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mp6024875_012_a.book Page 2 Monday, June 23, 2003 10:54 AM © 2003, Medtronic MiniMed. All rights reserved. BD Logic™ is a trademark of Becton, Dickinson and Company Dual Wave™ is a trademark of Medtronic MiniMed. Easy Bolus™ is a trademark of Medtronic MiniMed. Energizer® is a trademark of Eveready Battery Company. Glucagon Emergency Kit® is a trademark of Eli Lilly and Company. Paradigm® is a trademark of Medtronic MiniMed. Paradigm Link™ is a trademark of Medtronic MiniMed.
mp6024875_012_a.book Page i Monday, June 23, 2003 10:54 AM PLEASE READ THIS ENTIRE USER GUIDE BEFORE YOU TRY TO OPERATE YOUR PUMP.
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mp6024875_012_a.book Page i Monday, June 23, 2003 10:54 AM Table of contents Glossary .............................................. i Your personal information ........................... v Basal rate ............................................................................................................. v Insulin type ........................................................................................................ vi Carb ratios (meal bolus info) ..............................................
mp6024875_012_a.book Page ii Monday, June 23, 2003 10:54 AM The pump screen ..............................................................................................7 Is my pump on? ..................................................................................................... 7 Scroll bar .................................................................................................................. 7 Screen backlight ...........................................................................
mp6024875_012_a.book Page iii Monday, June 23, 2003 10:54 AM Basal ....................................................................................................................23 Start and stop times ........................................................................................ 23 Your basal settings ............................................................................................24 Basal programming and delivery ..................................................................
mp6024875_012_a.book Page iv Monday, June 23, 2003 10:54 AM Using your daily journal ................................................................................46 Chapter 5 Using Bolus Wizard ..................49 What is it? ......................................................................................................... 49 Information you need... ................................................................................ 49 Food entry ..................................................
mp6024875_012_a.book Page v Monday, June 23, 2003 10:54 AM Square Wave or Dual Wave bolus without Bolus Wizard ................... 68 Using Bolus Wizard for a Square Wave or Dual Wave bolus ............. 72 Easy bolus ..........................................................................................................74 Easy bolus setup ................................................................................................. 74 Step value setup ................................................
mp6024875_012_a.book Page vi Monday, June 23, 2003 10:54 AM Personal reminders ........................................................................................ 94 Alarm clock ...........................................................................................................94 Remote control option ................................................................................. 94 Turn on remote control option .....................................................................
mp6024875_012_a.book Page vii Monday, June 23, 2003 10:54 AM Auto off ............................................................................................................... 108 Batt out limit ...................................................................................................... 108 Bolus stopped .................................................................................................... 108 Button error .......................................................................
mp6024875_012_a.book Page viii Monday, June 23, 2003 10:54 AM Precautions ..................................................................................................... 116 Precautions - infusion sets and sites ......................................................... 116 Notice ................................................................................................................117 Insulin pump and RF accessories .................................................................
mp6024875_012_a.book Page ix Monday, June 23, 2003 10:54 AM Occlusion detection .................................................................................... 122 Percent temp basal ..................................................................................... 122 Power supply ................................................................................................. 122 Prime function ...............................................................................................
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mp6024875_012_a.book Page xi Monday, June 23, 2003 10:54 AM Practice lessons and examples Bolus examples Meal bolus Example #1 Normal meal bolus using the exchange system ................................................ 16 Bolus practice: ................................................................................................................................ 16 Normal meal bolus practice using exchanges: .........................................................................
mp6024875_012_a.book Page xii Monday, June 23, 2003 10:54 AM Bolus Wizard examples Example #1: Bolus Wizard, BG on target (normal BG) ..........................................................64 Example #2: Bolus Wizard, BG above target (high BG) .......................................................64 Example #3: Bolus Wizard, Blood glucose below target (low BG) .....................................65 Example #4: Bolus Wizard, Blood glucose above target (high BG) with active insulin .
mp6024875_012_a.book Page i Monday, June 23, 2003 10:54 AM Glossary A Accept - Pressing the ACT button to approve the selection or setting. Active Insulin -Bolus insulin that has been delivered to your body, but has not yet been used. Alarm -Audible or vibrating (silent) notice that indicates the pump is in Attention mode and immediate attention is required. Alarms are prefixed in the alarm history with the letter A. Alarm clock- Feature you can set to go off at specified times of the day.
mp6024875_012_a.book Page ii Monday, June 23, 2003 10:54 AM Correction bolus - The amount of insulin needed to return a high blood glucose level back down to target range. Correction bolus factor - How much 1.0 unit of insulin will lower your blood glucose. This factor is used to calculate a correction bolus amount when your blood sugar is high. (BG level) – (BG target) = X.
mp6024875_012_a.book Page iii Monday, June 23, 2003 10:54 AM 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 the Paradigm Link meter.
mp6024875_012_a.book Page iv Monday, June 23, 2003 10:54 AM S Scroll - Press the up or down arrow buttons to move through the screen text. Select - Pressing the up or down arrow buttons to highlight a desired screen item. Set bolus - Selectable item available in the BOLUS MENU when Bolus Wizard is inactive. One method of programming a bolus without Bolus Wizard.
mp6024875_012_a.book Page v Monday, June 23, 2003 10:54 AM Your personal information You may need the following information from your healthcare professional before going to your pump start appointment. If you are unsure, contact your healthcare professional or pump trainer for instructions. NOTE - This information is not for the Bolus Wizard. Refer to chapter 5 for Bolus Wizard settings. Basal rate Standard Basal insulin is required to maintain your target glucose values when you are not eating.
mp6024875_012_a.book Page vi Monday, June 23, 2003 10:54 AM Insulin type Your pump is sent from the factory with the insulin type set to U100 fast acting. The insulin type can also be set to U100 regular acting. Carb ratios (meal bolus info) Your carb ratios are used to calculate your meal boluses. If you count grams: this ratio is the number of carb grams covered by one (1) unit of insulin. If you count exchanges: this ratio is the number of insulin units you need to cover one carb exchange.
mp6024875_012_a.book Page vii Monday, June 23, 2003 10:54 AM Introduction Thank you for choosing Medtronic MiniMed as your partner in helping you gain better control of your diabetes. Whether you are beginning pump therapy for the first time or upgrading from a previous model, we believe that the combination of state-of-the-art technology and the simple, menu-driven programming of the pump will provide many benefits.
mp6024875_012_a.book Page viii Monday, June 23, 2003 10:54 AM How to use this guide For step-by-step instructions, refer to the applicable sections in this guide. Refer to the Glossary for defintions of terms and functions. The terms and symbols used in the step-by-step instructions are in the table below.
mp6024875_012_a.book Page 1 Monday, June 23, 2003 10:54 AM Chapter 1 Before you begin... Availability The pump and accompanying products are available from Medtronic MiniMed and authorized distributors. Assistance Medtronic MiniMed provides a 24-hour Product Help Line for assistance. The Help Line is staffed with technicians who are trained in the set-up and operation of the pump and are able to answer pumprelated questions.
mp6024875_012_a.book Page 2 Monday, June 23, 2003 10:54 AM Reservoir and infusion sets The Medtronic MiniMed Paradigm infusion system includes the pump, reservoirs and infusion sets. The pump is intended for use with a Paradigm reservoir. Medtronic MiniMed provides a variety of Paradigm infusion sets to fit your needs. Installation instructions for Paradigm reservoir and infusion sets are provided in chapter 4.
mp6024875_012_a.book Page 3 Monday, June 23, 2003 10:54 AM Chapter 2 The basics... Your pump CAUTION: Never use sharp objects to press the buttons on your Paradigm pump as this can damage the buttons or compromise the watertight seal of the pump. Some examples of sharp objects that may damage your keypad are fingernail files, pens or pencils, paperclips, knives, scissors, and keys. Take a look at your pump. The reservoir window allows you to view the insulin in the reservoir.
mp6024875_012_a.book Page 4 Monday, June 23, 2003 10:54 AM Install battery CAUTION: Do not use a rechargeable or carbon zinc battery in your pump. A new AAA Alkaline Energizer battery is strongly recommended. The use of any other battery type may not offer the same battery performance. Medtronic MiniMed designed the pump to only accept a NEW battery. As a safety measure, if you install a battery that does not have full power, the “failed batt test” alarm will sound. The pump uses one AAA alkaline battery.
mp6024875_012_a.book Page 5 Monday, June 23, 2003 10:54 AM 5. While the pump turns on, it will show various screens until the HOME screen appears. MiniMed MiniMed 7 MiniMed MiniMed Ver 1.2A (HOME screen) If the HOME screen does not appear, do these steps: a. Check that the battery is inserted correctly. If the battery has been installed backwards, remove the battery and install a NEW battery. b.
mp6024875_012_a.book Page 6 Monday, June 23, 2003 10:54 AM 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.) From the HOME screen... (Easy Bolus button) Shortcut to set and deliver an Easy Bolus. Turns the backlight on/off. Opens the MAIN MENU.
mp6024875_012_a.book Page 7 Monday, June 23, 2003 10:54 AM 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.
mp6024875_012_a.book Page 8 Monday, June 23, 2003 10:54 AM 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. in the HOME screen, the area below “MiniMed” is blank.
mp6024875_012_a.book Page 9 Monday, June 23, 2003 10:54 AM 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 caused the alarm. Refer to the section, “Alarm conditions” in chapter 9 for the conditions that will trigger the Attention mode. When the pump is in “Attention mode,” all insulin deliveries are stopped. Menus The MAIN MENU is the highest level menu.
mp6024875_012_a.book Page 10 Monday, June 23, 2003 10:54 AM STATUS screen The STATUS screen shows information about what your pump is doing. The information that shows on the STATUS screen depends on the current activities and conditions of your pump.
mp6024875_012_a.book Page 11 Monday, June 23, 2003 10:54 AM Alert conditions Your pump has a sophisticated network of safety checks and systems. If it detects an unusual condition that requires your immediate attention, it will beep or vibrate periodically to alert you. The pump will go into Special mode (open circles will display), and the backlight will illuminate. Additionally, the alert message will appear on the screen.
mp6024875_012_a.book Page 12 Monday, June 23, 2003 10:54 AM Alerts for special features Some features put the pump in Special mode, letting you know that an extended feature is active. When the feature is no longer active, the pump will return to Normal mode. Your pump will alert you (with open circles) if any of these extended features are active: Dual Wave or Square Wave bolus delivery ➠ Pattern A or B is active ➠ MiniMed Temp basal delivery ➠ Block feature is on ➠ If you remove your pump...
mp6024875_012_a.book Page 13 Monday, June 23, 2003 10:54 AM Chapter 3 Basic programming Setting the time and date Setting the correct time and date in your pump is necessary for accurate basal insulin delivery and allows you to keep an accurate record of your insulin delivery and other pump functions. You can select a 12-hour or 24-hour clock. You must reset the time and date if you receive a CHECK SETTINGS alarm or you clear your pump (Clear Pump function). 1. Go to the TIME/DATE SETUP screen.
mp6024875_012_a.book Page 14 Monday, June 23, 2003 10:54 AM 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. MiniMed TIME SET AT 8:33 AM 26FEB2003 After a “clear pump” function only: The TIME DATE CORRECT? screen will appear after you set the DAY. Select Yes to confirm the settings and press ACT. Your time/date settings are complete.
mp6024875_012_a.book Page 15 Monday, June 23, 2003 10:54 AM Bolus There are three bolus types: Normal, Square Wave, and Dual Wave. This section gives instructions for a Normal bolus using the express bolus button and navigating through the menus. (For information about Square Wave and Dual Wave boluses, refer to chapter 6, “Optimizing pump therapy.”) The Normal bolus delivers an immediate food or correction bolus. It can be delivered at any time except during another Normal bolus.
mp6024875_012_a.book Page 16 Monday, June 23, 2003 10:54 AM NOTE - The pump will beep/vibrate at the start of the bolus. When the bolus is finished, the pump will beep/vibrate again and the HOME screen will appear. MiniMed Example #1 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.
mp6024875_012_a.book Page 17 Monday, June 23, 2003 10:54 AM Example #2: 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 2/3 cup of rice ½ cup cooked broccoli 1 oz.
mp6024875_012_a.book Page 18 Monday, June 23, 2003 10:54 AM Example #3: Meal bolus, correction bolus and insulin sensitivity 3a. Jason is ready to eat his breakfast. He has calculated that he will need 4.0 units for his food. He tests his blood glucose and finds that it is 200 mg/dl (11 mmol/L). Jason knows that his blood glucose level is above his pre-meal blood glucose target and will need additional insulin before he eats.
mp6024875_012_a.book Page 19 Monday, June 23, 2003 10:54 AM Practice: Meal bolus You have determined your meal bolus as: _______ units. Your pre-meal target blood glucose range is: _______ to _______ (average is _______ ). Your current blood glucose level is: _________. Your correction factor is: 1 unit of insulin will drop your BG _________. You will take ________ unit(s) of insulin to correct your high BG level. Your total bolus (meal bolus plus correct bolus is _________.
mp6024875_012_a.book Page 20 Monday, June 23, 2003 10:54 AM 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.