Medtronic Paradigm Link Podręcznik Użytkownika

Insulin Pump User GuideINSULIN PUMP ANDCONTINUOUS GLUCOSE MONITORING SYSTEM

Chapter 3: The basics ... 27Your pump ...

Setting the BG Targets The BG Target setting allows you to setglucose targets. The Bolus Wizard will usethese targets to calculate a correction dose.B

7ಘIn the SET START TIME 2 screen enter the time of the day you want this BG Target range to becomeactive. 8ಘPress ACT. The TARGET RANGE 2 screen appe

Active insulin timeThe active insulin time setting lets the pump know which active insulin time to use in calculating the amountof active insulin to s

Meter optionParadigm Link™ and OneTouch® UltraLink™ glucose meters canbe programmed to communicate wirelessly to the Paradigm®insulin pump. When the w

Meter rules ಗIf you want your pump to communicate with the meter, the following conditions must apply:1ಘThe meter option must be turned on and program

a. Select Delete ID, then press ACT.b. Select the meter ID that you want to delete and press ACT.c. The selected ID is now deleted.Reviewing meter IDs

Your pump checks if the entered BG is within your target range. Press ACT to accept the Bloodglucose value. You can change this blood glucose value, i

Example 1: Blood glucose on target (normal blood glucose) and no active insulinMichael awakens in the morning before school and his mother has breakfa

Example 2: Blood glucose above target (high blood glucose) and no active insulinThe next day, Michael wakes up before school. Before eating the same b

Example 3: Blood glucose below target (low blood glucose) and no active insulinOn another morning, Michael sits down before eating the same breakfast.

Maximum bolus limit ... 49BG Reminder ...

Example 4: Blood glucose above target (high blood glucose) with active insulinMichael is at school and wants to eat a snack in the late morning. He te

Example 5: Blood glucose below target (low blood glucose) with active insulinAnother day at school, Michael is getting ready to eat lunch. He tests hi

Optimizing pump therapySquare Wave and Dual Wave bolusSquare Wave bolus delivers a bolus evenly over a period of time (30 minutes to 8 hours). This bo

See the following graphic for a description of the different bolus types:TIMEINSULIN123DUAL WAVEBOLUSSQUARE WAVEBOLUSNORMALBOLUSNowPortionSquarePortio

4ಘFor a Square Wave bolus, do these steps:a. Select Square Wave Bolus, then press ACT. The SET SQUARE BOLUS screen appears.b. Enter the desired amount

Square Wave bolus practiceYour target pre-meal blood glucose range is ______ to _______.Check your pre-meal blood glucose. Are you within your target?

Dual Wave bolus practiceCan you think of any meals where this feature would help you with blood glucose control?Your target pre-meal blood glucose ran

If you want to use the pump-to-meter link, make sure the meter option is on. Refer to the Meter optionsection in the Using the Bolus Wizard feature ch

7ಘThe SQUARE DURATION screen appears. Enter the amount of time you want the Square Wave bolus tolast, then press ACT.If you have BG Reminder turned On

Step value setup You can set the step value from 0.1 to 2.0 units, or to the set maximum bolus limit of less than 2.0 units(factory setting: 0.1). Set

LOW BG ... 76MAX BOLUS EXCEEDED ...

3ಘWhen your total bolus amount appears on the SET EASY BOLUS screen, press ACT. Listen/feel to countthe steps without looking at the screen.For exampl

Your turn: Easy bolus practiceThe factory default setting for the Easy Bolus feature is 0.1 unit steps. You can change the step level asnecessary to a

Turning on the patterns Your pump is set at the factory with the basal patterns feature turned off. After you turn on patterns, youstill have to progr

9ಘIf you do not need to set up any more basal rates, press ESC. If you need to set up more basal rates,repeat steps 5 through 8 above for each rate.1

Example 2: Basal patternsCynthia has had diabetes for about 12 years and has been on her Paradigm pump for several weeks. EveryMonday, Wednesday and F

Temp basal typesBased on your preference, you can select either Percent of Basal or Insulin Rate.Insulin rate (U/H) Insulin rate is a fixed basal in u

Percent of basalUnlike insulin rate, the percent of basal is dependent on your current basal rates. Percent temp basal is apercentage of your current

NOTE: The pump delivers basal amounts in 0.05 U/H increments. Because of this, your temp basal amountwill be rounded down to the next 0.05 U/H increme

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

Verifying temp basal delivery Press down button to scrollTemp Ba sal of 0.6 units per hour is now activeTemp Basal delivery will last 30 minutes4

Chapter 8: Sensor features ... 113Entering your sensor settings ...

Example 1: Temp Basal for a decreased temporary basal rateRamon and his friends got together for an unplanned game of soccer. Before using the pump, h

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 Te

Sensor featuresThe optional sensor and transmitter can provide continuous glucose measurements to help you control yourglucose levels better. The sens

Selecting the BG unitsYou must select the blood glucose units (BG Units) for the system (either mmol/L or mg/dL). All BGmeasurements will show in the

ExampleYou set your High Snooze to 15 minutes. You receive an alert at 1:00 pm and immediately clear it. However,the high glucose condition that cause

Setting the Low SnoozeAfter you receive and clear a Low Glucose alert, it will repeat until the low glucose condition is resolved.The Low Snooze featu

Setting the Cal ReminderThe Cal Reminder feature allows you to set a reminder to calibrate your system. For example, if you set yourreminder to four h

6ಘRepeat step 5 until all seven digits of the Transmitter ID have been selected.7ಘA message shows that the Transmitter ID has been changed. After abou

The transmitterThe Medtronic MiniLink Transmitter (MMT-7703) is a device that takes electronic signals generated by theglucose sensor and sends them b

Charging the transmitterBefore using the transmitter for the first time, you must fully charge the transmitter battery, which maytake up to eight hour

Removing the sensor ... 137Storage ...

4ಘWhen charging is complete, the green light on the charger will stay on, without flashing, for 15 to20 seconds and then turn off.5ಘAfter the green ch

WARNING: The sensor may create special needs regarding your medical conditions or medications. Pleasediscuss these conditions and medications with you

6ಘPlace your fingers on the back of the white tape and push the carrier down until it clicks into place.456 7ಘTurn the white button to lock the Sen-s

13ಘHold the sensor with two fingers on the base, and gently remove the introducer needle. Do NOT rotatethe introducer needle when removing. Dispose of

Connecting the transmitter to the sensor Before connecting the transmitter to the sensor, you must have the transmitter fully charged and set up (seeC

Preparing the sensor for communicationYou are now ready to use your pump to start communicating with the sensor and start sensor initialization.The pu

Entering meter BGSensor calibration will be successful only if the BG entry is in the range of 40-400 mg/dL (or 2.2 to 22 mmol/L).You should calibrate

Sensor features128

Using your sensorStatus screensYour STATUS screens tell you what is going on in your pump. In the SENSOR STATUS screen you can check thestatus of sens

Reading the sensor glucose graphsYour pump shows an updated, real-time glucose measurement. This measurement is generated by data sentfrom the sensor

Every month ... 155Every 3 months ...

Opening and viewing the graphsThe following table describes how to use the graphs.If you want to:Do the following:Open the graphs From the HOME screen

The graphsAll graphs show High and Low Glucose lines, a real-time SG measurement line, a data section, and the cursor(flashing vertical line).When you

When you move the cursor left to select an earlier SG measurement, the data section of the graph turnsblack, the word History appears here, and the ti

24-hour graphEach part of the graph between the vertical dashed lines represents 12 hours. The shaded area helps youmore easily see the sensor glucose

The arrow direction shows if your SG measurements are rising or falling. The number of arrows (one or two)shows how rapidly your SG is changing.• One

Calibration historyThe SENSOR UPDATE HISTORY screen lists the successful sensor calibration BG values that were entered intothe pump more than 15 minu

Disconnecting the transmitter and removing the sensorDisconnecting the sensor from the transmitterIf you are not going to replace the sensor, turn the

Using your system in waterYour pump must not be used in water and needs to be removed if planning water activities.ಗYou should shower, bathe and swim

UtilitiesAlarm reviewYou can review alarms and their details in the ALARM HISTORY screen. This screen shows up to 36 past alarms,errors, or LOW RESERV

Auto-offThe factory setting for this feature is Off. This is a safety feature that stops insulin delivery after a definedtime period (from 1 to 24 hou

SENSOR ERROR ... 166Alarms ...

a. For Insulin units:In the WARNING UNITS screen enter the number of units you want remaining for the first warning,then press ACT.The pump displays a

Pump data managementThe pump data management feature allows you and your healthcare professional to view and manage yourbasal and bolus insulin delive

4ಘThe INSULIN screen displays. This screen shows:• total insulin delivered for the day• total Basal and Bolus insulin delivered for the day• total per

3ಘThe AVG BG screen displays. This screen shows:• the average of all blood glucose values entered into the pump for the number of previous days yousel

• the average total number of food plus correction boluses delivered per day for the number ofprevious days you selected• the average total number of

To use the remote control, these pump settings must be programmed:• Remote Options = On• Remote control ID code entered in pump (code is on back of re

Block featureBlock restricts access to pump programming. The factory setting for this feature is off. Block is an importantsafety feature if the pump

Lock keypad featureLock keypad prevents accidental pump keypad presses. You can only press the to view the STATUS screen,and the button to turn on

3ಘPeriodically, you will hear beeps as different mechanisms in the pump are being tested. As part of theselftest, the pump will do these tests:a. Scre

Saving the settings ಗDo these steps to save your current pump settings:1ಘGo to the UTILITIES MENU screen and select User Settings.Main > Utilities

Alarm history ... 179Audio frequency ...

Clearing the settings Take the following steps only if you want to clear your pump to factory default settings.WARNING: Do not clear your pump setting

Utilities152

Therapy softwareMedtronic provides software to optimize your pump use. Contact your local representative for moreinformation.CareLink™ Personal Softwa

You can share your reports with your healthcare professional. These reports can help you and your healthcareprofessional to discover trends and other

Insulin pump therapy follow-upWe hope that you are now comfortable using the pump and your blood glucose values have improved throughinsulin pump ther

Laboratory tests• Test for HbA1c four or more times a year• Test for cholesterol, HDL, LDL, triglyceride yearly• Test for microalbuminuria yearlyEvery

Troubleshooting and alarmsThis chapter is designed to help you understand the messages that your pump is giving you when you get analarm or an alert m

What happens if I leave the pump battery out too long?If you leave the pump battery out too long (more than five minutes) you may receive a BATT OUT L

What is a CHECK SETTINGS alarm?This alarm occurs after an E alarm or after you clear your pump. It is advising you to make sure that all yoursettings

The pump is asking me to rewindThis is normal after any of the following:1ಘAny E-alarms,2ಘThe Clear Settings function,3ಘOr, a NO DELIVERY Alarm (durin

Bolus Wizard feature specifications ... 188Bolus Wizard feature examples ...

7ಘYour pump will not show another reading. Make sure the pump is idle and the HOME screen is blank.8ಘIf your pump still does not receive your blood gl

AlertsYour pump has a sophisticated network of safety checks and systems. If it detects an unusual condition thatrequires your immediate attention, it

3ಘIf the condition is due to a low battery, replace the battery.4ಘIf the condition is due to a low reservoir, monitor the reservoir volume frequently

LOST SENSOR Reason: The pump has not received a signal from the transmitter. Do not disconnect the transmitter fromthe sensor.Action:1ಘMake sure that

BAD TRANSMTRReason: The transmitter battery is depleted. Action: Recharge your transmitter immediately. See the Charging the transmitter section in t

METER BG NOWReason: A meter BG measurement is needed immediately to calibrate your sensor so that you can continuereceiving sensor glucose readings.A

AlarmsYour pump has a sophisticated network of safety checks and systems. If the safety network detects anythingunusual, your pump notifies you of con

Alarm conditionsAlarms put the pump in Attention mode. A (ALARM) This alarm shows a letter A followed by two numbers. A-alarms cause all insulin deliv

EMPTY RESERVOIR There is no insulin in the reservoir. Change the reservoir immediately. FAILED BATT TEST The pump tests the voltage of each battery i

RESETThe Reset alarm triggers when pump settings are cleared because of one of these reasons:• Pump settings were cleared (Clear Settings function) a

Contentsxviii

3ಘWithin 20 seconds, the green light on the transmitter will flash for about 10 seconds when properlyconnected. The Sensor feature must be turned On o

Troubleshooting sensor features Reconnect old sensorYou should only use this feature if you have disconnected the sensor from the transmitter and have

Understanding your transmitter, tester, and chargerThe charger has a green light that shows the charging status and a red light that communicates any

pattern for very low transmitter battery, leave the transmitter on the charger for eight hours to recharge.If the red light is still flashing after ei

MaintenanceIt is recommended that you read your warranty statement included in the Pumps specifications chapter forinformation about what is covered d

StorageIf you have to remove and store your pump, it is recommended that you store it with the battery in place.Keep a record of your current basal ra

Cleaning the Sen-serter1ಘWash your hands thoroughly.2ಘDampen a clean cloth with mild liquid soap and warm water. Wipe the Sen-serter.3ಘRinse with warm

Maintenance178

Pump specificationsThis section provides detailed information on specifications related to your pump. The safety features ofyour pump are individually

Basal• Rate increments: 0.05 units/hour• Delivery: 0.05 - 35 units/hour (maximum units: 35/hour)• Factory maximum setting: 2.0 units/hour• 3 patterns

Paradigm®522 and 722 Insulin PumpsUser Guide

IntroductionThank you for choosing Medtronic Diabetes (legally known as Medtronic MiniMed, Inc.) as your partner inhelping you gain better control of

Carb ratiosMaximum ratio settings Range Warning limits8 3 - 150 grams/u less than 5 or greater than 50 grams/u0.1 - 5.0 u/exch less than 0.3 or greate

Delivery accuracy• Delivery accuracy: +/-5 percent.• Displacement (piston) accuracy: +/-2 percent.• The delivery accuracy test was done using the Sof-

Pump motorThe pump motor has a unique, patented design with an integrated safety check system. The system deliversin precise increments.Dual Wave bolu

Low resv (reservoir) warningValues are based on displayed amount, not actual amount.time:2 - 24-hours, and @ 1:00 hour before empty08:00 hours (defaul

Percent temp basalDefault value: 100% of basal programmingPower supplyThe pump is powered by a standard 1.5 V AAA alkaline battery, size E92, type LR0

Remote controlUses radio signals to allow users to program Normal boluses or to suspend/resume their pumps.Reservoir• The user-filled reservoir is mad

Item When WhatBasal pattern information (if active) Pattern A or BBattery Status (always appears) Normal, Low, OffBG meter value(most recent BG value

Bolus Wizard feature specificationsThere are three different formulas the Bolus Wizard feature uses to estimate a bolus, depending on yourcurrent BG.

3ಘIf your current BG is between or equal to your High or Low BG Target, the total bolus estimate is basedonly on the food estimate.(food estimate)food

• The Bolus Wizard feature may utilize your current BG measurement, carbohydrate consumption, andactive insulin to calculate your estimated bolus.• Ac

Emergency kitKeep an emergency kit with you at all times to make sure that you always have necessary supplies. Informa family member, co-worker, and/o

Bolus Wizard feature examplesSettings:• Carb ratio: 30 grams/unit• BG Target: 90-120 mg/dL (5.0-6.7 mmol/L)• Insulin Sensitivity: 40 mg/dL/unit (2.2 m

#3: No active insulin from previous bolus delivery. User inputs 60 grams of carbs and a BG of 70 mg/dL (3.9mmol/L).(food estimate)60 g30 g/u= 2 units=

#5: Previous bolus activity results in a calculation of 1.5 units unabsorbed (active) insulin. User inputs 60grams of carbs and a BG of 200 mg/dL (11.

Insulin delivery default settingsMenu Item Default Set-tingLimits IncrementsBolus Menu: Bolus Wizard feature: OffEasy bolus: OnEasy bolus step: 0.1 u

Menu Item Default Set-tingLimits Increments(Time/Date) Time for-mat:12-hourBlock: OffAlarm clock: OffRemote option: OffMeter option: OffUser Settings:

Bolus Wizard feature default settingsItem Default Set-tingLimits Increments Warning Limitscarb units: grams none none noneins to carb (orexch) ratio:1

Sensor features default settingsFeature Options Default Setting Limits, Range of ValuesSensor • On• OffOff NoneHigh GlucoseAlert• On• OffOff Low–22.2

Guidance and manufacturer's declarationGuidance and Manufacturer's Declaration - Electromagnetic Emissions The Paradigm 522/722/522K/722K pu

Guidance and Manufacturer's Declaration - Electromagnetic Immunity The Paradigm 522/722/522K/722K pump system (consisting of the MMT-522/722/522K

Guidance and Manufacturer's Declaration - Electromagnetic Immunity The Paradigm 522/722/522K/722K pump system (consisting of the MMT-522/722/522K

ConsumablesThe pumps use disposable reservoirs and infusion sets for insulin delivery. Installation instructions forParadigm reservoir and Paradigm co

Guidance and Manufacturer's Declaration - Electromagnetic ImmunityThe Paradigm 522/522K/722/722K pump system is intended for use in the electroma

Guidance and Manufacturer's Declaration - Electromagnetic ImmunityThe Paradigm 522/522K/722/722K pump system is intended for use in the electroma

Recommended separation distances between portable and mobile RF communicationsequipment and the Paradigm 522/722/522K/722K pump system This section pr

Icon tableDo not reuseAttention: See Instructions for UseManufacturerDate of manufacture (year - month)Batch codeUse by (year - month)Catalogue number

Signifies compliance with Industry Canada EMC and Radio communicationsrequirementsPump specifications205ಘChapter 15

WarrantyMedtronic Diabetes warrants the Medtronic MiniMed Insulin Pump against defects in materials andworkmanship for a period of 4 years from the da

Sensor accuracyNOTE: You should review the information in this section with your healthcare professional.ಘThe Medtronic MiniMed Paradigm 522/522K/722/

Performance results in adultsThe performance of the Guardian RT in adults was evaluated in a clinical study. Guardian RT results werecompared to plasm

Accuracy of Guardian RT readingsIn this study, YSI measurements (taken every half hour) were paired with the corresponding Guardian RTreading (taken e

The Clarke Error Grid was used to assess the clinical relevance of the differences between the Guardian RTreadings and the comparative YSI measurement

To order supplies, call 800-646-4633, +1-818-362-5958 (outside U.S.), refer to the contacts list at thebeginning of this user guide, or visit our web

The plot below is a correlation plot of Guardian RT readings versus readings from the reference method, theYSI 2300 Glucose Analyzer. It is overlaid w

The percent of Guardian RT readings in the previous graph are presented in the following table according tothe percentage of points falling within eac

Precision of Guardian RT readingsThis study was also designed to look at the reproducibility of two sensors worn simultaneously at differentlocations

Low and High Alerts in adultsThe ability of the Guardian RT to detect high and low glucose levels was measured in the same clinical study.Since it is

Increasing the Low Alert settings will improve the ability to detect low blood glucose events, but it will alsoincrease the frequency of Guardian RT f

Guardian RT sensor performance and calibration stability as a function oftimeThe Guardian RT sensor may be worn for up to 3 days (72 hours) and must b

An analysis of the mean percentage of Absolute Relative Error (ARE percentage) and standard deviations,across 12-hour increments of wear periods, appe

The percentage of Guardian RT readings within 20 percent and 30 percent of YSI readings was analyzedaccording to time after sensor insertion and accor

Effects of calibration frequencyThe average bias when Guardian RT was calibrated ~ 3.5 times a day was -20.5 ± 41 mg/dl (LL: -22.40 mg/dland UL: -18.6

Time-elapsed plotsThe plot graph below is a representative example of continuous sensor tracing vs. reference blood glucosereading, where sensor showe

How to use this guideNOTE: This user guide shows sample screens only. Your pump screens may be slightly different.ಘFor step-by-step instructions, refe

The plot graph below is a representative example of continuous sensor tracing vs. reference blood glucosereading, where sensor showed average (typical

The plot graph below is a representative example of continuous sensor tracing vs. reference blood glucosereading, where sensor showed poor performance

Performance results in children and adolescentsThe performance of the Guardian RT in Children and Adolescents was evaluated in a clinical study. Guard

The accuracy of the Guardian RT was also evaluated by calculating the percentage of Guardian RT readingswithin 20% and within 30% of the blood glucose

The following figure is a correlation plot of Guardian RT readings versus readings from the reference method,the blood glucose meter. It is overlaid w

Stratified Clarke Error Grid AnalysisRange ofCompara-tive Glu-coseReadings(mg/dL)Total CountA + B A B C D E40-80 360 (13.9%) 201 (55.8%) 141 (39.2%) 6

Low and High Alerts in children and adolescentsThe ability of the Guardian RT to detect high and low glucose levels was measured in the same clinical

Increasing the Low Alert settings will improve the ability to detect low blood glucose events, but it will alsoincrease the frequency of Guardian RT f

GlossaryಘAA1C (HbA1c) test - A 2-3 monthaverage of blood glucosevalues expressed in percent.The normal range varies withdifferent labs and is expresse

Basal rate - The pump setting thatprovides a continuous infusionof insulin to keep the bloodglucose stable between mealsand during the night. Basalins

User safetyIndications: Paradigm 522/722PumpThe Paradigm MMT-522 and MMT-722 pumps are indicated for the continuous delivery of insulin, at set andvar

low, blood glucose level areelevated, and the body usesfat for energy. This processproduces ketones which upsetthe body's acid-base balanceleadin

Glucagon Emergency Kit - Aninjectable form of glucagonthat can be used to treatsevere low blood glucose levels(hypoglycemia). A GlucagonEmergency Kit

not enough insulin in theblood.kPa (kilopascal) - A unit ofmeasurement for quantifyingforce. Used to measureatmospheric pressure.Equivalent to 10,000

Nutritional content - Thebreakdown of nutrients foundin a particular food.Nutrition label - Used todetermine the nutritionalcontent of foods, as well

condition exists that requiresattention.Square Wave® bolus - Immediatebolus delivered evenly over aspecified time period (30minutes to 8 hours).Square

Glossary236

IndexಘNumerics3-hour graph 13324-hour graph 134Aaccessories 3activity guard 4CareLink USB 3holster 4leather case 4meter 3pump clip 4remote co

battery, pump 175, 185install 28removing 158short life 158beep/vibrate, alert type 33BG Reminder 42, 50BG Targets 81BG units 79default setting

Missed Data 197sensor 197sensor features 197discardingtransmitter 176disconnectingsensor from transmitter 137tester from transmitter 171transmit

LLanguage setting 41listcalibration values 136sensor alert 136Lock keypad feature 148Lost Sensor alert 164low batteryaffects meter option 85affe

MeterThe Paradigm REAL-Time insulin pump can be programmed to receive fingerstick blood glucose valuestransmitted from the LifeScan OneTouch® UltraLin

reading the real-time glucosegraphs 130real-time glucose graphsreading 130real-time sensor glucoselevels 132RECONNECT OLD SENSOR 172Reminder, alar

skinbleeding 7, 9bruising 9infection 7, 9redness 9swelling 7, 9Special mode 34Square portionof the Dual Wave bolus 98Square Wave bolus programm

6025250-011C 112106

Magnetic fieldsDo not use pump cases that have a magnetic clasp.Do not expose your insulin pump to MRI equipment or other devices that generate very s

Infusion sets and sitesAvoid using an infusion set insertion site that will be irritated by clothing and accessories, or by rigorousstretching and exe

These standards are designed to provide reasonable protection against excessive radio frequencyinterference and prevent undesirable operation of the d

©2008 Medtronic MiniMed, Inc. All rights reserved.This product is covered by U.S. Patent Nos. 6,551,276; 6,554,798; 6,872,200; 6,936,029; 6,979,326; 6

Communication problems can usually be resolved by:• ensuring that there is less than 6 feet (1.8 meters) between the receiving device and transmitter,

Introduction12

Introduction to pump therapyTheory of insulin pump therapyInsulin pumps deliver insulin closer to the way the human pancreas delivers insulin than any

As long as you are ready to learn how to use the pump, the pump can work for you.Understanding pump therapyIf you are new to pump therapy, you will ne

Insulin sensitivityInsulin sensitivity is used to decide a correction bolus for a high BG. This is how much your blood glucose willbe dropped with 1 u

Your healthcare professional will rely on the results of your blood glucose tests to make changes in your pumpsettings. The results of your A1C tests

Low blood glucose (hypoglycemia)Low blood glucose can occur while using the pump for the same reasons it can while using daily injections:• not enough

These items have 15 grams of fast acting carbohydrates:• Glucose tablets (three, 5-gram tablets or four, 4-gram tablets)• 4 oz. of juice or soda (not

If the second blood glucose is above 250 mg/dL (13.9 mmol/L):• Take an insulin injection by syringe (not through the pump). The amount should be the s

• Continue to test blood glucose and ketones. Continue to take correction insulin injections as told untilyour blood glucose reaches your target level

Contacts:ಘAfrica:Medtronic Africa (Pty) Ltd.Tel: +27 (0) 11 677 4800Australia:Medtronic Australasia Pty. Ltd.Tel: 1800 668 670 (product orders)Tel: 18

• Sugar free medicine for fever, cough, congestion, nausea and vomiting.• Extra blood glucose and ketone strips.• Glucagon emergency kit in case of se

Foods with carbohydrates include:• starches and starchy vegetables• fruits and fruit juices• milk and milk products• sugars and foods with sugarFacts

Nutrition FactsServing Size 1 piece (20g)Serving per Container 22Total Fat 0gSodium 0gTotal Carbohydrates 12gSugars 11gProtein 0gFat and blood glucose

• meat • fish • poultry• eggs • cheese • peanut butter• tofu • dried beans • dried peasProtein needs are the same for people with and without diabetes

ExerciseYour body needs insulin and carbohydrate to provide cells with energy during exercise. How much insulin andcarbohydrates you need varies with

Introduction to pump therapy26

The basicsYour pumpCAUTION: Never use sharp objects to press the buttons on your Paradigm pump as this can damage thebuttons or compromise the seal of

Install batteryCAUTION: Do not use a rechargeable or carbon zinc battery in your pump. For best results use a newEnergizer AAA alkaline battery, size

5ಘWhile the pump turns on, it will show one or more screens until theHOME screen appears.If the HOME screen does not appear, do these steps:a. Check t

The following table describes how to use the buttons on your pump from the HOME screen:ButtonDescriptionEASY BOLUS™ button—Shortcut to set and deliver

Schweiz:Medtronic (Schweiz) AGTel: + 41 (0)31 868 016024-Stunden-Hotline 0800 633 333Fax Allgemein: +41 (0)31 8680199Serbia & Montenegro:Novolab S

The pump screenThe screen shows five lines of text at one time. The first is the operating mode. The second is the currentopen menu or function. The l

Time displayThe current time of day is displayed across the top of the pump screen in the format you select—12-hour or 24-hour. The AM or PM is only d

Scroll barIf there is more text than the screen can show, a scroll bar appears onthe right side of the screen. Press to view any additional text.Scre

Normal modeMode for standard pump operations for normal basal and bolus delivery.No special features are active (such as basal patterns, temp basal, a

When the pump is in Attention mode, it will beep or vibrate periodically to remind you of the condition. Thebeep or vibrate frequency varies depending

PRIME MENUContains the functions to change your reservoir and fill the infusion set with insulin. Refer to the Changingyour infusion set section in th

If you remove your pumpYou may have an occasion when you need or want to remove your pump. If you have to remove and storeyour pump, it is recommended

The basics38

Basic programmingSetting the time and dateSetting the correct time and date in your pump is necessary for accurate basal insulin delivery and allowsyo

4ಘChange each of the settings as follows:a. HourChange the hour. Press ACT.For 12-hour setups, press or until the correct A (am) orP (pm) appears.ಘ

Important Safety InformationRegarding Your Paradigm Insulin Infusion Pump(includes all models)Avoid Immersing Your Pump In WaterAlthough it is unlikel

d. MonthChange the month. Press ACT.ಘe. DayChange the day. Press ACT.ಘ5ಘThe TIME SET AT screen will show the settings that youprogrammed. Press ACT a

BolusThere are three bolus types: Normal, Square Wave®, and Dual Wave®. This section gives instructions for aNormal bolus using the express bolus butt

Normal meal bolus using the exchange systemNormal bolus can be used to cover the carbohydrate in a meal or snack and to correct a blood glucose thatis

Normal meal bolus practice using exchanges: Choose a meal you might eat and fill in the blanks.Food:__________ exchange:______________________ exchang

Choose a meal you might eat and fill in the blanks.Food:__________ grams of carbohydrate:______________________ grams of carbohydrate:________________

Practice: Meal bolusYou have determined your meal bolus as: _______ units.Your target blood glucose range is: _______ to _______ (average is _______).

If a bolus was stopped before delivery was complete, the BOLUS HISTORY screen will show only the amountactually delivered. Refer to the Bolus details

Bolus detailsYou can view the details of any of the deliveries in the BOLUS HISTORY screen. The details include: • bolus types: normal, square, and du

Maximum bolus limitThe Maximum bolus (Max bolus) is a safety feature that limits the amount of insulin that can be delivered ina single bolus. The fac

BG ReminderAfter you deliver a bolus you may want to check your blood glucose. The BG Reminder is an optional featurethat makes the pump beep or vibra

Start and stop timesWhen you set your basal rate(s) in the BASAL MENU, your pump prompts you to set the start time for eachbasal delivery. The start t

For best results, setting or changing your basal rate(s) should be discussed with your healthcare professional.Your basal settingsYou must program you

Current basal deliverycurrent basalThe STATUS screen shows your current basal information.Daily basal rate(s)The BASAL REVIEW screen shows your daily

3ಘIf you do not use patterns, theSTANDARD screen appears.The delivery details for your standardbasal will appear.If you use patterns, the BASAL REVIEW

If you are setting your Max basal rate after your basal rates have been set, you cannot set a Max basal thatis less than any of the programmed basal r

When suspended, your pump is in Attention mode with a solid circle showing on the pump. When inSuspend, you can only resume your basal or view the STA

Example: Suspend functionHelen is ready to eat her lunch. She has just programmed her pump to deliver a meal bolus when the phonerings. Helen wants to

Basic programming58

Starting on insulinThe Paradigm pump is intended for use with U100 insulin.Prepare your pump for useWe recommend that you watch the training CD-ROM en

Filling the reservoirWARNING: Using cold insulin can cause air bubbles in the reservoir and tubing. If your insulin is storedin the refrigerator, allo

ಘContentsChapter 1: Introduction ... 1Assistance ...

6ಘGently tap the side of the reservoir to make any air bubbles rise to the top of the reservoir.456 7ಘSlowly push up on the plunger just enough to

12ಘTo purge air bubbles that have risen to the top of the reservoir, push up on the plunger until you seeinsulin in the tubing.13ಘ Without pulling,

Rewinding your pump Before you continue, make sure the infusion set is NOT connected to your body and the reservoir is NOT inthe pump.WARNING: Make su

1ಘIf you are using the pump for the first time, remove the red shipping cap from the reservoir compartment.WARNING: Do not insert the reservoir in the

Manual primeManual prime fills the infusion set tubing with insulin before you insert the set into the body. Manual primeis only available after you r

Inserting the infusion setWARNING: While the infusion set is connected to your body, do not unscrew and retighten the tubingconnector on the reservoir

Quick-set infusion set (with Quick-serter®)Always refer to the instructions that shipped with your infusion set.1345 67891011 12132Starting on insuli

Fixed primeA fixed prime fills the soft cannula with insulin and is required after the infusion set is inserted into yourbody and the introducer needl

Disconnecting Quick-setThe Quick-set allows you the freedom to temporarily disconnect from your pump without removing theinfusion set from your body.1

Record keeping for diabetes managementNow that you are using the pump, we will be asking you to test your blood glucose regularly. It is importantto t

Insulin pump and RF accessories ... 9RF interference from other devices ...

After you and your healthcare professional are satisfied with your initial pump settings, you may begin toexperiment with different food choices, meal

Starting on insulin72

Using the Bolus Wizard featureWhat is it?Bolus Wizard is a feature that calculates an estimated bolus to support your food intake or to correct a high

Your personal Bolus Wizard feature settingsIn addition to your blood glucose reading and/or your food entry, the Bolus Wizard feature uses personalset

Bolus Wizard feature settingsInformation SettingInsulin sensitivity:This ratio is used for your correction bolus calculations. This ratio is the BG un

Bolus Wizard feature settingsInformation SettingActive insulin time:The Bolus Wizard feature uses this time to calculate the activeinsulin in your sys

MAX BOLUS EXCEEDEDBolus Wizard feature will not deliver more than the limit set for your maximum bolus. If the Bolus Wizardfeature calculates a bolus

Selecting the Carb units The carb unit setting lets the pump know which way to count your carbohydrates (grams or exchanges). Anytime you make changes

5ಘThe SET START TIME 2 screen appears. The dashes under the screen name flash. The first Carb Ratio orExchange Ratio is now set.If you do not need a

Insulin sensitivity values are normally between 20 - 100 mg/dL (1.1 - 5.6 mmol/L). If your value is outsidethis range, a warning message will appear o