mp6024875_012_a.book Page 21 Monday, June 23, 2003 10:54 AM Bolus details You can view the details for any of the deliveries in the BOLUS HISTORY screen. The details include: ➠ bolus type: N (Normal), S (Square), D (Dual), DS (Dual Square portion), DN (Dual Normal portion). ➠ programmed bolus amount ➠ delivered bolus amount Bolus Wizard information (if used) To see the details for any bolus, do these steps: ➠ 1. In the BOLUS HISTORY screen, select the bolus that you want to review and press ACT. 2.
mp6024875_012_a.book Page 22 Monday, June 23, 2003 10:54 AM Maximum bolus limit The maximum bolus (max bolus) is a safety feature that limits the amount of insulin that can be delivered in a single bolus. The factory setting is 10.0 units. You can specify the limit from 0.0 to 25.0 units. It is important to discuss this feature with your healthcare professional to determine your maximum bolus amount. To set the maximum bolus limit, do these steps: 1. Go to the MAX BOLUS SETUP screen.
mp6024875_012_a.book Page 23 Monday, June 23, 2003 10:54 AM Basal Basal insulin is required to maintain your target glucose values when you are not eating. Your healthcare professional will calculate this rate for you. Your basal insulin should account for approximately one half of the body’s total daily insulin requirements. Your pump mimics your pancreas by delivering insulin continuously over 24-hours. You can set your insulin pump to change rates during the day to match your needs.
mp6024875_012_a.book Page 24 Monday, June 23, 2003 10:54 AM Your basal settings You must program your basal settings before you can deliver basal insulin. Keep a written record of your basal settings. It is recommended that you set your basal rates with the assistance of your healthcare professional. If you plan to take off your pump for an extended period of time, i.e. more than a day, set the basal rate to 0.0U/H. This will ensure that the insulin delivery records in your pump are accurate.
mp6024875_012_a.book Page 25 Monday, June 23, 2003 10:54 AM a. In the SET START TIME 2 screen, enter the start time for the next rate and press ACT. b. The SET BASAL RATE 2 screen will appear. Enter the rate and press ACT. c. Repeat steps a and b for each additional basal rate. Each rate will have a different number (i.e. Basal Rate 1, Rate 2, Rate 3, etc.). MiniMed SET START TIME 2 --:-- _._ _ MiniMed U ACT _.
mp6024875_012_a.book Page 26 Monday, June 23, 2003 10:54 AM Basal review Temporary basal information is only available in the STATUS screen. Current basal delivery The STATUS screen shows your current basal information. MiniMed standard basal is the current basal STATUS 2:12P U100fast Last Bolus N 3.8U 9:07A 11 NOV Basal 1: 0.80 U/H Units Remaining: 128U Battery: Normal Remote: On Tue 11 NOV 2002 S/N #000000 Model 512 VER 1.2A 1.
mp6024875_012_a.book Page 27 Monday, June 23, 2003 10:54 AM 2. If you do not use patterns: If you use patterns: The delivery details for your standard The screen will show the basal patterns. The current basal pattern will be highlighted. basal will appear. Select pattern you want to view. Press ACT. MiniMed STANDARD 16.80 U The start time and units for each deliv0.60U/H 1) 12:00A ery rate in that pattern will appear. 2) 11:30A 1.00U/H 3) 12:00P 0.
mp6024875_012_a.book Page 28 Monday, June 23, 2003 10:54 AM Max basal rate Maximum basal rate is a safety limit for the amount of basal insulin that is able to be delivered per hour. This maximum rate will apply to every basal that is set, including a temporary basal. It is important to discuss what your max (maximum) basal rate should be with your healthcare professional. Your pump is sent from the factory with the maximum basal set to two (2.0) units per hour.
mp6024875_012_a.book Page 29 Monday, June 23, 2003 10:54 AM Stopping your pump You can stop your pump with the suspend function. Suspend stops all insulin delivery including the current basal and any bolus or prime deliveries that are in progress. While suspended, your pump will not deliver insulin until you Resume your pump. When basal is resumed, the pump is taken out of the Suspend mode. The pump will beep or vibrate about every 15 minutes on the hour to remind you that it is not delivering insulin.
mp6024875_012_a.book Page 30 Monday, June 23, 2003 10:54 AM Example: Suspend function 1. Josh has been on a Medtronic MiniMed pump for several months. He is very active in soccer and basketball. He and his healthcare professional have determined that he does not need his basal insulin during his games, and that he is able to take the pump off for these short amounts of time. Josh uses the “Suspend” feature on his pump to stop the basal insulin during the time that he is disconnected from his pump.
mp6024875_012_a.book Page 31 Monday, June 23, 2003 10:54 AM Resume pump delivery When the pump is suspended, it defaults to the HOME screen with solid circles. Do these steps to resume your pump and basal delivery: 1. From any screen, press ACT until the RESUME screen appears. Press ACT again. 2. Your pump will beep once, then the HOME screen will appear (with no circles). NOTE - A bolus or fixed prime that was stopped by suspend will not restart when you resume your pump.
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mp6024875_012_a.book Page 33 Monday, June 23, 2003 10:54 AM Chapter 4 Starting on insulin Prepare your pump for use Before continuing with the steps in this chapter, we recommend that you watch your pump training video and complete your pump start training (U.S. only). NOTE - Your pump is in a “training mode” when it is sent to you. It has limited functions while in this mode. When you rewind your pump for the first time, the training mode is canceled and all pump functions become available.
mp6024875_012_a.book Page 34 Monday, June 23, 2003 10:54 AM Filling the reservoir WARNING: Your pump will not accurately deliver insulin if air bubbles are in the reservoir or the infusion set. To prevent this, take care to remove air bubbles when filling your reservoir. 1. Remove reservoir from package. Make sure plunger rod is fully extended. plunger rod reservoir 8 transfer guard 3. Snap transfer guard into locked position. locked “CLICK” 34 Chapter 4 2. Swab vial with alcohol.
mp6024875_012_a.book Page 35 Monday, June 23, 2003 10:54 AM 5. With the vial up, slowly pull down on the plunger to fill the reservoir. 6. Tap the side of the reservoir to make any air bubbles rise to the top of the reservoir. 7. Slowly push up on the plunger just enough to remove any air bubbles from the reservoir. Slowly pull down on the plunger to completely fill the reservoir. 8.
mp6024875_012_a.book Page 36 Monday, June 23, 2003 10:54 AM Changing your infusion set Removing the reservoir Each time you remove and replace a reservoir in your pump, you have to rewind and prime your pump. Priming requires insulin. 1. Remove the entire infusion set from your body. 2. If attached, remove the activity guard. 3. Turn the tubing connector 1/2-turn counterclockwise, then pull the reservoir and connector out from the pump. 4. Safely dispose of the used reservoir and infusion set items. 5.
mp6024875_012_a.book Page 37 Monday, June 23, 2003 10:54 AM Rewinding your pump Before you continue, make sure the pump is NOT connected to your body. WARNING: Make sure the infusion set is disconnected from your body before you rewind or prime the pump. Never insert the reservoir into the pump while the tubing is connected to your body. Doing so could result in an accidental infusion of insulin. 1. If you removed your reservoir and are replacing it, go to the REWIND screen.
mp6024875_012_a.book Page 38 Monday, June 23, 2003 10:54 AM Inserting the reservoir in your pump If your reservoir is already inserted in your pump, continue to the next section, “Manual prime.” You must do these steps in the order described. Your pump screen will show instructions to help you with these steps. If you are practicing, do NOT insert the reservoir in your pump. CAUTION: You must rewind your pump before installing a new reservoir.
mp6024875_012_a.book Page 39 Monday, June 23, 2003 10:54 AM Manual prime Manual prime fills the infusion set tubing with insulin before you attach it to the infusion site. Manual prime is only available after you rewind your pump. WARNING: Make sure the infusion set is disconnected from your body before you press ACT to prime the pump. Never insert the reservoir into the pump while the tubing is connected to your body. Doing so could result in an accidental infusion of insulin. 1.
mp6024875_012_a.book Page 40 Monday, June 23, 2003 10:54 AM MiniMed IS PRIMING COMPLETE? If your manual prime uses more than 30U insulin, the pump will ask you, “is priming complete?” If you get this message, do these steps: Disconnect from body. See user guide for instruction. ESC, ACT to clear a. Make sure you are not connected to the pump. b. Read the message on the screen, then press ESC, ACT to clear. c.
mp6024875_012_a.book Page 41 Monday, June 23, 2003 10:54 AM Quick-set Plus infusion set (with Quick-serter) Instructions are also included with the infusion set. 1. Wash your hands. 3. 6. 2. Clean and dry the infusion site. 4. 5. 7.
mp6024875_012_a.book Page 42 Monday, June 23, 2003 10:54 AM 8. 11. 42 Chapter 4 9. 10. 12.
mp6024875_012_a.book Page 43 Monday, June 23, 2003 10:54 AM Disconnecting Quick-set Plus The Quick-set Plus allows you the freedom to temporarily disconnect from your pump without removing the infusion set from your body. Squeeze the side grips of the connector part with your fingers. Remove the connector from the site. Reconnecting Quick-set Plus Place the connector part (flat-side facing down) on the infusion set until it is fully seated. Do not grip the connector part by the flat side-grips.
mp6024875_012_a.book Page 44 Monday, June 23, 2003 10:54 AM Fixed prime A fixed prime fills the soft cannula with insulin and is required after the infusion set is inserted into your body. You will start the fixed prime after the introducer needle is removed. Additionally, a fixed prime is required if you disconnect your quick release and you need to reprime the infusion set or if you change your infusion set without changing the reservoir.
mp6024875_012_a.book Page 45 Monday, June 23, 2003 10:54 AM Prime history Do these steps to see a list of the delivered primes. 1. Go to the PRIME MENU. Main > Prime 3. The PRIME HISTORY screen will appear. 2. Select Prime History and press ACT. MiniMed MiniMed PRIME MENU Fixed Prime Rewind Prime History M manual prime 4. Scroll through the list of prime deliveries. The “F” at the end of the text line indicates a fixed prime. An “M” indicates a manual prime. Exit the menus.
mp6024875_012_a.book Page 46 Monday, June 23, 2003 10:54 AM Determining your pump settings Your healthcare professional will use your daily blood glucose journal records to program your pump. It is very important to keep good records during the first weeks after you start on pump therapy. Not only must you record your blood glucose readings, but it will be important to eat regularly scheduled meals and to keep your activity as consistent as possible.
mp6024875_012_a.book Page 47 Monday, June 23, 2003 10:54 AM 8. Record the food you eat in the “breakfast,” “lunch,” and “dinner” columns. 9. In the “notes” section, write down any information that may explain your blood glucose values or diabetes management decisions. Use this section as you would a personal journal. 10. At the end of the journal, there are blood glucose graphs.
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mp6024875_012_a.book Page 49 Monday, June 23, 2003 10:54 AM Chapter 5 Using Bolus Wizard What is it? The Bolus Wizard is an optional feature of the pump that calculates an estimated bolus: ➠ to support your food intake AND/OR ➠ to correct high blood glucose Information you need... Food entry You need to know how many exchanges or grams of carbohydrates you are going to eat. (You need to know what foods contain carbohydrate and understand carbohydrate counting.
mp6024875_012_a.book Page 50 Monday, June 23, 2003 10:54 AM Make sure you receive your Bolus Wizard settings from your healthcare professional. Bolus Wizard settings table Name:_________________________________ Date: __________ Refer to this table when you setup the Bolus Wizard as described in the section, “How to program Bolus Wizard.” Information Carb units: Carb ratios: Bolus Wizard uses this for your food bolus calculations.
mp6024875_012_a.book Page 51 Monday, June 23, 2003 10:54 AM Bolus wizard settings table (continued) Name:_________________________________ Date: ______________ Information Insulin sensitivity: Bolus Wizard uses this ratio for your correction bolus calculations. Setting BG units reduced / 1 unit of insulin start time #1: _________ (midnight) #2: _________ This ratio is the BG units reduced by 1.0 unit of insulin range: 10 – 250 mg/dL or 0.5 - 13.
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mp6024875_012_a.book Page 53 Monday, June 23, 2003 10:54 AM About maximum delivery Bolus Wizard will not deliver more than the limit set for your maximum bolus. If Bolus Wizard calculates a bolus amount that is larger than your max bolus limit setting, the message, “MAX BOLUS EXCEEDED” will appear. If this happens, do these steps: 1. In the MAX BOLUS EXCEEDED screen, press ACT to continue your bolus programming. The estimate and maximum bolus amounts will appear for your information. Continue to step 2.
mp6024875_012_a.book Page 54 Monday, June 23, 2003 10:54 AM How to program Bolus Wizard You need your personal settings fron the Bolus Wizard settings table to setup the Bolus Wizard. Your Bolus Wizard settings are programmed in the EDIT SETTINGS screen. Main > Bolus > Bolus Wizard Setup > Edit Settings Once the settings are programmed, you do not have to program them again unless the values change. After you program one setting, the screen will automatically go to the next required setting.
mp6024875_012_a.book Page 55 Monday, June 23, 2003 10:54 AM Carb/Exch ratios If you use grams as your carb units: Carb ratio is the number of carb grams that are covered by one unit of insulin. If you use exchanges as your carb units: Carb ratio is the number of insulin units that are needed to cover one (1.0) carb exchange. Because this ratio may vary throughout the day, your pump allows you to set up to eight (8) settings.
mp6024875_012_a.book Page 56 Monday, June 23, 2003 10:54 AM 7. The screen will return to the EDIT SETTINGS screen. Set your BG Units as described in the next section. MiniMed EDIT SETTINGS Wizard On Carb Units: grams Carb Ratios: ---> BG units You can select mg/dL or mmol/L as your BG Unit (measurement type). NOTE - If you make changes to your BG units setting, you must reprogram your insulin sensitivity and BG targets. 8. In the EDIT SETTINGS screen, select BG Units and press ACT.
mp6024875_012_a.book Page 57 Monday, June 23, 2003 10:54 AM 3. The SET START TIME 2 screen will appear. To set just one ins sensitivity: To set more than one ins sensitivity: Press ESC. a. Set the start time for ins sensitivity 2 and press ACT. MiniMed SET START TIME 2 _:_ mg/dL per unit insulin __ (flashing) MiniMed __ SET START TIME 2* _:_ mg/dL per unit insulin (flashing) set, then press ACT b. Set the value for ins sensitivity 2 and press ACT.
mp6024875_012_a.book Page 58 Monday, June 23, 2003 10:54 AM 3. To set just one BG Target: a. Press ESC. To set more than one BG Target: MiniMed SET START TIME 2 _:_ -- mg/dL (flashing) press ESC a. Set the start time for BG Target 2 and press ACT. MiniMed SET START TIME 2* _:_ -- mg/dL (flashing) set, then press ACT b. Set the value for BG Target 2 and press ACT. c. Repeat steps a and b to set more BG Targets. d. Press ESC when you are done.
mp6024875_012_a.book Page 59 Monday, June 23, 2003 10:54 AM Review your Bolus Wizard settings Check your Bolus Wizard settings in the REVIEW SETTINGS screen. If necessary, compare this information with your information in the Bolus Wizard settings table. Bolus > Bolus Wizard Setup > Review Settings 1. In the REVIEW SETTINGS screen, scroll through the text to view your Bolus Wizard settings. 2. If an arrow appears next to an item, that item has more than one setting. You can review these settings.
mp6024875_012_a.book Page 60 Monday, June 23, 2003 10:54 AM Meter rules If you want your pump to communicate with the Paradigm Link meter, the following conditions must apply: 1. The meter option must be turned on and programmed. Refer to the instructions in this section. 2. Your pump must be within 4 feet (1.22 meters) of your Paradigm Link meter to receive the BG reading. 3. The pump cannot have a LOW BATTERY alert condition. 4.
mp6024875_012_a.book Page 61 Monday, June 23, 2003 10:54 AM 2. Add, delete or review your meter ID(s) as desired. Add a. Select Add ID and press ACT. Delete b. Enter each of the six ID numbers. Press ACT after each entry. b. Select the meter ID that you want to delete and press ACT. MiniMed ADD METER ID ------ (flashing) c. After you set the last number of the ID, the screen will return to the METER ID MENU. MiniMed a. Select Delete ID and press ACT.
mp6024875_012_a.book Page 62 Monday, June 23, 2003 10:54 AM Normal bolus using Bolus Wizard After the Bolus Wizard is turned on and the settings are programmed, Bolus Wizard can calculate an estimate of insulin you need for your correction bolus and/or your food bolus. You have the option of using the estimate or changing it as necessary. Additionally, your pump can receive your BG reading from the Paradigm Link meter, if they are linked.
mp6024875_012_a.book Page 63 Monday, June 23, 2003 10:54 AM 4. In the ENTER FOOD screen, if this is a food bolus: enter the food value you will eat and press ACT. if this is a correction bolus: select 0 (zero) as the value and press ACT. MiniMed MiniMed ENTER FOOD 45 ENTER FOOD grams* * or exch (flashing) 5. Review the information in the ESTIMATE DETAILS screen. Press ACT to continue to step 6.
mp6024875_012_a.book Page 64 Monday, June 23, 2003 10:54 AM Bolus Wizard examples For the scenarios that follow, Michael has his Bolus Wizard turned on with the following settings: Carb ratio: 15 grams per unit of insulin Insulin Sensitivity: 40 mg/dL per unit of insulin Target BG: 120 mg/dL Example #1: Bolus Wizard, BG on target (normal BG) Michael awakens in the morning before school and his mother has breakfast waiting for him.
mp6024875_012_a.book Page 65 Monday, June 23, 2003 10:54 AM Example #3: Bolus Wizard, Blood glucose below target (low BG) On another morning, Michael sits down before eating the same breakfast. He tests his BG with his Paradigm Link meter and finds it at 80 mg/dL, which is below his target. His reading is automatically sent to his pump. When prompted by Bolus Wizard, he enters his carbohydrate amount of 60 grams in the ENTER FOOD screen. Based on his settings, the pump will suggest that he only take 3.
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mp6024875_012_a.book Page 67 Monday, June 23, 2003 10:54 AM Chapter 6 Optimizing pump therapy Square Wave and Dual Wave bolus Square Wave bolus delivers a bolus evenly over a specified period of time (30 minutes to 8-hours). This bolus can be used for insulin delivery when you have eaten a long meal with extended snacking. It can also be useful if you have delayed food digestion due to gastroparesis or meals high in fat. A Square Wave bolus can be useful if a Normal bolus drops your BG too rapidly.
mp6024875_012_a.book Page 68 Monday, June 23, 2003 10:54 AM Square Wave or Dual Wave bolus without Bolus Wizard NOTE - To deliver a Square Wave or Dual Wave bolus, the dual/square bolus option must be on. 1. Make sure the dual/square option is on. 2. Calculate your food and/or correction bolus amount. 3. Press on your pump, or go to the BOLUS MENU and select Set Bolus (or Manual Bolus), then press ACT. 4. The BOLUS TYPE (or MANUAL BOLUS TYPE) screen will appear.
mp6024875_012_a.book Page 69 Monday, June 23, 2003 10:54 AM Example #1: Square Wave bolus, Use of a Square Wave bolus while eating a meal high in fat Conner loves pizza. When he was using insulin shots, he began to avoid pizza because he always had high blood glucose readings several hours after eating this high fat meal. Now that Conner is using the Paradigm pump, he can use the Square Wave bolus feature to help with this problem.
mp6024875_012_a.book Page 70 Monday, June 23, 2003 10:54 AM Example #1: Dual Wave bolus Set a Dual Wave bolus for a barbecue style dinner Carol is going to a barbecue at a friend's house. Her meal consists of: mixed green salad potato salad fruit salad baked beans a dinner roll and margarine pork ribs with barbecue sauce. She calculates her total carbohydrates and determines her total meal bolus amount.
mp6024875_012_a.book Page 71 Monday, June 23, 2003 10:54 AM Your turn: Dual Wave bolus practice Can you think of any meals where this feature would help you with blood glucose control? Your target pre-meal blood glucose range is ______ to _______ Check your pre-meal blood glucose. Are you within your target? _____ If yes, continue.
mp6024875_012_a.book Page 72 Monday, June 23, 2003 10:54 AM Using Bolus Wizard for a Square Wave or Dual Wave bolus If you are using Bolus Wizard to calculate your Square Wave or Dual Wave bolus amounts, you will be prompted to enter your BG reading and/or the (carb or exchange) units you will eat. Bolus Wizard will use this input to calculate your suggested correction and/or food bolus amount. If you do not want to use the Bolus Wizard estimate, you can change it, if desired. 1.
mp6024875_012_a.book Page 73 Monday, June 23, 2003 10:54 AM 4. For a Square Wave bolus: The SET SQUARE BOLUS screen will appear. Change the amount if desired. Press ACT to accept. MiniMed SET SQUARE BOLUS Estimate 4.0U ACT For a Dual Wave bolus do these steps: NOTE - The number of units you program for the SET DUAL BOLUS TOTAL is a total of both the Normal and Square Wave bolus units. a. The SET DUAL BOLUS TOTAL screen will appear. Change the amount if desired. Press ACT to accept. b.
mp6024875_012_a.book Page 74 Monday, June 23, 2003 10:54 AM Easy bolus The EASY BOLUS button allows a quick way to deliver a Normal bolus. You will pre-set the settings for this feature in the EASY BOLUS OPTION screen in the BOLUS MENU. Your pump is sent from the factory with the Easy Bolus feature set to on. If you do not want to use Easy Bolus, turn it off. NOTE - If you are using the remote control, the Easy Bolus must be set to on.
mp6024875_012_a.book Page 75 Monday, June 23, 2003 10:54 AM 4 Total # Steps = 4 Total # Button Presses = 4 Example: 2.0 unit Easy bolus with a step amount set at 0.5 units 1 Step = 0.5 units 3 1 Step = 0.5 units 2 1 Step = 0.5 units 1 0 1 Step = 0.5 units 0 0.5 1.0 1.5 2 Total # Units Deliver Easy Bolus Practice using the Easy Bolus feature while looking at the pump screen as you count the beeps.
mp6024875_012_a.book Page 76 Monday, June 23, 2003 10:54 AM 3. If this amount is correct, press ACT to start the Easy Bolus delivery. The BOLUS DELIVERY screen will show the units being delivered. When the total bolus is finished, the pump will beep or vibrate. MiniMed MiniMed SET EASY BOLUS 1.0 to start If this amount is wrong, press ESC or over. The pump will return to the HOME screen. U ACT to accept ESC to cancel BOLUS DELIVERY 1:32P Normal 0.
mp6024875_012_a.book Page 77 Monday, June 23, 2003 10:54 AM Basal patterns The Basal Patterns feature is optional for pump users. You can set your pump to deliver a standard basal and two additional basal patterns to meet your individual daily, weekly, or monthly needs. Keep a paper copy of your programmed patterns with you at all times in case you need to reprogram your pump. To select and use pattern A or pattern B, the patterns option must be on and programmed.
mp6024875_012_a.book Page 78 Monday, June 23, 2003 10:54 AM Program a pattern Your pump will keep your pattern settings even when the Patterns option is turned off. The patterns feature must be on to program a basal pattern. NOTE - Be aware. When you make changes to a pattern, the pump will use that pattern as the current basal. Make sure the basal you want is selected in the SELECT PATTERNS screen. Do these steps to program your patterns: 1. Go to the EDIT BASAL screen. MiniMed EDIT BASAL 16.
mp6024875_012_a.book Page 79 Monday, June 23, 2003 10:54 AM Select a pattern Before you try to select a pattern, make sure the Patterns feature is on. After your standard pattern and/or pattern A or B are set, do these steps to select a pattern: 1. Go to the SELECT PATTERNS screen. Main > Basal > Select Patterns 2. Select the desired pattern, press ACT. MiniMed SELECT PATTERNS Standard 16.80 U Pattern A 19.60 U Pattern B - -.- - U ACT 3. The screen will return to the BASAL MENU.
mp6024875_012_a.book Page 80 Monday, June 23, 2003 10:54 AM Example #1: Basal patterns Ken has had his insulin pump for about a month. He tests his blood glucose 4 - 6 times a day and records his results in his logbook. He is happy with his glucose control during the week but on the weekends, he noticed that he has to eat more food to prevent his blood glucose from running too low. Ken has realized that during the week while he is at work, he is very inactive and sits at a desk most of the time.
mp6024875_012_a.book Page 81 Monday, June 23, 2003 10:54 AM Temp basal rates The temp basal rate feature is useful to manage BG levels during unusual short-term activities or conditions. These conditions could be an illness or unplanned physical activity that is not part of your daily routine. A temporary basal rate allows an immediate short-term change to your basal insulin for a specified period of time (30 minutes – 24-hours). This rate can be up to your maximum basal rate setting.
mp6024875_012_a.book Page 82 Monday, June 23, 2003 10:54 AM Insulin rate Insulin rate is a fixed basal in units per hour (U/H). This temp basal type is independent of your current basal. When you select Insulin rate (U/H) for your temp basal type, your pump will deliver the fixed amount you have set for the duration as set. The amount of your temp basal insulin rate can be set up to your maximum basal rate setting.
mp6024875_012_a.book Page 83 Monday, June 23, 2003 10:54 AM Percent of basal The temp basal type is dependent on your current basal rates. Percent temp basal is a percentage increase or decrease of your current basal (0 - 200 percent limited to your maximum basal rate setting). The maximum percent limit is based on the largest basal rate segment of your current basal. For example: It’s 6:00PM (your current basal rate is 1.30 U/H). You want to set a temp basal of 150%.
mp6024875_012_a.book Page 84 Monday, June 23, 2003 10:54 AM Selecting temp basal type Your pump will remember the temp basal type setting. Once the type is set, you do not have to set it again. To select a temp basal type, do these steps: 1. Go to the BASAL MENU. Main > Basal > Temp Basal Type Select Temp Basal Type and press ACT. MiniMed BASAL MENU Max Basal Rate Patterns Temp Basal Type ACT 2. The SET TEMP BASAL AS screen will appear. Select Insulin Rate or Percent of Basal and press ACT.
mp6024875_012_a.book Page 85 Monday, June 23, 2003 10:54 AM 3. In the SET TEMP BASAL screen, the temporary basal rate will flash. Enter your temp basal rate, then press ACT. MiniMed SET TEMP BASAL U/H 03:00 0.05 U/H OR 03:00 60 % appears if Temp Basal Type is set to “Percent of basal.” appears if Temp Basal Type is set to “Insulin rate (U/H).” 4. The BASAL MENU will appear. Your temp basal is now set and delivering. Exit the menus.
mp6024875_012_a.book Page 86 Monday, June 23, 2003 10:54 AM Example #1: Temp Basal for a decreased temporary basal rate Ramon and his friends got together for an unplanned game of soccer. Before using the pump, he was taking shots to manage his diabetes. Ramon experienced frequent low blood glucose reactions sometime during, and very often after, he played games with his friends. Now that he is using his Paradigm pump, he can use the Temporary Basal Rate feature to help prevent low blood glucose.
mp6024875_012_a.book Page 87 Monday, June 23, 2003 10:54 AM Your turn: Think of an activity where you might need to use a Temporary Basal Rate. At what rate is your current basal rate running? ____________ What Temporary Basal Rate would you try using at this time? ___________________ How long will you be active?___________________ What duration will you set for the Temporary Basal Rate?________________ Test your blood glucose before and during activity and several times after as well.
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mp6024875_012_a.book Page 89 Monday, June 23, 2003 10:54 AM Chapter 7 Insulin pump therapy follow-up We hope that you are now comfortable using the pump and your blood glucose values have improved through insulin pump therapy. Diabetes management requires much more than blood glucose control. You need to take care of your complete physical and mental health. This includes seeking treatment for any condition both directly related to and not related to diabetes.
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mp6024875_012_a.book Page 91 Monday, June 23, 2003 10:54 AM Chapter 8 Utilities Alarm review You can review alarms in the ALARM HISTORY screen. This screen shows up to 36 past alarms and/or errors. You can also review the details for each alarm when you are in the ALARM HISTORY screen. 1. Go to the ALARM HISTORY screen Main > Utilities > Alarm > Alarm History 2. Scroll through your past alarms. MiniMed ALARM 11OCT 08OCT 05OCT 3.
mp6024875_012_a.book Page 92 Monday, June 23, 2003 10:54 AM Auto-off The factory setting for this feature is off (set to 0 hours). This is a safety feature that stops insulin delivery after a defined time period (from 1 to 24-hours). If the pump detects that no buttons have been pressed for the selected amount of time, insulin delivery will stop. You may choose to program this feature into your pump based on the numbers of hours that you usually sleep at night.
mp6024875_012_a.book Page 93 Monday, June 23, 2003 10:54 AM For “Insulin units”: Enter the number of units you want remaining when the first warning will go off. Press ACT. MiniMed MiniMed (flashing) WARNING UNITS __ For “Time”: Enter the amount of remaining time you want for the first warning. Press ACT. (flashing) WARNING TIME __:__ U The pump will alarm first when the specified units remain, then again when half that remaining amount is used.
mp6024875_012_a.book Page 94 Monday, June 23, 2003 10:54 AM Personal reminders Alarm clock The alarm clock is a feature that allows you to set daily reminders for various events (8 max). The factory setting for this feature is off. The alarm clock can be useful to remind you when to check your blood glucose, eat, bolus, etc. When the alarm clock goes off, the message, “REMINDER” will appear. MiniMed 12:40P REMINDER ESC, ACT to clear 1. Go to the ALARM OPTION screen. Main > Utilities > Alarm Clock 2.
mp6024875_012_a.book Page 95 Monday, June 23, 2003 10:54 AM Turn on remote control option WARNING: If there is “Low Battery” condition, the pump will not receive signals from the remote. To ensure the pump communicates with the remote control, make sure the pump does not have a low battery. (Replacing the low battery with a new battery will restore remote control function.) 1. Go to the REMOTE OPTION screen. Select On and press ACT.
mp6024875_012_a.book Page 96 Monday, June 23, 2003 10:54 AM Add Delete Review Select Add ID and press ACT. Enter each of the six ID numbers. Press ACT after each. Select Delete ID and press ACT. Select Review ID and press ACT. The programmed IDs will show in the REVIEW REMOTE ID screen. MiniMed ADD REMOTE ID Select the remote ID that you want to delete and press ACT. MiniMed (flashing) ------ After you set the last number of the ID, the screen will return to the REMOTE ID MENU.
mp6024875_012_a.book Page 97 Monday, June 23, 2003 10:54 AM Example #1: Block Nicholas is a very active toddler who wears a Paradigm pump. His parents don't want to worry that he will play with the pump and accidentally change his programmed settings. They simply activated the Block feature, and now, except for the Suspend and Self-Test, no other features are active when using the pump buttons. When Nicholas needs a bolus, his parents and caregivers simply program it with the Remote Control.
mp6024875_012_a.book Page 98 Monday, June 23, 2003 10:54 AM Selftest Selftest is a safety utility that allows you to check if your pump is operating properly. This self-diagnostic feature can be used for maintenance or to check your pump if it operates unusually. During selftest, your pump will automatically run internal tests, including a check for proper operation of the beep and vibrate modes. The selftest is additional to the routine tests that run independently while the pump operates.
mp6024875_012_a.book Page 99 Monday, June 23, 2003 10:54 AM Clear pump The clear pump function resets the time and date and clears all pump settings except for language. The pump settings are restored to the factory defaults. When you clear your pump, you must reprogram all your settings before you can use your pump again. The pump does not clear the internal pump memory. WARNING: Do not clear your pump while it is connected to your body.
mp6024875_012_a.book Page 100 Monday, June 23, 2003 10:54 AM Select your insulin type WARNING: Do not change your insulin type unless your healthcare professional has instructed you to do so. Make sure you select the correct insulin type. The correct insulin type is essential for proper use of the Bolus Wizard. The factory setting for the insulin type is 100U fast-acting.
mp6024875_012_a.book Page 101 Monday, June 23, 2003 10:54 AM Language setting The language shown on the pump screens can be changed. Some languages will not be available on all pumps. To change the language for your pump, do these steps: 1. Go to the LANGUAGE MENU. Select your language and press ACT. Main > Utilities > Language 2. The language setting is now changed. Exit the menus.
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mp6024875_012_a.book Page 103 Monday, June 23, 2003 10:54 AM Chapter 9 Troubleshooting and alarms NOTE - It is recommended that you read your warranty statement included with your pump for information on what is covered during your warranty period. Troubleshooting My pump has a no delivery alarm... When a “No Delivery” alarm occurs, it means the pump is working correctly. Your pump is not broken, but it has detected that something is preventing insulin from being delivered. Do the following steps: 1.
mp6024875_012_a.book Page 104 Monday, June 23, 2003 10:54 AM What happens if I leave the battery out too long? If you leave the battery out too long (more than five minutes) you may receive a BATT OUT LIMIT alarm message when you install the new battery. Do the following steps: 1. Set your pump clock to the correct time, date, and year. 2. Check to make sure that all your settings, such as basal rate, are set as desired.
mp6024875_012_a.book Page 105 Monday, June 23, 2003 10:54 AM I can’t get out of the priming loop... 1. Is there a filled reservoir in the pump? If no, place a filled reservoir or shipping cap in the pump. If yes, make sure you are disconnected from the pump. 2. Hold the ACT button until the second set of beeps and numbers appear on the screen. If yes, your pump is okay, go to step 4 in the section, “Manual prime” (chapter 4) to finish the manual prime.
mp6024875_012_a.book Page 106 Monday, June 23, 2003 10:54 AM My pump won’t display my BG reading from my meter... 1. Make sure you are using the correct meter (Paradigm Link Blood Glucose Monitor Powered by BD Logic Technology). Your 512 pump will communicate with this meter only. 2. Make sure your meter is on (set to “snd”) and working correctly. 3. Make sure the meter option in your pump is set to “on” and your meter ID is programmed correctly. 4.
mp6024875_012_a.book Page 107 Monday, June 23, 2003 10:54 AM What to do When an alarm is triggered, the pump goes into Attention mode and an alarm message will show on the screen. The pump will then default to the HOME screen. Do these steps when you get an alarm: 1. View the alarm: From the HOME screen, press any button to see the alarm message. MiniMed (any button) 2. Read all of the alarm text. There will be instructions on how to fix the alarm condition. (Press to read more text, if available.
mp6024875_012_a.book Page 108 Monday, June 23, 2003 10:54 AM Alarm conditions Alarms put the pump in “Attention” mode. A (Alarm) MiniMed Axx This alarm will show an “A” Pump reset Settings preserved followed by two numbers. ESC, ACT to clear A-alarms cause all insulin XX indicates delivery to stop and the the alarm number pump to reset. Your pump settings are retained. If this alarm repeats often, call the Medtronic MiniMed 24-hour Product Help Line for assistance.
mp6024875_012_a.book Page 109 Monday, June 23, 2003 10:54 AM Failed batt test FAILED The pump tests the voltage of BATT TEST each battery installed. This Replace with new battery test ensures a battery with Delivery stopped low voltage is not used. If the ESC, ACT to clear battery does not have enough voltage, this alarm will occur. The pump will not function and the battery must be replaced. (Always make sure that you install a NEW battery into the pump.
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mp6024875_012_a.book Page 111 Monday, June 23, 2003 10:54 AM Chapter 10 Pump maintenance It is recommended that you read your warranty statement included with your pump for information about what is covered during your warranty period. Battery The Paradigm pump uses a AAA alkaline battery. As a safety measure, Medtronic MiniMed has designed the pump to only accept a NEW battery. The pump is very particular, if you insert a used battery, an alarm will be triggered.
mp6024875_012_a.book Page 112 Monday, June 23, 2003 10:54 AM Cleaning your pump 1. Use only a damp cloth and mild detergent mixed with water to clean the outside of your pump. 2. After wiping down the pump, rinse with clean water and dry with a cloth. 3. Never use organic solvents, such as lighter fluid, nail polish remover, or paint thinner to clean your pump. 4. Keep the reservoir compartment and battery compartment dry and away from moisture. 5. Do not use any lubricants with your pump. 6.
mp6024875_012_a.book Page 113 Monday, June 23, 2003 10:54 AM Special circumstances If the pump is dropped Take care to protect your pump from being dropped. 1. Check that all connections are still tightly in place. 2. Check the LCD, keypad and pump case for cracks or damage. 3. Check infusion set, including the tubing connector and tubing for cracks or damage. 4. Review the status screen, basal rates and other pump settings. 5. Perform the Selftest procedure located in the UTILITIES MENU. 6.
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mp6024875_012_a.book Page 115 Monday, June 23, 2003 10:54 AM Chapter 11 User safety Indications The pump is indicated for the continuous delivery of insulin, at set and variable rates, for the management of diabetes mellitus in persons requiring insulin. Contraindications Pump therapy is not recommended for people who are unwilling or unable to perform a minimum of four (4) blood glucose tests per day and to maintain contact with their healthcare professional.
mp6024875_012_a.book Page 116 Monday, June 23, 2003 10:54 AM Precautions Although the pump has multiple safety alarms, it cannot notify you if the set is leaking or the insulin has lost its potency. It is essential, therefore, that you test your blood glucose levels at least four times per day. If your BG is out of range, check the pump and the infusion set to ensure that the necessary amount of insulin is being delivered.
mp6024875_012_a.book Page 117 Monday, June 23, 2003 10:54 AM Notice CAUTION: Any changes or modifications to the devices not expressly approved by Medtronic MiniMed could void your ability to operate the equipment. Insulin pump and RF accessories The pump, Paradigm Link meter and remote control comply with the United States Federal Communications Commission and international standards for Electromagnetic Compatibility. These devices comply with Part 15 of the FCC Rules.
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