Contacts and Important Information Use the spaces below to record important health and product information.
© 2011 Insulet Corporation. All rights reserved. OmniPod is a registered trademark of Insulet Corporation. U.S. Patent No. 6,740,059. FreeStyle is a registered trademark of Abbott Laboratories. Third-party trademarks used herein are the trademarks of their respective owners.
Contents Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viii About This User Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viii Symbols. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viii Conventions and Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix Important Information . . . . . . . . . . . . . . . . . . . . .
Contents Enter the duration of insulin action . . . . . . . . . . . . . . . . . . . . . . . . . . Select bolus increment and enter maximum bolus . . . . . . . . . . Set extended bolus doses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Set low reservoir advisory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Set expiration notification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Contents Suspend Insulin Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Resume Insulin Delivery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Avoid Infusion Site Infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Get the Most From Your Pod . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Avoid extreme temperatures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Contents Insert the blood glucose test strip . . . . . . . . . . . . . . . . . . . . . . . . . . . Set the blood glucose test strip code . . . . . . . . . . . . . . . . . . . . . . . . Lance your finger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Lance your forearm, upper arm, or hand. . . . . . . . . . . . . . . . . . . . . Fill the blood glucose test strip with blood . . . . . . . . . . . . . . . . . . Wait for the reading . . . . . . . . . . . . . . . . . . . .
Contents Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Advisory Alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hazard Alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Manual Shut-off of a Hazard Alarm. . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 124 124 130 11 Communication Failures . . . . . . . . . . . . . . . . . . . . . .
Introduction ■ About This User Guide Symbols Symbol viii Term Meaning Warning Describes potential serious adverse reactions, or indicates conditions that could cause death or serious injury. Caution Indicates conditions that could cause minor or moderate injury to you or damage to the device. Note Provides helpful information. Tip Offers a suggestion for successful use of the OmniPod® Insulin Management System. This User Guide is intended for use only with PDM model UST400.
Introduction Conventions and Terms Convention/Term Meaning Bold Names of buttons, soft keys, menus, and screens are in bold. Italics Words in italics are defined in the Glossary at the end of this User Guide. Press Press and release a button or soft key. Hold Keep pressing a button until its function is complete. Menu A list of options on the PDM. Options allow you to perform tasks. Screen Displays programming, operating, and alarm/alert information.
Introduction Contraindications Insulin pump therapy is NOT recommended for people who are either: • Unable to perform at least four (4) blood glucose tests per day • Unable to maintain contact with their healthcare provider • Unable to use the System according to instructions Do not use the integrated FreeStyle® Blood Glucose Monitoring System for: • Testing on newborns • Testing arterial blood • Diagnosing of or screening for diabetes mellitus The OmniPod System is designed to use rapid-acting U-100 insuli
Introduction Please read all the instructions provided in this User Guide and practice the blood glucose testing procedures before using the System. Monitor your blood glucose with the guidance of your healthcare provider. Undetected hyperglycemia or hypoglycemia can result without proper monitoring. If you are unable to use the System according to instructions, you may be putting your health and safety at risk.
Introduction Your individual needs influence the initial settings you and your healthcare provider will enter into the Personal Diabetes Manager (PDM) during setup (see Chapter 2, Getting Started). Your healthcare provider must help you enter these initial settings. Soon you will enter and change your own settings with confidence and ease. The OmniPod System is more user-friendly than most electronic devices you use every day. In fact, technology is what makes the OmniPod System so easy to use.
CHAPTER 1 Your New OmniPod Insulin Management System ■ Insulin Delivery with the OmniPod System The OmniPod® Insulin Management System is an innovative continuous insulin delivery system that provides all the proven benefits of continuous subcutaneous insulin infusion (CSII) therapy in a way no conventional insulin pump can. The System’s innovative design and features allows you to live your life—and manage your diabetes—with unprecedented freedom, comfort, convenience, and ease.
1 Your New OmniPod Insulin Management System ■ How Does the OmniPod System Work? The Pod is a small, lightweight, self-adhesive device that you fill with insulin and wear directly on your body. The Pod delivers precise, personalized doses of insulin into your body through a small flexible tube (called a cannula), based on instructions that you program into its wireless companion, the Personal Diabetes Manager. The cannula is inserted only once with each Pod.
Your New OmniPod Insulin Management System You can also enter your own favorite foods, snacks, or entire meals as “carb presets.” Presets contain the grams of carbohydrate in the food item or meal. Next time you eat this same food, you don’t have to count the carbs; just select your carb preset and the System does the calculating for you. The System stores up to 36 carb presets.
1 Your New OmniPod Insulin Management System ■ The Pod ■ The Personal Diabetes Manager The Pod (Figure 1-1) is applied to your skin with an adhesive backing, similar to an adhesive bandage. All Pod operations are programmed and controlled through the palm-sized Personal Diabetes Manager (PDM; Figure 1-2).
Your New OmniPod Insulin Management System 1 Buttons that program and control the OmniPod System Button Action Home/ Power Pressing and holding turns the PDM on and off. When the PDM is on, pressing this button (quickly/briefly) displays the Home screen, from which you can choose a menu item or view the Status screens (shown later in this chapter). Up/Down Controller Pressing and releasing scrolls through a list of available menu options or numbers, so you can pick the one you want.
1 Your New OmniPod Insulin Management System Primary screens Messages on the screen either: • Let you identify your PDM • Tell you how the System is operating • List menu choices • Explain how to perform certain tasks The System’s primary screens are the ID screen (Figure 1-3), the Status screen (Figure 1-4), and the Home screen (Figure 1-6 on the next page). Figure 1-3 6 Figure 1-4 ID screen The System displays an ID screen to make the PDM easy to identify when you first turn it on.
Your New OmniPod Insulin Management System If a Pod has not yet been activated (during Pod changes), the screen displays “No active Pod. Would you like to activate a Pod now?” (See Chapter 5, Using the Pod, for details on activating a Pod.) Status support screen From the Status screen, press the User Info/Support button to see details about the current insulin on board (IOB) in your body (Figure 1-5). See page 30, for additional information describing insulin on board (IOB).
1 Your New OmniPod Insulin Management System ■ Safety Features The OmniPod System’s state-of-the-art design includes the latest safety technology. Its built-in safety features include: Automatic priming, safety checks, and insertion Every time you activate a new Pod, the System automatically primes and performs a safety check on the Pod, then inserts and primes the cannula (see Chapter 5, Using the Pod).
CHAPTER 2 Getting Started ■ The OmniPod Starter Kit Your initial shipment contains everything you need to begin using the OmniPod System. If you are a first-time OmniPod System user, you need to meet with your healthcare provider for training and System setup before using it. To get a head start on learning about your new OmniPod System, review this User Guide and complete the PreTraining section of OmniPod’s online Interactive Training Program, found in the Customer Care section of MyOmniPod.com.
2 Getting Started Turn on the PDM 1. Open the battery compartment on the back of the PDM by pushing the compartment latch and lifting upward (Figure 2-1). No special tools are necessary. Figure 2-1 Do not use any other type of batteries than AAA alkaline batteries to power the PDM. Never use old or used batteries; the PDM may not work properly. 3. Replace the battery door. 4. Turn the PDM face up. The PDM has begun to power on automatically.
Getting Started You can adjust these settings later as your needs change or as you fine-tune your OmniPod System. To get started, press Next on the Wizard's Welcome Screen to begin setting up your PDM. Enter your PDM ID 1. Use the Up/Down Controller buttons to scroll through the list of characters. An up-and-down-arrow symbol on the screen indicates the character you are changing. 2. Press the middle Soft Key (labeled with the right arrow) to move the underscore to the next character. 3.
2 Getting Started 6. Choose a temporary basal feature, then press Next. Choose % to show temporary basal rates as a percent increase or decrease of your current basal rate. Choose U/hr to show temporary basal rates in units per hour. Or choose Off to turn off the temporary basal feature. For details about setting temporary basals, see Chapter 3, Understanding and Adjusting Basal Rates. You can add up to 7 basal programs and set 24 segments per program. Enter blood glucose sound setting and BG goal 1.
Getting Started b. Enter a start time for the target BG segment, then press Enter. c. Enter an end time for the target BG segment, then press Next. d. Enter a target blood glucose value, then press Next. Use the Up/Down Controller buttons to enter the “correct above” value or “correction threshold” (the BG value above which you want the PDM to suggest a correction bolus), then press Next. e. When you have finished entering segments, press Done. 4. To see the segments as a list, press List.
2 Getting Started a. Press New. b. Enter a start time for the segment, then press Next. c. Enter an end time for the segment, then press Next. d. Enter the correction factor, then press Next. e. To save the new correction factor segment, press Done. 3. To see the factors as a list, press List. To return to the graphic view, press Graph. 4. Press Save to accept the correction factors you have set. Set reverse correction 1.
Getting Started Set low reservoir advisory 1. Choose the level of insulin in the reservoir at which the PDM should give you an alarm. Choose from 10 to 50 units in 5-unit increments, then press Next. Set expiration notification 1. Choose the number of hours before a Pod expires when the PDM should give you a notification, then press Next. The values are in 1-hour increments and range from 1 to 24 hours. (The default is 4 hours.) The PDM asks whether you want to activate a Pod.
CHAPTER 3 Understanding and Adjusting Basal Rates ■ What Is a Basal Rate? A basal rate is a small base or background amount of insulin that is delivered, at a preset rate, continuously for a specified period of time. Even without eating, our bodies need a small, constant supply of insulin for normal daily living. In people without diabetes, the pancreas continuously delivers this basal insulin.
Understanding and Adjusting Basal Rates In addition to normal daily changes, insulin needs can vary with different routines or days of the week. For example, regular school or workday routines may differ from weekend routines, and insulin needs may differ, too. With your healthcare provider, you will decide on the basal rates that best match your lifestyle and insulin needs.
3 Understanding and Adjusting Basal Rates b. Press the middle Soft Key (labeled with the right arrow) to move the underscore to the next character. c. Enter each character one at a time. For example, if your weekend schedule is different from your weekday schedule, you might enter W, e, e, k, e, n, d (Figure 3-3). (A blank character or space is the first and last option in the scrolling menu.) Figure 3-3 d. Press Next.
Understanding and Adjusting Basal Rates Basal rates outside the changed segment do not change. Figure 3-5 3 Figure 3-6 e. Repeat steps a–d for each new segment and rate you want, then press Done. Press and hold the Power button to turn the screen back on. In some cases, if it has been less than 5 minutes since the screen timed out, pressing the Power button returns you to the same screen you were using. If it has been longer than 5 minutes, the PDM brings you to the Status screen. 7.
3 Understanding and Adjusting Basal Rates 3. Choose the program you want from the list (Figure 3-7), then press Enable. A diamond icon (♦) appears next to the program that is active. You cannot select the active program to enable it, because it is already running. Figure 3-7 4. Press Enable again to start the selected basal program. If a Pod is active, the PDM beeps to indicate that the chosen basal program is running.
Understanding and Adjusting Basal Rates Figure 3-8 Figure 3-9 3 3. Enter a start time for the segment you want to change, then press Next. 4. Enter an end time for this segment, then press Next. 5. Enter a basal rate for the new segment, then press Enter. 6. To save the newly entered segment into the basal program, press Save (Figure 3-10). If you want to make additional edits, repeat steps 2–5. Figure 3-10 To edit or add a segment or rate in the basal program 1. Choose Edit, then press Select.
3 Understanding and Adjusting Basal Rates To rename a basal program 1. After choosing a program from the list, choose Rename, then press Select. 2. Press the Up/Down Controller buttons to enter the characters that spell out the new name you want. Press the middle soft key (labeled with the right arrow) to move the underscore to the next character, then press Save. To delete a basal program 1. After choosing a program from the list, choose Delete and then press Select. 2.
Understanding and Adjusting Basal Rates join a summer soccer league. For women, a monthly hormonal change that affects blood glucose is an example of predictable change. To easily handle predictable, short-term changes, you can “preset” a temporary basal rate, so it is ready whenever you need it. The PDM can remember up to 7 temporary basal presets. You can set a temporary basal rate for a duration of 30 minutes to 12 hours.
3 Understanding and Adjusting Basal Rates Cancel a one-time temporary basal rate 1. On the Home screen, use the Up/Down Controller buttons to choose Suspend/cancel, then press Select. 2. Choose Cancel temp basal (Figure 3-13), then press Select. Figure 3-13 3. Press Confirm to cancel the temporary basal shown on the screen. Create a temporary basal preset 1. On the Home screen, use the Up/Down Controller buttons to choose Settings, then press Select. 2. Choose Presets, then press Select. 3.
Understanding and Adjusting Basal Rates Figure 3-14 Enable an existing temporary basal preset 1. On the Home screen, use the Up/Down Controller buttons to choose Temp basal, then press Select. 2. Choose the temporary basal preset you want to use from the list (Figure 3-15), then press Select. Figure 3-15 d. Press Next. 6. Enter the new temporary basal rate (or percent change), then press Next. 7. Enter the duration of the temporary basal rate, from 0.5 hours to 12 hours, then press Next. 8.
3 Understanding and Adjusting Basal Rates Cancel an active temporary basal preset 1. On the Home screen, use the Up/Down Controller buttons to choose Suspend/cancel;, then press Select. 2. Choose Cancel temp basal, then press Select. 3. Press Confirm to cancel the actively running temporary basal preset. To change a temporary basal preset 1. Choose Edit, then press Select (Figure 3-17).
Understanding and Adjusting Basal Rates To rename a temporary basal preset 1. Choose Rename, then press Select. 2. Press the Up/Down Controller buttons to enter the characters that spell out the name you want, then press Save. 3. Press Done. To delete a temporary basal preset 1. Choose Delete, then press Select. 2. Press Delete to permanently delete the preset.
CHAPTER 4 Understanding and Delivering Bolus Doses ■ What Is a Bolus? A bolus is an extra dose of insulin, delivered when needed to: • Match the carbohydrates (sugar content) in a meal or snack— also known as a meal bolus • Lower blood glucose when it gets too high—also known as a correction bolus This extra dose is in addition to the basal rate delivered throughout the day and night (see Chapter 3, Understanding and Adjusting Basal Rates).
Understanding and Delivering Bolus Doses 4 ■ Bolus Dose Options ■ Suggested Bolus Calculator So that you can fully enjoy freedom and flexibility in your life, the OmniPod System offers the following bolus dose options: Suggested bolus calculator: When you want the System to calculate your suggested bolus, based on your personal settings, your current blood glucose, the amount of insulin still active in your body from previous boluses, and the grams of carbohydrate (“carbs” for short) you are about to ea
4 Understanding and Delivering Bolus Doses Figure 4-1 Figure 4-2 How a suggested bolus is calculated The suggested bolus calculator estimates the suggested amount for each bolus portion based on your personal settings and inputs.
Understanding and Delivering Bolus Doses ■ Deliver a Normal Bolus Deliver a bolus when suggested bolus calculator is On 1. After you check your blood glucose, the PDM displays the results (Figure 4-3; see the end of Chapter 7, Checking Your Blood Glucose). Press Next. Figure 4-3 4 A blood glucose value is current for up to 10 minutes after it is tested.
4 Understanding and Delivering Bolus Doses 2. If you are not going to eat now, press No (Figure 4-4). The Suggested Bolus screen appears (Figure 4-5). Press Enter to accept the suggested bolus. Or, if you wish, press the Up/Down Controller buttons to increase or decrease the suggested bolus. Then press Enter to accept the bolus. Figure 4-4 Figure 4-5 In the Suggested Bolus screen (Figure 4-5), “adjusted for Insulin on Board (IOB)” appears only when Insulin on Board (IOB) is a factor in the calculation.
Understanding and Delivering Bolus Doses Figure 4-6 If the reverse correction feature is turned On and if your blood glucose level is below your target, the System subtracts a correction amount from the meal portion of the bolus. If the reverse correction setting is turned Off, the System does not subtract anything for a blood glucose level below your target. 4 4. If you have set the blood glucose reminder option to On and you want to add a reminder: a. Press Yes. b.
4 Understanding and Delivering Bolus Doses ■ Deliver an Extended Bolus The extended bolus feature lets the OmniPod System deliver some (or no) insulin now and the remainder over a period of time you choose. Deliver an extended bolus instead of a normal bolus 1. After you get your suggested bolus, press Extend instead of Enter (see Figure 4-7). If you have set the Extended bolus option to Off, the PDM will not display the Extend Soft Key.
Understanding and Delivering Bolus Doses 3. Enter the time (up to 8 hours, in 30-minute increments) over which to deliver the remainder of the bolus, then press Enter (Figure 4-9). In Figure 4-10 you can see a detailed view of the extended bolus. Figure 4-9 Figure 4-10 4. If the blood glucose reminders feature is turned On, you can now set a blood glucose reminder. 5. Press Confirm to begin the bolus delivery. 4 As a safety feature, the correction bolus is always delivered first and cannot be extended.
4 Understanding and Delivering Bolus Doses ■ Cancel Active Boluses The OmniPod System is extremely flexible, so you can use it to respond to your changing insulin needs. It is easy to cancel an active bolus (one that is currently being delivered), even after insulin delivery has started. 1. To check the Pod status, refer to Page 54 for detailed instructions. The ID screen must be confirmed before you can check Pod status.
Understanding and Delivering Bolus Doses 2. Press Yes to cancel the active extended bolus (Figure 4-13). Or press Back to return to the Suggested Meal Bolus screen. Figure 4-13 4 Figure 4-15 Figure 4-14 ■ Bolus Presets 3. Press Confirm (Figure 4-14). 4. The screen displays the amount of the old extended bolus that has yet to be delivered (Figure 4-15). Press Next to return to the Suggested Meal Bolus screen. You can add what remained of the old extended bolus to the new one.
4 Understanding and Delivering Bolus Doses Create a bolus preset 1. On the Home screen use the Up/Down Controller buttons to choose Settings; then press Select. 2. Choose Presets, then press Select. 3. Choose Bolus presets, then press Select. 4. Choose [add new], then press New. 5. To use the OmniPod System’s default naming system, simply press Next. The default naming system automatically assigns program names in numerical order, such as bolus 1, bolus 2, bolus 3.
Understanding and Delivering Bolus Doses 4. Press Confirm to deliver the bolus shown on the screen. Change, rename, or delete a bolus preset 1. On the Home screen, use the Up/Down Controller buttons to choose Settings, then press Select. 2. Choose Presets, then press Select. 3. Choose Bolus presets, then press Select. 4. Choose a preset from the list, then press Edit. Change a bolus preset 1. Choose Edit, then press Select. 2. Enter a new insulin amount for the bolus, then press Save.
4 Understanding and Delivering Bolus Doses 6. To use the OmniPod System’s default naming system, simply press Next. The default naming system automatically assigns program names in numerical order, such as carb preset 1, carb preset 2, carb preset 3. Or, to give a different name to the program: a. Press the Up/Down Controller buttons to enter the characters that spell the name you want. An up and down arrow symbol on the screen indicates the character you are changing. b.
Understanding and Delivering Bolus Doses 3. Choose Carb presets, then press Select. 4. Choose the category of the preset you want to change, then press Select (Figure 4-19). Figure 4-19 Figure 4-20 4 3. To rename the carb preset, press the Up/Down Controller buttons to enter the characters that spell out the name you want, then press Next. To “erase” characters, press either Up or Down until you reach the end of the characters, which gives you the option to choose a blank space. 4.
4 Understanding and Delivering Bolus Doses ■ Reference Food Library Figure 4-21a Figure 4-21b The Food Library is for reference only. (Food references contained in the library cannot be populated and used for calculations.) The OmniPod System includes a reference library of over 1,000 common food items. The library shows each item’s grams or carbohydrate, fat, protein, and fiber values , and calories for a single portion.
CHAPTER 5 Using the Pod ■ The Pod Change Process Replace the Pod at least once every 48–72 hours or up to 200 units of insulin (2–3 days). Refer to the insulin labeling and follow your healthcare provider’s directions for how often to replace your Pod. If you like, you can set the Personal Diabetes Manager (PDM) to notify you when it is time to replace the Pod (see Chapter 6, Using the Personal Diabetes Manager).
5 Using the Pod ties, shock, coma, or death. If insulin delivery is interrupted for any reason, you may need to replace the missing insulin usually with an injection of rapid-acting insulin. Ask your healthcare provider for instructions on handling interrupted insulin delivery. Gather equipment and supplies Gather the following before you begin: • A vial of rapid-acting U-100 insulin (See the warning on page x of the Introduction for a list of insulins approved for use in the OmniPod System.
Using the Pod 5. After you press Confirm, you will see the message in Figure 5-4 on the next page. To remove the old Pod: a. Gently lift the edges of the adhesive tape from your skin and remove the entire Pod (Figure 5-3). Removing the Pod slowly will help to avoid possible skin irritation. b. Use soap and water to remove any adhesive that remains on the skin or, if necessary, use an adhesive remover. c. Discard the used Pod according to local waste disposal regulations.
5 Using the Pod Use care after removing the needle cap and exposing the fill needle. Figure 5-5 Figure 5-6 Only use room temperature insulin when filling the Pod. 4. Determine the amount of insulin you need to insert into the Pod. For example, if you will use this Pod for 48 hours, you need enough insulin to last you 48 hours. Your healthcare provider will help you determine the correct amount. The Pod requires a minimum of 85 units of insulin to begin operation.
Using the Pod 5 To ensure proper fill, do not insert the fill syringe at an angle into the fill port. Do not insert the fill syringe into the fill port more than once. Do not use any other type of needle or filling device besides the syringe provided with each Pod. NEVER inject air into the fill port. Doing so may result in unintended or interrupted insulin delivery. 9. Depress the syringe plunger to completely empty the insulin into the Pod.
5 Using the Pod Figure 5-7 Figure 5-8 Select the infusion site Before applying a new Pod, you must first select an appropriate infusion site. Due to ease of access and viewing, the abdomen is often used. Your healthcare provider may suggest other potential sites that, like the abdomen, typically have a layer of fatty tissue, such as the hip, back of upper arm, upper thigh, or lower back (Figure 5-9 and Figure 5-10, on the next page).
Using the Pod Figure 5-9: Adult/Youth 5 Figure 5-10: Toddler Front Back Front Back 49
5 Using the Pod To help avoid condensation from occurring in the viewing window, make sure both your Pod and your insulin are at room temperature. Figure 5-11 Figure 5-12 You can reduce the risk of infection at the infusion site by following aseptic technique and disinfecting the infusion site. Before applying a new Pod, always: 1. Wash hands with soap and water. 2. Use soap to wash the infusion site. Antibacterial soap may irritate skin, especially at the infusion site.
Using the Pod • If Pod is accidentally dropped discard - sterility may be compromised. If you are unsure the Pod is ready to be applied to the site, press “Discard” and do not use (Figure 5-14). Select a new Pod. Do not remove the needle cap until you are instructed to do so by the PDM. When you remove the needle cap, a drop of insulin may be visible at the end of the cannula or in the well. 3. Using the pull tabs, remove and discard the white paper backing from the adhesive tape (Figure 5-12). 4.
5 Using the Pod The Pod automatically inserts the soft cannula below your skin. It takes a few seconds to complete the insertion process. Once the cannula is inserted, the Pod delivers a prime bolus to fill the cannula with insulin (Figure 5-18). Insert cannula and begin insulin delivery 1. To insert the soft cannula, press Start (Figure 5-15). Figure 5-15 Figure 5-16 Figure 5-20\ If you are applying a Pod in a place that does not have a lot of fatty tissue or is very lean, pinch the skin around the Pod
Using the Pod Check the infusion site after insertion to ensure that the cannula was properly inserted. It is also a good idea to check your blood glucose about 1.5 to 2 hours after each Pod change and to check the infusion site periodically. If the cannula is not properly inserted, hyperglycemia may result. Verify there is no wetness or scent of insulin, where as may indicate the cannula has dislodged.
5 Using the Pod NEVER inject insulin (or anything else) into the fill port while the Pod is on your body. Doing so may result in unintended or interrupted insulin delivery. ■ Check Pod Status To check Pod status, if the PDM is turned Off, press and hold the Power button to display the ID screen, then press Confirm to display the Status screen. If the PDM is On, press Back until you reach the Status screen. (If you press and hold the Power button, you will turn off the PDM instead.
Using the Pod 2. Enter how long you want to stop all insulin delivery, from 30 minutes to 2 hours, in 30-minute increments (Figure 5-20), then press Enter. Figure 5-23 Figure 5-20 Figure 5-21 5 At the end of the suspend time, a Pod Advisory alarm occurs (Figure 5-22). Figure 5-25\ Figure 5-22 3. Press Confirm to confirm that you want to halt all insulin delivery (basal and bolus). The PDM beeps and an on-screen message lets you know that insulin delivery is indeed suspended (Figure 5-21).
5 Using the Pod ■ Resume Insulin Delivery ■ Avoid Infusion Site Infections 1. On the Home screen, use the Up/Down Controller buttons to choose Resume (Figure 5-23), then press Select. • • Figure 5-23 • • • Always wash your hands and use the aseptic technique to prepare the infusion site before applying a Pod. Do not apply a Pod to any area of the skin with an active infection. If you are unsure whether to use a specific site, ask your healthcare provider.
Using the Pod Do NOT expose a Pod to direct sunlight for long periods of time. It is recommended that you remove your Pod prior to using hot tubs, whirlpools, or saunas. These conditions could expose the Pod to extreme temperatures and may also affect the insulin inside the Pod. Remember to check your blood glucose levels frequently before and after removing the Pod. Check with your healthcare provider for guidelines on removing the Pod for extended periods.
CHAPTER 6 Using the Personal Diabetes Manager ■ The ID Screen Figure 6-1 Figure 6-2 When you first turn on the PDM, it displays the identification (ID) screen (Figure 6-1), which allows you to identify that the PDM is yours. You can personalize the ID screen by adding your name and choosing its color. You must acknowledge the ID screen before you can use the PDM. It is important that you always identify the PDM as yours before you use it.
Using the Personal Diabetes Manager • • • • • Amount of insulin on board (IOB), if suggested bolus calculator is in use Name and rate of active basal program or temp basal program “Ext bolus,” the amount of insulin and the delivery time remaining if an extended bolus is being delivered “INSULIN SUSPENDED” if insulin delivery has been suspended Time and date when the Pod will expire If a Pod has not yet been activated (as in during Pod changes), the screen displays “No active Pod.
6 Using the Personal Diabetes Manager Figure 6-3 You and your healthcare provider entered initial System settings using the Setup Wizard (see Chapter 2, Getting Started). After setup, you can use the System setup menu to customize or change those settings, as described in this chapter. ■ Reset the Date or Time Occasionally, you need to change date and time settings (for example, to adjust for daylight savings time or after resetting the PDM).
Using the Personal Diabetes Manager Reset the time 1. To enter the current time, press the Up/Down Controller buttons. Press and hold the button to increase or decrease the time faster. 2. Press 12/24 hr to choose either a 12-hour or 24-hour clock, then press Enter (Figure 6-4). Figure 6-4 Figure 6-5 6 Reset the date 1. Press the Up/Down Controller buttons to choose the current year, then press Next. 2. Choose the current month, then press Next. 3. Choose the current day, then press Next. 4.
6 Using the Personal Diabetes Manager 4. Choose one of the options (Figure 6-6a and Figure 6-6b), then press Select. Each option is described below. Figure 6-6a Figure 6-6b Bolus calcs When the suggested bolus calculator is turned Off and you want to turn it On, press On and follow these steps: 1. Target BG and correct-above value—You can edit existing time segments and add segments, up to a total of 8. 62 a. To edit an existing target BG time segment, choose the segment, then press Edit.
Using the Personal Diabetes Manager Figure 6-7 6 5. Reverse correction—Choose On or Off, then press Next. 6. Insulin action (duration)—Use the Up/Down Controller buttons to choose a duration of insulin action, then press Done. 7. Press OK. Ratios/factors/targets When the suggested bolus calculator is turned On, you can view and change all the settings using the Ratios/factors/targets menu option.
6 Using the Personal Diabetes Manager When the suggested bolus calculator is turned Off, the Ratios/factors/targets option does not appear in the Bolus/basal/calcs menu. 1. Target BG and correct-above value—You can edit existing segments and add segments, up to a total of 8. a. To edit an existing target BG time segment, choose the segment, then press Edit. Use the Up/Down Controller buttons to choose a new start time, end time, target BG value, and correct-above value (correction threshold).
Using the Personal Diabetes Manager Temp basal Choose %, U/hr , or Off to set the mode for temporary basal rates and presets, then press Select. Extended Choose %, Units, or Off to set the mode for extended boluses, then press Select. Bolus increment Choose 0.05, 0.10, 0.50, or 1.00 units for bolus increments, then press Select. Max bolus Use the Up/Down Controller buttons to enter the maximum bolus dose you can take, then press Enter.
6 Using the Personal Diabetes Manager The Low reservoir alert will escalate to an Empty reservoir hazard alarm when insulin is depleted. Be sure to respond to the alert when it occurs. Auto-off: Alerts you if the PDM does not receive a Pod status within a predefined period of time. Obtain Pod status by pressing and holding the PDM’s Power button. Choose a time period from 1 to 24 hours, in 1-hour increments, or choose Off. The default setting is Off. Refer to page 54 to check Pod status and to Confirm ID.
Using the Personal Diabetes Manager Custom reminders: Displays text reminders that you enter, at times that you select. You can choose to receive a notification Daily, One time only, or Off. You can change or delete these notifications at any time. Set alerts and reminders 1. On the Home screen, use the Up/Down Controller buttons to choose Settings, then press Select. 2. Choose System setup, then press Select. 3. Choose Alerts/reminders, then press Select. 4.
6 Using the Personal Diabetes Manager To delete a Bolus reminder a. Choose the bolus reminder you wish to delete, then press Edit. b. Choose Delete then press Select. c. Press Delete to remove the bolus reminder. 7. For Custom reminders • Use the Up/Down Controller buttons to choose [add new], then press New. • To use the OmniPod System’s default naming system, simply press Next. The default naming system automatically assigns names in numerical order, such as alert 1, alert 2, alert 3.
Using the Personal Diabetes Manager ■ Change Blood Glucose Meter Settings You can adjust blood glucose (BG) meter settings: • BG goal lower and upper limits (for BG history) • Manage BG tags list • BG sound—On or Off 1. On the Home screen, use the Up/Down Controller buttons to choose Settings, then press Select. 2. Choose System setup, then press Select. 3. Choose BG meter, then press Select. 4. Choose the setting you want to change (Figure 6-11), then press Select.
6 Using the Personal Diabetes Manager 1. To hide or show a standard BG tag, choose the tag, and press Show (if it is marked as hidden) or Hide. Tags you choose to show will be check marked; hidden ones will not be. 2. To add a custom tag, choose [add new] at the end of the list of custom tags, then press New. In the Edit name screen, either: a. Press Save to save the new tag with the default name, custom tag1, custom tag2, and so on; or b.
Using the Personal Diabetes Manager Backlight time-out: The backlight is on by default while you are using the PDM. The time-out setting dims the backlight and causes the screen to dim when you have not used it within the time interval that you set. Set at the lowest setting to maximize battery life. Figure 6-13 6 Figure 6-14 For extra brightness on the PDM screen, press and hold the User Info/Support button (?) for 2 seconds. This enables a “bright mode.
6 Using the Personal Diabetes Manager To change the ID screen color: 1. Choose Screen color, then press Select. 2. Use the Up/Down Controller buttons to choose a color, then press Select. Set PDM lock Choose On or Off, then press Select. If you choose On, other PDM options and most other soft keys are locked and will not respond to button presses. To use them, you must first set PDM lock to Off. Set the Screen time-out Choose a time interval, then press Select.
Using the Personal Diabetes Manager Diagnostic options 1. On the Home screen, use the Up/Down Controller buttons to choose Settings, then press Select. 2. Choose System setup, then press Select. 3. Choose Diagnostics, then press Select. Figure 6-15 6 Figure 6-16 To check alarms 1. Choose Check alarms, then press Select. 2. Press OK. The PDM beeps three times and vibrates three times. If a Pod is active, it then beeps three times. Be sure to check the alarm function at every Pod change.
6 Using the Personal Diabetes Manager ■ Set a Reminder to Vibrate For certain reminders, you can choose vibration instead of beeps or vibration followed by beeps, instead of only beeps. If you activate it, the PDM will vibrate for: • Blood Glucose reminders • Missed Bolus reminders • Custom reminders • “No active Pod” reminders The PDM cannot be set to vibrate for hazard or advisory alarms. To change the type of notification 1. Use the Up/Down Controller buttons to choose Settings,then press Select. 2.
Using the Personal Diabetes Manager Avoid extreme temperatures Extreme operating temperatures can affect PDM batteries and interfere with System operation. Avoid using the PDM in temperatures below 40°F (4.4°C) or above 104°F (40°C). 6 Only connect a USB cable to your PDM when downloading data to a computer. Other PDM functions are disabled while a USB cable is connected, and the PDM cannot communicate with the Pod.
CHAPTER 7 Checking Your Blood Glucose ■ The Built-in FreeStyle® Blood Glucose Meter With the FreeStyle® blood glucose meter, checking your blood glucose requires a very small sample size, 0.3 microliter of blood. Refer to your FreeStyle test strip instructions for use for important test strip information.
Checking Your Blood Glucose ■ The FreeStyle® Blood Glucose Test Strips Complete information on the FreeStyle® test strips (such as interferences and performance) can be found in the test strip package insert. Please read all instructions provided on the test strip package insert before using the OmniPod System and FreeStyle accessories. Important test strip information • Store the blood glucose test strip package in a cool, dry place between 40° and 86° F (4.4° and 30° C).
7 Checking Your Blood Glucose When to perform a control solution test You should perform a control solution test: • When you suspect that your meter or test strips are not working properly • When you think your test results are not accurate or if your test results are not consistent with how you feel • When you drop or damage your PDM or expose it to liquids • When your healthcare provider advises you to do so Check that the meter and test strips are working A control solution test follows the same procedur
Checking Your Blood Glucose The control solution range is a target range for control solution only. It is not a target range for your blood glucose. If control solution results are out of this range, REPEAT THE TEST.
7 Checking Your Blood Glucose If you need to adjust the code number after the PDM has moved to the next screen, just press the Up/Down Controller buttons. The code screen reappears and you can adjust the number. The code number remains on the PDM screen for your reference until you have completed the control test. Figure 7-3 Figure 7-4 From some PDM screens, you cannot access the Freestyle® blood glucose meter.
Checking Your Blood Glucose Figure 7-5 Figure 7-6 The “Checking” screen appears while the sample is processing (Figure 7-7). The strip port light turns off when the sample is accepted. Figure 7-7 5. Gently touch only ONE EDGE of the test strip to the control solution. Specifically, apply the control solution to the test strip edge next to one of the dark-colored half-circles (Figure 7-6). If BG sound is set to On, the PDM beeps when the test strip is full.
7 Checking Your Blood Glucose 6. To mark the result as a control solution result rather than a blood glucose test: a. Press Tag. b. Use the Up/Down Controller buttons to select Control (Figure 7-8), then press Select. You can select a second tag for the test result in the same way. You can select a maximum of 2 tags. c. Press OK. 7. If you do not want to mark the test as a control solution test, press Next instead of Tag.
Checking Your Blood Glucose 7 Prepare the lancing device 1. Snap off the cap on the lancing device at an angle (Figure 7-10). Figure 7-9 Cocking handle Figure 7-10 Figure 7-11 Depth settings dial Depth indicator window Release button Clear cap, for testing sites other than the finger Gray cap, for testing on the fingers 2. Insert a new FreeStyle® lancet firmly into the white lancet holder cup (Figure 7-11). Pushing the device into the cup may cock the device, which is fine. 3.
7 Checking Your Blood Glucose 4. Replace the cap until it snaps or clicks into place (Figure 7-13). Be careful not to touch the exposed needle on the lancet. Figure 7-12 Figure 7-13 5. The lancing device offers four different depth settings. Level 1 is the shallowest depth; level 4 is the deepest. Move the dial to the desired setting as shown in the depth indicator window (Figure 7-14). To lance your finger, we recommend that you start at Level 1. To lance your arm, we recommend that you start at level 2.
Checking Your Blood Glucose 6. Pull out the dark gray cocking handle until it clicks (Figure 715 on the previous page). (You may have already cocked the handle in step 2. This is okay.) You are now ready to perform a blood glucose test. Figure 7-16 7 Figure 7-17 Top Insert the blood glucose test strip 1. Insert a new blood glucose test strip into the test strip port until it stops. The test strip port is at the bottom of the PDM.
7 Checking Your Blood Glucose Set the blood glucose test strip code After you insert the strip, the PDM displays a code number (Figure 7-18). This number must match the code on the side of the vial. Figure 7-18 Figure 7-19 If you need to adjust the code number after the PDM has moved to the next screen, just press the Up/Down Controller buttons. The code screen reappears and you can adjust the number. The code number remains on the PDM screen for your reference until you have completed the BG test.
Checking Your Blood Glucose 4. Press the release button. 5. Gently squeeze your finger, if needed, until a blood drop the size of a pinhead forms. Figure 7-20 7 Lance your forearm, upper arm, or hand 1. To bring fresh blood to the surface of the test site, rub the site vigorously for a few seconds (Figure 7-22) until you feel it getting warm. Figure 7-21 Figure 7-22 Figure 7-23 2. Set the depth setting on the lancing device (Figure 7-23). 3.
7 Checking Your Blood Glucose Figure 7-24 Fill the blood glucose test strip with blood 1. Make sure that the strip is in the PDM and the PDM is powered on. If the PDM has powered off, take out the strip and reinsert it (Figure 7-25), or simply press and hold the Power button to turn on the PDM. Refer to page 54 to check Pod status and to Confirm ID. Figure 7-25 Figure 7-26 5. While holding the lancing device on your test site, look through the clear cap.
Checking Your Blood Glucose Use only one edge of the blood glucose test strip per test. Do not apply blood to both edges (Figure 7-27). Only use strips once. Discard used strips. The test strip pulls the blood into the strip through the edge (Figure 7-28).
7 Checking Your Blood Glucose Figure 7-29 Figure 7-30 2. If after 5 seconds the PDM does not display “Checking,” the sample may be too small. If needed, add more blood to the same edge of the strip for up to 60 seconds from the time of the first application. The strip port light turns off when the blood sample is accepted.The reading is complete when you hear 2 beeps (if BG sound is turned On) and the PDM shows your reading on the screen (Figure 7-30).
Checking Your Blood Glucose Figure 7-31 Figure 7-32 7 ■ Blood Glucose Results and the Suggested Bolus Calculator If the suggested bolus calculator feature is turned On when you check your blood glucose, the PDM will display the result. From here, press Next to enter carbs (if eating) and have the System calculate a suggested bolus. (See “Suggested Bolus Calculator” in Chapter 4, Understanding and Delivering Bolus Doses.
7 Checking Your Blood Glucose Figure 7-33 ■ Entering Blood Glucose Readings Manually You can enter blood glucose readings manually into the PDM. This is particularly helpful if you use a separate blood glucose meter. 1. On the Home screen, use the Up/Down Controller buttons to choose More actions,then press Select. 2. Choose Add BG reading, then press Select. 3. Use the Up/Down Controller buttons to enter the BG reading from your separate meter.
Checking Your Blood Glucose ■ Editing Tags Within 2 hours of a blood glucose reading, you can remove or change a tag or add one. However, you cannot alter a Control tag. 1. On the Home screen, use the Up/Down Controller buttons to choose More actions, then press Select. 2. Choose Assign/Edit BG tags, then press Select. 3. Use the Up/Down Controller buttons to choose a reading, then press Tag (Figure 7-34).
7 Checking Your Blood Glucose To learn how to manage your list of tags and to add custom tags, see ”Manage the blood glucose tags list” in Chapter 6, Using the Personal Diabetes Manager. ■ Low and High Blood Glucose Readings WARNINGS! “LOW” or “HIGH” blood glucose readings can indicate a potentially serious condition requiring immediate medical attention. If left untreated, this situation can quickly lead to diabetic ketoacidosis (DKA), shock, coma, or death.
Checking Your Blood Glucose ■ Important Health-Related Information • For additional information, consult your test strip product information sheet. WARNINGS! • • • • • Severe dehydration and excessive water loss may cause false low results. If you believe you are suffering from severe dehydration, consult your healthcare provider immediately. Test results below 70 mg/dL mean low blood glucose (hypoglycemia). Test results greater than 250 mg/dL mean high blood glucose (hyperglycemia).
CHAPTER 8 Understanding Your Records ■ Record Keeping Record keeping is an important part of successful diabetes management. The Personal Diabetes Manager (PDM) helps simplify this task. It automatically stores records of insulin delivery history, blood glucose readings, alarms and carbohydrates. The PDM can store over 5,000 records or approximately 90 days’ worth of information. Once the memory is full, new information begins to replace the oldest information.
Understanding Your Records ✔ The record for this item is “unconfirmed.” When you power on the PDM, it will request a status update from the active Pod and then update the insulin history. If the PDM does not receive a status update from the Pod, the PDM will update history with “unconfirmed” records. The next time the PDM receives a status update, it will update these records. Figure 8-1 8 Figure 8-2 This insulin delivery item spans midnight. The date given is the start date.
8 Understanding Your Records Figure 8-3 Figure 8-4 For a temporary basal program, the display shows the % adjustment that have been made to the default basal rate (active or current). So, in Figure 8-3, “1.10 temp U/hr (+10%)” means that you delivered a temporary basal of 1.10 units per hour, which was 10% more than the default basal. (Notice that two hours later, the basal rate returns to the default.) Also, the “Pod activated” entry shows what time you applied a new Pod.
Understanding Your Records ■ Blood Glucose Records Figure 8-5 8 Figure 8-6 The PDM stores blood glucose records for the past 90 days. You can choose to view individual readings, single-day trends with individual readings, or trends for the previous 7, 14, 30, 60 or 90 days. View single-day trends 1. On the Home screen, use the Up/Down Controller buttons to choose My records, then press Select. 2. Choose BG history, then press Select.
8 Understanding Your Records In the List view, press Event to select individual readings. Readings with a question mark icon (?) next to them have additional information available (Figure 8-7). To see this information, use the Up/Down Controller buttons to choose the reading. Then press the User Info/Support button to view details about that reading (Figure 8-8). Figure 8-7 Figure 8-8 View multiple-day trends 1.
Understanding Your Records 5. For the 7-, 14- and 30-day trends, press Graph to see a graph of the trends (Figure 8-11). (Graphs are not available for 60- or 90-day trends.) Press Stats to return to the detail view. Figure 8-11 Figure 8-12 8 ■ Alarm Records The PDM lists the entire alarm history for the OmniPod System. The PDM can store over 90 days’ worth of alarm records. 1. On the Home screen, use the Up/Down Controller buttons to choose My records, then press Select. 2.
8 Understanding Your Records Figure 8-13 Figure 8-14 2. Choose All history, then press Select. The PDM displays all history for the most recent date (Figure 8-14). 3. Press the Up/Down Controller buttons to see additional days. Press Event to use the Up/Down Controller buttons to scroll through the list of information on the screen. Press Day to use the Up/Down Controller for dates. ■ User Information/Support 3. Press the Up/Down Controller buttons to see additional days.
Understanding Your Records The User Info/Support icon is also displayed on the suggested bolus screen. For information about the support information displayed on these screens, see Chapter 4, Understanding and Delivering Bolus Doses. Figure 8-15 8 Figure 8-16 Add or change user information The first line of My Info displays the information that was entered for the ID screen during your PDM setup.
CHAPTER 9 Living with Diabetes ■ Your Role: Safely Using the OmniPod System Before deciding on the OmniPod® Insulin Management System, you and your healthcare provider discussed the advantages and benefits of the OmniPod System, as well as the responsibilities that come with insulin pump therapy. Remember: safe use begins and ends with you. If you have questions or doubts about being able to safely use the OmniPod System at any time, consult your healthcare provider immediately.
Living with Diabetes ■ Daily Diabetes Management Activities To ensure proper OmniPod System operation and your continued good health: • Check your blood glucose frequently • Inspect the infusion site daily Check your blood glucose frequently When you routinely check your blood glucose level, you can identify and treat high or low blood glucose before it becomes a problem (see “Avoid Lows, Highs and DKA” later in this chapter).
9 Living with Diabetes ■ Prepare for Emergencies Keep an emergency kit with you at all times to quickly respond to any diabetes emergency. The kit should include: • Several new, sealed Pods • Extra new PDM batteries (at least two AAA alkaline) • A vial of rapid-acting U-100 insulin (See the warning on page x of the Introduction for insulins approved for use in the OmniPod System.
9 Living with Diabetes ■ Traveling and Vacationing Plan for changing time zones If you’re planning a vacation or business trip to a different time zone, you may need to adjust your basal rate programs. For changes of just a few hours, basal rate adjustments are minor and easy to calculate. For long-distance travel, however, figuring out the correct program can be more challenging. Your healthcare provider can help with these adjustments.
9 Living with Diabetes Minimize airport security delays With changing airport security checks and screening procedures, you may have questions on how this impacts traveling with your diabetes supplies. Below you will find more information on prepping for travel and what you can expect when going through security checkpoints.
Living with Diabetes 9 Keep supplies accessible On airplanes and trains, keep these items with you, rather than checking them: • Personal Diabetes Manager (PDM) • An emergency kit • Vials of insulin (cargo area temperatures may affect insulin) • A copy of your healthcare provider’s letter (see “Minimize airport security delays”) • Prescriptions for insulin and supplies • Snacks, in case food is not available • Bottled water (especially on planes) to prevent dehydration The name and phone number of a physi
9 Living with Diabetes Symptoms of hypoglycemia Never ignore these symptoms: • Shakiness • Fatigue • Unexplained sweating • Cold, clammy skin • Weakness • Blurred vision or a headache • Sudden hunger • Rapid heart rate • Confusion • Tingling in the lips or tongue • Anxiety • • • • Work with your healthcare provider to establish individualized blood glucose targets and guidelines. Keep a fast-acting carbohydrate with you at all times to respond quickly to low blood glucose.
Living with Diabetes Again, frequent blood glucose checks are the key to avoiding potential problems. Detecting low blood glucose early lets you treat it before it becomes a problem. Check with your healthcare provider for guidance in any and all areas listed above. To treat hypoglycemia (low blood glucose) Any time your blood glucose is low, treat immediately. Check it every 15 minutes while you are treating, to make sure you don’t overtreat the condition and cause blood glucose levels to rise too high.
9 Living with Diabetes Possible causes of hypoglycemia (low blood glucose) Possible cause of low Incorrect basal program Incorrect bolus timing Bolus too large 112 Suggested action Possible cause of low Confirm that correct basal program is active. Confirm that PDM time is set correctly. Consult your healthcare provider about adjusting your basal programs or using a temporary (temp) basal rate. Incorrect target blood glucose levels Take bolus with food.
Living with Diabetes Possible cause of low Suggested action Prolonged or intense exercise Adjust insulin delivery as instructed by your healthcare provider. Check blood glucose before, during and after activity and treat as necessary. Effects of exercise can last several hours—even a full day—after activity ends. Consult your healthcare provider about adjusting your basal programs or using a temporary (temp) basal rate.
9 Living with Diabetes To avoid hyperglycemia (high blood glucose) Check your blood glucose at least 4–6 times a day (when you wake up, before each meal, and before going to bed).
Living with Diabetes 9 Possible causes of hyperglycemia (high blood glucose) Possible cause of high Suggested action Possible cause of high Suggested action Expired insulin Deactivate and remove used Pod. Apply a new Pod filled from a new vial of insulin. Empty Pod Deactivate and remove used Pod. Apply a new Pod in a different location. Incorrect basal program Confirm that correct basal program is active. Confirm that PDM time is set correctly.
9 Living with Diabetes Possible cause of high Suggested action Possible cause of high Suggested action High-protein or high-fat meal Calculate protein/fat intake and account for it in your bolus timing and bolus type. Consult healthcare provider about using the extended bolus option. Weight loss or gain Consult your healthcare provider for guidance. Less activity than normal Consult your healthcare provider about adjusting your basal programs or using a temporary (temp) basal rate.
Living with Diabetes Diabetic ketoacidosis (DKA) Insulin Pods use rapid-acting insulin, so you have no long-acting insulin in your body. If insulin delivery from the Pod is interrupted (an occlusion), your blood glucose can rise rapidly and lead to diabetic ketoacidosis (DKA). DKA is a serious—but totally preventable—emergency that can occur if you ignore high blood glucose levels. If left untreated, DKA can cause breathing difficulties, shock, coma, and eventually death.
9 Living with Diabetes ■ Handling Special Situations • Sick days Any physical stress can cause your blood glucose to rise, and illness is a physical stress. Your healthcare provider can help you make a plan for sick days. The following are only general guidelines. When you are ill, check your blood glucose more often (at least once every 2 hours) to avoid DKA. The symptoms of DKA are much like those of the flu.
Living with Diabetes For some contact sports, you may want to remove the Pod. Be sure to check your blood glucose levels before removing the Pod and after applying a new one. Pods are designed for onetime use. Do not attempt to reapply a used Pod. If possible, avoid wasting Pods by planning removal times that coincide with a scheduled Pod replacement. If you will need to remove the Pod for more than 1 hour, ask your healthcare provider to recommend appropriate guidelines.
CHAPTER 10 Alerts and Alarms ■ Safety Checks The OmniPod System has a very important safety feature: It can check its own functions and let you know when something needs attention. When you turn on the Personal Diabetes Manager (PDM), the System automatically performs a series of safety checks. (Refer to Page 54 for detailed instructions. The ID screen must be confirmed before you can check Pod status.
Alerts and Alarms 10 The following table explains what the message could mean and what you should do. Alert error message Meter Error 1 See user manual for further instructions. Meter Error 2 See user manual for further instructions. Possible causes Action • • • • Blood sample is too small. Problem with the test strip. Problem with the meter. Very low blood glucose: less than 20 mg/dL. 1.
10 Alerts and Alarms Alert error message Meter Error 3 Possible causes • 1. Be sure you see the Blood Drop and Test Strip symbols on the display screen before you apply blood or control solution. 2. Conduct a control solution test using a new test strip. If the results of the control solution test are within the range printed on the side of the test strip vial, retest using blood and a new test strip. 3. If the control solution test does not work or the error persists, call Customer Care.
Alerts and Alarms ■ Alarms The OmniPod System provides alarms to make you aware of serious or potentially serious conditions. When a condition occurs that requires your attention an Advisory Alarm or a Hazard Alarm will sound. Advisory alarms beep intermittently and inform you about a condition that requires your attention. Hazard alarms are continuous tones and occur when either the Pod or PDM is in a serious condition.
10 Alerts and Alarms If you ever need to return the PDM for repair or replacement, contact your healthcare provider for instructions on going back to treatment by injections. Alarm Use the form at the end of this User Guide to write down all your settings from the Setup Wizard. If you ever need to reset your PDM, having these settings handy will make setup very easy. Type Source Beep Pattern Action End of insulin suspend. Press OK to resume basal rate delivery.
Alerts and Alarms Alarm Auto-off. Remove Pod now. 10 Type Source Beep Pattern Action Hazard Alarm Pod and PDM Continuous tone. Pod has been deactivated. Insulin delivery has stopped. Press OK to acknowledge. Change Pod. Check blood glucose. Low reservoir. Replace Pod soon. (This is based on the volume level you selected.) Advisory Alarm Pod and PDM 2 sets of beeps every minute for 3 minutes. Repeats every 60 minutes until acknowledged. Escalates to Empty reservoir hazard alarm when empty.
10 Alerts and Alarms Alarm Pod expiration advisory. Change Pod now. Type Source Beep Pattern Action Advisory Alarm Pod and PDM 2 sets of beeps repeat periodically. Press OK to acknowledge. Repeats every 15 minutes during the last hour of the Pod’s life and is independent of the Expiration notification that you can set. (See Chapter 6, Using the Personal Diabetes Manager.) Change Pod. (See Chapter 5, Using the Pod.) Escalates to Pod expired hazard alarm. Pod expired. Insulin delivery stopped.
Alerts and Alarms Alarm Type Source Beep Pattern Action Occlusion detected. Insulin delivery stopped. Change Pod now. Hazard Alarm Pod and PDM Continuous tone. Press OK to acknowledge. Pod Error. Insulin delivery stopped. Change pod now. Hazard Alarm 10 Change Pod. Check blood glucose. Pod or PDM Continuous tone. This alarm occurs when the Pod detects an unexpected error. Press OK to acknowledge. Change Pod. Check blood glucose. PDM Error. Remove Pod now. Call Customer Care: 800-591-3455.
10 Alerts and Alarms Alarm Type Source Beep Pattern Action PDM Error. Memory corruption. Press “Ok” to reset PDM and delete all user settings. History records will not be deleted. Hazard Alarm PDM Continuous tone. This alarm occurs after the PDM is reset and a memory corruption error occurs. Press OK to acknowledge. System Error. Remove pod now. Call Customer Care: 800-591-3455. Hazard Alarm Change Pod. Check blood glucose. Pod or PDM Continuous tone.
Alerts and Alarms Alarm Type Pod deactivation required. Hazard Alarm Press “Ok” to deactivate. 10 Source Beep Pattern Action PDM Continuous tone. This alarm occurs after a PDM error occurs that requires the user to reset the date and time. Press OK to acknowledge. Change Pod. Check blood glucose. ■ Manual Shut-off of a Hazard Alarm If you respond to a hazard alarm but the PDM cannot communicate with the Pod to acknowledge or shut off the alarm, you can shut off the alarm manually. 1.
CHAPTER 11 Communication Failures ■ The Communication Process ■ Failure During Pod Activation or Operation When you turn on or use the Personal Diabetes Manager (PDM), it establishes communication with the active Pod. Usually, communication occurs quickly. Occasionally, communication takes longer and the PDM displays the communication icon during that time in the upper left-hand corner of the current screen.
Communication Failures Figure 11-1 Figure 11-2 2. Move across the room or to a different room. Then press Retry. a. If you press Retry within 2 minutes, the PDM tries to communicate with the Pod again. If it cannot communicate, it displays the same screen as in Figure 11-2, then finally the “Communication time-out” screen (Figure 113). Press OK to check the Pod status. Figure 11-3 11 Figure 11-4 b. If the status check fails, you will see the screen in Figure 11-4.
11 Communication Failures 3. If at any point in this process the PDM can communicate again with the Pod, you will see either: a. Figure 11-5, indicating that your original instruction or command was successfully sent to the Pod. When you press OK, or within 5 seconds, the System displays the next screen in the command sequence you were entering. b. Figure 11-6, indicating that your last command was not sent to the Pod. Press OK.
Communication Failures 2. Press Discard. The PDM will consider the Pod lost and ask whether you want to activate a new Pod. If you have an unconfirmed correction bolus when you discard a Pod, then the bolus calculator will be temporarily disabled. In this situation, the bolus calculator is disabled until the duration-of-insulin-action period passes (Figure 11-8). If you have any questions, call Customer Care.
11 Communication Failures If the Pod has expired, you will see the screen in Figure 11-11 instead. the “Communication error” screen (Figure 11-12). Figure 11-12 Figure 11-13 Figure 11-11 At either “Pod status not available” screen, press Home to return to the Home screen or press Status to send another status request. ■ Failure During Bolus Cancellation When you instruct the PDM to cancel a bolus, if the PDM cannot send your instruction to the Pod within a few seconds, it displays 134 1.
Communication Failures If your PDM is damaged or not working as expected. contact Customer Care for assistance. Be sure to check your blood glucose frequently. Remove your Pod and contact your healthcare provider for treatment guidelines to follow after you remove it. 3. Move across the room or to a different room. Then either: a. Press Discard to begin the deactivation process. b. Press Retry to repeat the attempts to communicate with the Pod. The PDM tries to communicate with the Pod again.
Appendix The OmniPod® Insulin Management System has no user-serviceable parts. If you require assistance operating or maintaining the System, please call our Customer Care. ■ Pod Care and Maintenance ■ Personal Diabetes Manager Care and Maintenance Storage Store unopened Pods in a cool, dry place. Extreme heat or cold can damage Pods and cause them to malfunction. If Pods are exposed to extreme temperatures, inspect them carefully before use. Pods are sterile unless packaging is opened or damaged.
Appendix Cleaning and disinfecting Keep your PDM test strip port and USB port free of debris and liquids. Dirt, dust, blood, and control solution can impair the functionality of your PDM or damage it. If the battery compartment becomes soiled, gently shake out the debris or use a dry, lint-free cloth to remove it. Do NOT use IV Prep™ wipes, alcohol wipes, soap, detergent, or solvents. Never put any liquid into the battery compartment. The PDM is NOT waterproof.
Appendix The PDM automatically alerts you when its battery power gets low (see Figure A-1). When you see the “Low PDM battery” alert, press OK to turn off the alert. Replace the batteries as soon as you can. Figure A-1 If the batteries run out, data in the memory is at risk. DO NOT remove the old batteries until you have new ones at hand. The PDM protects data in the memory for up to 2 hours after the batteries run out or are removed. Figure A-2 To replace batteries 1.
Appendix 2. Open the battery compartment; remove the batteries and discard them. 3. Use a clean, lint-free cloth to gently absorb any water in the battery compartment. 4. Leave the battery compartment door open until the PDM is thoroughly dry. Never use a blow dryer or hot air to dry the Pod or PDM. Extreme heat can damage the electronics. 5. Do not put in fresh batteries or attempt to use the PDM until it has thoroughly air-dried.
Appendix ■ Suggested Bolus Calculator Examples and Guidelines A suggested bolus is equal to the sum of a correction bolus and meal bolus, then adjusted for insulin on board, if applicable. Examples of each of these elements are shown below.
Appendix Example of meal IOB Duration of insulin action: 3 hours Time since previous meal bolus: 2 hours Previous meal bolus: 4.5 units 3 hours – 2 hours = 1 hour 1 hours ÷ 3 hours = 1/3 1/3 ∗ 4.5 units = 1.5 units meal insulin on board (IOB) In other words, two hours after your previous meal bolus, you have received 3 units of insulin from it; 1.5 units of insulin are still working to cover your meal.
Appendix Example 3 Current BG level: 100 mg/dL Carb intake: 45 carbs Meal IOB: 1 unit Correction insulin on board (IOB): 0 units Correction bolus: 100 mg/dL (current) – 100 mg/dL (target) = 0 0 ÷ 50 (CF) = 0 units Meal bolus: 45 (carbs) ÷ 15 (IC ratio) = 3 units Suggested bolus dose = 0 (correction) + 3 (meal) – 0 (IOB) = 3U Meal IOB is never subtracted from another meal bolus—only from a correction bolus.
Appendix • • • The calculated insulin on board is rounded up to the nearest 0.05U. A reverse correction only occurs if the meal bolus is greater than 0.00U. If your blood glucose value is below the target blood glucose value and you have set reverse correction to On, the suggested correction bolus is subtracted from the suggested meal bolus. If you have set reverse correction to Off, the System will not subtract insulin from the suggested meal bolus dose.
Appendix ■ OmniPod System Options and Settings 12-hour or 24-hour clock MM/DD/YY DD/MM/YY MM.DD.YY DD.MM.YY YY.MM.DD YY-MM-DD Maximum basal rate 30 U/hr Default is 3.00 U/hr Basal programs 7 Basal rate segments 24 per program Basal rate increment 0.
Appendix Bolus presets Carbohydrate presets Suspend Low reservoir volume indicator Pod expiration alert Auto-off alert PDM lock History storage Language 7 36 30 minutes to 2 hours 10 to 50 units in 5-unit increments Default is 10.0 units 1 to 24 hours in 1-hour increments Default is 4 hours 1 to 24 hours or Off in 1-hour increments Default is Off On or Off Default is Off 5400 records/90 days English ■ Pod Specifications Size: 1.53" wide x 2.05" long x 0.57" high (3.88cm x 5.2cm x 1.
Appendix ■ Accuracy Test Results The following graphs are designed to show flow accuracy of the Pod against given time periods. Flow rate from startup The following graph shows changes in the flow rate over the stabilization period. The measurements were made using a Pod with a basal rate of 0.05 U/h at high operating temperature. 146 Flow rate error The following trumpet curve shows the accuracy of the delivery rate in relation to the observation period.
Appendix ■ Personal Diabetes Manager Specifications ■ Blood Glucose Meter Specifications Size: 2.5" wide x 4.5" long x 1.0" high (6.4cm x 11.4cm x 2.5cm) Weight (with batteries): 135 grams (4.76 oz) Screen: 1.4" wide x 1.9" long (3.6cm x 4.8cm); 2.4" diagonal (6.1cm) LCD Battery: Powered by 2 AAA alkaline batteries Battery life: Approximately 3 weeks Operating temperature range: 40° F to 104° F (4.4° C to 40° C) Storage temperature range: -20.
Appendix ■ OmniPod System Label Symbols Symbol Meaning Meaning Do not reuse this device; single-use only Storage temperature Caution: Consult accompanying documents Do not use if package is damaged Refer to Instruction Manual Sterilized by ethylene oxide Manufacture date: (year–month) Lot number Rx ONLY Prescription home-use IVD ■ Personal Diabetes Manager Icons Icon Meaning Icon Meaning Power More actions Reference/reorder number Bolus Communication Device serial number Type BF medical d
Appendix Icon Meaning (Alternating) Hazard alarm Icon Meaning Insulin gauge Alert Apply blood sample/ Blood glucose records PDM lock Setup Wizard Battery 3/4 full Battery full Battery 1/4 full Battery half full Basal program Battery empty “Lost” history record “Unconfirmed” history record “Delivery Spans Midnight” history record User Information/ Support Temperature out of range Active/default program or selected BG tag ■ OmniPod System Notice ConcerningInterference The OmniPod Insulin Mana
Appendix ■ Electromagnetic Compatibility The information contained in this section (such as separation distances) is, in general, specifically written with regard to the OmniPod System. The numbers provided will not guarantee faultless operation but should provide reasonable assurance of such. This information may not be applicable to other medical electrical equipment; older equipment may be particularly susceptible to interference.
Appendix Electromagnetic Emissions This equipment is intended for use in the electromagnetic environment specified below. The user of this equipment should assure that is used in such an environment. Emissions Compliance according to Electromagnetic environment RF Emissions (CISPR 11) Group 2 The Pod and the PDM emit low level electromagnetic energy (RF) in order to communicate. Although unlikely, nearby electronic equipment may be affected.
Appendix Radiated RF (IEC 61000-4-3) 80 MHz–2.5 GHz Electromagnetic Immunity (Continued) 10 V/m Portable and mobile RF communications equipment should be used no closer to any part of the System than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter as below. Recommended separation distance: d=1.17 √P d=0.35/ √P 80 MHz to 800 MHz d=0.7 √P 800 MHz to 2.
Appendix Recommended Separation Distances Between Portable and Mobile RF Communications Equipment and the System You can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment (transmitters) and the System, as recommended below, according to the maximum output power of the communications equipment.
Appendix ■ Customer Bill of Rights Mission Statement Insulet Corporation is dedicated to designing, developing, and distributing products that provide superior treatment options and lifelong health benefits for people with diabetes. Scope of Services Insulet Corporation’s scope of services is limited to providing the OmniPod Insulin Management System.
Appendix Customer’s Bill of Rights and Responsibilities You have the right to: 1. Receive considerate and respectful service. 2. Receive service without regard to race, creed, national origin, sex, age, disability, sexual orientation, illness, or religious affiliation. 3. Expect confidentiality of all information pertaining to you, your medical care and service. Please review our HIPAA Privacy Notice later in this section. 4. Receive a timely response to your request for service. 5.
Appendix ■ Limited Warranty for the Personal Diabetes Manager Limited Warranty Coverage Insulet Corporation warrants to the original purchaser (“you”) that the Personal Diabetes Manager (the “PDM”) will be free from defects in materials and workmanship, under normal use and conditions, for a period of four (4) years from the date of purchase.
Appendix ■ HIPAA Privacy Notice THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION IS USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO IT. PLEASE REVIEW IT CAREFULLY.
Appendix Appointment Reminder and Other Communications: We may use or disclose your Medical Information without your prior written authorization to provide you or others with, among other things: (i) appointment reminders; (ii) product/supply reorder notifications; and/or (iii) information about treatment alternatives or other health-related products and services that we provide.
Appendix repairs, or replacement, or lookback (including locating and notifying individuals who have received products that have been recalled, withdrawn, or are the subject of lookback); or (iv) to conduct post-marketing surveillance.
Appendix Required Uses and Disclosures: Under the law, we must make disclosures to you when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of HIPAA. Nonidentifiable Information: We may use or disclose your Medical Information if we have removed from it any information that is personally identifiable to you.
Appendix Your request must state the specific restriction requested and to whom you want the restriction to apply. We are not required to agree to a restriction that you may request, but if we do agree to the requested restriction, we may not use or disclose your Medical Information in violation of that restriction unless it is needed to provide emergency treatment. If you would like to request a restriction of the use of your Medical Information, please download our Request Form at http://www.myomniPod.
Appendix Our Duties Generally: We are required by law to maintain the privacy and security of your Medical Information and to provide you with notice of our privacy practices with respect to Medical Information. Revisions and Modifications: We may change our HIPAA Privacy Notice at any time. Before we make a significant change in our policies, we will change this HIPAA Privacy Notice and post our new notice (the “Revised HIPAA Privacy Notice”).
Glossary A1c (see Hemoglobin A1c) Advisory alarm Notification by the PDM that a serious condition exists. Aseptic technique A method for maintaining sterilization and preventing contamination. Basal program One or more basal rates that together cover a 24-hour period from midnight to midnight. Basal rate A small base or background amount of insulin that is delivered, at a preset rate, continuously for a specified period of time. Basal rates are measured in units per hour (U/hr).
Glossary Calorie A unit of measurement used to express the energy value of food. Calories come from carbohydrate, protein, fat, and alcohol. Cannula A small, thin tube inserted below the skin, which serves to introduce a liquid medication into the body. Carbohydrate (carb) One of the three main nutrients found in food. (The other two are protein and fat.) Foods that contain carbohydrates include starches, sugars, vegetables, fruits, and dairy products.
Glossary Diabetes Control and Complications Trial (DCCT) A study by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), conducted from 1983 to 1993 in people with type 1 diabetes, which showed that good blood glucose control significantly helped prevent or delay diabetes complications. Diabetes, diabetes mellitus A condition characterized by hyperglycemia (high blood glucose) resulting from the body’s inability to use blood glucose for energy.
Glossary Hazard alarm Notification by the PDM that a dangerous condition exists. Infusing Introducing a liquid substance under the skin into the body. Healthcare provider A professional who practices medicine or teaches people how to manage their health. All healthcare providers are a resource for valuable diabetes management information. Hemoglobin A1c (HbA1c) A test that measures a person’s average blood glucose level over the past 2 to 3 months.
Glossary Insulin-to-carbohydrate ratio (IC) Number of grams of carbohydrate covered by one unit of insulin. For example, if your insulin-to-carbohydrate ratio is 1:15, then you need to deliver one unit of insulin to cover every fifteen grams of carbohydrate you eat. In vitro Literally, “in glass.” Refers to a biological function taking place in a laboratory dish rather than in a living organism.
Glossary Reverse correction (negative correction) Using an individual’s correction factor (sensitivity factor), the reverse correction is a calculation that reduces a portion of a meal bolus dose when the patient’s blood glucose level is below their blood glucose target. This feature is an option in the OmniPod® Insulin Management System, which should be turned on or off according to the advice of a healthcare provider.
Index A activate a new Pod. . . . . . . . . . . . . . . 43–57 active insulin . . . . . . .See insulin on board add basal segment or rate . . . . . . . . . 17–21 bolus reminder. . . . . . . . . . . . . . . . . . . . 68 custom reminders. . . . . . . . . . . . . . . . . 68 user information . . . . . . . . . . . . . . . . 104 adhesive . . . . . . . . . . . . . . . . . . . . . . . . . . 4, 50 remover. . . . . . . . . . . . . . . . . . . . . . . . . . . 45 advisory alarms . . . . . . . . . .
Index level. . . . . . . . . . . . . . . . . . . . . . . . . . 28, 165 monitoring. . . . . . . . . . . . . . . . . . . . . . xi, 2 sound . . . . . . . . . . . . . . . . . . . . . . . . . 12, 70 test sites. . . . . . . . . . . . . . . . . . . 77, 88–89 test strip. . . . . . . . . . . . . . . . . . . . . . . . . . .86 blood glucose meter. . . . . .2, 77–96, 165 error messages. . . . . . . . . . . . . 121–123 readings. . . . . . . . . . . . . . . . . . . . . . . . 3, 91 settings . . . . . . . . . . . . . . . .
Index user information . . . . . . . . . . . . . . . . 104 check alarms. . . . . . . . . . . . . . . . . . . . . . . . . 73 check blood glucose. . . . . . . . . . . . . 77–96 cleaning . . . . . . . . . . . . . . . . . . . . . . .138, 139 clock 12-hour or 24-hour. . . . . . . . . . . . . . . . 61 code number, test strip vial . . . . . . 82, 88 communication distance to Pod . . . . . . . . . . . . . . 75, 149 interruption . . . . . . . . . . . . . . . . . . 76, 132 communication failure . . . . . . .
Index bolus reminder. . . . . . . . . . . . . . . . . . . .68 carb presets . . . . . . . . . . . . . . . . . . . . . . .41 electrical interference. . . . . . . . . . . . . . . .76 electrical safety . . . . . . . . . . . . . . . 152–155 electromagnetic compatibility 152–155 electromagnetic fields . . . . . . . . . . . . . . .76 emergency kit . . . . . . . . . . . .105, 107, 108 empty reservoir hazard alarm. . . . . . 126 enable basal program. . . . . . . . . . . . . . . . . . . . .19 bolus preset. . . . . .
Index color . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 set. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 illness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 infection . . . . . . . . . . . . . . . . . . . . . . . . 56, 106 infusion set, automated insertion. . . . . 2 infusion site. . . . . . . . . . . . 49, 56, 106, 168 infusion site, inspection. . . . . . . . . . . . 106 insulin . . . . . . 16, 28, 43, 46, 47, 107, 109, 141, 168 insulin action .
Index cancel . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24 enable . . . . . . . . . . . . . . . . . . . . . . . . . . . .23 operating temperatures . . . 75, 147, 149 options Bolus calcs . . . . . . . . . . . . . . . . . . . . . . . .62 Extended. . . . . . . . . . . . . . . . . . . . . . . . . .65 Max basal rate. . . . . . . . . . . . . . . . . . . . .65 Max bolus . . . . . . . . . . . . . . . . . . . . . . . . .65 Ratios/factors/targets . . . . . . . . . . . . .64 Temp basal. . . . . . . . . .
Index R radio interference. . . . . . . . . . . . . . . . . . . . 76 rapid-acting insulin . . . . . . . . . . . . . . . . 118 Ratios/factors/targets option . . . . 64–65 record keeping . . . . . . . . . . . . . . 3, 97–104 record screens . . . . . . . . . . . . . . . . . .97–104 alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . 102 all . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 blood glucose. . . . . . . . . . . . . . . . . . . 100 carbohydrates. . . . . . . . . . . . . . .
Index surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 suspend insulin delivery . . . . . . . . . . . . .54 symbols in history records. . . . . . . . . . . . . . . . . .97 on screen . . . . . . . . . . . . . . . . . . . . . . . 150 System labels . . . . . . . . . . . . . . . . . . . 150 symptoms DKA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118 hyperglycemia . . . . . . . . . . . . . . . . . . 114 hypoglycemia. . . . . . . . . . . . . . . .
My PDM Settings Use this form to keep track of your important PDM settings. Remember to update your information as you change or add settings.
My PDM Settings Duration of Insulin Action Time that insulin will remain “active” in the body from a previous bolus. Temp Basal Presets Name ___________ hrs Correction Factor Correction factor for each time segment defined, starting at midnight.