Medtronic Paradigm Revel User Manual

Paradigm® REAL-Time

Revel™ Insulin Pump

User Guide

©2009 Medtronic MiniMed, Inc. All rights reserved.
This product is covered by U.S. Patents. Other U.S. and/or foreign patents may be pending. Please visit

http://www.medtronicdiabetes.com/patents for a listing of patents covering this product.
Bolus Wizard

®

, CareLink®, Dual Wave®, Guardian®, Guardian RT®, MiniLink®, Paradigm®, Paradigm Link®, Quick-serter®,

Quick-set

®

,Sen-serter®,Silhouette®,Sof-set®, and Square Wave® are registered trademarks of Medtronic MiniMed, Inc.
Easy Bolus™ and Revel™ are trademarks of Medtronic MiniMed, Inc.
CONTOUR

®

is a registered trademark of Bayer.

Energizer

®

is a registered trademark of Eveready Battery Company.

Glucagon Emergency Kit

®

is a registered trademark of Eli Lilly and Company.

YSI 2300 STAT Plus™ is a trademark of YSI Inc.

OneTouch

®

, OneTouch® Ultra®, and OneTouch® UltraLink® are registered trademarks of

LifeScan, Inc

.

6025306-018_d

REF MMT-523 MMT-723 MMT-523K MMT-723K

Contacts:
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Medtronic Africa (Pty) Ltd.
Tel: [phone]

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Medtronic Australasia Pty. Ltd.
Tel: [phone] (product orders)
Tel: [phone] (customer help)

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or ([phone]

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Medtronic of Canada Ltd.
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Medtronic (Shanghai) Ltd.
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Medtronic B.V.
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Medtronic Danmark A/S
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Deutschland:

Medtronic GmbH
Geschäftsbereich Diabetes
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Telefax: [phone]
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Medtronic Europe S.A. Europe, Middle
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To order supplies: [phone]
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Medtronic International Ltd.
Tel: [phone]
or [phone]

Polska:

Medtronic Poland Sp. Z.o.o.
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Medtronic Portugal Lda
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or [phone]

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Sri Lanka

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or ([phone]

Suomi:

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Help line: [phone]

Sverige:

Medtronic AB
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Taiwan:

Medtronic-Taiwan Ltd.
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Toll Free: +886.0800.005.285

Thailand:

Medtronic (Thailand) Ltd.
Tel: [phone]

Turkiye:

Medtronic Medikal Teknoloji
Ticaret Ltd. Sirketi.
Tel: [phone]

USA:

Medtronic Diabetes Global
Headquarters
Tel: [phone]
24 Hour HelpLine: [phone]
To order supplies: [phone]

Ukraine:

Med EK Service Ltd.
Tel: [phone]

United Kingdom:

Medtronic Ltd.
Tel: [phone]

Österreich:

Medtronic Österreich GmbH
Tel: [phone]
24 – Stunden – Hotline: [phone]

Česká republika:

Medtronic Czechia s.r.o.
Tel: [phone]
Non-stop help line:
[phone]

Important Safety Information

Regarding Your Paradigm Insulin Pump

(includes all models)

Avoid Immersing Your Pump In Water

Although it is unlikely that water damage will occur if your pump is splashed or briefly dunked, you should
avoid immersing your Paradigm insulin pump in water. To swim or participate in other water activities,
always disconnect from your Paradigm pump and reconnect after you are out of the water.

If you inadvertently submerge your pump in water, dry the pump quickly using a soft, clean towel and verify
that it is working properly by selecting Selftest from the pump's Utilities Menu. If you believe that water has
entered your pump or you observe any other possible pump malfunction, please check your blood glucose,
treat high blood glucose (if necessary) with an injection and contact our 24 Hour HelpLine at 1-800-646-4633
for further assistance. Symptoms of high blood glucose include fatigue, excessive thirst and nausea. You
should always contact your healthcare professional if you experience excessively high or low blood glucose
levels, or if you have any questions about your care.

Electrostatic Discharge

Although your Paradigm pump is designed to be unaffected by typical levels of electrostatic discharge (ESD),
very high levels of ESD can result in a reset of the pump's software with an associated pump error alarm. In
most cases, exposure to high levels of ESD will trigger the pump's A-13 alarm although, under certain
circumstances, high level ESD exposure can cause A-44, Bolus Stopped or Max Delivery alarms. High levels of
ESD are more likely in situations where the relative humidity is very low, such as inside a heated building
during the winter in areas where it is cold outside.

If your pump experiences an A-13 or other error alarm, press the ESC and ACT buttons to clear the alarm. If
you are unable to clear the alarm by pressing ESC and ACT, you may need to remove and replace the pump's
battery to clear the alarm. After clearing the alarm, you should always verify that your pump is set to the
correct date and time and that all other settings (basal rate, max basal and bolus limits, etc.) are programmed
to the desired values, since the software reset could erase your previously programmed settings. Please see
the Alarms and Alerts section of this User Guide for more details regarding what to do if your pump displays
an error alarm or other alert message.

Please contact our 24 Hour HelpLine at 1-800-646-4633 to report any error alarms or other problems that
occur with your pump.

Warranty

Medtronic Diabetes warrants the Medtronic MiniMed Insulin Pump against defects in materials and
workmanship for a period of 4 years from the date of purchase.

During the warranty period, Medtronic Diabetes will, at its discretion, either repair or replace (with a new
or recertified pump, at Medtronic Diabetes’ discretion) any defective pump or motor, subject to the
conditions and exclusions stated herein. In the event that a pump is repaired or replaced, the warranty period
will not be extended.

This warranty is valid only if the Medtronic MiniMed Insulin Pump is used in accordance with the
manufacturer’s instructions. This warranty will not apply:

• If damage results from changes or modifications made to the pump by the user or third persons after

the date of manufacture.

• If damage results from use of non-Medtronic reservoirs and/or infusion sets.

• If damage results from service or repairs performed by any person or entity other than the

manufacturer.

• If damage results from a Force Majeure or other event beyond the control of the manufacturer.

• If damage results from negligence or improper use, including but not limited to: improper storage,

submersion in water or physical abuse, such as dropping or otherwise.

This warranty shall be personal to the original user. Any sale, rental or other transfer or use of the product
covered by this warranty to or by a user other than the original user shall cause this warranty to immediately
terminate. This warranty does not apply to batteries, infusion sets, reservoirs, and other accessories.

The remedies provided for in this warranty are the exclusive remedies available for any breach hereof.
Neither Medtronic Diabetes nor its suppliers or distributors shall be liable for any incidental,
consequential, or special damage of any nature or kind caused by or arising out of a defect in the
product.

Pumps purchased through our Pathway Program will assume the warranty stated in our Pathway Program
agreement.

All other warranties, expressed or implied, are excluded, including the warranties of merchantability
and fitness for a particular purpose.

Contents

Chapter 1: Introduction ..................................................................... 1

Assistance ...................................................................................................... 1

Emergency kit ................................................................................................. 1

Consumables .................................................................................................. 2

Accessories .................................................................................................... 3

How to wear your pump ..................................................................................... 3

How to use this guide ........................................................................................ 4

User safety ..................................................................................................... 5

Indications .................................................................................................. 5

Paradigm REAL-Time Revel insulin pump ............................................................ 5

Meter ...................................................................................................... 5

Contraindications .......................................................................................... 5

Warnings .................................................................................................... 6

Pump ...................................................................................................... 6

Reservoir and infusion sets ............................................................................ 6

Sensor ..................................................................................................... 6

Transmitter .............................................................................................. 6

Magnetic fields .......................................................................................... 6

X-rays, MRIs and CT scans .............................................................................. 7

Precautions ................................................................................................. 7

Avoid extreme temperatures .......................................................................... 7

Infusion sets and sites .................................................................................. 8

Sensor ..................................................................................................... 8

Adverse reactions .......................................................................................... 8

Notice .......................................................................................................... 8

Insulin pump and RF accessories ........................................................................ 8

RF interference from other devices ..................................................................... 9

Contents

ix

Chapter 2: The basics ...................................................................... 11

Your pump .................................................................................................... 11

Install battery ................................................................................................ 12

Pump buttons ................................................................................................ 13

The pump screen ............................................................................................ 15

HOME screen ................................................................................................. 15

Screen icons ............................................................................................... 15

Battery .................................................................................................. 15

Time display ............................................................................................ 16

Reservoir volume ...................................................................................... 16

Alert and alarm icons ................................................................................. 16

Sensor icons ............................................................................................ 16

Scroll bar .................................................................................................. 17

Screen backlight .......................................................................................... 17

Beep/vibrate ................................................................................................. 17

Operating modes ............................................................................................ 17

Normal mode .............................................................................................. 18

Special mode .............................................................................................. 18

Attention mode ........................................................................................... 18

Menus ......................................................................................................... 19

MAIN MENU ................................................................................................ 19

BOLUS MENU ............................................................................................... 19

SUSPEND ................................................................................................... 19

SENSOR ..................................................................................................... 19

CAPTURE EVENT .......................................................................................... 20

BASAL MENU ............................................................................................... 20

RESERVOIR + SET ......................................................................................... 20

UTILITIES MENU ........................................................................................... 20

STATUS screen ............................................................................................... 20

If you remove your pump .................................................................................. 21

Chapter 3: Basic programming ........................................................... 23

Setting the time and date ................................................................................. 23

Selecting the language ..................................................................................... 25

Bolus .......................................................................................................... 25

Setting the Normal bolus ................................................................................ 26

Normal meal bolus using the exchange system ...................................................... 27

Contents

x

Bolus practice: ............................................................................................ 27

Normal meal bolus practice using exchanges ........................................................ 28

Normal meal bolus using carbohydrate counting .................................................... 28

Normal meal bolus practice using carbohydrates ................................................... 29

Meal bolus, correction bolus and insulin sensitivity ................................................ 29

Practice: Meal bolus ..................................................................................... 30

Review your bolus deliveries .............................................................................. 30

Bolus details ............................................................................................... 31

Maximum bolus limit ........................................................................................ 33

Example 1: Max bolus .................................................................................... 33

Example 2: Max bolus .................................................................................... 33

Scroll rate .................................................................................................... 33

Example: Scroll rate ..................................................................................... 34

BG Reminder ................................................................................................. 34

Capturing Events ............................................................................................ 35

Turning on the Capture Event feature ................................................................ 35

Entering BG measurements ............................................................................. 36

Entering insulin injection information ................................................................ 37

Entering carbohydrate information .................................................................... 38

Entering exercise information .......................................................................... 38

Entering Other markers .................................................................................. 39

Viewing Capture Event history ......................................................................... 39

Basal .......................................................................................................... 39

Start and stop times ..................................................................................... 40

Your basal settings ....................................................................................... 41

Basal programming and delivery .................................................................... 41

Current basal delivery ................................................................................... 42

Daily basal rate(s) ........................................................................................ 42

Setting the Max basal rate ................................................................................. 43

Example 1: Max basal .................................................................................... 44

Example 2: Max basal .................................................................................... 44

Stopping your pump ........................................................................................ 44

Resume pump delivery ..................................................................................... 45

Example: Suspend function ............................................................................. 46

Practice: Suspend function ............................................................................. 46

Practice: Resume basal delivery after a suspend ................................................... 47

Contents

xi

Chapter 4: Starting on insulin ............................................................ 49

Prepare your pump for use ................................................................................ 49

Setting up the reservoir .................................................................................... 50

Filling the reservoir ...................................................................................... 50

Changing your infusion set ................................................................................. 52

Removing the reservoir .................................................................................. 52

Rewinding your pump .................................................................................... 52

Inserting the reservoir in your pump .................................................................. 53

Filling the tubing ......................................................................................... 54

Inserting the infusion set ................................................................................ 55

Quick-set infusion set (with Quick-serter

®

) .......................................................... 57

Filling the cannula ....................................................................................... 57

Disconnecting Quick-set ................................................................................. 59

Reconnecting Quick-set ................................................................................. 59

Record keeping for diabetes management .............................................................. 60

Determining your pump settings .......................................................................... 60

Chapter 5: Using the Bolus Wizard feature ............................................ 63

What is it? .................................................................................................... 63

Carbohydrate counting .................................................................................. 63

Your blood glucose reading ............................................................................. 63

Your personal Bolus Wizard feature settings ......................................................... 63

How the Bolus Wizard feature works ..................................................................... 66

Bolus Wizard warnings ...................................................................................... 67

HIGH BG .................................................................................................... 67

LOW BG .................................................................................................... 67

MAX BOLUS EXCEEDED ................................................................................... 67

How to program the Bolus Wizard feature .............................................................. 67

Turning on the Bolus Wizard feature .................................................................. 68

Selecting the Carb units ................................................................................. 68

Setting the Carb/Exch ratios ........................................................................... 69

Setting the BG units ...................................................................................... 70

Insulin sensitivity ......................................................................................... 70

Setting the BG Targets .................................................................................. 71

About active insulin ...................................................................................... 72

Active insulin time ..................................................................................... 73

Review your Bolus Wizard feature settings ............................................................. 73

Contents

xii

Normal bolus using Bolus Wizard feature ................................................................ 74

Bolus Wizard feature examples ........................................................................... 75

Example 1: Blood glucose on target (normal blood glucose) and no active insulin ............ 76

Example 2: Blood glucose above target (high blood glucose) and no active insulin ........... 77

Example 3: Blood glucose below target (low blood glucose) and no active insulin ............ 78

Example 4: Blood glucose above target (high blood glucose) with active insulin .............. 79

Example 5: Blood glucose below target (low blood glucose) with active insulin ............... 80

Chapter 6: Optimizing pump therapy ................................................... 81

Square Wave and Dual Wave bolus ....................................................................... 81

Turning on the Dual Wave/Square Wave option ..................................................... 82

Square Wave or Dual Wave bolus without Bolus Wizard feature .................................. 82

Square Wave bolus practice ............................................................................ 84

Dual Wave bolus practice ............................................................................... 85

Using the Bolus Wizard feature for a Square Wave or Dual Wave bolus ......................... 85

Easy bolus .................................................................................................... 87

Easy bolus setup .......................................................................................... 87

Step value setup .......................................................................................... 88

Delivering Easy Bolus .................................................................................... 88

Example 1: Easy bolus ................................................................................... 89

Your turn: Easy bolus practice ......................................................................... 90

Missed Bolus Reminder ..................................................................................... 90

Add, delete, and review bolus reminders ............................................................ 90

Add ......................................................................................................... 91

Delete ...................................................................................................... 91

Review ..................................................................................................... 91

Basal patterns ............................................................................................... 91

Turning on the patterns ................................................................................. 92

Programming a pattern .................................................................................. 92

Select a pattern .......................................................................................... 93

Example 1: Basal patterns .............................................................................. 93

Example 2: Basal patterns .............................................................................. 94

Your turn: .................................................................................................. 94

Temp basal rates ............................................................................................ 94

How does temp basal work? ............................................................................ 94

Temp basal types ......................................................................................... 95

Insulin rate (U/H) ...................................................................................... 95

Contents xiii

Percent of basal ....................................................................................... 96

Chapter 7: Sensor features .............................................................. 103

Entering your sensor settings ............................................................................ 103

Turning on the sensor .................................................................................. 103

Turning on the Glucose Alerts ........................................................................ 104

Setting the Glucose Limits ............................................................................. 104

Selecting the BG units .................................................................................. 105

Setting the Glucose Limits start time ................................................................ 106

Setting the High Repeat ................................................................................ 107

Setting the Low Repeat ................................................................................ 108

Setting the Predictive glucose alert ................................................................. 108

Setting the Rate of Change Alerts .................................................................... 110

Setting the Cal Repeat ................................................................................. 111

Setting the Cal Reminder .............................................................................. 111

Entering the transmitter ID ............................................................................ 111

Setting up the Weak Signal feature .................................................................. 112

Setting the sensor glucose graph timeout ........................................................... 113

Reviewing your settings ................................................................................ 113

Using the Sensor Demo .............................................................................. 114

The transmitter ............................................................................................ 114

Starting the sensor ........................................................................................ 114

Inserting the sensor ....................................................................................... 115

Removing the sensor ...................................................................................... 115

Preparing the sensor for communication .............................................................. 115

Calibrating the sensor ..................................................................................... 115

Entering meter BG for calibration ...................................................................... 116

Chapter 8: Using your sensor ........................................................... 119

Status screens .............................................................................................. 119

Reading the sensor glucose graphs ...................................................................... 120

Opening and viewing the graphs ...................................................................... 121

The graphs ............................................................................................... 122

Examples of real-time sensor glucose graphs ....................................................... 123

3-hour graph .......................................................................................... 123

6-hour graph .......................................................................................... 124

12-hour graph ......................................................................................... 124

Contents

xiv

24-hour graph ......................................................................................... 125

How to check for rapid changes in sensor glucose ................................................... 126

The rapid change arrows ............................................................................... 126

How to make glucose alerts silent ...................................................................... 127

Calibration history ......................................................................................... 128

Sensor alert history ........................................................................................ 128

Using your system in water ............................................................................... 129

Chapter 9: Utilities ....................................................................... 131

Alarm review ............................................................................................... 131

Setting your alert type .................................................................................... 131

Auto-off ..................................................................................................... 132

LOW RESV WARNING (Low reservoir warning) ......................................................... 132

Review daily insulin totals ............................................................................... 133

Pump data management .................................................................................. 134

Insulin delivery information ........................................................................... 134

Sensor glucose information ............................................................................ 135

Meter blood glucose information ..................................................................... 136

AUC calculation ....................................................................................... 138

Personal reminders ........................................................................................ 140

Alarm clock .............................................................................................. 140

PC connect for change settings .......................................................................... 140

Remote control option .................................................................................... 140

Turn on remote control option ....................................................................... 141

Add, delete, review remote control IDs ............................................................. 141

Other Devices option ...................................................................................... 142

Block feature ............................................................................................... 142

Turning block on ........................................................................................ 142

Example 1: Block ........................................................................................ 142

Example 2: Block ........................................................................................ 143

Lock keypad feature ...................................................................................... 143

Locking the keypad ..................................................................................... 143

Unlocking the keypad .................................................................................. 143

Selftest ...................................................................................................... 143

User settings ................................................................................................ 144

Saving the settings ...................................................................................... 145

Restoring the settings .................................................................................. 145

Contents xv

Clearing the settings ................................................................................... 146

History .................................................................................................... 146

Chapter 10: Meter option ............................................................... 147

About meters ............................................................................................... 147

Meter rules ............................................................................................... 147

Add, delete, review meter IDs ........................................................................ 148

Chapter 11: Therapy management software ........................................ 149

CareLink® Personal Software ............................................................................ 149

Reports ................................................................................................... 149

Logbook ................................................................................................... 150

Chapter 12: Insulin pump therapy follow-up ........................................ 151

Recommended follow-up ................................................................................. 151

Everyday .................................................................................................. 151

Every month ............................................................................................. 151

Every three months ..................................................................................... 151

Laboratory tests ......................................................................................... 152

Every visit ................................................................................................ 152

Annually .................................................................................................. 152

Chapter 13: Troubleshooting, alerts and alarms ................................... 153

My pump has a NO DELIVERY alarm ..................................................................... 153

What happens if I leave the pump battery out too long? ............................................ 154

Why doesn't my pump battery last very long? ......................................................... 154

What is a CHECK SETTINGS alarm? ...................................................................... 155

My screen appears distorted ............................................................................. 155

The pump is asking me to rewind ....................................................................... 155

My bolus stopped .......................................................................................... 155

My pump buttons are not acting right during a bolus ................................................ 156

My pump will not display my blood glucose reading from my meter .............................. 156

I dropped my pump ........................................................................................ 156

I submerged my pump in water ......................................................................... 157

I cannot get to the USER SETTINGS screen ............................................................ 157

Alerts ........................................................................................................ 157

Example: ................................................................................................. 158

Contents

xvi

What to do ............................................................................................... 158

Pump alert conditions ..................................................................................... 159

LOW RESERVOIR ......................................................................................... 159

LOW BATTERY ........................................................................................... 159

Sensor alert conditions ................................................................................... 159

WEAK SIGNAL ............................................................................................ 159

ALERT SILENCE .......................................................................................... 159

MISSED BOLUS ............................................................................................ 160

LOST SENSOR ............................................................................................ 160

LOW TRANSMTR ......................................................................................... 160

CHARGE TRANSMTR ..................................................................................... 161

CHANGE SENSOR ......................................................................................... 161

SENSOR END .............................................................................................. 161

CAL ERROR ............................................................................................... 161

METER BG NOW .......................................................................................... 162

METER BG BY ............................................................................................. 162

LOW XX MG/DL (XX = SG measurement) ............................................................. 162

HIGH XXX MG/DL (XXX = SG measurement) ......................................................... 162

LOW PREDICTED ......................................................................................... 162

HIGH PREDICTED ........................................................................................ 163

RISE RATE ................................................................................................ 163

FALL RATE ................................................................................................ 163

SENSOR ERROR ........................................................................................... 163

Alarms ....................................................................................................... 163

What to do ............................................................................................... 164

Alarm conditions ........................................................................................... 164

A (ALARM) ................................................................................................ 164

AUTO OFF ................................................................................................ 165

BATT OUT LIMIT ......................................................................................... 165

BOLUS STOPPED ......................................................................................... 165

BUTTON ERROR .......................................................................................... 165

CHECK SETTINGS ........................................................................................ 165

E (ERROR) ................................................................................................ 165

EMPTY RESERVOIR ....................................................................................... 166

FAILED BATT TEST ...................................................................................... 166

FINISH LOADING ......................................................................................... 166

MAX FILL REACHED ...................................................................................... 166

Contents xvii

MAX DELIVERY ........................................................................................... 167

MOTOR ERROR ........................................................................................... 167

NO DELIVERY ............................................................................................. 167

NO RESERVOIR ........................................................................................... 167

OFF NO POWER .......................................................................................... 167

RESET ..................................................................................................... 167

WEAK BATTERY .......................................................................................... 167

Testing the transmitter ................................................................................... 168

Connecting the tester .................................................................................. 168

Disconnecting the tester ............................................................................... 169

Troubleshooting sensor features ........................................................................ 169

Reconnect old sensor ................................................................................... 169

Find lost sensor .......................................................................................... 170

Chapter 14: Maintenance ................................................................ 171

Battery ...................................................................................................... 171

Storage ...................................................................................................... 172

Cleaning your pump ....................................................................................... 172

Cleaning the transmitter ................................................................................. 172

Cleaning the Sen-serter ................................................................................... 173

Chapter 15: Pump specifications ....................................................... 175

Alarms and error messages ............................................................................... 175

Alarm history ............................................................................................... 175

Audio frequency ........................................................................................... 175

Backlight .................................................................................................... 176

Basal ......................................................................................................... 176

BG Target ................................................................................................... 176

Bolus delivery .............................................................................................. 176

Maximum bolus ............................................................................................. 176

Bolus history ................................................................................................ 176

Bolus units .................................................................................................. 177

Bolus Wizard feature ...................................................................................... 177

Carb ratios .................................................................................................. 177

Carb units ................................................................................................... 177

Daily totals .................................................................................................. 177

Default screen .............................................................................................. 177

Contents

xviii

Delivery accuracy .......................................................................................... 178

Pump motor ................................................................................................ 178

Dual Wave bolus ........................................................................................... 179

Easy bolus ................................................................................................... 179

Filling the infusion set .................................................................................... 179

Infusion pressure ........................................................................................... 179

Insulin sensitivity .......................................................................................... 179

Low resv (reservoir) warning ............................................................................. 180

Meter value ................................................................................................. 180

Normal bolus ............................................................................................... 180

Occlusion detection ....................................................................................... 180

Percent temp basal ........................................................................................ 180

Power supply ............................................................................................... 181

Reservoir + Set history .................................................................................... 181

Program safety checks .................................................................................... 181

Pump size ................................................................................................... 181

Pump weight ................................................................................................ 181

Remote control ............................................................................................ 181

Reservoir .................................................................................................... 181

Square Wave bolus ........................................................................................ 182

Temporary (temp) basal rate ............................................................................ 182

Time and date screen ..................................................................................... 182

Environmental conditions ................................................................................ 182

Radio frequency (RF) communication specifications ................................................. 182

Quality of service .......................................................................................... 182

Data security ............................................................................................... 182

Status screen ............................................................................................... 183

Bolus Wizard feature specifications .................................................................... 185

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

Insulin delivery default settings ......................................................................... 190

Bolus Wizard feature default settings .................................................................. 192

Sensor features default settings ......................................................................... 193

Guidance and manufacturer's declaration ............................................................. 196

Icon table ................................................................................................... 202

Appendix A: Sensor accuracy ........................................................... 203

Performance results in adults ........................................................................... 204

Contents xix

Accuracy of Guardian RT readings ...................................................................... 205

Precision of Guardian RT readings ...................................................................... 209

Low and High alerts in adults ............................................................................ 210

The Low Glucose alert ................................................................................. 210

The High Glucose alert ................................................................................. 211

Guardian RT sensor performance and calibration stability as a function of time ............... 212

Effects of calibration frequency ......................................................................... 215

Time-elapsed plots ..................................................................................... 216

Performance results in children and adolescents ..................................................... 219

Accuracy of Guardian RT readings ................................................................... 219

Low and High alerts in children and adolescents ..................................................... 223

The Low Glucose alert ................................................................................. 223

The High Glucose alert ................................................................................. 224

Glossary ...................................................................................... 225

Index ......................................................................................... 233

Contents

xx

Introduction

Thank you for choosing Medtronic Diabetes (legally known as Medtronic MiniMed, Inc.) as your partner in
helping you gain better control of your diabetes. Whether you are beginning pump therapy for the first time
or upgrading from a previous model, we believe that the combination of state-of-the-art technology and the
simple, menu-driven programming of the pump will provide many benefits.

This user guide is designed to help you to understand pump therapy and the operation of your Medtronic
MiniMed Paradigm

®

REAL-Time Revel™ insulin pump. We strongly recommend that you work closely with your

healthcare professional for a safe and complete pump start.

Assistance

Medtronic Diabetes provides a 24 Hour HelpLine for assistance. The HelpLine is staffed with representatives
who are trained in the set-up and operation of the pump and are able to answer pump-related questions.
When calling the HelpLine or your local Medtronic Diabetes office, please have your pump and serial number
available. The phone number for the 24 Hour HelpLine is also on the back of your pump.

Department

Telephone number

24 Hour HelpLine (calls within the United States) 800.646.4633
24 Hour HelpLine (calls outside the United States) +1.818.576.5555
Web site www.medtronicdiabetes.com

Emergency kit

Keep an emergency kit with you at all times to make sure that you always have necessary supplies. Inform
a family member, co-worker, and/or friend where this emergency kit is kept. Please refer to the User safety
section in this chapter for more information on pump safety. Your emergency kit should include these items:

• Fast-acting glucose tablets

• Blood glucose monitoring supplies

Introduction

1

 Chapter 1

• Urine ketone monitoring supplies

• Extra Paradigm

®

compatible infusion set and Paradigm reservoir

• Insulin syringe and fast-acting insulin (with dosage instructions from your healthcare professional)

• Wallet card

• Dressing and adhesive

• Glucagon Emergency Kit

®

• Extra AAA alkaline batteries (Energizer® brand is recommended)

CAUTION: If you give yourself insulin by using a syringe, the Bolus Wizard feature will not be able to
correctly determine the active insulin in your system. Consult with your healthcare professional on how
long you need to wait after a manual injection before you can rely on the active insulin calculation of
your Bolus Wizard feature.

Consumables

The pumps use disposable reservoirs and infusion sets for insulin delivery. Installation instructions for
Paradigm reservoir and Paradigm compatible infusion sets are provided in the Starting on insulin chapter.

• Reservoirs — The 523 and 523K pumps are only used with the 176-unit Paradigm reservoir (MMT-326A).

The 723 and 723K pumps can be used with either the 300-unit Paradigm reservoir (MMT-332A) or the 176­unit reservoir, depending on your insulin needs.

• Infusion sets — Medtronic Diabetes provides a variety of Paradigm-compatible infusion sets to fit your

needs. Contact your healthcare professional for help in choosing an infusion set that fits your needs.
Change your infusion set every two to three days.

WARNING: For your protection the pump has undergone extensive testing to confirm appropriate
operation when used with Paradigm reservoirs and Paradigm compatible infusion sets manufactured or
distributed by Medtronic Diabetes. We recommend using Medtronic Diabetes infusion sets and reservoirs
as we cannot guarantee appropriate operation if the pump is used with reservoirs or infusion sets offered
by third-parties and therefore we are not responsible for any injury or malfunctioning of the pump that
may occur in association with such use.

Introduction

2

Accessories

• Meter — Your pump can be used with an optional blood glucose meter powered by MWT1 technology

(where or if available). MWT1 is the wireless Radio Frequency (RF) technology that is used to transmit
information from the meter to the pump. You can program your pump to automatically receive your BG
reading from this meter. All meters referenced in this user guide are blood glucose meters supported by
MWT1 technology.

• Remote control — The optional Paradigm remote control can be used with the pump to deliver normal

boluses and suspend/resume the pump from a distant location. (This user guide provides programming
instructions for the remote control. Refer to the remote control user guide for operating instructions.)

• Medtronic MiniLink

®

Transmitter — The transmitter (MMT-7703) is a small device that connects to the

sensor. It comes with a tester and a charger. When connected to a sensor that is inserted in the body,
the transmitter automatically initializes the sensor and begins to periodically send glucose data to the
pump using a radio signal.

• Sensor — The sensor (MMT-7002/MMT-7003) continuously converts tiny amounts of glucose from your

fatty layer under the skin into an electronic signal. This signal is sent to the transmitter.

• CareLink USB Upload Device — The Medtronic Diabetes CareLink USB (MMT-7305) is used to download

the Paradigm 523, 723, 523K or 723K pump data to the diabetes management software using a USB port
on your computer.

To order supplies, call 800-646-4633, [phone] (outside U.S.), refer to the contacts list at the
beginning of this user guide, or visit our web site at www.medtronicdiabetes.com.

How to wear your pump

There are different ways to wear your pump. Medtronic Diabetes has optional accessories that can hide,
protect, and add to the convenience of wearing a pump. Refer to the accessories catalog or the website
(www.medtronicdiabetes.com) for more information.

• Holster — To wear the pump on your belt.

• Pump clip — To wear the pump underneath your clothing.

• Activity guard — If you are active in sports, or you are a child, use the guard to protect the pump from

disconnecting.

• Leather case — Fine leather lined with nylon. Styling complements business and formal wear. Velcro

flap provides easy access for programming. Wear it vertically with the built-in belt clip.

Introduction

3

 Chapter 1

How to use this guide

NOTE: This user guide shows sample screens only. Your pump screens may be slightly different.

For step-by-step instructions, refer to the appropriate sections in this guide. Refer to the Glossary for
definitions of terms and functions. The terms and symbols used in this guide are in the table below.

Conventions

Meaning

Press to push and release the button
Hold to push and keep pressure on the button

Select

to press or to highlight a screen item you want to select

Exit the menus press ESC until the HOME screen appears
Pump buttons always bold and uppercase; for example, ESC, ACT
Screen and menu names always uppercase; for example, MAIN MENU, REWIND screen
Menu selections always bold; for example, 24-Hour Setup, On, Off

Flashing (blinking) screen item

you can change the value for that item with the or buttons

NOTE and TIP additional helpful information

CAUTION

warns of a potential hazard which, if not avoided, may result in minor
or moderate injury to the equipment

WARNING

notifies you of a potential hazard which, if not avoided, could result
in death or serious injury. It may also describe potential serious
adverse reactions and safety hazards

Go to the...screen.

when a step instructs you to go to a certain screen, the path to that
screen is shown. For example:
Go to the ALARM MENU.

Main > Utilities > Alarm

1

From the MAIN MENU, select Utilities and press ACT.

2

In the UTILITIES MENU, select Alarm and press ACT.

3

The ALARM MENU appears.

Introduction

4

User safety

Indications

Paradigm REAL-Time Revel insulin pump

The Paradigm REAL-Time Revel insulin pumps (523/723/523K/723K) are indicated for the continuous delivery
of insulin, at set and variable rates, for the management of diabetes mellitus in persons requiring insulin.

The Paradigm REAL-Time system consists of the Paradigm MMT-523/723 insulin pumps, or the MMT-523K/723K
pediatric versions of the insulin pumps, the MMT-7002/ MMT-7003 glucose sensor, and the MMT-7703
transmitter. Use of the MMT-523/723 insulin pumps with the optional sensor and transmitter components is
indicated for continuous or periodic monitoring of glucose levels in the fluid under the skin, and possible low
and high blood glucose episodes in adults (ages 18 and older). Use of the MMT-523K/723K insulin pumps with
the optional sensor and transmitter components is indicated for continuous or periodic monitoring of glucose
levels in the fluid under the skin, and possible low and high blood glucose episodes in children and adolescents
(ages 7 through 17). The pediatric system provides an alert if glucose levels fall below or rise above preset
values. Glucose values provided by the Paradigm 523/723/523K/723K systems are not intended to be used
directly for making therapy adjustments, but rather to provide an indication of when a fingerstick may be
required. All therapy adjustments should be based on measurements obtained using a home glucose monitor
and not on the sensor glucose readings provided by the Paradigm 523/723/523K/723K systems.

Meter

The Paradigm pump can be programmed to receive fingerstick blood glucose values transmitted from Bayer's
CONTOUR

®

NEXT LINK Wireless Meter, Bayer's CONTOUR® LINK Wireless Meter, a OneTouch® UltraLink

®

meter, or a BD Paradigm Link® glucose meter for use in the Bolus Wizard calculator and for use as calibration
values for the glucose sensor. Glucose values from other glucose meters must be manually entered into the
pump.

Contraindications

Pump therapy is not recommended for people who are unwilling or unable to perform a minimum of four
blood glucose tests per day and to maintain contact with their healthcare professional. Successful insulin
pump therapy requires sufficient vision or hearing to allow recognition of the pump signals and alarms.

Do not expose your insulin pump to MRI equipment or other devices that generate very strong magnetic fields.
The magnetic fields in the immediate vicinity of these devices can damage the part of the pump’s motor
that regulates insulin delivery, possibly resulting in over-delivery and severe hypoglycemia.

Introduction

5

 Chapter 1

Your pump must be removed and kept outside the room during magnetic resonance imaging (MRI)
procedures.

If your pump is inadvertently exposed to a strong magnetic field, discontinue use and contact the 24 Hour
HelpLine for further assistance.

Warnings

Pump

The pump is not suitable for use in the presence of a flammable anaesthetic mixture with air, oxygen or
nitrous oxide.

Reservoir and infusion sets

Standard Luer sets are not compatible with the Medtronic MiniMed Paradigm pump. Medtronic Diabetes
Paradigm reservoirs and Paradigm-compatible infusion sets are specifically designed for use with the pump.
Do not modify your Paradigm reservoir or Paradigm-compatible infusion set.

Do not put any other drugs/medications inside your reservoir to use with this pump. Only insulin that has
been prescribed by your physician can be used in this pump.

Sensor

Bleeding, swelling, irritation and/or infection at the insertion site are possible risks associated with inserting
the sensor and sometimes result from improper insertion and maintenance of insertion site.

Transmitter

Product contains small parts and may pose a choking hazard for young children.

Optional occlusive dressing should be removed if irritation or reaction to this develops.

Magnetic fields

Do not use pump cases that have a magnetic clasp.

Do not expose your insulin pump to MRI equipment or other dev ices that ge ner ate very str ong mag netic fi eld s.
The magnetic fields in the immediate vicinity of these devices can damage the part of the pump’s motor
that regulates insulin delivery, possibly resulting in over-delivery and severe hypoglycemia.

Your pump must be removed and kept outside the room during magnetic resonance imaging (MRI)
procedures.

Introduction

6

If your pump is inadvertently exposed to a strong magnetic field, discontinue use and contact our 24 Hour
HelpLine for further assistance.

X-rays, MRIs and CT scans

If you are going to have an X-ray, CT scan, MRI or other type of exposure to radiation, take off your pump,
sensor, transmitter, meter and remote control before entering a room containing any of these

equipment.

The Paradigm pump is designed to withstand common electromagnetic interference, including airport
security systems. Be sure to carry the Emergency Card provided, when you are traveling. This card provides
airport information.

Precautions

Although the pump has multiple safety alarms, it cannot notify you if the set is leaking or the insulin has lost
its potency. It is essential, therefore, that you test your blood glucose levels at least four times per day. If
your blood glucose is out of range, check the pump and the infusion set to ensure that the necessary amount
of insulin is being delivered.

Avoid extreme temperatures

1 Avoid exposure of your pump and remote control to temperatures above 108°F (42°C) or below 34°F

(1°C).

2

Insulin solutions freeze near 32°F (0°C) and degrade at high temperatures. If you are outside in cold
weather, wear your pump close to your body and cover it with warm clothing. If you are in a warm
environment, take measures to keep your pump and insulin cool.

3

Do not steam, sterilize or autoclave your pump or remote control.

Introduction

7

 Chapter 1

Infusion sets and sites

Avoid using an infusion set insertion site that will be irritated by clothing and accessories, or by rigorous
stretching and exercise.

Sensor

Prior to exercising, make sure the sensor is firmly attached.

Adverse reactions

Operation of the sensor feature requires the insertion of a glucose sensor into the skin. Bleeding, swelling,
bruising, or infection at the sensor insertion site are possible risks of sensor use. The sensor should be removed
if redness, pain, tenderness or swelling develop at the insertion site. The optional occlusive dressing should
be removed if irritation or a reaction to this develops. Contact your doctor and our 24 Hour HelpLine in the
event of any adverse reaction.

Notice

CAUTION: Any changes or modifications to the devices not expressly approved by Medtronic Diabetes
could void your ability to operate the equipment.

Insulin pump and RF accessories

The pump, meter, transmitter and remote control comply with the United States Federal Communications
Commission and international standards for electromagnetic compatibility.

Do not use the RF meter to send your blood glucose reading to the pump while on an aircraft. Manually enter
your blood glucose.

These devices comply with Part 15 of the FCC Rules. Operation is subject to the following two conditions:
(1) This device may not cause harmful interference, and (2) this device must accept any interference
received, including interference that may cause undesirable operation. It does not interfere with any RF
signals transmitted from outside sources.

Introduction

8

These standards are designed to provide reasonable protection against excessive radio frequency
interference and prevent undesirable operation of the device from unwanted electromagnetic interference.
Operation is subject to the following two conditions:

1

This device has been tested and found to comply with the regulations governing such devices in your
area. For the specific regulation and test results for your area, please contact our 24 Hour HelpLine.

2

This device generates, uses, and can radiate radio frequency energy and, if installed and used in
accordance with the instruction, may cause harmful interference to radio communications. If the device
does cause interference to radio or television reception, you are encouraged to try to correct the
interference by one or more of the following measures:

• Reorient or relocate the insulin pump/remote control/transmitter/meter

• Increase the separation between the insulin pump/remote control/transmitter/meter and the

device that is receiving/emitting interference

The meter and the transmitter send information to the pump using radio frequency. If other devices that
use radio frequency are in use, such as cell phones, cordless phones and wireless networks, they may
prevent communication between the pump and the meter. This interference will not cause any incorrect
data to be sent and will not cause any harm to your pump or meter. Moving away from or turning off
these other devices may allow communication. Refer to the Troubleshooting, alerts and alarms chapter
to correct interference problems you may have.

Wireless transmission between the pump and transmitter within the 6 feet (1.8 meters) operating range
may be interrupted due to the transmitter orientation and the pump position on the body. Move the
pump closer to the transmitter or to another position. If a Lost Sensor alarm has occurred retry:

Main > Sensor > Link to Sensor > Find Lost Sensor

If you have questions, please contact the 24 Hour HelpLine.

RF interference from other devices

Common consumer electronic devices that transmit in the same frequency band used by the MMT-7703
MiniLink transmitter may prevent the pump from receiving the glucose information sent by the transmitter.
Most cellular (mobile) phones and 900 MHz cordless phones, when transmitting or receiving, may cause
significant interruption of transmitter-receiver communication. It is likely that other devices operating in
similar frequency ranges will have a similar effect. This interference, however, will not cause any incorrect
data to be sent and will not cause any harm to your transmitter.

The pump includes a programmable WEAK SIGNAL alert that notifies you when one or more expected
transmissions were not received as expected by the pump. (The pump will also issue a LOST SENSOR alert if
communication is interrupted for an extended period of time.)

Introduction

9

 Chapter 1

Communication problems can usually be resolved by:

• ensuring that there is less than 6 feet (1.8 meters) between the receiving device and transmitter, to

include RF glucose meters;

• turning off or moving away from other RF transmitting devices; or

• reorienting or relocating the transmitter or receiving device, or both.

Communications problems may also occur due to cellular telephone interference. Testing conducted with
several different cellular telephones indicates that, while a glucose value is being transmitted, using a cell
phone within 12 inches (31 cm) of receiving devices, transmitters or RF glucose meters can interfere with
reception of the transmitted values. In the event of such interference, normal communication can be re­established by:

• turning the cell phone off; or

• keeping the cell phone at least 12 inches (31 cm) away from the receiving device, transmitter or glucose

meter when a glucose measurement is being transmitted.

If you have questions, please contact the 24 Hour HelpLine.

Introduction

10

The basics

Your pump

CAUTION: Never use sharp objects to press the buttons on your Paradigm pump as this can damage the
buttons or compromise the seal of the pump. Some examples of sharp objects that may damage your
keypad are fingernail files, pens or pencils, paper clips, knives, scissors, and keys.

Take a look at your pump. The reservoir window allows you to view the insulin in the reservoir. The reservoir,
with the tubing connector attached, is inserted into the reservoir compartment of the pump.

E
S
C

reservoir

window

screen

tubing

connector

reservoir

compartment

battery

compartment

buttons

The basics 11

 Chapter 2

Install battery

CAUTION: Do not use a rechargeable or carbon zinc battery in your pump. For best results use a new
Energizer AAA alkaline battery, size E92, type LR03.

Medtronic Diabetes designed the pump to only accept a new battery. As a safety measure, if you install a
battery that does not have full power, the WEAK BATTERY or FAILED BATT TEST alarm may sound. If you
receive a WEAK BATTERY alarm, respond to the alarm and continue. The pump will still operate normally,
but with a decreased battery life. The pump uses one AAA alkaline battery.

1

Make sure all the following apply:

• Clear (ESC, ACT) any alarms and/or alerts before removing and replacing the battery.

• Make sure the pump is at the HOME (idle) screen when you remove the battery.

• Do NOT remove the battery during a bolus or Fill Cannula delivery.

2

Use the edge of a coin to remove the battery cap. Turn the cap in a counter-clockwise direction.

3

Remove the old battery and dispose of it per the
disposable requirements of your state or country. Put
the new battery in the pump with the negative end [(-)
symbol] going in first. Check the label on the back of
the pump to make sure the battery is inserted
correctly.

NOTE: Do not use batteries that have been in cold

storage, such as in the refrigerator or in your car during winter in cold climates.

battery cap

battery

4 Place the battery cap in the pump and tighten so the slot is aligned

horizontally with the pump as shown here:

CAUTION: Do NOT over-tighten the battery cap. You should not turn
the cap more than four half turns. If you over-tighten the cap you
may not be able to remove it, and you can damage your pump.

one half-turn

one half-turn

The basics

12

5 While the pump turns on, it will show one or more screens until the

HOME screen appears.
If the HOME screen does not appear, do these steps:

a. Check that the battery is inserted correctly. If the battery has

been installed backwards, remove the battery and install it
properly.

b. If your pump still does not turn on or you get a FAILED BATT

TEST alarm, remove and replace the battery with a new one.

c. If the pump is still not on, call our 24 Hour HelpLine.

HOME screen

6 Check to make sure the time and date are correct. If more than five minutes have passed since you

removed the battery, you will be prompted to check the time and date. Refer to the Setting the time
and date section in the Basic programming chapter for programming instructions.

7

Press ESC to view the STATUS screen, making sure no alarms are active. If an alarm is active, follow the
instructions on the screen.

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

DOWN

button
ACT
button

ESC

button

EXPRESS

BOLUS

button

The basics 13

 Chapter 2

The following table describes how to use the buttons on your pump from the HOME screen:

Button

Description

EASY BOLUS™ button – Shortcut to set and deliver an Easy Bolus.

Turns the backlight on or off.

Opens the MAIN MENU.

• Opens the pump STATUS screen if the sensor feature is turned off.

• Opens the following screens and graphs from the HOME screen if the sensor feature is

turned on:

• 1 press opens the last sensor graph selected.

• 2 presses open the pump STATUS screen.

• 3 presses open the SENSOR STATUS screen.

EXPRESS BOLUS button – Shortcut to set any bolus.

The following table describes how to use the buttons on your pump from the menus and programming

screens:

Button

Description

Increases or decreases the value of a flashing item. Scrolls up or down the items in a list.

Accepts a selected menu item or activates a selected setting.

• Returns to previous screen or exits the menu.

• Backs out of unintentional menu selections if the ACT button has not been pressed yet.

• Press simultaneously with to turn on backlight when in the menus.

• Use as a Shift button by pressing it in combination with another button to access certain

features.

The basics

14

The pump screen

The screen shows five lines of text at one time. The first is the operating mode. The second is the current
open menu or function. The last three lines show either information or text that you can select for the current
function.

NOTE: The screen text in the examples used in this guide might not exactly match the text on your pump

screen. Please follow your pump screen instructions. If you have any questions, contact our 24 Hour
HelpLine.

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 scree n, the MAIN MENU w ill appe ar.

When the pump is on, the following icons always appear across the top of the screen: reservoir volume icon,
the time (12- or 24-hr), and the battery icon. If these do not appear, the pump is not operating.

Screen icons

There are various icons that appear at the top of your pump screen, like the time, battery and reservoir icons
mentioned above. The next sections describe what the icons mean.

Battery

The battery icon tells you how much usable life is left in your battery. There are
four segments in the icon. Each segment represents approximately 25 percent of
the usable battery life you have left until you reach Low Battery point. So if you
only have one segment left, make sure you have a new battery available.

At least 75% left

Low battery

The basics 15

 Chapter 2

Time display

The current time of day is displayed across the top of the pump screen in the
format you select—12-hour or 24-hour. The AM or PM is only displayed for the 12­hour format. For instructions on setting the time on your pump, see the Setting
the time and date section in the Basic programming chapter.

Reservoir volume

The reservoir volume icon tells you how much insulin is in your pump. This icon is also
divided into four segments. Each segment represents approximately 25 percent of the
reservoir volume you have left. This allows you to be aware of how much insulin you
have left in your pump. Refer to your STATUS screen to view the number of units left
in the reservoir.

NOTE: For the Paradigm 723/723K pump, your reservoir icon will only appear full

if using a filled 300–unit Paradigm reservoir. The icon will not appear full if you use
the 176–unit Paradigm reservoir.

Alert and alarm icons

An open circle (alert) or a solid circle (alarm) are displayed in the upper part of
your pump screen only when there is an alert or alarm condition on your pump. For
alarm and alert information, see the Troubleshooting, alerts and alarms
chapter.

Sensor icons

A dark sensor icon means that the sensor is on and the pump is receiving
sensor data. A light-colored sensor icon with a dark circle around it means
that the sensor is on, but the pump is not receiving sensor data. For
information about the sensor, see the Sensor features chapter.

Time Display

24-Hr

12-Hr

Less than 25% left

75 to 100% left

Alarm icon

Alert icon

Sensor is on and the pump
is receiving sensor data

Sensor is on but the pump
is not receiving sensor data

The basics

16

Scroll bar

If there is more text than the screen can show, a scroll bar appears on
the right side of the screen. Press

to view any additional text.

Screen backlight

When you press from the HOME screen, the light on the screen turns
on or off. During programming, the backlight can be turned on by

pressing the

and the together. The light will stay on while you are pressing any of the pump buttons.

It will stay on as long as the current screen is active.

To conserve your battery, the backlight will turn off automatically while the pump is vibrating. After the
vibration is finished, the light will turn back on. The backlight cannot be turned on in a low or dead battery
condition.

Beep/vibrate

Your pump will beep or vibrate to indicate activity. Refer to the Setting your alert type section in the Utilities
chapter for setup instructions.

Operating modes

The screen lets you know when a special feature is active or if there is a condition that needs your attention.
The active features and pump status will determine the operating mode. The screens for the three modes
are shown in the following sections.

scroll bar

The basics 17

 Chapter 2

Normal mode

Mode for standard pump operations for normal basal and bolus delivery.
No special features are active (such as basal patterns, temp basal, and
others). No alarms and no alerts exist.

Special mode

Indicates a special feature is active or an alert condition(s) exists.
Special mode does not restrict any of the pump functions. When the
pump is in Special mode, an open circle appears at the top of the screen
and it beeps or vibrates periodically to remind you of the condition. The
conditions and features that put the pump in Special mode are:

• Low Reservoir condition

• Low Battery condition

• Block feature is on

• Dual or Square Wave bolus delivery

• Basal pattern A or B is active

• Sensor alerts

• Temporary basal delivery

• Alert Silence is active

Attention mode

WARNING: When the pump is in Attention mode, showing a solid circle icon, all insulin deliveries are
stopped.

Indicates insulin delivery has stopped. This can mean that the pump is
in Suspend mode. It can also mean an alarm is active or an alarm
condition exists that needs immediate attention for insulin delivery to
resume. A solid circle appears at the top of the screen and the pump
will beep periodically until either the pump is taken out of Suspend
mode or the condition is cleared. The screen will show text describing
the condition that put the pump in Attention mode. For example, if the reservoir is empty, EMPTY RESERVOIR
will appear on the screen.

The basics

18

When the pump is in Attention mode, it will beep or vibrate periodically to remind you of the condition. The
beep or vibrate frequency varies depending on the condition that put the pump in Attention mode. Refer to
the Alarm conditions section in the Troubleshooting, alerts and alarms chapter for alarm conditions that will
trigger the Attention mode. See the Stopping your pump section in the Basic programming chapter to learn
about Suspend mode.

Menus

The MAIN MENU is the highest level menu. There are submenus, functions, status and programming screens
in the lower menu levels. The menus are described in the following paragraphs.

Tip: If a screen item is flashing (blinking), during programming, press or to change the value.

MAIN MENU

Highest menu level in the menu system. When you press ACT from the HOME screen, the MAIN MENU will
appear.

BOLUS MENU

Contains the settings and functions for bolus deliveries. The button allows direct access to MANUAL BOLUS
or to the BOLUS WIZARD feature without having to navigate through the menus. Refer to the Basic

programming chapter for the manual bolus information or to the Using the Bolus Wizard feature chapter for
bolusing using the Bolus Wizard feature.

SUSPEND

Stops all current insulin deliveries. Refer to the Stopping your pump section in the Basic programming chapter
for more information.

SENSOR

Contains the functions to setup the interface between the sensor and the pump and access to the pump's
sensor features.

The basics 19

 Chapter 2

CAPTURE EVENT

Contains the options you use to enter information about different events into the system. Examples of events
include: the amount of insulin used for injections, and the carbohydrates consumed during meals or snacks.
The Capture Event option appears in the MAIN MENU after this feature has been turned on in the UTILITIES
MENU menu. See the Capturing Events section in the Basic programming chapter for more details.

BASAL MENU

Contains the functions to setup and deliver your basal. Refer to the Basal section in the Basic programming
chapter for more information.

RESERVOIR + SET

Contains the functions required to change your reservoir and fill the infusion set with insulin. Refer to
Changing your infusion set section in the Starting on insulin chapter for more information.

UTILITIES MENU

Contains features for your safety and convenience. Refer to the Utilities chapter for more information.

STATUS screen

The STATUS screen shows information about what your pump is doing.
Only check your pump status (press ESC) when you are not programming
your pump. If you press ESC during programming, you will cancel the
settings you are trying to enter.

The information that shows on the STATUS screen depends on the
current activities and conditions of your pump.

• To open the STATUS screen, press ESC until the STATUS screen appears.

• To view more text on STATUS screen, press

or to scroll and view all of the information.

• To exit the STATUS screen, press ESC until the STATUS screen disappears.

The screen includes information about:

• Last bolus insulin delivery

• Current basal insulin delivery

• The amount of active insulin, if any

The basics

20

• Special features that are turned on

• Last alarm/alert that was cleared within 24 hours

• Most recent BG meter reading received within 24 hours

• Reservoir status

• Battery status

• Time and date

Refer to the Pump specifications chapter for a complete list of the information that is available in the STATUS
screen.

If you remove your pump

You may have an occasion when you need or want to remove your pump. If you have to remove and store
your pump, it is recommended that you do the following:

• Store your pump with the battery in place

• Keep a record of your current basal rates and use the Save Settings feature (see the Saving the settings

section in the Utilities chapter).

• To preserve battery life, reset the basal rates to 0 (zero), turn off the RF options (meter, remote), and

set Auto-off to dashes or zeroes.

Remember, your body still needs insulin while your pump is removed.

It is important that you consult with your healthcare professional to determine an alternate method of
receiving your insulin. You can remove your pump for up to one hour without taking insulin. If you remove
your pump for more than one hour, you will have to use another way to take your insulin, such as injections
of fast-acting insulin, or reconnecting your pump to take boluses. Take the injection or bolus approximately
every four hours. Calculate the amount of insulin to take based on the total of your basal insulin in four hours.
Include the amount you need for meal and correction boluses. If you will have your pump off for several days,
you will need to return to a multiple injection regimen.

The basics 21

 Chapter 2

The basics

22

Basic programming

Setting the time and date

Setting the correct time and date in your pump is necessary for accurate basal insulin delivery and allows
you to keep an accurate record of your insulin delivery and other pump functions. You can select a 12-hour
or 24-hour clock. You must reset the time and date if you receive a CHECK SETTINGS alarm or you clear your
settings (Clear Settings function).

1

Go to the TIME/DATE SETUP screen.

Main > Utilities > Time/Date

2 Select 12-Hour Setup or 24-Hour Setup and press ACT.

3 Press ACT again to change the settings.

Basic programming 23

 Chapter 3

4 Change each of the settings as follows:

a. Hour

Change the hour. Press ACT.
For 12-hour setups, press

or until the correct A (am) or

P (pm) appears.

b. Minutes

Change the minutes. Press ACT.

c. Year

Change the year. Press ACT.

d. Month

Change the month. Press ACT.

e. Day

Change the day. Press ACT.

Basic programming

24

5 The TIME SET AT screen will show the settings that you

programmed. Press ACT and exit the menus.
Your time/date settings are complete.

Selecting the language

The language shown on the pump screens can be changed. Some languages may not be available on all pumps.
Before you can select another language, you need to set the time using the English screens. Refer to the
previous section.

To change the language for your pump:

1

Go to the LANGUAGE MENU screen.

Main > Utilities > Language

2 Select your language, then press ACT.

3 The language setting is now changed. Exit the menus.

Bolus

There are three bolus types: Normal, Square Wave®, and Dual Wave®. This section gives instructions for a
Normal bolus using the EXPRESS BOLUS button and navigating through the menus. (For information about
Square Wave and Dual Wave boluses, refer to the Optimizing pump therapy chapter.)

Basic programming 25

 Chapter 3

The Normal bolus delivers an immediate food or correction bolus. It can be delivered at any time except
during another Normal bolus. During a Normal bolus, most pump features are disabled until after all the bolus
has been delivered. The suspend function and the STATUS screen, however, are always available.

Setting the Normal bolus

Normal bolus can be used to cover the carbohydrate in a meal or snack and/or to correct a blood glucose
that is higher than your blood glucose target.

The following instructions are for a Normal bolus when the Bolus Wizard feature is turned off.
1

Go to the BOLUS MENU.

Main > Bolus

Select Set Bolus and press ACT. Go to step 2.
You can also use the

EXPRESS BOLUS button to get to step 2. Press from your HOME screen.

2

a. If the SET BOLUS screen appears: (Dual/Square option is off) Go to step 3.
b. If the BOLUS TYPE screen appears: (Dual/Square Wave is on) Select Normal Bolus and press ACT.

Go to step 3.

3

The SET BOLUS screen (or SET NORMAL BOLUS screen if the Dual/Square option is on) appears with

0.0 unit bolus amount flashing. Enter your bolus amount and press ACT.
If some of the bolus insulin delivered by the pump has not been used and is active in your body, the

screen will show this amount as Act. Ins. (Active Insulin). This amount is based on the active insulin
setting selected in the Bolus Wizard feature. The Active Insulin amount shows even if the Bolus Wizard
feature is turned off. Take this amount into consideration to determine your bolus. See About active
insulin, on page 72 for more information.

NOTE: If you have BG Reminder turned On, the BG REMINDER DURATION screen displays. It allows you

to set the duration before you are reminded to check your blood glucose after a bolus. See the BG
Reminder section in this chapter for information about this feature.

4 The BOLUS DELIVERY screen appears and the Normal bolus starts. The pump will beep/vibrate at the

start of the bolus. As the bolus delivers, the amount shown on the screen will increase until the entire
bolus has been delivered. When the bolus is finished, the pump will beep/vibrate again and the HOME
screen will appear.

The following practice lessons will help you understand this pump feature.

Basic programming

26

Normal meal bolus using the exchange system

Normal bolus can be used to cover the carbohydrate in a meal or snack and to correct a blood glucose that
is higher than the target that was chosen for you.

Fred has been taught that he needs to take 1 unit of insulin for every carbohydrate exchange that he eats
(every milk, every starch or every fruit). For lunch today he will eat:

Turkey sandwich with two slices of bread 2 starches

1 small apple 1 fruit

1 cup of non-fat milk 1 milk

__________________

Total carbohydrate exchanges = 4

Fred's lunch has a total of 4 carbohydrate exchanges so he will take a meal bolus of 4 units for his lunch.

Bolus practice:

NOTE: Make sure that you are not connected to your pump while practicing.

Going through the menus, program a 2.0 unit Normal bolus now.

Check here if you were able to program it.

Using the EXPRESS BOLUS button , program a 2.0 unit Normal bolus now.

Check here if you were able to program it.

Basic programming 27

 Chapter 3

Normal meal bolus practice using exchanges

Choose a meal you might eat and fill in the blanks.

Food:__________ exchange:____________

__________ exchange:____________
__________ exchange:____________

total exchanges:____________

You will take _______ units of insulin for each exchange. Your total bolus is _______ for this meal.

Normal meal bolus using carbohydrate counting

Lydia has been taught that she needs to take 1 unit of insulin for every 10 grams of carbohydrate. This is
her insulin to carbohydrate ratio. For dinner she will have:

4 oz. broiled chicken 0 grams

2/3 cup of rice 30 grams

1/2 cup cooked broccoli 5 grams

1 oz. dinner roll 15 grams

1 tsp margarine 0 grams

__________________

total grams of carbohydrates = 50 grams

Lydia's dinner totals 50 grams of carbohydrate. Her insulin to carbohydrate ratio is 1 unit to 10 grams. She
will take a meal bolus of 5 units for her dinner. She determined this by dividing 50 (total grams of
carbohydrate) by 10 (insulin to carbohydrate ratio).

Basic programming

28

Normal meal bolus practice using carbohydrates

Choose a meal you might eat and fill in the blanks.

Food:__________ grams of carbohydrate:____________

__________ grams of carbohydrate:____________
__________ grams of carbohydrate:____________

total grams of carbohydrate:____________

Your insulin to carbohydrate ratio: 1 unit of insulin for _______ grams carbohydrate.

Divide your total carbohydrates by your insulin to carbohydrate ratio and take _____ units of insulin for
your meal.

Meal bolus, correction bolus and insulin sensitivity

Jason is ready to eat his breakfast. He has calculated that he will need 4.0 units for his food.

He tests his blood glucose and finds that it is 200 mg/dL (11.1 mmol/L). Jason knows that his blood glucose
level is above his blood glucose target and will need additional insulin before he eats.

Jason's healthcare professional has determined the following for him:

BG Target: 110 mg/dL (6.1 mmol/L)

Insulin sensitivity

1

: 36 mg/dL/u (2.0 mmol/L/u)

Jason determines that he will need a correction bolus of 2.5 units insulin to lower his elevated blood
glucose. The 2.5 correction bolus will lower his current blood glucose of 200 mg/dL (11.1 mmol/L) to his
target of 110 mg/dL (6.1 mmol/L).

• elevated blood glucose: 200 − 110 = 90 mg/dL (11.1 − 6.1 = 5 mmol/L)

• correction bolus: 90 / 36 mg/dL/u (insulin sensitivity) (5.0 / 2.0 mmol/L/u) = 2.5 units

(He will add this 2.5 correction bolus to the 4.0 units of insulin that he will need for his meal bolus. Jason
will take a total bolus of 6.5 units.)

1. Insulin sensitivity is the amount (in mg/dL or mmol/L) by which blood glucose will be lowered after taking 1 unit of insulin.

Consult with your healthcare professional to determine your insulin sensitivity.

Basic programming 29

 Chapter 3

Practice: Meal bolus

You have determined your meal bolus as: _______ units.

Your target blood glucose range is: _______ to _______ (average is _______).

Your current blood glucose level is: _________.

Your correction factor is: 1 unit of insulin will drop your blood glucose _________.

You will take ________ unit(s) of insulin to correct your high blood glucose level.

Your total bolus (meal bolus plus correction bolus) is _________.

Review your bolus deliveries

You can view a list of your bolus deliveries in the BOLUS HISTORY screen. This screen shows a list of the
dates, times, units, and types for your last 24 boluses. This feature is helpful for record keeping or to check
if you bolused for your last meal.

If a bolus was stopped before delivery was complete, the BOLUS HISTORY screen will show only the amount
actually delivered. Refer to the Bolus details section in this chapter for instructions about viewing bolus
details.

Do the following steps to view the BOLUS HISTORY screen:
1

Go to the BOLUS HISTORY screen and scroll through the bolus deliveries.

Main > Bolus > Bolus History

Basic programming

30

If you used the Bolus Wizard feature to deliver any of these boluses, the BOLUS HISTORY screen shows
the carbohydrate/food (CH) and blood glucose values that the Bolus Wizard feature used to calculate
the boluses.

(with the Bolus Wizard feature)

date

time

amount/type

carb value BG value

N = Normal
S = Square Wave
DN = Normal part of dual wave bolus
DS = Square part of dual wave bolus

2 Refer to the instructions in the Bolus details section to see the details for any of these boluses.

Bolus details

You can view the details of any of the deliveries in the BOLUS DETAIL screen. The details include:

• bolus types: normal, square, and dual

• programmed bolus amount

Basic programming 31

 Chapter 3

• delivered bolus amount

• Bolus Wizard feature information (if used)

To see the details of any bolus, do these steps:

1

In the BOLUS HISTORY screen, select the bolus that you want to review and press ACT.

2

The details for that bolus will appear on the screen. Scroll through the details.

Press the down key to see the
details

If the Bolus Wizard feature
calculated your bolus, more
information will appear in the
BOLUS DETAIL screen.

delivery is active

delivery stopped

delivery completed

Without the Bolus Wizard feature With the Bolus Wizard feature

3 Exit when you are done.

Basic programming

32

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 Max bolus amount.

To set the Maximum bolus limit, do these steps:
1

Go to the MAX BOLUS SETUP screen.

Main > Bolus > Bolus Setup > Max Bolus

2

Set your Max bolus limit and press ACT. To accept the set Max bolus limit, press ACT. To change this
limit, press ESC, and then set a lower Max bolus limit.

3

Your Max bolus is set. Exit the menus.

Example 1: Max bolus

Shelby takes very small doses of insulin for her meal boluses. As a safety limit, she and her healthcare
professional reset her pump with a Maximum bolus of 5.0 units.

Example 2: Max bolus

David is a growing teenager. He loves to eat big meals and requires very large doses of insulin for his food.
He reset his pump with a Maximum bolus of 20.0 units so he can take more insulin when he needs to.

Scroll rate

The scroll rate feature allows you to program bolus insulin delivery in preset increments. These increments
are effective on all bolus screens, except for the SET EASY BOLUS screen. See the Easy bolus setup section
in the Optimizing pump therapy chapter for more information on how to set up the steps for your Easy Bolus.
The factory setting for the scroll rate feature is 0.10 units, and the available options are 0.025, 0.05, or

0.10 unit increments.

When you set the scroll rate to 0.025, you can use the following increments to program a bolus:

• 0.025 unit increments for a bolus of 0.975 units or less

• 0.05 unit increments for a bolus between 1 unit and 9.95 units

• 0.10 unit increments for a bolus of 10 units or more

Basic programming 33

 Chapter 3

When you set the scroll rate to 0.05, you can use the following increments to program a bolus:

• 0.05 unit increments for a bolus of 9.95 units or less

• 0.10 unit increments for a bolus of 10 units or more

When you set the scroll rate to 0.10, the increments will increase or decrease by 0.10 units during bolus
programming regardless of the bolus value.

To program your scroll rate:
1

Go to the SET SCROLL RATE screen.

Main > Bolus > Bolus Setup > Scroll Rate

2

The scroll rate value appears flashing. Change the value and press ACT.

3

The pump returns to the BOLUS SETUP screen. Your scroll rate is now programmed and ready to use. Exit
the menus.

Example: Scroll rate

You have set your scroll rate to 0.025 units. You need to set your pump to deliver a 2.5 unit bolus. The
bolus values on the SET BOLUS screen will change in 0.025 unit increments until you reach 1.0 unit. After
this the value will change in 0.05 unit increments until you reach 2.5 units in the SET BOLUS screen.

BG Reminder

After you deliver a bolus you may want to check your blood glucose. The BG Reminder is an optional feature
that makes the pump beep or vibrate to remind you to check your blood glucose after a bolus. However, this
reminder is not available after an Easy Bolus. Your pump is set at the factory with the BG Reminder feature
turned off.

When setting a bolus, if the BG Reminder is on, your pump will ask you to set up the BG Reminder Duration.
This sets how long after bolus delivery you will be reminded to check your BG. This time can be from
30 minutes to 5 hours, or NONE. The BG Reminder is not available after an Easy Bolus.

1

Go to the BG REMINDER SETUP screen.

Main > Bolus > Bolus Setup > BG Reminder

2

Select On and press ACT. The BG Reminder is now enabled. Exit the menus.
Now, the next time you program a bolus, your pump will ask you for the amount of time after your bolus

before you want to be reminded to check your blood glucose.

Basic programming

34

When the BG Reminder goes off, your pump will beep or vibrate and CHECK BG will appear on the screen.
Your pump will beep or vibrate periodically until it is cleared (ESC, ACT).

When you set a BG Reminder after a bolus, the STATUS screen will
show the amount of time remaining before the reminder goes off.
Here, the STATUS screen indicates that the BG Reminder will go off
in 18 minutes.

Capturing Events

The Capture Event feature electronically saves certain types of information. Some examples include:

• Blood glucose (BG) measurements

• The amount of insulin you use

• The amount of carbohydrates you eat or drink

• The exercise you do

• Other (this can be used for anything else as needed)

Make sure that you enter events when they happen since the system records the time of the entry. You cannot
change entries after you have put the information into your device. The entered information can be sent to

Medtronic CareLink

®

Personal software. Here it can be used to generate treatment reports that you can share
with your healthcare professional. You can view up to 10 of the latest saved events in the CAPTURE HISTORY
screen.

Turning on the Capture Event feature

The Capture Events option appears in the MAIN MENU after this feature has been turned on in the UTILITIES
MENU.

To turn on the Capture Event feature, do these steps:
1

Go to the CAPTURE EVENT ON/OFF screen:

Main > Utilities > Capture Option

2

Select On, then press ACT.
You will now have a Capture Event option in the MAIN MENU.

Basic programming 35

 Chapter 3

Entering BG measurements

You can save non-calibrating BG readings in device history. Non-calibration meter BG measurements are those
that are taken at times when you will not use them for calibration, such as after eating or when your blood
glucose is rising or falling rapidly. You also have the option of using the entered reading for calibration
purposes. Do not calibrate if your sensor is not communicating with your device.

Before you can enter BG readings, you must select the BG units for the Capture Event features. You can set
the BG units to mg/dL or mmol/L.

To set the BG units:
1

Go to the BLOOD GLUCOSE UNITS screen.

Main > Capture Event > BG Units

2

Select either mg/dL or mmol/L, then press ACT. The CAPTURE EVENT menu shows.

3

You can now enter your BG reading.

To enter the BG measurement:
1

Make a note of the BG measurement.

2

Go to the ENTER BG screen.

Main > Capture Event > Enter BG

The ENTER BG screen flashes with dashes or the most recent meter BG measurement you entered.

3

Enter your new measurement, then press ACT. The BG measurement must be between 20–600 mg/dL
(1.1–33.3 mmol/L). A message asks if you want to save the new measurement that is shown on the
screen.

• If the information is correct, select Save BG, then press ACT. Your BG is saved.

• If the Bolus Wizard feature is off, the CAPTURE EVENT screen appears.

• If the Bolus Wizard is on and the saved BG is below your BG Target range, the BG Saved screen

appears. This screen indicates that your saved BG is below your BG Target set in the Bolus Wizard
feature, and the pump beeps three times. See Setting the BG Targets, on page 71 for more
information.

• If the Bolus Wizard is on, the saved BG is above your BG Target range, and the calculated

correction estimate is more than the preset scroll rate increment, the BG Saved screen appears.
This screen indicates that your saved BG is above your BG Target set in the Bolus Wizard feature,
and the pump beeps three times. Go to the ENTER BG screen of the Bolus Wizard feature to
enter a correction bolus. See Setting the BG Targets, on page 71 for more information.

Basic programming

36

• If you want to use the new BG measurement for calibration, select Save and Calibrate. This option

is available when your sensor is communicating with the pump, and the BG measurement is between
40 mg/dL (2 mmol/L) and 400 mg/dL (22.2 mmol/L).

• If the Bolus Wizard is on and the saved BG is below your BG Target range, the BG Saved screen

appears. This screen indicates that your saved BG is below your BG Target set in the Bolus Wizard
feature, and the pump beeps three times. See Setting the BG Targets, on page 71 for more
information.

• If the Bolus Wizard is on, the saved BG is above your BG Target range, and the calculated

correction estimate is more than the preset scroll rate increment, the BG Saved screen appears.
This screen indicates that your saved BG is above your BG Target set in the Bolus Wizard feature,
and the pump beeps three times. Go to the ENTER BG screen of the Bolus Wizard feature to
enter a correction bolus. See Setting the BG Targets, on page 71 for more information.

• If the information is not correct, select Cancel, then press ACT. The CAPTURE EVENT screen

reappears with Enter BG selected. Repeat the procedure and enter the correct information.

Entering insulin injection information

Follow these steps to enter the amount of insulin you use.

1

Go to the ENTER INSULIN screen.

Main > Capture Event > Insulin Marker

The ENTER INSULIN screen flashes with dashes or the insulin amount that you most recently entered.

2

Enter the amount of insulin you used, then press ACT. A message appears asking you if you want to save
this information. The Yes option is selected.

3

Make sure that the amount of insulin shown on the screen is correct.

• If the information is correct, press ACT. The information you entered is saved to the system and can

now be used in reports.

• If the information is not correct, select No, then press ACT. The CAPTURE EVENT menu shows.

Repeat the procedure to enter the correct information.

Basic programming 37

 Chapter 3

Entering carbohydrate information

This section shows you how to enter information about the carbohydrates you eat or drink.

Before you begin

Before you can enter carbohydrate information, you must select the carbohydrate units (Carb Units) for the
Capture Event feature. You can set the carbohydrate units to grams or exchanges.

To set the carbohydrate units:
1

Go to the CARB UNITS screen.

Main > Capture Event > Carb Units

2

Select either Grams or Exchanges, then press ACT. The CAPTURE EVENT menu shows. You are now ready
to enter your carbohydrate information.

To enter carbohydrate information:
1

Determine the total units of carbohydrates in the meal or snack that you plan to eat.

2

Go to the ENTER FOOD screen.

Main > Capture Event > Meal Marker

3

The ENTER FOOD screen flashes with dashes or with the number of carbohydrate grams or exchanges you
entered last time.

4

Enter the carbohydrate grams or exchanges, then press ACT. A message asks if you want to save the
information that is displayed on the screen. The Yes option is selected.

5

Make sure the number shown on the screen is correct.

• If the information is correct, press ACT. The information you entered is saved to the system and can

now be used in reports.

• If the information is not correct, select No, then press ACT. The CAPTURE EVENT menu shows.

Repeat the steps above to enter the correct information.

Entering exercise information

Follow these steps to enter exercise information. Be consistent and enter the marker either before or after
each time you exercise.

1

Follow the path below to save your exercise information:

Main > Capture Event > Exercise Marker

2

A message asks if you want to save this exercise.

3

Make your selection, then press ACT.

Basic programming

38

Entering Other markers

This section shows you how to enter markers other than Enter BG, Insulin Marker, Meal Marker, or Exercise
Marker. Examples of Other markers include: when you take medications, when you feel ill, when you are
under stress, and so on. The Other marker appears in CareLink Personal reports, and shows at what time you
have entered it in the Capture Event feature.

To enter Other markers:
1

Follow the path below to save your Other marker:

Main > Capture Event > Other

A message asks if you want to enter this marker.

2

Select Yes, then press ACT. Your pump saves your Other marker and returns to the CAPTURE EVENT
screen.

Viewing Capture Event history

You can view up to 10 captured events saved into the device. The most recent event will be displayed at the
top of the CAPTURE HISTORY screen.

To view the Capture Event history:
1

Go to the CAPTURE HISTORY screen:

Main > Capture Event > History

2

The CAPTURE HISTORY screen displays the saved events. Each event has the date and time when it was
saved, the name, and any detail associated with that event.

Basal

Basal insulin is required to maintain your target glucose values when you are not eating. Your healthcare
professional will calculate this rate for you. Your basal insulin accounts for approximately one half of the
body's total daily insulin requirements. Your pump mimics your pancreas by delivering insulin continuously
over 24 hours.

You can set your insulin pump to change rates during the day to match your needs. Your needs depend on
your lifestyle and insulin requirements. Some people only use one rate throughout the day, while others find
they need more. Your basal rates are made up of insulin deliveries that have start and stop times. Once set,
these rates make up your 24-hour basal pattern and are repeated daily.

Basic programming 39

 Chapter 3

Start and stop times

When you set your basal rate(s) in the BASAL MENU, your pump prompts you to set the start time for each
basal delivery. The start time of one basal rate is the stop time of the previous rate. This gives you continuous
basal insulin through a 24-hour period. For basal rate 1, the start time is midnight (00:00 or 12:00 a.m.) and
cannot be changed. See the following sample graph of basal rates.

12:00 AM

Basal Rate 1

start time

3:00 AM

Basal Rate 2

start time

7:00 AM

Basal Rate 3

start time

9:00 PM

Basal Rate 4

start time

24 hours

rate 3

rate 4 rate 1

rate 2

The start and stop times of basal rates for this example are:

• 12:00 a.m. (00:00) to 2:59 a.m. (2:59) for basal rate 1

• 3:00 a.m. (3:00) to 6:59 a.m. (6:59) for basal rate 2

• 7:00 a.m. (7:00) to 8:59 p.m. (20:59) for basal rate 3

• 9:00 p.m. (21:00) to 11:59 p.m. (23:59) for basal rate 4

If you need one basal insulin that starts before midnight and stops after midnight, you need to set up two
basal rates. These basal rates have the same rate but different start and stop times. For example, in this
graph a basal rate is needed from 9:00 p.m to 2:59 a.m. (21:00 to 2:59) at one rate. Basal rate 1 always starts
at midnight and should be set to end at 2:59 a.m. (2:59). After setting basal rates 2 and 3, rate 4 is set from
9:00 p.m. (21:00) to 11:59 p.m. (23:59) at the same rate as basal rate 1. This gives continuous basal insulin
from 9:00 p.m to 2:59 a.m. (21:00 to 2:59) at one rate.

You cannot set a start time for one basal rate to overlap the next basal rate. The addition of a new basal
rate will erase any basal rates that follow.

Basic programming

40

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

Your basal settings

You must program your basal settings before you can deliver basal insulin. Keep a written record of your
basal settings.

It is recommended that you set your basal rates with the assistance of your healthcare professional.

If you plan to take off your pump for an extended period of time, such as more than a day, set the basal rate
to 0.000 U/H. This will ensure that the insulin delivery records in your pump are accurate. Refer to the If
you remove your pump section in The basics chapter for more information.

Basal programming and delivery

NOTE:

You cannot make changes to your basal rate settings while a percent temp basal is active.

To set your basal rates:
1

Go to the SET BASAL RATE 1 screen.

Main > Basal > Basal Setup > Set/Edit Basal

2

The SET BASAL RATE 1 screen flashes the basal rate in U/H.

3

Enter your first basal rate amount and press ACT.
The start time for your first basal rate is midnight and cannot be changed.

4

The SET START TIME 2 screen appears. The dashes under the screen name flash. The first basal rate is
now set.

If you do not need a second basal rate for the day, press ESC. If you need to set up a second basal rate
for the day, follow steps 5 and 6.

5

In the SET START TIME 2 screen, enter the start time for the next rate.

6

Press ACT. The SET BASAL RATE 2 screen appears. Enter the rate.

7

Press ACT. The SET START TIME 3 screen appears. The second basal rate is now set. If you do not need
to set up any more basal rates for the day, press ESC and skip to step 9. If you need to set up more basal
rates, follow steps 5 and 6 for each basal rate.

8

After you program your last basal rate, press ESC.

Basic programming 41

 Chapter 3

9 The BASAL RATE screen appears. Your basal rate(s) will now deliver as programmed. Exit the menus.

NOTE: The pump delivers basal amounts in 0.025 U/H increments for basal rates of less than 1.00 U/H,

and in 0.05 U/H increments for basal rates of 1.00 U/H or more.

10 When you have finished programming your pump, you can save your settings. Refer to the User settings

section in the Utilities chapter for instructions.

Current basal delivery

The STATUS screen shows your current basal information.

current basal

Daily basal rate(s)

The BASAL REVIEW screen shows your daily basal rates programmed for delivery from midnight to midnight.
Compare your daily insulin deliveries to your blood glucose records to help you and your healthcare
professional identify your optimal daily basal insulin rate(s).

To review your basal rates, do these steps:
1

Go to the BASAL MENU screen.

Main > Basal

2

Select Basal Review and press ACT.

Basic programming

42

3 If you do not use patterns, the STANDARD screen appears.

The delivery details for your standard basal will appear.

basal rate

start times

basal

delivery rates

(24-hour total)
basal insulin

If you use patterns, the BASAL REVIEW screen appears.
The current basal pattern will be highlighted. Select the pattern you want to view. Press ACT.
The delivery details for that pattern will appear.

basal rate

start times

basal

delivery rates

(24-hour total)
basal insulin

4 Exit the menus when you are done.

Setting the Max basal rate

Maximum basal (Max basal) rate is a safety limit for the amount of basal insulin that is able to be delivered
per hour. Your pump is sent from the factory with the Max basal set to 2.00 units per hour. It is important
to determine your Max basal rates with your healthcare professional. This safety feature will not allow you
to program any basal rates, including patterns and temporary basal rates, that are greater than the Max basal
rate.

Basic programming 43

 Chapter 3

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

To set your Max basal rate, do these steps:
1

Go to the MAX BASAL RATE screen. The Max basal rate will be flashing.

Main > Basal > Basal Setup > Max Basal Rate

2

Change the rate and press ACT.

3

Your Max basal rate is now set. Exit the menus.

Example 1: Max basal

Helen has a very low insulin requirement. Her highest basal rate is only 0.400 units per hour. As a safety
measure, Helen's healthcare professional set her pump with a Maximum basal rate of 1.00 units per
hour.

Example 2: Max basal

Rusty needs large amounts of insulin to control his blood glucose levels. His new pump was delivered from
the factory with a Maximum basal rate of 2.00 units per hour, but he needs 2.80 units per hour in the early
morning. Rusty will reprogram his Maximum basal to 3.00 units per hour to accommodate his needs.

Stopping your pump

Suspend stops all insulin delivery, including the current basal and any bolus or Fill Cannula deliveries that
are in progress. While suspended, your pump will not deliver insulin until you resume your pump. When you
resume your pump, the basal delivery will continue.

The pump will beep or vibrate about every 15 minutes on the hour to remind you that it is not delivering
insulin. Example: You suspend your pump at 11:20 AM. The pump will beep/vibrate at 11:30 AM, 11:45 AM,
12:00 PM, and so on until you resume your pump (basal resumes).

Basic programming

44

When suspended, your pump is in Attention mode with a solid circle showing on the pump. When in
Suspend, you can only resume your basal or view the STATUS screen. If the Sensor feature is turned on, you
can also view the sensor graphs and the SENSOR STATUS screen. No other functions are available.

To suspend the pump:
1

Select Suspend from the MAIN MENU, and press ACT.
Main > Suspend

2

SUSPEND will flash on your screen. Press ACT to stop your pump.

3 The screen will show that the pump is suspended and the time that it stopped. After less than one minute,

the pump will return to the HOME screen with a solid circle.

You can verify on your pump STATUS screen that your pump is
suspended.

Resume pump delivery

When the pump is suspended, it defaults to the HOME screen with a solid circle.

To resume your pump and basal delivery, do these steps:

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 without the solid circle.

Basic programming 45

 Chapter 3

NOTE: A bolus or fill cannula that was stopped by suspend will not restart when you resume your pump.

You must reprogram and activate it to finish delivery.

Example:
Suspend function

Helen is ready to eat her lunch. She has just programmed her pump to deliver a meal bolus when the phone
rings. Helen wants to talk on the phone and not eat her lunch right away. She knows that if she lets the
bolus continue and she does not eat her lunch soon, she may be at risk for low blood glucose. Helen suspends
delivery of her pump to stop the bolus, but then resumes delivery to restart her basal insulin. When she is
off the phone and ready to eat, she checks her STATUS screen to see how much insulin she received from
the partially delivered bolus before she suspended her pump. She will reprogram a new bolus for the
remainder of her bolus amount.

Practice:
Suspend function

1 Make sure you are NOT connected to your pump while practicing.

Program your pump to deliver a Normal bolus of 3.0 units. Once the bolus begins, stop the bolus by
suspending your pump.

Remember, when you stop the bolus delivery with SUSPEND, all insulin delivery will stop.

2 Now, RESUME delivery, so that your basal insulin will continue.
3 Check the STATUS screen.
4 How much insulin did the bolus deliver before you Suspended delivery? _______.
5 If you wanted to take the rest of the bolus later, how much would you take to equal 3.0 units?

_______.

Basic programming

46

Practice:
Resume basal delivery after a suspend

Make sure you are NOT connected to your pump while practicing.

1 Give a 3.0 unit bolus now. While it is delivering, suspend the bolus.
2

Check here if you were able to suspend the bolus.

3 Now restart the pump.
4

Check here if you were able to restart the pump.

Basic programming 47

 Chapter 3

Basic programming

48

Starting on insulin

The Paradigm pump is intended for use with U100 insulin. The following insulins have been tested by
Medtronic MiniMed and found to be safe for use in Paradigm REAL-Time insulin pumps (MMT-523, MMT-723,
MMT-523K, and MMT-723K):

• Humalog

• Novolog

Before using different insulin with this pump, check the insulin label to make sure the insulin can be used
with the pump.

Prepare your pump for use

Before continuing with the steps in this chapter, we recommend that you watch your pump training CD-ROM
and complete your pump start training.

When you are done practicing and ready to use your pump with insulin, you must make sure the time and
date are correct on your pump. You must also program your settings as instructed by your healthcare
professional.

You will need these items:

• Pump

• Insulin (U100)

• Paradigm reservoir and user guide

• Paradigm compatible infusion set and user guide

Starting on insulin 49

 Chapter 4

Setting up the reservoir

WARNING: Using cold insulin can cause air bubbles in the reservoir and tubing. If your insulin is stored
in the refrigerator, allow it to reach room temperature before filling your reservoir. When filling the
reservoir, take care to remove air bubbles.

Filling the reservoir

1 Remove the reservoir from the package. Make sure the plunger rod is fully extended.
2

Swab the vial with alcohol.

3

Making sure you do not push down on the plunger, press the transfer guard onto the vial.

plunger
rod

transfer
guard

reservoir

vial

31

4 Push down on the plunger to pressurize the vial.
5

While still holding the plunger rod, flip the vial over so the vial is up, slowly pull down on the plunger
to fill the reservoir.

6

Gently tap the side of the reservoir to make any air bubbles rise to the top of the reservoir.

45

6

Starting on insulin

50

7 Slowly push up on the plunger just enough to remove any air bubbles from the reservoir.
8

Slowly pull down on the plunger to fill the reservoir to the number of units desired.

9

With the vial down, hold the transfer guard. Turn the reservoir counter-clockwise, then pull straight up
to remove the vial from the transfer guard.

10

Place the tubing connector onto the reservoir. Turn the connector clockwise, pressing gently against the
reservoir until you feel it slide in. Push in and continue turning until the reservoir and the connector lock
with a click.

7

8

9

10

11 Tap the side of the reservoir to remove any air bubbles.
12

To purge air bubbles that have risen to the top of the reservoir, push up on the plunger until you see
insulin in the tubing.

13

Without pulling, turn the plunger counter-clockwise to remove it from the reservoir.

11 12

13

14 Use your reservoir immediately after you fill it. Do not store it filled.

Starting on insulin 51

 Chapter 4

Changing your infusion set

Removing the reservoir

Each time you remove and replace a reservoir in your pump, you have to rewind your pump, and fill the
infusion set with insulin.
1

Remove the entire infusion set from your body.

2

If attached, remove the activity guard.

3

Turn the tubing connector half-turn counter clockwise, then pull the reservoir and connector out from
the pump.

tubing connector
half-turn counter-clockwise

3

4 Safely dispose of the used reservoir and infusion set item in a sharps container.
5

You must now rewind your pump as described in the next section.

Rewinding your pump

Before you continue, make sure the infusion set is NOT connected to your body and the reservoir is NOT in
the pump.

Starting on insulin

52

WARNING: Make sure the infusion set is disconnected from your body before you rewind your pump or
fill the infusion set tubing. Never insert the reservoir into the pump while the tubing is connected to
your body. Doing so could result in an accidental infusion of insulin.

1 If you removed your reservoir and are replacing it, go to the REWIND screen.

Main > Reservoir + Set > Reservoir Setup

2

In the REWIND screen, press ACT to start the rewind process. The REWINDING screen will appear while
the pump rewinds.

3

After the pump rewinds the REWIND COMPLETE screen will appear.

If you are practicing:

a. Do NOT insert the reservoir in your pump. Make sure the red shipping cap is installed in the reservoir

compartment as shipped.

b. Press ACT, then continue with the instructions in the Filling the tubing section in this chapter.

If you are not practicing, continue to the next section to insert the reservoir in your pump.

Inserting the reservoir in your pump

If your reservoir is already inserted in your pump, continue to the next section.

You must do these steps in the order described. If you are practicing, do NOT insert the reservoir in your

pump.

CAUTION: You must rewind your pump before installing a new reservoir. As part of the pump's function,
it calculates the reservoir volume. To ensure correct volume calculations, your pump has been designed
to require a rewind before you insert your reservoir.

1 If you are using the pump for the first time, remove the red shipping cap from the reservoir

compartment.

WARNING: Do not insert the reservoir in the pump if you did not rewind. Doing so could result in
inaccurate insulin delivery.

Never insert the reservoir into the pump while the tubing is connected to your body. Doing so could
result in an accidental infusion of insulin.

2 Insert the reservoir into the top of the pump case.

Starting on insulin 53

 Chapter 4

3 Turn the tubing connector approximately 1/2 -turn clockwise until the connector is seated. The tubing

connector should be aligned horizontally with the pump case as shown here.

tubing connector

2

3

4 Attach the activity guard, if desired.
5

If the pump has returned to the HOME screen, press ACT to show the REWIND COMPLETE screen. Press
ACT again to go to the FILL TUBING screen.

6

You must now fill the infusion set tubing as described in the next section.

Filling the tubing

You need to fill the infusion set tubing with insulin before you insert the set into the body.

WARNING: Make sure the infusion set is disconnected from your body before you fill the infusion set
tubing. Never insert the reservoir into the pump while the tubing is connected to your body. Doing so
could result in an accidental infusion of insulin.

1 After you rewind your pump, the FILL TUBING screen will appear.

a. If the infusion set is NOT disconnected from your body, press ACT to select No on the screen. After

you disconnect the infusion set from your body, press ACT on the next screen to continue.

b. If the infusion set is disconnected from your body, select Yes on the FILL TUBING screen. Press ACT

to continue to the next FILL TUBING screen.

2

Press and hold ACT. The pump will beep six times indicating that the pump is positioning the
reservoir.

3

After the reservoir is positioned, you need to fill the infusion set tube with insulin. Press and hold ACT
until insulin droplets form on the tip of the infusion set needle, then release. Follow the instructions on
the screen. You will hear beeps as the pump fills the tubing with insulin. Be sure no bubbles are in the
tubing.

Starting on insulin

54

WARNING: If the FILL TUBING screen does not display, do NOT continue. Do NOT insert the infusion
set into your body. Please contact our 24 Hour HelpLine for assistance.

Take care to remove air bubbles when filling the infusion set tubing.

If you use more than 30 units of insulin to fill the infusion set tubing, the MAX FILL REACHED alarm screen
will appear. If you get this alarm, do these steps:

a. Make sure that you are not connected to the pump.
b. Read the message on the screen, then press ESC, ACT to clear.
c. To continue filling the infusion set tubing, select Yes, Continue and press ACT. See the next step

to continue. If you have made a mistake, select No, Rewind and press ACT. The REWIND screen will
appear. Refer to the pump rewinding and insulin loading instructions in this chapter to continue.

4

A message will appear: DO YOU SEE DROPS AT END OF TUBING?
Do not press ESC because this will trigger a FINISH LOADING alarm in 10 minutes. Make sure to complete

this Fill Tubing step. Select Yes or No.

a. If you do NOT see drops at the tip of the needle, select No and press ACT. Make sure your infusion

set is NOT connected to your body. Follow the instructions on the FILL TUBING screens to continue
filling the infusion set tubing with insulin.

b. If you see drops formed at the tip of the needle, select Yes and press ACT. The FILL CANNULA screen

will appear.

5

You can now insert the infusion set into your body as described in the next section.

Inserting the infusion set

WARNING: While the infusion set is connected to your body, do not unscrew and retighten the tubing
connector on the reservoir.

After you complete all of the following, you will be ready to insert the infusion set into your body:

• fill your reservoir

• rewind your pump

• insert the reservoir into pump

Starting on insulin 55

 Chapter 4

• and fill the infusion set with insulin

Shown here are the best body areas (shaded) for infusion set insertion.
Avoid the 2-inch (5.0 cm) area around the navel.

It is important that you change your infusion set every two to three
days. Be sure to rotate the infusion set insertion sites so that they do
not become overused. The abdominal area is the most common site for
set insertions because absorption is very consistent. To keep abdominal
sites healthy, some people find it helpful to use a visual scheme to help
them rotate their insertion sites in an organized way. Here are two commonly used methods. For maximum
effectiveness, use both methods, alternating between them:

• Visualize an imaginary clock drawn on your abdomen surrounding your belly button.

Rotate infusion set insertion sites by starting at 12 o’clock and then rotate the site
clockwise to 3 o’clock, 6 o’clock, and so on.

• Imagine a letter M or a letter W on either side of your belly button. Start at the end of

one letter and proceed through the letter, rotating to each intersection in turn.

Medtronic Diabetes offers different infusion sets for your pump. Instructions for the Quick-set® begin on the
next page as an example. Always refer to the instructions that shipped with your infusion set.

After your infusion set is inserted, see the Filling the cannula section in this chapter to fill the infusion set
cannula.

Starting on insulin

56

Quick-set infusion set (with Quick-serter®)

There are different infusion sets that you can use with your pump. As an example, the following procedure
shows how to insert the Quick-set infusion set. Always refer to the instructions that shipped with your infusion
set.

2

4

5

7

8

9

10

11

12

13

14

3

1

6

Starting on insulin 57

 Chapter 4

Filling the cannula

Filling the soft cannula with insulin is required after the infusion set is inserted into your body and the
introducer needle is pulled out. The insulin amounts required to fill the cannula depend on the type of
infusion set you are using. Refer to your infusion set instructions for this information. If you are using an
infusion set with a needle, press ESC to skip this step.

If you do not complete the Fill Cannula steps, your pump triggers a FINISH LOADING alarm. If you need to
skip the Fill Cannula step, press ESC to avoid getting this alarm.

1

After you have filled the infusion set tubing, the FILL CANNULA screen appears. It displays a message to
connect the infusion set to your body. Press ACT to fill the cannula. To skip this step, press ESC until
you see the MAIN MENU screen. If you do not complete this step, the RESERVOIR + SET MENU screen
appears after 15 minutes. After 10 minutes, your pump triggers a FINISH LOADING alarm.

2

Enter the amount for your type of infusion set, then press ACT. To skip this step, press ESC until you see
the MAIN MENU screen. If you do not complete this step, the RESERVOIR + SET MENU screen appears after
one minute. After 10 minutes, your pump triggers a FINISH LOADING alarm.

3

As the cannula starts filling, the FILLING CANNULA screen will count up the units as they are delivered.
The pump will beep or vibrate when the cannula is full.

To see how much insulin was delivered to fill the infusion set:
1

Go to the HISTORY screen.

Main > Reservoir + Set > History

2

Scroll through the list of insulin deliveries. The letter T at the end of the text line indicates that insulin
was delivered to fill the tubing. The letter C at the end of the text line indicates insulin was delivered
to fill the cannula. Exit the menus.

Starting on insulin

58

Disconnecting Quick-set

The Quick-set allows you the freedom to temporarily disconnect from your pump without removing the
infusion set from your body.

1

Hold the side grips of the connector part with your fingers.

2

Twist the connector counter-clockwise.

3

Remove the connector from the site.

12

3

Reconnecting Quick-set

Place the connector part (flat side facing down) on the infusion site until it is fully seated. Do not squeeze
the connector part by the flat side grips.

12

3

Starting on insulin 59

 Chapter 4

Record keeping for diabetes management

Now that you are using the pump, we will be asking you to test your blood glucose regularly. It is important
to test often and write down your blood glucose readings, the food you eat, any exercise you perform and
any other notes to explain your blood glucose results.

You must test at the recommended times and any other time that you feel your blood glucose is high or low.
Be sure to include your meal boluses, correction boluses, the amount of carbohydrate you eat, basal rate
and any other information that will be helpful in assisting your healthcare professional in adjusting your pump
settings.

It is very important to look at your blood glucose readings as feedback regarding your diabetes management,
not as statements about you or your self-worth. Try not to have an emotional reaction to the numbers and
do not judge them too harshly. You will soon learn how to modify the numbers easily and precisely through
insulin pump therapy.

Test at least four to six times per day. These are the recommended times to test to determine control:

• Overnight (occasionally, at approximately 2:00 - 3:00 AM)

• Pre-breakfast (fasting)

• Post-breakfast (approximately two hours after eating)

• Pre-lunch

• Post-lunch (approximately two hours after eating)

• Pre-dinner

• Post-dinner (approximately two hours after eating)

• Bedtime

• Before driving

Determining your pump settings

Your healthcare professional will use your daily blood glucose journal records to program your pump. It is
very important to keep good records during the first weeks after you start on pump therapy. Not only must
you record your blood glucose readings, but it will be important to eat regularly scheduled meals and to keep
your activity as consistent as possible.

Until you and your healthcare professional determine the pump settings that will work best for you, it is
important to eat meals for which it is easy to count the carbohydrates. After your correct basal rate is
determined, you will be able to experiment with varied food choices and amounts.

Starting on insulin

60

After you and your healthcare professional are satisfied with your initial pump settings, you may begin to
experiment with different food choices, meal times and exercise schedules.

Starting on insulin 61

 Chapter 4

Starting on insulin

62

Using the Bolus Wizard feature

What is it?

Bolus Wizard is a feature that calculates an estimated bolus to support your food intake or to correct a high
blood glucose. To use this feature, you need the following information:

Carbohydrate counting

You need to know which foods contain carbohydrates and how to count these.

Your blood glucose reading

You need to know your blood glucose (BG) reading. When using
the Bolus Wizard feature, the pump can work with blood glucose
meter powered by MWT1 technology to automatically receive
your blood glucose reading. MWT1 is the wireless Radio
Frequency (RF) technology that is used to transmit information
from the meter to the pump. You can program your pump to automatically receive your BG reading from this
meter. All meters referenced in this user guide are blood glucose meters supported by MWT1 technology. The
Meter option section has more information. If you are not using this meter, you will manually enter your
blood glucose.

Your personal Bolus Wizard feature settings

In addition to your blood glucose reading and/or your food entry, the Bolus Wizard feature uses personal
settings that you program into the pump. (For instructions see the How to program the Bolus Wizard feature
section in this chapter.)

• carb units (grams or exchanges)

• carb ratios (in carbohydrate grams/unit of insulin or insulin units/carb exchanges)

• BG units (mg/dL or mmol/L)

• insulin sensitivity

Meter

BG readings

Using the Bolus Wizard feature 63

 Chapter 5

• target blood glucose range

• active insulin time (hours)

Get this information from your healthcare professional, and, for best results, talk to your healthcare
professional before making any changes. Keep a record of your settings in the following Bolus Wizard feature
settings table:

Bolus Wizard feature settings

Information Setting

Carb units: _____ grams or ____ exchanges
Carb ratios:

Bolus Wizard feature uses this for your food bolus calculations.

If you count carbs:
this ratio is the amount of carbohydrate grams covered by one
unit of insulin.

range: 1–200 grams/unit

If you count exchanges:
this ratio is the amount of insulin you need to cover one (carb)
exchange.

range: 0.075–15.0 units/exchange

NOTE: Your carb ratios may vary throughout the day. Your

pump allows you to program up to eight different carb
ratios.

#1: __________
#2: __________

#3: __________
(additional settings,
if needed)

#4: __________

#5: __________

#6: __________

#7: __________

#8: __________

start time

(midnight)

BG units: (how you measure your blood glucose) _____ mg/dL or _____ mmol/L

Using the Bolus Wizard feature

64

Bolus Wizard feature settings

Information Setting

Insulin sensitivity:

This ratio is used for your correction bolus calculations.
This ratio is the BG units reduced by 1.0 unit of insulin.

range: 10–400 mg/dL/u or 0.5–22.2 mmol/L/u

NOTE: Your insulin sensitivity may vary throughout the day.

Your pump allows you to program up to eight different insulin
sensitivities.

BG units reduced /
1 unit of insulin

#1: __________

#2: __________

#3: __________
(additional settings,
if needed)

#4: __________

#5: __________

#6: __________

#7: __________

#8: __________

start time

(midnight)

Using the Bolus Wizard feature 65

 Chapter 5

Bolus Wizard feature settings

Information Setting

BG Target range:

If your current blood glucose is above the BG Target range, the
Bolus Wizard feature will calculate a correction dose. If your
current blood glucose is below the BG Target range, the Bolus
Wizard feature will calculate a negative correction and
subtract it from your food bolus.

range: 60–250 mg/dL or 3.3–13.9 mmol/L

NOTE: Your pump will allow you to program up to eight

different BG Target ranges.

#1: __________
#2: __________

#3: __________
(additional settings,
if needed)

#4: __________

#5: __________

#6: __________

#7: __________

#8: __________

start time

(midnight)

Active insulin time:

The Bolus Wizard feature uses this time to calculate the active
insulin in your system (see the About active insulin section in
this chapter). Use your healthcare professional's
recommendation for the active insulin time that best
represents the insulin type you use and your physiological
insulin absorption rate.

range: 2-8 hours

Number of Hours: _____

How the Bolus Wizard feature works

1 If you want your current blood glucose to be factored in, enter your BG Reading.

• automatically from the meter (refer to the Meter option section), or

• manually by selecting the

button.

2

If you are going to eat, enter your food amount in grams or exchanges.

3

The Bolus Wizard feature will calculate a bolus for you. An ESTIMATE DETAILS screen will appear with
your estimated total bolus amount.

Using the Bolus Wizard feature

66

Bolus Wizard warnings

When using the Bolus Wizard feature, the pump may display a HIGH BG, LOW BG, and MAX BOLUS EXCEEDED
warnings.

HIGH BG

If your blood glucose in the ENTER BG screen is above 250 mg/dL (13.9 mmol/L), the Bolus Wizard feature
displays a HIGH BG warning. Read the instructions, then press ACT or ESC to clear the message. You can then
continue programming to deliver your bolus.

LOW BG

If your blood glucose in the ENTER BG screen is below 70 mg/dL (3.9 mmol/L), the Bolus Wizard feature
displays a LOW BG warning. Read the instructions, then press ACT or ESC to clear the message. You can then
continue programming to deliver your bolus.

MAX BOLUS EXCEEDED

Bolus Wizard feature will not deliver more than the limit set for your maximum bolus. If the Bolus Wizard
feature calculates a bolus amount that is larger than your max bolus limit setting, the message, MAX BOLUS
EXCEEDED will appear. If this happens, do these steps:

1

In the MAX BOLUS EXCEEDED screen, press ACT to continue your bolus programming. The EST : MAX screen
appears with the estimated and maximum bolus amounts. Continue to the next step.

If you do not want to continue, press ESC to cancel and the screen will return to the ENTER BG
screen.

2

In the EST : MAX screen, press ACT again to continue your bolus programming.

3

The SET BOLUS screen appears with the maximum bolus amount flashing. Enter the bolus amount. This
amount cannot be more than the max bolus amount. Press ACT.

4

The BOLUS DELIVERY screen appears showing the insulin units being delivered.

5

The pump will beep/vibrate after it has completed the insulin delivery.

How to program the Bolus Wizard feature

You need your personal settings from the Bolus Wizard feature settings table to setup the Bolus Wizard
feature. Your Bolus Wizard feature settings are programmed in the EDIT SETTINGS screen.

Main > Bolus > Bolus Setup > Bolus Wizard Setup > Edit Settings

Using the Bolus Wizard feature 67

 Chapter 5

Once the settings are programmed, you do not have to program them again unless the values change. After
you program one setting, the screen will automatically go to the next required setting. After you program
all your settings, review them as described in this section to make sure they are set correctly.

Instructions for programming the Bolus Wizard feature settings are in the next paragraphs. Program your
settings in the order described to make sure you program all the settings. If you have not completed setting
up all of the required settings, MISSING INFO screen appears. It lists the required settings for this feature.
You must program the listed settings before you can use the Bolus Wizard feature.

Turning on the Bolus Wizard feature

1 Go to the EDIT SETTINGS screen.

Main > Bolus > Bolus Setup > Bolus Wizard Setup > Edit Settings

2

The EDIT SETTINGS screen appears with Wizard: Off selected. Press ACT.

3

The WIZARD ON/OFF screen appears. Select On, then press ACT.

4

The EDIT SETTINGS screen appears, showing that the wizard is now turned on. You are now ready to
select your carb units.

Selecting the Carb units

The carb unit setting lets the pump know which way to count your carbohydrates (grams or exchanges).

1

Make sure the EDIT SETTINGS screen is open.

Main > Bolus > Bolus Setup > Bolus Wizard Setup > Edit Settings

2

Select Carb Units, then press ACT.

3

The CARB UNITS screen appears. Select Grams or Exchanges, then press ACT.

4

The EDIT SETTINGS screen shows the carb units you selected. You are now ready to set your carb/
exchange ratios.

Using the Bolus Wizard feature

68

Setting the Carb/Exch ratios

Your pump allows you to set up to eight Carb/Exch ratios because this ratio may vary throughout the day.
Your healthcare professional may only have you program one or two carb ratios when you first start using
the Bolus Wizard feature.

To set the Carb/Exch ratios:
1

Make sure the EDIT SETTINGS screen is open.

Main > Bolus > Bolus Setup > Bolus Wizard Setup > Edit Settings

2

Select Carb Ratios, then press ACT.

• If you use grams as your carb units: Carb ratio is the number of carb grams that are covered by

one (1.0) 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.

3

The SET CARB RATIO 1 (if you are using grams) or SET EXCH RATIO 1 (if using exchanges) screen appears.
The default ratio flashes on the screen.

4

Set your first ratio, then press ACT. Carb ratio values are normally between 5-50 grams/u or 0.3-3.0 u/
exch. If your ratio value is outside the range, a warning message will appear on the screen. This message
warns that the entered carb ratio is valid but outside the usual range. Press ESC to correct or ACT to
continue.

The start time for your first ratio is midnight and cannot be changed.

5

The SET START TIME 2 screen appears. The dashes under the screen name flash. The first Carb Ratio or
Exchange Ratio is now set.

If you do not need a second ratio, press ESC and skip to the next section. If you need to set up another
ratio, follow steps 6 through 9.

6

In the SET START TIME 2 screen, enter the time of the day you want this ratio to become active.

7

Press ACT. The SET CARB RATIO 2 screen (if using grams) or SET EXCH RATIO 2 screen (if using exchanges)
appears.

8

The default ratio flashes. Select your ratio.

9

Press ACT. The SET START TIME 3 screen appears. The second carb or exchange ratio is now set.

10

If you do not need to set up any more ratios, press ESC. If you need to set up more ratios, repeat steps
6 through 9 above for each ratio.

You are now ready to set up the BG units.

Using the Bolus Wizard feature 69

 Chapter 5

Setting the BG units

You can select mmol/L or mg/dL as your Blood Glucose Unit (measurement type). You can also set these
units in the Sensor and Capture Event menus.

1

Make sure the EDIT SETTINGS screen is open.

Main > Bolus > Bolus Setup > Bolus Wizard Setup > Edit Settings

2

Select BG Units, then press ACT.

3

The BLOOD GLUCOSE UNITS screen displays. Select mmol/L or mg/dL, then press ACT.

4

The EDIT SETTINGS screen shows the BG units you selected. You are now ready to set your insulin
sensitivity.

Insulin sensitivity

Your insulin sensitivity is the amount your blood glucose (BG) level is reduced by one unit of insulin. This
value is used to calculate a suggested insulin dose to correct a high BG. Because this sensitivity may vary
throughout the day, your pump lets you set up to eight sensitivity settings. Your healthcare professional may
only have you program one or two insulin sensitivities when you first start using the Bolus Wizard feature.
Record your settings in the Bolus Wizard feature settings table in this chapter.

Insulin sensitivity values are normally between 20–100 mg/dL/u (1.1–5.6 mmol/L/u). If your value is outside
this range, a warning message will appear on the screen.

1

Make sure the EDIT SETTINGS screen is open.

Main > Bolus > Bolus Setup > Bolus Wizard Setup > Edit Settings

2

Select Sensitivity, then press ACT.

3

The INS SENSITIVITY 1 screen appears. The default sensitivity value flashes on the screen.

4

Set the value for your first insulin sensitivity setting, then press ACT.
The start time for your first insulin sensitivity is midnight and cannot be changed.

5

The SET START TIME 2 screen appears. The dashes under the screen name flash. The first insulin
sensitivity is now set.

If you do not need a second insulin sensitivity, press ESC and skip to the next section. If you need to set
up another insulin sensitivity, follow steps 6 through 9.

6

In the SET START TIME 2 screen enter the time of the day you want this insulin sensitivity to become
active.

7

Press ACT. The INS SENSITIVITY 2 screen appears.

8

The default sensitivity value flashes. Select the value for this insulin sensitivity.

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70

9 Press ACT. The SET START TIME 3 screen appears. The second insulin sensitivity is now set.
10

If you do not need to set up any more insulin sensitivities, press ESC. If you need to set up more insulin
sensitivities, repeat steps 6 through 9 above for each insulin sensitivity.

You are now ready to set up the BG Target.

Setting the BG Targets

The BG Target setting allows you to set glucose targets. The Bolus Wizard will use these targets to calculate
a correction dose. Because the targets may vary throughout the day, your pump allows you to set up to eight
BG Targets each day. If you want to set just one target value, instead of a range, set both the low and high
values to the same number.

If your current BG is above the BG Target range, the Bolus Wizard feature may calculate a correction dose.
The correction dose will deliver enough insulin to bring your BG down to your current high end of the BG
Target range. If your current BG is below the BG Target range, the Bolus Wizard may calculate a negative
correction and subtract it from your food bolus. This will bring your BG to the low end of the BG Target
range.

Example:

Glucose Concentration

22.2

13.9

5.6

3.8

400

250

100

70

mmol/L mg/dL

Correct down to the upper
limit of 100 mg/dL

Correct up to the lower limit
of 70 mgl/dL

Targ et Range

Using the Bolus Wizard feature 71

 Chapter 5

Pumps are sent from the factory with default BG Target range of 100–100 mg/dL (5.6–5.6 mmol/L).

1

Make sure the EDIT SETTINGS screen is open.

Main > Bolus > Bolus Setup > Bolus Wizard Setup > Edit Settings

2

Select BG Target, then press ACT.

3

The TARGET RANGE 1 screen appears. The low end of your BG Target range flashes on the screen.

4

Set the BG Target, then press ACT.

5

The high end of your BG Target range flashes on the screen. Enter the BG Target, then press ACT.
The start time for your first BG Target is midnight and cannot be changed.

6

a. If your BG Target is outside of 90–140 mg/dL (5.0–7.8 mmol/L), the pump screen displays a warning

that the values are acceptable but outside normal range. Press ESC to chan ge your BG T arge t or pr ess
ACT to set this range.

b. If your BG Target is within 90–140 mg/dL (5.0–7.8 mmol/L), the SET START TIME 2 screen appears.

The dashes under the screen name flash. The first BG Target range is now set.
If you do not need a second BG Target range, press ESC and skip to the next section. If you need to

set up another BG Target range, follow steps 7 through 11.

7

In the SET START TIME 2 screen enter the time of the day you want this BG Target range to become
active.

8

Press ACT. The TARGET RANGE 2 screen appears.

9

The low end of your BG Target range flashes on the screen. Set the BG Target, then press ACT.

10

The high end of your BG Target range flashes on the screen. Enter the BG Target, then press ACT.

11

The SET START TIME 3 screen appears. The second BG Target range is now set.

12

If you do not need to set up any more BG Target ranges, press ESC. If you need to set up more BG Target
ranges, repeat steps 7 through 11 above for each one.

You are now ready to set up the Active insulin time.

About active insulin

Active insulin is the bolus insulin that has already been delivered to your body, but has not yet been used.
The pump considers your active insulin time setting in determining any active insulin still in your body from
prior boluses. This may help prevent hypoglycemia caused by over-correcting for high blood glucose.

The pump shows the active insulin amount in the ESTIMATE DETAILS screen during the Bolus Wizard
programming steps, the STATUS and the SET BOLUS screens. However, the active insulin amount is calculated
differently in the ESTIMATE DETAILS screen and appears with an asterisk (*Active Insulin). The active insulin
amount calculated in the Bolus wizard steps includes the insulin that has already been delivered and insulin
that is going to be delivered by the active Square Bolus.

Using the Bolus Wizard feature

72

Your Paradigm pump is shipped from the factory with an active insulin time setting of six hours, which most
closely matches the published scientific data. If your healthcare professional prescribes a different time for
you, the active insulin time setting can be adjusted in the Bolus Wizard menu in one-hour increments from
two to eight hours.

For more details about active insulin, see the Bolus Wizard feature specifications section in the Pump
specifications chapter.

CAUTION: If you give yourself insulin by using a syringe, the Bolus Wizard feature will not be able to
correctly determine the active insulin in your system. Consult with your healthcare professional on how
long you need to wait after a manual injection before you can rely on the active insulin calculation of
your Bolus Wizard feature.

Active insulin time

The active insulin time setting lets the pump know which active insulin time to use in calculating the amount
of active insulin to subtract before estimating a bolus. Your healthcare professional should determine the
active insulin time that is best for you.

To set the Active insulin time, do the following steps:
1

Make sure the EDIT SETTINGS screen is open.

Main > Bolus > Bolus Setup > Bolus Wizard Setup > Edit Settings

2

Select Active Ins Time, then press ACT.

3

The ACTIVE INS TIME screen appears. The default time of 6 hours flashes on the screen.

4

Set the number of hours for the active insulin time, then press ACT.

5

The EDIT SETTINGS screen shows the new Active insulin time setting. You have now completed the Bolus
Wizard setup. Press ESC or wait to see the message: Bolus Wizard setup is complete.

Review your Bolus Wizard feature settings

Check your Bolus Wizard feature settings in the REVIEW SETTINGS screen. If necessary, compare this
information with your information in the Bolus Wizard feature settings table.

1

Go to the REVIEW SETTINGS screen.

Main > Bolus > Bolus Setup > Bolus Wizard Setup > Review Settings

2

Scroll through the text to view your Bolus Wizard settings.

3

Exit the menus when you are done.

Using the Bolus Wizard feature 73

 Chapter 5

Normal bolus using Bolus Wizard feature

After the Bolus Wizard feature is turned on and programmed, this feature can calculate an estimate of insulin
you need for your correction bolus and/or your food bolus. You have the option of using the estimate or
changing it as necessary. Additionally, your pump can receive your blood glucose reading from the meter, if
they are linked.

Use the button to deliver a Normal bolus at any time except during another Normal bolus. A Normal bolus
will temporarily interrupt a Square Wave or Dual Wave bolus that is delivering. After the Normal bolus is

finished, the Square Wave or Dual Wave bolus delivery will resume.

NOTE: If you want to use the pump-to-meter link, make sure the meter option is on. Refer to the Meter

option section for instructions.

1 If you want a correction bolus, check your blood glucose with your blood glucose meter and go to step 2.

If you want to bolus for food, go to step 2.

2

Press on your pump, or go to the BOLUS MENU, select Use Bolus Wizard, and press ACT.

3

The ENTER BG screen will appear.

a. If you are not using the meter:

Enter your blood glucose value. Press ACT and continue to step 4. If you are not entering a blood
glucose and want to bolus for food, select the dashes in the ENTER BG screen. The Bolus Wizard
feature will calculate the insulin needed for your food entry without considering your blood glucose
level. Press ACT and continue to step 4.

b. If you are using the meter, you must program your bolus within 12 minutes of the pump receiving

the reading from the meter. If more than 12 minutes have passed, the reading will no longer be
available from the screen and you must enter your blood glucose manually.

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

4

The ENTER FOOD screen appears.

a. If this is a food bolus, enter the food value you will eat, then press ACT.
b. If this is a correction bolus, select 0 (zero) as the value, then press ACT.

5

The ESTIMATE DETAILS screen appears. Review the information on this screen. If you need to make any
changes, press ESC to return to the ENTER BG screen (step 3) and make changes as necessary.

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74

6 Press ACT in the ESTIMATE DETAILS screen. The SET BOLUS screen appears with the estimated bolus

amount flashing. Change the amount if desired. Press ACT to accept and start delivering your bolus.

NOTE: If you have BG Reminder turned On, the BG REMINDER DURATION screen displays. It allows you

to set the duration before you are reminded to check your blood glucose after a bolus. See the BG
Reminder section in the Basic programming chapter for information about this feature.

7 The BOLUS DELIVERY screen appears. The pump will beep or vibrate at the start and end of the bolus.

As the bolus is delivered, the screen shows the bolus type and amount until the total units have been
delivered. The screen then returns to the HOME screen.

Bolus Wizard feature examples

For the scenarios that follow, Michael has his Bolus Wizard feature turned on with the following settings:

Carb ratio: 15 grams per unit of insulin
Insulin Sensitivity: 40 mg/dL (2.2 mmol/L) per unit of insulin

BG Target: 90–120 mg/dL (5.0–6.6 mmol/L)

Active Insulin Time: 6 hours

NOTE: If you want to see details of the formulas the Bolus Wizard feature uses to calculate estimate

boluses like the ones in the following examples, see the Bolus Wizard feature specifications section in the
Pump specifications chapter.

Using the Bolus Wizard feature 75

 Chapter 5

Example 1: Blood glucose on target (normal blood glucose) and no active insulin

Michael awakens in the morning before school and his mother has breakfast waiting for him. Before he
begins eating, he tests his blood glucose with his meter and his blood glucose result of 120 mg/dL
(6.6 mmol/L) is automatically sent to his pump.

He estimates that his meal consists of 60 grams of carbohydrates. When prompted by the Bolus Wizard
feature, he enters this amount in the ENTER FOOD screen. Based on his Bolus Wizard feature settings, the
pump will suggest that he take 4.0 units of insulin.

Food estimate:

Carb grams ÷ Carb ratio = Units of insulin

60 g ÷ 15 g/u = 4 units

Correction estimate:

Correction is 0 because the current BG reading is within the BG Target range.

Total bolus estimate:

Food estimate + Correction estimate = Units of insulin

4 units + 0 units = 4 units

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76

Example 2: Blood glucose above target (high blood glucose) and no active insulin

The next day, Michael wakes up before school. Before eating the same breakfast, he tests his blood glucose
with his meter and finds it to be 200 mg/dL (11.1 mmol/L), which is above his target of 120 mg/dL
(6.6 mmol/L). His blood glucose reading is automatically sent to his pump.

When prompted by the Bolus Wizard feature, he enters his carbohydrate amount of 60 grams in the ENTER
FOOD screen. Based on his settings, the pump will suggest that he take 6.0 units of insulin.

Food estimate:

Carb grams ÷ Carb ratio = Units of insulin

60 g ÷ 15 g/u = 4 units

Correction estimate:

(Current BG - High BG Target) ÷ Insulin sensitivity = Units of insulin

(200 mg/dL - 120 mg/dL) ÷ 40 mg/dL/u = 2 units, or

(11.1 mmol/L - 6.6 mmol/L) ÷ 2.2 mmol/L/u = 2 units

Total bolus estimate:

Food estimate + Correction estimate = Units of insulin

4 units + 2 units = 6 units

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 Chapter 5

Example 3: Blood glucose below target (low blood glucose) and no active insulin

On another morning, Michael sits down before eating the same breakfast. He tests his blood glucose with
his meter and finds it at 70 mg/dL (3.9 mmol/L), which is below his Low BG target of 90 mg/dL
(5.0 mmol/L). His reading is automatically sent to his pump.

When prompted by the Bolus Wizard feature, he enters his carbohydrate amount of 60 grams in the ENTER
FOOD screen. Based on his settings, the pump will suggest that he only take 3.5 unit of insulin.

Food estimate:

Carb grams ÷ Carb ratio = Units of insulin

60 g ÷ 15 g/u = 4 units

Correction estimate:

(Current BG - Low BG Target) ÷ Insulin sensitivity = Units of insulin

(70 mg/dL - 90 mg/dL) ÷ 40 mg/dL/u = -0.5 units, or

(3.9 mmol/L - 5.0 mmol/L) ÷ 2.2 mmol/L/u = -0.5 units

Total bolus estimate:

Food estimate + Correction estimate = Units of insulin

4 units + (-0.5) units = 3.5 units

Using the Bolus Wizard feature

78

Example 4: Blood glucose above target (high blood glucose) with active insulin

Michael is at school and wants to eat a snack in the late morning. He tests his blood glucose with his meter
and finds it at 200 mg/dL (11.1 mmol/L), which is above his target of 120 mg/dL (6.6 mmol/L). He estimates
that his snack contains 60 grams of carbohydrate, so he enters 60 into the pump when prompted by the
Bolus Wizard feature. Based on his settings, and as a result of 1.5 units of active insulin, his pump will
suggest that he take 4.5 units.

Food estimate:

Carb grams ÷ Carb ratio = Units of insulin

60 g ÷ 15 g/u = 4 units

Correction estimate:

(Current BG - High BG Target) ÷ Insulin sensitivity - Active insulin = Units of insulin

(200 mg/dL - 120 mg/dL) ÷ 40 mg/dL/u - 1.5 units = 0.5 units, or

(11.1 mmol/L - 6.6 mmol/L) ÷ 2.2 mmol/L/u - 1.5 units = 0.5 units

Total bolus estimate:

Food estimate + Correction estimate = Units of insulin

4 units + 0.5 units = 4.5 units

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 Chapter 5

Example 5: Blood glucose below target (low blood glucose) with active insulin

Another day at school, Michael is getting ready to eat lunch. He tests his blood glucose with his meter and
finds it at 70 mg/dL (3.9 mmol/L), which is below his Low BG target of 90 mg/dL (5.0 mmol/L). His reading
is automatically sent to his pump.

When prompted by the Bolus Wizard feature, he enters his carbohydrate amount of 60 grams in the ENTER
FOOD screen. Based on his settings, and despite 1.5 units of active insulin, his pump will suggest that he
take 3.5 units of insulin.

Food estimate:

Carb grams ÷ Carb ratio = Units of insulin

60 g ÷ 15 g/u = 4 units

Correction estimate:

(Current BG - Low BG Target) ÷ Insulin sensitivity - Active insulin= Units of insulin

(70 mg/dL - 90 mg/dL) ÷ 40 mg/dL/u - 0* = -0.5 units, or

(3.9 mmol/L - 5.0 mmol/L) ÷ 2.2 mmol/L/u - 0* = -0.5 units

NOTE: *When the current BG is below the Low BG Target, an active insulin amount is not considered in

the Bolus Wizard feature calculations.

Total bolus estimate:

Food estimate + Correction estimate = Units of insulin

4 units + (-0.5) units = 3.5 units

Using the Bolus Wizard feature

80