A few minutes later, his pump receives a
NO DELIVERY alarm. John's pump does not display the LOW RESERVOIR alert or the NO DELIVERY alarm until he
clears the first alarm. After John clears the BUTTON ERROR alarm, his pump displays the LOW RESERVOIR alarm.
After he clears the LOW RESERVOIR alarm, his pump displays the NO DELIVERY alert.
•
•
•
•
•
•
Dual Wave or Square Wave bolus delivery
Pattern A or B is active
Temp basal delivery
Block feature is on
Low reservoir
Low battery
Question: Why are alerts important?
130
Troubleshooting and alarms
Answer: 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:
ಘ
1
ಘ
2
ಘ
3
ಘ
4
Read and follow the instructions on the screen. Press ESC, ACT to silence an alert.
Check the STATUS screen to determine what caused the alert.
If the condition is due to a low battery, replace the battery.
If the condition is due to a low reservoir, monitor the reservoir volume frequently and change the reservoir
when appropriate. Make sure you have a new reservoir, infusion set and vial of insulin with you.
LOW RESERVOIR ALERT
You can program the pump to sound an alert when either a specified number of units remains or a specified amount
of time remains before the reservoir will be empty.
LOW BATTERY ALERT
If you get this alert, DO NOT go to sleep without replacing the battery. The backlight, the remote, and meter
functions are disabled during a LOW BATTERY condition. If the alert type is set to Vibrate, the pump will change to
the audio alert Beep Medium. Clear (ESC, ACT) this alert before you replace your battery.
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.
If you do not clear an alarm, the pump will not display any other alarms or alerts. Your pump behaves differently
if an alarm happens after an alert that has not been cleared. It will display an alarm before you clear the initial
alert. Alarms and alerts are displayed in the order of importance. When you clear the initial alarm, the pump displays
any alarms or alerts received after the first alarm in this order. See the example in the Alert conditions section of
this chapter.
Troubleshooting and alarms
131
Check your pump and test your blood sugar. Follow the guidelines prescribed by your healthcare professional to
manage your diabetes as needed.
NOTE:
The STATUS screen shows any alarms and alerts that are active.
ಘ
Question: Why are alarms important?
Answer: Your pump monitors activities and notifies you if there is an unusual pump status or your attention is
required. When an attention alarm is active, INSULIN DELIVERY IS STOPPED and immediate operator interaction is
required.
If the Vibrate mode is on, all alarms and alerts start as vibrations and then change to beeps. For your safety, if
there is no response after ten minutes, the beeps change to a siren. The siren continues every minute until the
alarm is cleared.
What to do
When an alarm is triggered, the pump goes into Attention mode (a solid circle displays) and an alarm message shows
on the screen. The pump then defaults to the HOME screen. Do these steps when you get an alarm:
ಘ
1
View the alarm: From the HOME screen, press any button to see the alarm message.
ಘ
2
Read all of the alarm text. There are instructions on how to fix the alarm condition. (Press
ಘ
3
ಘ
4
ಘ
5
ಘ
6
text, if available.)
Clear the alarm. Press ESC then ACT after you read the alarm instructions.
The HOME screen appears.
Follow the instructions that appeared with the alarm to fix the alarm condition.
Check your settings (i.e., time/date, basal, etc.) to make sure they are correct.
to read more
Alarm conditions
Alarms put the pump in Attention mode.
A (ALARM)
This alarm shows the letter A followed by two numbers. A-alarms cause all insulin delivery to stop. Your pump
settings are retained. If this alarm repeats often, call our 24 Hour HelpLine for assistance.
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Troubleshooting and alarms
AUTO OFF
Alerts you that no buttons were pressed during the time limit you set for the AUTO OFF DURATION feature, and so
insulin delivery has been stopped.
BATT OUT LIMIT
Occurs if the battery has been out of the pump for more than five minutes. Verify that the pump time and date are
correct. If not correct, go to the UTILITIES MENU and reset the date and time.
BOLUS STOPPED
If this alarm occurs, it is very important to check bolus history to review how much of the bolus was actually
delivered. If necessary, reprogram a bolus with the amount not yet delivered.
BUTTON ERROR
Occurs if a button has been continually pressed for more than three minutes.
CHECK SETTINGS
When this alarm is active, you should check and/or reprogram your pump settings, including the time/date.
E (ERROR)
After receiving this alarm, note the error number then call our 24 Hour HelpLine for assistance. An error alarm will
show the letter E followed by two numbers. E-alarms cause all insulin delivery to stop, the pump resets, and all
your settings are cleared.
EMPTY RESERVOIR
There is no insulin in the reservoir. Change the reservoir immediately.
Troubleshooting and alarms
133
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.)
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.
NO RESERVOIR
The reservoir is not inserted correctly or no reservoir has been inserted.
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.
RESET
The Reset alarm triggers when pump settings are cleared because of one of these reasons:
•
•
Pump settings were cleared (Clear Settings function) and settings have not been reprogrammed.
A download attempt from the PC is incomplete. (The download function is applicable to the optional software
feature. Refer to the software user guide for more information.)
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Troubleshooting and alarms
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.
Troubleshooting and alarms
135
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Troubleshooting and alarms
12
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 single 1.5 V AAA alkaline battery, size E92, type LR03. As a safety measure, Medtronic
Diabetes has designed the pump to only accept a NEW battery. If you insert a used battery, the FAILED BATT
TEST alarm may be triggered. Refer to the Install battery in The basics chapter 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
Meter
Backlight
Vibrate alert type setting
CAUTION: It is recommended that you use a AAA Energizer battery. Do not use a rechargeable or carbon zinc
battery in the pump. Do not remove the battery unless you are changing your battery (installing a NEW battery).
Replace it within five minutes. If not replaced within five minutes, the screen may display an alarm message.
Follow the instructions in the message and make sure the time and date are set correctly. Check that the
battery is inserted correctly. If the battery has been installed backwards, remove the battery and install it
properly.
Pump maintenance
137
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.
Cleaning your pump
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1
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2
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3
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4
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5
ಘ
6
ಘ
7
ಘ
8
ಘ
9
Use only a damp cloth and mild detergent mixed with water to clean the outside of your pump.
Rinse the pump with a clean cloth, dampened with clean water.
Dry with a clean cloth.
Never use organic solvents, such as lighter fluid, nail polish remover, or paint thinner to clean your pump.
Keep the reservoir compartment and battery compartment dry and away from moisture.
Do not use any lubricants with your pump.
Use a 70 percent alcohol wipe to disinfect your pump.
Use a dry clean cotton tip to remove any battery residue from the battery cap.
Use a dry clean cloth to remove any battery residue from the battery compartment opening.
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Pump maintenance
13
Pump specifications
This section provides detailed information on specifications related to your pump. The safety features of your pump
are individually listed and described.
Alarms and error messages
•
•
Indicators: audible tone (beep) or vibration (silent)
All alarms and errors show messages on the pump's screen and provide instructions on what to do. Unresolved
alarms will escalate to siren mode for added safety.
Alarm history
Maximum records shown: 36
Audio frequency
Name
Frequency (+/- 25%)
Alarm
1850 Hz
Escalated alarm
2.5 kHz, followed by 3.2 kHz
Alert
1.8 kHz, followed by 2.1 kHz and 1.8 kHz
Backlight
•
•
LCD (Liquid Crystal Display) type
Time-out: 30 seconds
Pump specifications
139
Basal
•
•
•
•
Rate increments: 0.05 units/hour
Delivery: 0.05 - 35 units/hour (maximum units: 35/hour)
Factory maximum setting: 2.0 units/hour
3 patterns maximum, each with 48 rates
BG target
•
Maximum targets: 8
• Range: 60 - 250 mg/dL (3.3 - 13.9 mmol/L)
• Warning limits: less than 90 or greater than 140 mg/dL (less than 5.0 or greater than 7.8 mmol/L)
Bolus delivery
•
•
•
•
Fluid delivered/stroke: 0.05 u
Fluid delivered/stroke: 0.5 μL
Time between/delivery strokes: 2 seconds
Delivery rate (per minute): 1.5 u
Bolus history
Maximum records shown: 24
Bolus units
Increments: 0.1 units
Bolus Wizard feature
(see the end of this section for information)
140
Pump specifications
Carb ratios
Maximum ratio settings
Range
Warning limits
8
3 - 150 grams/u
less than 5 or greater than 50 grams/u
0.1 - 5.0 u/exch
less than 0.3 or greater than 3.0 u/exch
Carb units
•
The food entry when using Bolus Wizard feature
• grams: 0 - 300 (increments: 1 gram)
• exchanges 0.0 - 20 (increments: 0.5 exch)
Daily totals
Maximum records shown: 31 days of data, maximum display: 999.95 units/day. Daily delivery accuracy: +0/-0.05
units.
Default screen
The HOME screen. For most screens, if no buttons are pressed for 30 seconds, the pump returns to this screen.
Pump specifications
141
Delivery accuracy
•
•
Delivery accuracy: +/-5 percent.
Displacement (piston) accuracy: +/-2 percent.
Delivery Volume Accuracy Curve ( -0.40% ) Overall Error
(MMT-515 Model) Qualification Testing (0.01 ml/hr 06/28/04 S/N: 010264-B061); 23°C
MMT-326 Reservoir Lot:kd0203245, MMT-318 Infusion set Lot: 314453
50
40
Maximum Error (%)
30
Minimum Error (%)
Overall Flow Error (%)
Percent Error (%)
20
10
0
0
15
30
45
60
75
90
105
120
135
150
165
180
195
210
-10
-20
-30
-40
-50
Time Interval (Minutes)
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).
142
Pump specifications
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 (94.46 kPa).
Insulin sensitivity
•
•
•
•
Maximum settings: 8
Factory default: 50 mg/dL (2.8 mmol/L)
Range: 10 - 400 mg/dL (0.5 - 22.2 mmol/L)
Warning limits: less than 20 or greater than 100 mg/dL (less than 1.1 or greater than 5.6 mmol/L)
Pump specifications
143
Low resv (reservoir) warning
Values are based on displayed amount, not actual amount.
time:
2 - 24-hours, and
@ 1:00 hour before empty
08:00 hours (default when time is selected)
units:
5 - 50 units, and
@ 1/2 amount remaining
20 units (factory default)
Meter value
•
The BG measurement received from the meter. Appears in the ENTER BG screen during bolus programming.
Appears on the screen when the pump is idle at the HOME screen.
• Expiration: 12 minutes
• Range: 20 - 600 mg/dL (1.1 - 33.3 mmol/L)
• Maximum meter ID entries: 3
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. The Paradigm pump is intended for use with U100 insulin. This table shows occlusion
detection for 3 different situations when using U100 insulin.
144
Rate
Minimum time
before alarm
Typical time
before alarm
Maximum time
before alarm
bolus delivery (1.5 u/min)
92 seconds
116 seconds
162 seconds
basal delivery (1.0 u/h)
2.2 hours
3.09 hours
4.47 hours
basal delivery (0.05 u/h)
37.4 hours
59.2 hours
87 hours
Pump specifications
Percent temp basal
Default value: 100% of basal programming
Power supply
The pump is powered by a standard 1.5 V AAA alkaline battery, size E92, type LR03 (Energizer brand recommended).
Prime function
•
•
•
Fixed prime range: 0.1 - 25.0 units (limited by maximum bolus)
Manual prime limit: Warning at 30 units, then at each 10 units thereafter.
Fill rate: 1 to 5 units/second.
Prime history
Maximum records shown: 20 manual and fixed
Program safety checks
Maximum infusion with single fault condition: 0.0 units
Pump size
The dimensions of the pump are approximately:
•
•
515
•
•
715
•
•
Pump:
2.0 x 3.0 (2.8 at the battery cap) x 0.75 inches
5.1 x 7.6 (7.1 at the battery cap) x 2.0 cm
Pump:
2.0 x 3.7 (3.5 at the battery cap) x 0.75 inches
5.1 x 9.4 (8.9 at the battery cap) x 2.0 cm
Pump specifications
145
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 volume: up to 176 units of U100 insulin
715 Pump volume: up to 300 units of U100 insulin
Square Wave bolus
Delivers bolus insulin over a duration of 30 minutes up to 8 hours (limited by the max bolus setting).
Temporary (temp) basal rate
Allows you to temporarily change the current basal rate for a duration of 30 minutes up to 24 hours (limited by
maximum basal setting). The temp basal rate can be set to either Percent of basal or Insulin rate.
Time and date screen
12-hour or 24-hour formats. Pump users set the time/date, including the year, month and day. The date is included
in the STATUS screen. Time always appears on the top of the screen.
Environmental conditions
•
•
•
Pump operating temperature range: from 37°F (3°C) to 104°F (40°C)
Air pressure range: from 700 hPa to 1060 hPa (from 10.2 psi to 15.4 psi)
Operating humidity range inside the case: from 20% to 90% per EN 60601-1 2-24, Section 10.2.1c.
146
Pump specifications
Status screen
Item
When
What
Active Insulin
if any
(Active Ins:) the amount of active insulin, displayed to the next 0.025U
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)
XXX m/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 alarm/alert
if cleared within 24 hours
(Last:) with the date, time and abbreviation for the most recently cleared
alarm/alert
Last bolus information
type and units delivered
(S = Square, N = Normal, D = Dual)
ON
delivery time and date
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)
date, time, units left, time left
Pump specifications
147
Item
When
What
Standard basal delivery data
(always appears)
current basal rate (basal 1, basal 2, etc.)
Status of pump
(i.e., Rewind, Suspended, Low Reservoir, Set Time, etc.)
Time
(always appears)
*If all of the Reminders and the Alarm Clock are enabled, only the reminder that is nearest to alarming will
appear in the STATUS screen.
Bolus Wizard feature specifications
There are three different formulas the Bolus Wizard feature uses to estimate a bolus, depending on your current
BG. The following formulas apply only when the carb units are in grams.
ಘ
1
If your current BG is greater than your High BG Target, the Bolus Wizard feature subtracts active insulin from
the BG correction estimate, then adds this to the food estimate to get the total bolus estimate. However, if
the result of subtracting active insulin from BG correction estimate is a negative number (less than zero), the
total bolus estimate is based only on the food estimate.
(food estimate)
total bolus
estimate =
ಘ
2
food
carb ratio
(correction estimate)
+
total bolus
estimate =
food
carb ratio
(correction estimate)
+
current BG - Low BG Target
insulin sensitivity
If your current BG is between or equal to your High or Low BG Target, the total bolus estimate is based only on
the food estimate.
(food estimate)
total bolus
estimate =
ಘ
4
- active insulin
If your current BG is less than your Low BG Target, the Bolus Wizard feature adds the BG correction estimate
to the food estimate to get the total bolus estimate.
(food estimate)
ಘ
3
current BG - High BG Target
insulin sensitivity
food
carb ratio
If you do not enter a BG, the total bolus estimate is based only on the food estimate.
148
Pump specifications
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 the stacking of insulin, and lowers the chances of hypoglycemia.
The Bolus Wizard feature may utilize your current BG measurement, carbohydrate consumption, and active
insulin to calculate your estimated bolus.
Active Insulin Curves
Pump specifications
149
Active Insulin Curve
100%
90%
8 Hour
80%
7 Hour
6 Hour
5 Hour
70%
4 Hour
% Insulin Remaining
3 Hour
2 Hour
60%
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
ಘ
150
Pump specifications
Bolus Wizard feature examples
Settings:
•
•
•
•
Carb ratio: 30 grams/unit
BG Target: 90-120 mg/dL (5.0-6.7 mmol/L)
Insulin Sensitivity: 40 mg/dL/unit (2.2 mmol/L/unit)
Active Insulin Time: 6 Hours
#1: No active insulin from previous bolus delivery. User inputs 60 grams of carbs and does not enter BG.
(food estimate)
60 g
= 2 units
30 g/u
bolus estimate
= 2 units
#2: No active insulin from previous bolus delivery. User inputs 60 grams of carbs and a BG of 200 mg/dL (11.1 mmol/
L).
(food estimate)
(correction estimate)
60 g
= 2 units
30 g/u
+
11.1 mmol/L - 6.7 mmol/L = 2 units
2.2 mmol/L/u
200 mg/dL - 120 mg/dL = 2 units
40 mg/dL/u
bolus estimate
=2+2
= 4 units
Pump specifications
151
#3: No active insulin from previous bolus delivery. User inputs 60 grams of carbs and a BG of 70 mg/dL (3.9 mmol/
L).
(food estimate)
(correction estimate)
60 g
= 2 units
30 g/u
+
3.9 mmol/L - 5.0 mmol/L
2.2 mmol/L/u
= -0.5 units
70 mg/dL - 90 mg/dL
40 mg/dL/u
= -0.5 units
= 2 + (-0.5)
= 1.5 units
bolus estimate
#4: No active insulin from previous bolus delivery. User inputs 60 grams of carbs and a BG of 100 mg/dL (5.6 mmol/
L).
(food estimate)
60 g
= 2 units
30 g/u
(correction estimate)
+
bolus estimate
152
Pump specifications
Correction is 0 because the
current blood glucose reading
is between the BG High and
Low Targets
=2+0
= 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 BG of 200 mg/dL (11.1 mmol/L).
(food estimate)
(correction estimate)
60 g
= 2 units
30 g/u
+
bolus estimate
11.1 mmol/L - 6.7 mmol/L - 1.5 units (active insulin)
2.2 mmol/L/u
= 0.5 units
200 mg/dL - 120 mg/dL - 1.5 units (active insulin)
40 mg/dL/u
= 0.5 units
= 2 + 0.5
= 2.5 units
#6: Previous bolus activity results in a calculation of 3.5 units unabsorbed (active) insulin. User inputs 60 grams of
carbs and a BG of 200 mg/dL (11.1 mmol/L).
(food estimate)
(correction estimate)
60 g
= 2 units
30 g/u
+
11.1 mmol/L - 6.7 mmol/L - 3.5 units (active insulin)
2.2 mmol/L/u
= -1.5 units*
200 mg/dL - 120 mg/dL - 3.5 units (active insulin)
40 mg/dL/u
= -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.
bolus estimate
=2+0
= 2 units
Pump specifications
153
Insulin delivery default settings
Menu
Item
Bolus Menu:
Default Setting
Bolus Wizard feature:
Off
Easy bolus:
On
Easy bolus step:
Dual/Square bolus:
Maximum bolus:
Basal Menu:
2u
Off
0 - 25 u (per single bolus)
BG reminder:
Off
0:00 - 5:00
0:30
Patterns:
Off
0.00 - 35.00 u/h
0.05 u
Maximum basal rate:
2.0 u/h
Basal rate:
0.0 u/h
Lock Keypad:
U/H
(no defaults)
Alert type:
audio, beepmed
Low reservoir warning:
max basal rate
setting
0.05 u/h (or 1%)
5 - 50 u;
2nd: @ 1\2
amount (2:00 24:00;
2nd: after 1:00)
20 u
(0:30)
Off
(20) insulin
units
(Time/Date) Time:
12 a.m. (midnight)
(Time/Date) Date:
1/1/04
Pump specifications
0.05 u
Off
(Alarm) History:
Auto-off:
154
Increments
10.0 u
Temp basal type:
Utilities Menu:
0.1 u
Limits
(0:30 mins)
Menu
Item
Default Setting
(Time/Date) Time format:
Increments
12-hour
Block:
Off
Alarm clock:
Off
Remote option:
Off
Meter option:
Off
User Settings:
(no defaults)
Language:
Limits
English
Pump specifications
155
Bolus Wizard feature default settings
Item
Default Setting
Limits
Increments
Warning Limits
carb units:
grams
none
none
none
ins to carb (or
exch) ratio:
15 grams/u
or
1 unit/exch
3-150 g/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
(insulin) sensitivity:
2.8 mmol/L
or
50 mg/dL
0.5 - 22.2 mmol/L
or
10 - 400 mg/dL
0.1 mmol/L or
1 mg/dL
1.1 - 5.6 mmol/L
or
20 - 100 mg/dL
BG target:
5.6–5.6
mmol/L
or
100–100 mg/
dL
3.3 - 13.9 mmol/L
or
60 - 250 mg/dL
0.1 mmol/L or
1 mg/dL
5.0 - 7.8 mmol/L
or
90 - 140 mg/dL
Active Ins Time:
6 hours
2 - 8 hours
1 hour
156
Pump specifications
Icon table
Attention: See Instructions for Use
Date of manufacture (year - month)
Batch code
Catalogue number
Device serial number
Storage temperature range
Magnetic Resonance (MR) unsafe
Fragile product
Type BF equipment (Protection from electrical shock)
Conforms to IEC60601-1 sub-clause 44.6 and IEC60529 standard
Recycle
Radio communication
Signifies compliance to Australian EMC and Radio communications
requirements
Signifies compliance with Industry Canada EMC and Radio communications
requirements
Pump specifications
157
Warranty
Medtronic Diabetes warrants the Medtronic MiniMed Insulin Pump against defects in materials and workmanship for
a period of 4 years from the date of purchase.
During the warranty period, Medtronic Diabetes will, at its discretion, either repair or replace (with a new or
recertified pump, at Medtronic Diabetes’ discretion) any defective pump or motor, subject to the conditions and
exclusions stated herein. In the event that a pump is repaired or replaced, the warranty period will not be extended.
This warranty is valid only if the Medtronic MiniMed Insulin Pump is used in accordance with the manufacturer’s
instructions. This warranty will not apply:
•
•
•
•
•
If damage results from changes or modifications made to the pump by the user or third persons after the date
of manufacture.
If damage results from use of non-Medtronic reservoirs and/or infusion sets.
If damage results from service or repairs performed by any person or entity other than the manufacturer.
If damage results from a Force Majeure or other event beyond the control of the manufacturer.
If damage results from negligence or improper use, including but not limited to: improper storage, submersion
in water or physical abuse, such as dropping or otherwise.
This warranty shall be personal to the original user. Any sale, rental or other transfer or use of the product covered
by this warranty to or by a user other than the original user shall cause this warranty to immediately terminate.
This warranty does not apply to Pathway pumps, batteries, infusion sets, reservoirs, and other accessories.
The remedies provided for in this warranty are the exclusive remedies available for any breach hereof. Neither
Medtronic Diabetes nor its suppliers or distributors shall be liable for any incidental, consequential, or special
damage of any nature or kind caused by or arising out of a defect in the product.
All other warranties, expressed or implied, are excluded, including the warranties of merchantability and
fitness for a particular purpose.
158
Pump specifications
Glossary
ಘ
A
A1C (HbA1c) test - A 2-3 month
average of blood glucose values
expressed in percent. The normal
range varies with different labs
and is expressed in percent (such
as 4 - 6%).
Accept - Pressing the ACT button to
approve the selection or setting.
Active insulin - Bolus insulin that
has been delivered to your body,
but has not yet been used.
Alarm - Audible or vibrating (silent)
notice that indicates the pump is
in Attention mode and immediate
attention is required. Alarms are
prefixed in the alarm history with
the letter A.
Alarm clock - Feature you can set to
go off at specified times of the
day.
Alarm icon - a solid circle that
shows at the top of the screen and
the pump beeps or vibrates
periodically until the condition is
cleared (see Attention mode).
ALARM HISTORY - Screen that
displays the last 36 alarms/errors
that have occurred on your pump.
Alert - Audible or vibrating (silent)
indicator that notifies you the
pump needs attention soon or
that you should be reminded of
something. Insulin delivery
continues as programmed.
Alert icon - an open circle that
appears at the top of the screen
and the pump beeps or vibrates
periodically to remind you of the
condition (see Special mode).
Attention mode - Operating mode
that stops all current insulin
delivery. This mode indicates an
alarm or condition exists that
requires immediate attention.
B
Backlight - Pump screen light. Turns
button is
on whenever the
pressed or in combination with
button if not on the
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 nonfood related insulin needs.
BASAL REVIEW screen - shows the
basal rates programmed in the
pump, with the 24-hour total for
each rate.
BG - Blood Glucose
BG reminder - Feature that you can
set to remind you to check your
blood glucose after a bolus.
BG target - Normal blood glucose
level
BG Units - Blood glucose units used
by the pump (mg/dL or mmol/L).
Block - Feature that restricts access
to all programming except
suspend, selftest and the delivery
of a bolus with the remote
control.
Blood glucose (BG) - A form of
digested sugar in the
bloodstream. Glucose is the
major source of energy for living
Glossary
159
cells, and is carried to each cell
through the blood stream. Cells
cannot use glucose without the
help of insulin.
Bolus - A dose of insulin given to
cover an expected rise in blood
glucose (such as the rise after a
meal) or to lower a high blood
glucose down to target range.
BOLUS HISTORY - This screen
displays the last 24 boluses
delivered by your pump.
Bolus Wizard® feature - Calculates
the bolus amount based on
personal information of the pump
user.
sugars found in fruits, milk, and
starches that the body breaks
down into glucose.
CH - Carbohydrate
Contraindication - A condition that
makes a specific treatment or
procedure NOT advisable. A
contraindication is literally
contra- (against) an indication,
against something that is
indicated as advisable or
necessary.
Correction bolus - The amount of
insulin needed to return a high
blood glucose level back down to
target range.
C
D
Calibrate - Check, adjust, or set to
a standard (calibrate your pump).
Cannula - A short, thin, and flexible
tubing at the end of the infusion
set that is inserted into the
subcutaneous tissue to deliver
insulin.
Carb ratio - (Carbohydrate ratio).
Used when counting
carbohydrates in grams. The
amount of carbohydrates covered
by one unit of insulin. (Also see
exch ratio.)
Carb units - The food entry when
using the Bolus Wizard feature.
Entered as (carbohydrate) grams
or exchanges.
Carbohydrate - One of the three
main sources of energy or calories
in food. Carbohydrates are mainly
Daily totals - Shows the total insulin
delivered (basal and bolus) in the
last 24-hours. Maximum records:
14 days
Default - A setting or value for your
pump that is assigned
automatically by your system.
Some default settings cannot be
changed; other default settings
remain in effect until you change
them.
Diabetic Ketoacidosis (DKA) - A
serious condition that occurs
when the insulin levels are low,
blood glucose level are elevated,
and the body uses fat for energy.
This process produces ketones
which upset the body's acid-base
balance leading to a potentially
life threatening situation.
DKA - Diabetic Ketoacidosis
160
Glossary
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
.
Electromagnetic compatibility The condition that exists when
systems and devices that use
electromagnetic energy operate
properly without causing or
suffering accidental
electromagnetic interference to
or from other electromagnetic
devices.
Electrostatic discharge - The rapid,
spontaneous transfer of
electrostatic charge induced by a
high electrostatic field. The
charge usually flows through a
spark, known as static discharge,
between two objects at different
electrostatic levels as they
approach each other (for
example, when people touch
each other after dragging their
feet on a carpet).
Exch ratio - (Exchange ratio) Used
when counting carbohydrates as
exchanges. The amount of insulin
required to cover one (1)
carbohydrate exchange. (Also see
carb ratio.)
Exchange system - A system of
estimating carbohydrate and
calorie intake that groups by
type. Each exchange group lists
similar types of food in serving
sizes. A person can exchange,
trade, or substitute a food serving
in a particular group for another
food serving in the same group.
Express bolus - Method of delivery
for any bolus type using the
express bolus button
.
F
Fats - One of the three main classes
of foods and a source of calories
or energy in foods. Fats help the
body use some vitamins and keep
the skin healthy.
Fiber - A substance found in foods
that comes from plants. Fiber
may help in the digestive process
and is thought to lower
cholesterol and help control
blood glucose. Fiber grams are
not absorbed, and can be
subtracted from the Total
Carbohydrate amount for foods or
meals with more than 5 grams of
fiber.
Fingerstick - One method used to
test blood glucose by taking a
sample of blood for testing from
a finger using a lancet or
automatic finger puncture
device.
Fixed prime - Fills the cannula with
insulin. This is done after you
insert the infusion set into your
body and remove the introducer
needle.
Food bolus - A dose of insulin given
to cover the expected rise in
blood glucose that occurs after
eating.
G
Gastroparesis - A condition of the
digestive system that slows down
the emptying of food from the
stomach.
Glucagon - A hormone that raises
the level of glucose in the blood.
The alpha cells of the pancreas
make glucagon when the body
needs to put more sugar into the
blood. Glucagon primarily causes
sugar stored in the liver to be
released into the blood stream.
Glucagon Emergency Kit - An
injectable form of glucagon that
can be used to treat severe low
blood glucose levels
(hypoglycemia). A Glucagon
Emergency Kit can be obtained in
a pharmacy with a prescription.
Glucose tablet - A simple sugar in
tablet form, that is taken orally
to treat low blood glucose
(hypoglycemia). Glucose tablets
can be purchased from the
Medtronic Diabetes online store
at www.medtronicdiabetes.com
as well as drug stores and
pharmacies.
H
HbA1c - Glycosylated hemoglobin
HDL - High-density lipoprotein A
complex of lipids and proteins in
approximately equal amounts
that functions as a transporter of
cholesterol in the blood.
Hold - Press and continue to press a
pump button.
Hyperglycemia - A condition in
which blood glucose values are
elevated above target. Symptoms
may include excessive thirst,
frequent urination, dry mouth,
headache, fatigue, and blurred
vision.
Hypoglycemia - A condition in
which blood glucose values are
low below 3.9 mmol/L (70 mg/
dL). Symptoms may include
behavioral changes, pale
complexion, hunger, sweating,
sudden weakness, headache,
confusion, drowsiness, nonresponsiveness to questions, and
the most serious: seizure,
convulsion or loss of
consciousness.
I
Idle - The pump is at the HOME
screen.
Glossary
161
Increment - A small increase or
decrease in a measurement.
Indication - A condition that makes
a specific medical treatment or
procedure advisable or
necessary.
Infusion set - Flexible tubing with a
reservoir connector and an
infusion site. This tubing delivers
insulin from the pump to the
body.
Infusion site - The end of the
infusion set held to the body with
a tape. It consists of a cannula
and an introducer needle.
Insulin - A hormone that helps the
body use glucose (sugar) for
energy. The beta cells of the
pancreas make the insulin.
Insulin sensitivity - The amount by
which your blood glucose (BG)
level is reduced by one unit of
insulin. (Bolus Wizard feature
data)
Insulin to carbohydrate ratio - The
amount of insulin required to
cover a given number of
carbohydrates. This ratio helps
you estimate what size bolus you
should take when eating
carbohydrates. Your healthcare
professional will determine your
insulin to carbohydrate ratio.
Introducer needle - This needle
allows the insertion of a cannula
into the subcutaneous tissue. It is
removed and discarded after
insertion leaving only the cannula
in the body.
162
Glossary
K
Ketone - A chemical created by the
human body when there is not
enough insulin in the blood.
kPa (kilopascal) - A unit of
measurement for quantifying
force. Used to measure
atmospheric pressure. Equivalent
to 10,000 dynes per square
centimeter.
L
LDL - Low-density lipoprotein A
complex of lipids and proteins,
with greater amounts of lipid
than protein, that transports
cholesterol in the blood.
Link - To turn on and setup the
meter option that allows the
pump to receive BG readings from
a meter that communicates with
your pump.
Log - A record of measurements,
alarms or other actions by your
pump.
Low resv warning - Programmable
warning that notifies you with an
alert when either a specified
number of units remain in the
reservoir or a specified amount of
time remains before the reservoir
will be empty.
M
Manual bolus - Selectable item
available in the BOLUS MENU
when the Bolus Wizard feature is
active. It is one method of
programming a bolus without the
Bolus Wizard feature. (see Set
bolus)
Manual prime - Fills the infusion set
tubing with insulin before you
insert the set into your body.
(This function is available after a
rewind)
Max bolus - The maximum amount
of bolus insulin that the pump will
deliver at one time. (set by the
user)
Max basal rate - The maximum
amount of basal insulin that the
pump will deliver at one time.
(set by the user)
Meter - An optional blood glucose
meter powered by MWT1
technology. Your pump can be
programmed to receive your BG
readings from this meter.
Meter option - Feature that allows
the pump to receive BG readings
from a meter powered by MWT1
technology.
Mineral - Minerals and vitamins are
essential micronutrients, needed
in very small amounts to keep our
bodies functioning properly.
MWT1 technology - MWT1 is the
wireless Radio Frequency (RF)
technology that is used to
transmit information from the
meter to the pump. You can
program your pump to
automatically receive your BG
reading from this 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 - An immediate
delivery of a specified unit
amount of insulin.
Now portion - The normal portion of
a Dual Wave bolus. The now
portion delivers immediately and
is then followed by the Square
portion.
Nutrition - The process by which the
body draws nutrients from food
and uses them to make or mend
cells.
Nutrition label - Used to determine
the nutritional content of foods,
as well as calories,
carbohydrates, fats, proteins,
vitamin and mineral content.
Nutritional content - The
breakdown of nutrients found in a
particular food.
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.
Post-prandial reading - Blood
glucose reading taken after a
meal
Press - To push and release a
button.
Protein - One of the three main
sources of energy or calories in
food. Proteins are made of amino
acids, which are called the
building blocks of the cells. The
cells need proteins to grow and to
mend themselves. Protein is
found in many foods such as
meat, fish, poultry, and eggs.
PSI - Pound-force per square inch.
Pump S/N - Pump S/N is the serial
number of the pump currently in
use.
R
Reservoir - The syringe that holds
insulin.
Reset - To set again, or change the
information (reset your glucose
values).
Resume - Restarts basal delivery
after the pump is suspended.
Rewind - The pump drive moves
back to its starting position to
prepare the pump for a new
reservoir.
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.
Sensitive - Easily irritated (sensitive
skin), or able to measure very
slight differences (a sensitive
instrument).
Set - To enter or establish a value
for your pump (set your Basal
Reminder).
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.)
S/N# - Serial number.
Sodium - Is an essential element for
your body. As table salt, it is used
freely in foods as a flavor
enhancer and a preservative.
Sodium is listed on food labels
and is expressed in milligrams.
Special mode - Operating mode
that indicates one or more special
functions is active or a condition
exists that requires attention.
Square Wave™ bolus - Immediate
bolus delivered evenly over a
specified time period (30 minutes
to 8 hours).
Glossary
163
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 - The condition of a part of
your system (battery status,
alarm/alert status).
Status screen - Displays the current
operations of the pump, including
active functions, the most recent
basal and bolus deliveries,
reservoir information, and
battery condition.
Step - Measurement of insulin that
you set and use for Easy Bolus and
other bolus deliveries.
Submerge - To place under water or
cover completely with water.
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.
Timeout - If you do not enter
information or do something in a
specific length of time, your
pump automatically stops what it
164
Glossary
is doing and goes to the HOME
screen.
U
—L - microliter
Index
ಘ
A
accessories, 4
activity guard, 4
CareLink USB, 4
holster, 4
leather case, 4
meter, 4
pump clip, 4
remote control, 4
active insulin, 76
Active insulin time
setting, 76
alarm clock, 112
Alarm conditions, 132
alarm frequency, 139
ALARM HISTORY screen, 107
Alarm types
A (alarm), 132
Auto off, 133
Batt out limit, 133
Bolus stopped, 133
Button error, 133
Check settings, 127, 133
E (error), 133
Empty reservoir, 133
Failed batt test, 134
Max delivery, 134
Motor error, 134
No delivery, 125, 134
No reservoir, 134
Off No power, 134
Reset, 134
Weak battery, 135
Alarms
responding to, 132
review, 107
alert frequency, 139
alert type
Setting your, 107
alerts
for alert conditions
low reservoir alert, 131
areas
inserting infusion set, 59
Attention mode, 32
auto-off, 108
B
backlight, 31, 159
BASAL MENU, 33
basal rate
daily, 47
maximum, 48
patterns, 96
programming, 46
stop delivery of, 49
temp, 99
battery, pump, 137, 145
install, 26
removing, 126
short life, 126
beep/vibrate, alert type, 31
BG reminder, 43
BG targets, 75
BG units, 73
Block feature, 114
Turn on, 114
BLOCK OPTION screen, 114
bolus
basic, 37
details, 41
history, 40
manual, 88
maximum limit, 43
stop delivery of, 49
bolus delivery
Easy Bolus, 93
bolus delivery, methods for normal
Bolus Wizard, 79
remote control, 4
BOLUS MENU, 33
bolus types
Dual Wave, 87
Normal, 37
Square Wave, 87
Bolus Wizard
about, 67
estimate details, 41
how it works, 71
maximum delivery, 71
on/off, 72
review settings, 77
Index
165
settings, 68
Active insulin time, 69
BG target range, 69
BG units, 68
Carb ratios, 68
Carb units, 68
Insulin sensitivity, 69
specifications, 148
your BG reading, 67
buttons, pump, 25, 28
C
Carb units, 72
carbohydrate counting, 19
CareLink Personal, 121
CareLink USB, 4
CHECK BG message, 44
cleaning the pump, 138
Clear settings, 118
consumables, 3
correction bolus, 37, 79, 80
D
Daily totals, 109
DAILY TOTALS screen
Review, 109
default settings
insulin delivery, 154
Dual Wave bolus programming
with Bolus Wizard, 91
without Bolus Wizard, 88
dual/square option
on-off, 88
E
Easy bolus, 93
166
Index
cancel, 95
deliver an, 94
step value, 94
emergency kit, 2
ESC, 5
cancels programming, 33
express bolus button, 28
F
filling
reservoir, 54
food bolus, 37, 68, 71, 79, 80
food entry, 68, 80
food label, 20
frequency
alarm, 139
alert, 139
H
high BG levels
Bolus Wizard and, 71
history
alarms, 107
bolus delivery, 40
user settings, 119
HOME screen, 29
I
infusion set, 3, 53
changing your, 56
inserting, 59
best sites, 60
rotating sites, 60
Insulin sensitivity, 74
L
Language setting, 36
Lock keypad feature, 115
low battery
affects meter option, 78
affects remote control, 113
affects selftest, 116
affects your alert type, 107
low BG levels
Bolus Wizard and, 71
low reservoir alert, 131
Low resv warning feature, 108
M
MAIN MENU, 32
manual
prime, 59
maximum bolus limit, 43
menus, 32
meter, 4, 67
meter IDs
add, delete, review, 78
meter option, 77
rules, 78
METER OPTION screen, 78
modes
Attention, 32
Normal, 31
Special, 31
MWT1, 4
MWT1 technology , 67
N
no delivery, 125
Normal Bolus
with Bolus Wizard, 79
without Bolus Wizard, 37
Normal mode, 31
Now, 92
Now portion
of the Dual Wave bolus, 89, 92
nutrition, 19
P
Patterns
basal, 96
on/off, 96
pattern A, B, 96
Program a basal pattern, 97
Select a basal pattern, 97
standard basal pattern, 96
Personal reminders, 112
personal settings, 68
practicing, 57
prime
manual, 59
PRIME MENU, 33
pump
battery compartment, 25
buttons, 25, 28
if you remove your, 34
screen, 25, 29
using in water, 129
warranty, 158
R
Reminder, alarm clock, 112
remote control, 4
remote control IDs
add, delete, review, 114
Remote control option
turn on, 113
removing your pump, 34
reservoir
filling the, 54
inserting in your pump, 57
low reservoir warning, 108
plunger rod, 54
removing the, 56
transfer guard, 54
tubing connector, 25
reservoirs, 3
Restore settings, 117
rewinding your pump, 57
during practice, 57
RF features
meter, 77
remote control, 113
use on aircraft, 7
S
Save settings, 117
scroll bar, 30
Selftest, 116, 129
Special mode, 31
Square portion
of the Dual Wave bolus, 92
Square Wave bolus programming
with Bolus Wizard, 91
without Bolus Wizard, 88
STATUS screen, 33
Step value setup, 94
supplies, ordering, 4
Suspend function, 33, 49
temp basal types
Insulin rate, 99
Percent of basal, 101
terms and symbols, 5
therapy follow-up
Recommended, 123
time and date, setting, 35
U
User settings, 117
User Settings menu, 129
Utilities, 107
UTILITIES MENU , 33
W
warranty, 158
T
Temp basal, 130
Canceling a, 104
Deliver a, 103
rates, 99
Selecting type, 103
verify delivery, 104
Index
167
INSULIN PUMP
6025020-016C
113007

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