OmniPod FreeStyle Blood Glucose MonitoringSystem, FreeStyle User Manual

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More actions
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My records
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ettings Suspend
User Guide
GUIDE DE L’UTILISATEUR
Système de gestion de l’insuline
www.MyOmniPod.ca
www.MonOmniPod.ca
Insulin Management System
Système de gestion de l’insuline
Manufactured by / Fabriqué par: Insulet Corporation 9 Oak Park Drive Bedford, MA 01730 USA
Distributed by / Distribué par: GlaxoSmithKline Inc. 7333 Mississaugua Road Mississaugua, Ontario Canada L5N 6L4 1 855 POD INFO (1 855 763 4636) 647-788-3132 (Outside of Canada)
www.MyOmniPod.ca www.MonOmniPod.ca
© 2013 Insulet Corporation. All rights reserved. Printed in USA. © 2013 GlaxoSmithKline Inc. All rights reserved.
OmniPod® is a registered trademark of Insulet Corporation, used under license by GlaxoSmithKline Inc. FreeStyle® is a registered trademark of Abbott Diabetes Care Inc. Third-party trademarks used herein are the trademarks of their respective owners.
PDM imagery is for illustrative purposes only. PDM screens may vary based on model or user settings. Model: CAT45E
15546-AW Rev. A
© 2013 Insulet Corporation. Tous droits réservés. Imprimé au USA. © 2013 GlaxoSmithKline Inc. Tous droits réservés.
OmniPod® est une marque déposée d’Insulet Corporation, utilisée sous license par GlaxoSmithKline Inc. FreeStyle® est une marque deposee de Abbott Diabetes Care Inc. Les marques de commerce tierces utilisees dans cet ouvrage sont la propriete de leurs detenteurs respectifs.
Les images du GPD ne servent qu’à titre d’exemple. Les écrans du GPD peuvent varier selon le modèle ou les réglages de l’utilisateur. Model: CAT45F
User Guide/Guide de l’utilisateur
CAT45E / CAT45F
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Contacts and Important Information
o
Name Address
Telep ho ne and Fax Email Address
Name Address
Telep ho ne and Fax Email Address
Name Address
Telephone Number(s) Policy Number
Name Address
Teleph on e and Fax Email Address
OmniPod System Start Date: ____________________________ PDM Model: CAT45E Serial Number: __________________
Distributor:
GlaxoSmithKline Inc. 7333 Mississauga Road, Mississauga, Ontario, Canada L5N 6L4
Customer Care:
Please call 1 855 POD INFO (1 855 763 4636). When outside of Canada, please call 647-788-3132. Visit www.myOmniPod.ca for additional information and resources.
Doctor
Nurse/Educator
Health Insurance
Pharmacy
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Copyright © 2013 GlaxoSmithKline Inc. All rights reserved OmniPod® is a registered trademark of Insulet Corporation
, used under license by GlaxoSmithKline Inc. FreeStyle® is a registered trademark of Abbott Diabetes Care Inc. Apidra® is a registered trademark of Aventis Pharma S.A. Humalog® is a registered trademark of Eli Lily and Company Corp. Third-party trademarks used herein are the tr
ademarks of their respective owners.
15546-AW Rev A
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iii
Contents
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viii
About This User Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viii
Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viii
Conventions and Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Important Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Indication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Contraindications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Your Role: Safely Using the OmniPod System . . . . . . . . . . . . . . . . . . . xi
1 Your New OmniPod Insulin Management System . . . . . . . . . . 1
Insulin Delivery with the OmniPod System. . . . . . . . . . . . . . . . . . . . . . 1
How Does the OmniPod System Work? . . . . . . . . . . . . . . . . . . . . . . . . . 2
No tubing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Suggested bolus calculation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Carb presets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
A fully-integrated design with blood glucose monitoring . . . . 3
Personalizing your System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
The Pod . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
The Personal Diabetes Manager. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Buttons that program and control the OmniPod System. . . . . 5
Primary screens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Safety Features. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Automatic priming, safety checks, and insertion . . . . . . . . . . . . . 8
Occlusion detection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Alerts and alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
2 Getting Started . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
The OmniPod Starter Kit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Set Up the Personal Diabetes Manager (PDM) . . . . . . . . . . . . . . . . . . . 9
Turn on the PDM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
The Setup Wizard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Enter your PDM ID. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Select the ID screen color. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Set date and time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Enter basal settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Enter blood glucose sound setting and BG goal. . . . . . . . . . . . . 12
Set the suggested bolus calculator . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Enter target blood glucose value. . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Enter minimum BG allowed for use in bolus calculation. . . . . 13
Enter insulin-to-carbohydrate ratio. . . . . . . . . . . . . . . . . . . . . . . . . . 13
Enter correction factor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Set reverse correction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Enter the duration of insulin action. . . . . . . . . . . . . . . . . . . . . . . . . . 14
Select bolus increment and enter maximum bolus. . . . . . . . . . 15
Set extended bolus doses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Set low reservoir advisory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Set expiration notification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
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3 Understanding and Adjusting Basal Rates . . . . . . . . . . . . . . . . 17
What Is a Basal Rate? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Personalized Basal Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Create a basal program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Enable an existing basal program . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Change, rename, copy, or delete a basal program . . . . . . . . . . . 21
Temporary Basal Rates and Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
What is a temporary basal rate? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Enable a one-time temporary basal rate. . . . . . . . . . . . . . . . . . . . . 24
Cancel a one-time temporary basal rate . . . . . . . . . . . . . . . . . . . . . 25
Create a temporary basal preset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Enable an existing temporary basal preset . . . . . . . . . . . . . . . . . . 26
Cancel an active temporary basal preset . . . . . . . . . . . . . . . . . . . . 27
Change, rename, or delete a temporary basal preset . . . . . . . . 27
Maximum Basal Rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
What is the maximum basal rate?. . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Change the maximum basal rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
4 Understanding and Delivering Bolus Doses. . . . . . . . . . . . . . . 29
What Is a Bolus? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Bolus Dose Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Suggested Bolus Calculator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
How a suggested bolus is calculated . . . . . . . . . . . . . . . . . . . . . . . . 31
Deliver a Normal Bolus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Deliver a bolus when suggested bolus calculator is On. . . . . . 32
Deliver a bolus manually (suggested bolus calc is Off). . . . . . . 34
Deliver an Extended Bolus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Deliver an extended bolus instead of a normal bolus. . . . . . . . 35
Cancel Active Boluses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Replace an Extended Bolus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Bolus Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Create a bolus preset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Enable an existing bolus preset. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Change, rename, or delete a bolus preset . . . . . . . . . . . . . . . . . . . 40
Cancel an active bolus preset. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Carb Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Create a carb preset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Change or edit a carb preset. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Delete a carb preset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
5 Using the Pod. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
The Pod Change Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Gather equipment and supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Deactivate the current Pod . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Fill a new Pod. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Select the infusion site. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Insert cannula and begin insulin delivery . . . . . . . . . . . . . . . . . . . . 53
Check Pod Status. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Suspend Insulin Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Resume Insulin Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Avoid Infusion Site Infections. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Get the Most From Your Pod . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Avoid extreme temperatures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Water and your Pod . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Safe storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
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6 Using the Personal Diabetes Manager . . . . . . . . . . . . . . . . . . . . 61
The ID Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
The Status Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Insulin gauge and display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
PDM settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
The System Setup Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Reset the Date or Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Reset the time. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Reset the date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Change Bolus and Basal Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Bolus calcs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Ratios/factors/targets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
Temp basal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Extended. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Bolus increment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Max bolus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Max basal rate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Alerts and Reminders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Set alerts and reminders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
Change Blood Glucose Meter Settings . . . . . . . . . . . . . . . . . . . . . . . . . 72
Change BG goal limits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
Manage the blood glucose tags list . . . . . . . . . . . . . . . . . . . . . . . . . 72
Change BG sound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Customize the Personal Diabetes Manager . . . . . . . . . . . . . . . . . . . . 73
Set PDM options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Set Diagnostic Functions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Diagnostic options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Set a Reminder to Vibrate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Get the Most from Your PDM. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Keep it handy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Communicating with the Pod. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Water and your PDM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Avoid extreme temperatures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Electrical interference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
7 Checking Your Blood Glucose . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
The Built-in FreeStyle® Blood Glucose Meter . . . . . . . . . . . . . . . . . . . 79
The FreeStyle® Blood Glucose Test Strips . . . . . . . . . . . . . . . . . . . . . . . 80
Important test strip information. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
The FreeStyle® Control Solution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
When to perform a control solution test. . . . . . . . . . . . . . . . . . . . . 81
Check that the meter and test strips are working. . . . . . . . . . . . 81
Control solution expiration date. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Ensure accurate control solution results. . . . . . . . . . . . . . . . . . . . . 81
Performing a Control Solution Test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Performing a Blood Glucose Reading . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Prepare the lancing device . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Insert the blood glucose test strip . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Set the blood glucose test strip code. . . . . . . . . . . . . . . . . . . . . . . . 88
Lance your forearm, upper arm, or hand . . . . . . . . . . . . . . . . . . . . 90
Fill the blood glucose test strip with blood . . . . . . . . . . . . . . . . . . 91
Remove the lancet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
Blood Glucose Results and the Suggested Bolus
Calculator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
Entering Blood Glucose Readings Manually. . . . . . . . . . . . . . . . . . . . 95
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Editing Tags . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Low and High Blood Glucose Readings. . . . . . . . . . . . . . . . . . . . . . . . . 97
Low readings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
High readings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Important Health-Related Information . . . . . . . . . . . . . . . . . . . . . . . . . 98
8 Understanding Your Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Record Keeping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Special symbols in record screens . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Insulin Delivery Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100
View insulin delivery records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100
Blood Glucose Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
View single-day trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
View multiple-day trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Alarm Records. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Carbohydrate Records. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
All Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
User Information/Support. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
9 Living with Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Your Role: Safely Using the OmniPod System. . . . . . . . . . . . . . . . . . 107
Daily Diabetes Management Activities . . . . . . . . . . . . . . . . . . . . . . . . 107
Check your blood glucose frequently. . . . . . . . . . . . . . . . . . . . . . . 108
Inspect the infusion site daily . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
Prepare for Emergencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Water and Your Pod . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Traveling and Vacationing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Plan for changing time zones. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Take enough supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Minimize airport security delays . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Keep supplies accessible . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Avoid lows, highs, and DKA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
General precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
Hypoglycemia (Low Blood Glucose) . . . . . . . . . . . . . . . . . . . . . . . . 112
Symptoms of hypoglycemia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
To avoid hypoglycemia (low blood glucose) . . . . . . . . . . . . . . . . 112
To treat hypoglycemia (low blood glucose). . . . . . . . . . . . . . . . . 113
Examples of fast-acting foods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
Hyperglycemia (high blood glucose) . . . . . . . . . . . . . . . . . . . . . . . 116
Diabetic ketoacidosis (DKA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119
Handling Special Situations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
Sick days. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
Exercising, playing sports, or working hard . . . . . . . . . . . . . . . . . 121
X-rays, MRIs, and CT scans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Surgery or hospitalization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
10 Alerts and Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Safety Checks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Blood Glucose Meter Alerts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
Advisory Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
Hazard Alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
Manual Shut-off of a Hazard Alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
11 Communication Failures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
The Communication Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Failure During Pod Activation or Operation . . . . . . . . . . . . . . . . . . . 133
Failure During Pod Deactivation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Page 9
Contents
vii
Failure During Request for Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
Failure During Bolus Cancellation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Appendix. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Pod Care and Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Storage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Personal Diabetes Manager Care and Maintenance . . . . . . . . . . . 139
Storage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Cleaning and disinfecting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140
Replacing Batteries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
If the PDM becomes submerged in water . . . . . . . . . . . . . . . . . . 143
If you drop the PDM. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Storage and Supplies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
Ordering Supplies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
Suggested Bolus Calculator Examples and Guidelines . . . . . . . . 144
Meal bolus calculation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
Insulin-on-board (IOB) calculation. . . . . . . . . . . . . . . . . . . . . . . . . . 145
Examples of suggested bolus calculations . . . . . . . . . . . . . . . . . 145
Calculator guidelines. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
OmniPod System Options and Settings . . . . . . . . . . . . . . . . . . . . . . . 148
Pod Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Accuracy Test Results. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150
Flow rate error . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150
Personal Diabetes Manager Specifications . . . . . . . . . . . . . . . . . . . . 150
Blood Glucose Meter Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
OmniPod System Label Symbols. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
Personal Diabetes Manager Icons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
OmniPod System Notice Concerning Interference . . . . . . . . . . . . 153
Electromagnetic Compatibility. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154
Limited Warranty for the Personal Diabetes Manager . . . . . . . . . 158
Privacy Code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
You and Your Healthcare Provider. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159
Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Page 10
viii
About This User Guide
Symbols
Symb ol Te rm Meaning
War nin g
Describes potential serious adverse reactions, or indicates conditions that could cause death or serious injury.
Caution
Indicates conditions that could cause minor or moderate injury to you or damage to the device.
Note
Provides helpful information.
Tip
Offers a suggestion for successful use of the OmniPod
®
Insulin
Management System.
This User Guide is intended for use only with PDM model CAT45E. To learn which version of the PDM you have, turn it over. On the back of the PDM, look for “CAT45E.” If you see it, this is the correct User Guide. If you do not see “CAT45E” on the back of the PDM, please call Customer Care.
This User Guide is periodically updated. Visit www.myomnipod.ca to see the most recent version and to find other helpful information.
Screen displays shown in this User Guide are for illustrative purposes only and should not be considered suggestions for user settings. Consult with your healthcare provider to determine the appropriate settings for you.
Introduction
Page 11
Introduction
ix
Conventions and Terms
Important Information
Indication
The OmniPod® Insulin Management System is intended for subcutaneous (below the skin) delivery of insulin at set and variable rates for the management of diabetes mellitus in persons requiring insulin and for the quantitative measurement of glucose in fresh whole capillary blood (in vitro).
Contraindications
Insulin pump therapy is NOT recommended for people who are either:
Unable to perform at least four (4) blood glucose tests per day
Unable to maintain contact with their healthcare provider
Unable to use the System according to instructions
Convention/Term Meaning
Bold
Names of buttons, soft keys, menus, and screens are in bold.
Italics
Words in italics are defined in the Glossary at the end of this User Guide.
Press
Press and release a button or soft key.
Hold
Keep pressing a button until its function is complete.
Menu
A list of options on the PDM. Options allow you to per form tasks.
Screen
Displays programming, operating, and alarm/alert information.
Button
A physical button on the PDM, such as the Home/Power button.
Convention/Term Meaning
Icon
An image on the PDM screen that indicates a menu option or item of information. A table of screen icons appears in the Appendices.
Soft keys
A row of three unlabeled buttons on the PDM whose label or function appears on the screen directly above the button. The label changes depending on the task you are performing.
This device is for prescription use only.
Convention/Term Meaning
Page 12
Introduction
x
Do not use the integrated FreeStyle® Blood Glucose Monitoring System for:
Testing on newborns
Testing arterial blood
Diagnosing of or screening for diabetes mellitus
The OmniPod System is designed to use rapid­acting U-100 insulin. The following U-100 rapid­acting insulin analogs have been tested and found to
be safe for use in the Pod: NovoRapid, Humalog®,
or Apidra®. NovoRapid is compatible with the OmniPod System for use up to 72 hours (3 days). Bef
ore using a different insulin with the OmniPod
System, check the insulin drug label to make sure it can be used with a pump. Refer to the insulin labeling and follow your health
care provider's
directions for how often to replace the Pod.
Not recommended for individuals with hearing loss.
Always verify ability to hear Pod/PDM alerts
and alarms.
The Pod and PDM may be affected by strong radi­ation or magnetic fields. Before having an X-ray, MRI, or CT scan (or any similar test or procedure), remove your Pod and put it and the PDM outside the treatment area. Check with your healthcare provider for Pod removal guidelines.
Please read all the instructions provided in this User Guide
and practice the blood glucose testing procedures before using the System. Monitor your blood glucose with the guidance of your healthcare provider. Undetected hyperglycemia or hypoglycemia can result without proper monitoring.
If you are unable to use the System according to in
structions, you may be putting your health and
safety at risk. Talk with your healthcare provider if you have questions or concerns about using the System properly.
This device is intended for self-testing by the user.
If you are having symptoms that are not consistent with y
our blood glucose test and you have followed all instructions described in this User Guide, call your healthcare professional.
Page 13
Introduction
xi
You r R ole : S af el y U sin g t he Om ni Po d Sy ste m
Work with your healthcare provider to establish diabetes management guidelines and settings that best fit your needs. These may include:
Insulin-to-Carbohydrate Ratio (IC): Number of
grams of carbohydrate covered by one unit of insulin. For example, if your insulin-to-carbohydrate ratio is 1:15, then you need to deliver one unit of insulin to cover every fifteen grams of carbohydrate you eat.
Correction or Sensitivity Factor: Ho
w much one unit of insulin
will lower blood glucose. For example, if your sensitivity factor is
2.8, one unit of insulin will lower your blood glucose by
2.8 mmol/L. Target Blood Glucose Value: The
blood glucose level you want to achieve. For example, you may want to keep your blood glucose close to 5.6 mmol/L.
Duration of Insulin Action: The
length of time that insulin remains active and available in your body after a correction or meal bolus.
Your individual needs influence th
e initial settings you and your healthcare provider will enter into the Personal Diabetes Manager (PDM) during setup (see Chapter 2, Getting Started).
Your healthcare provider must help you enter these initial s
ettings. Soon you will enter and change your own settings with confidence and ease. The OmniPod System is more user­friendly than most electronic devices you use every day. In fact, technology is what makes the OmniPod System so easy to use.
Your healthcare provider is a valuable resource. You will rely on h
im or her for a lot of critical information about your OmniPod System, especially during the first few weeks and months. When you have questions about diabetes management after starting on the OmniPod System, do not hesitate to talk with your healthcare provider. For nonmedical emergencies or for technical questions about your OmniPod System setup or operation, you can call Customer Care 24 hours a day, 7 days a week.
Customer Care:
Please call customer care at 1 855 POD INFO (1 855 7634636). When
outside of Canada, please call 647-788-3132.This user guide is periodically updated. Please visit www.MyOmniPod.ca to see the most recent version and to find other helpful information.
Page 14
Introduction
xii
Your healthcare provider will give you all the tools and training you need to be successful with the OmniPod Insulin Management System. However, in the end, your success depends on YOU. You must become actively involved in your own diabetes management to enjoy the outstanding control, freedom, and flexibility that is possible with the OmniPod System.
Being actively involved means:
Frequently monitoring blood glucose levels
Learning how to operate your OmniPod System and practicing proper techniques
Visiting your healthcare provider
Do NOT attempt to use the OmniPod® Insulin Management System before you receive training from your healthcare provider. Inadequate training could put your health and safety at risk.
Page 15
1
CHAPTER 1
Your New OmniPod Insulin Management System
Insulin Delivery with the OmniPod System
The OmniPod® Insulin Management System is an innovative continuous insulin delivery system that provides all the proven benefits of c
ontinuous subcutaneous insulin infusion (CSII) therapy
in a way no conventional insulin pump can. The System’s innovative design and features allows you to live your life— and manage your diabetes—with unprecedented freedom, co
mfort, convenience, and ease.
The long-term health benefits of better blood glucose control ar
e well known. Maintaining near-normal blood glucose levels
can help you live a longer, healthier life with fewer diabetes­related complications. The OmniPod System also has many practical, everyday benefits, including convenience, freedom, flex
ibility, and ease of use.
Continuous insulin delivery most closely mimics the insulin release of a healthy pancreas. Since the landmark 10-year Diabetes Control and Complications Trial (DCCT), the long­term health benefits of maintaining near-normal blood glucose levels have been widely recognized.
Continuous insulin delivery at preset rates eliminates the need for injections and the interruptions that come with them. In addition, with the OmniPod System, insulin delivery can be changed with the press of a button to adapt to snacks or unexpected changes in daily routine. The OmniPod System is a great option for people with diabetes who require insulin.
The OmniPod System works much like the pancreas of a person without diabet
es by delivering insulin in two ways:
A small, constant, background supply of insulin (called a basal
ra
te) is delivered automatically at a programmed rate, all day
and night.
An extra dose of insulin (called a bolus) can be delivered when you need it to match the carbohy drates in a meal or snack or to correct a high blood glucose.
Page 16
Your New OmniPod Insulin Management System
2
1
How Does the OmniPod System Work?
The Pod is a small, lightweight, self-adhesive device that you fill with insulin and wear directly on your body. The Pod delivers precise, personalized doses of insulin into your body through a small flexible tube (called a cannula), based on instructions that you program into its wireless companion, the Personal Diabetes Manager. The cannula is inserted only once with each Pod.
The Personal Diabetes Manager (PDM) is a wireless, handheld device tha
t:
Programs the Pod with your personaliz
ed insulin-delivery
instructions
Wirelessly monitors the Pod’s operation
Incorporates a FreeStyle® blood glucose meter With just two parts, you’ll enjoy all the func
tionality and benefits of continuous insulin delivery and blood glucose monitoring. Plus you’ll enjoy the safety, convenience, and freedom of:
No tubing
There is no tubing connecting the Pod to the PDM. You wear the Pod comfortably and discreetly under your clothes. You can carry the PDM separately in a backpack, briefcase, or purse. With the OmniPod Insulin Management System, you don’t have to worry about snagging, tangling, or feeling tethered by tubing.
Suggested bolus calculation
Calculating bolus doses has never been easier. After you check your blood glucose, enter the carbs for your snack or meal. Based on your individual settings, the System displays a suggested bolus dose. You can accept the suggestion, change it, or cancel it.
Carb presets
To make carbohydrate counting easier, the OmniPod System includes “carb presets.” You can enter your favorite foods, snacks, or entire meals as “carb presets.” Presets contain the grams of carbohydrate in the food item or meal. Next time you eat this same food, you don’t have to count the carbs; just select your carb preset and the System does the calculating for you. The System stores up to 36 carb presets.
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Your New OmniPod Insulin Management System
3
1
Automated cannula insertion
With the OmniPod System, you don’t have to insert the infusion set ma
nually or carry around a separate inserter. You simply press a button on the PDM and the Pod’s automated insertion system safely and consistently inserts the cannula beneath the skin, virtually pain free. It then begins delivering insulin according to your programmed basal rate.
A fully-integrated design with blood glucose monitoring
With a fully integrated two-part design, there’s no need to carry separ
ate infusion sets, reservoirs, or inserters. It’s all integrated into the Pod. With the PDM, you can check your blood glucose level using FreeStyle® blood glucose test strips, but without the hassle of carrying a separate blood glucose meter.
If you prefer to use another blood glucose meter, you can enter the
readings manually into the PDM.
Record keeping
Another convenient part of the OmniPod System is record ke
eping. Paper charts are useful, but sometimes they can be
inconvenient to carry or use. The data storage system in the Personal Diabetes Manager (PDM) displ
ays up to 90 days’ worth of information. This includes blood glucose readings, basal rates and bolus doses, carbohydrates, and alarms.
Personalizing your System
You can personalize your OmniPod System in other ways, too:
•Enter and name basal programs
Name and save temporary basal presets
Add your own customized reminders
Enter your name, phone number, doctor’s name and
number, and other emergency information
Page 18
Your New OmniPod Insulin Management System
4
1
The Pod
The Pod (Figure 1-1) is applied to your skin with an adhesive backing, similar to an adhesive bandage.
The Personal Diabetes Manager
All Pod operations are programmed and controlled through the palm-sized Personal Diabetes Manager (PDM; Figure 1-2).
To p
Bottom
Needle cap
Viewing window
Fill port
Figure 1-1
Adhesive backing
Housing vent
Figure 1-2
Up/Down Controller
User Info/ Support
Soft Key Label
Soft Keys
Home/ Power
USB Port
Test Strip Por t
LCD Screen
Page 19
Your New OmniPod Insulin Management System
5
1
Buttons that program and control the OmniPod System
Button Action
Home/ Power
Pressing and holding turns the PDM on and off. When the PDM is on, pressing this button (quickly/briefly) displays the Home screen, from which you can choose a menu item or view the
Status screens (shown later in this chapter).
Up/Down Controller
Pressing and releasing scrolls through a list of available menu options or numbers, so you can pick the one you want. Holding the button scrolls faster.
Soft Keys
Soft key labels and functions depend on the menu or screen you are viewing. The label appears on the screen directly above the physical button you press. Select, Save, and Back are just three examples of the soft key labels on your PDM.
Button Action
User Info/ Support
Pressing opens a User Info/Support screen that displays additional information about the current screen you are viewing. The User Info/ Support icon appears when additional information can be viewed. It may be displayed at the top of the screen, to the right of an event detail (such as a suggested bolus), or to the right of a record item (such as a BG history record). (See “Personal Diabetes Manager Icons” in the Appendix).
In addition, pressing and holding this button for 2 seconds
enables a “bright mode” on the PDM
screen.
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Your New OmniPod Insulin Management System
6
1
Primary screens
Messages on the screen either:
Let you identify your PDM
Tell you how the System is operating
List menu choices
Explain how to perform certain tasks The System’s primary screens are the ID scr
een (Figure 1-3), the
Status s
creen (Figure 1-4), and the Home screen (Figure 1-6).
ID screen
The System displays an ID screen to make the PDM easy to identify when you first turn it on. You can personalize the ID screen by adding your name and choosing its color. (See , for details on customizing your PDM.) You must acknowledge the ID screen before you can use the PDM. It is important that you always identify the PDM as yours before you use it.
Status screen
Lists the System’s current operating status (Figure 1-4). From top to bottom, the Status scr
een displays:
Time, date, and result of last blood glucose checked or ent
ered manually
Time, date, and total amount of last bolus delivered
Amount of Insulin on Board (IOB) will be displayed on Status screen (if calculator in use)
Name and rate of active basal program or temp basal program
“Ext bolus,” the amount of insulin, and the delivery time remaining if an extended bolus is being delivered
“INSULIN SUSPENDED” if insulin delivery has been suspended
Time and date of when the Pod will expire
Figure 1-3
Figure 1-4
Page 21
Your New OmniPod Insulin Management System
7
1
Status support screen
From the Status screen, press the User Info/Support button to see details about the current insulin on board (IOB) in your body (Figure 1-5). See page 30, for additional information describing insulin on board (IOB).
Home screen
Lists all the major menus (Figure 1-6).
Bol
us menu to deliver bolus doses
More actions menu to change the Pod, manually enter
blood glucose readings, and assign and edit tags for BG readings that are less than 2 hours old.
Tem p b as al menu to deliver temporary basal rates (This submenu does not appear if temp basal is turned Off in Settings.)
My records menu to review insulin delivery, blood glucose history, alarm history, carb history, and personal user information
Settings menu to edit, enter, and name basal programs, temp basal, carbohydrate and bolus presets, and to customize System settings
Suspend menu to suspend, cancel, or resume insulin delivery programs
If a Pod has not yet been activated (during Pod changes), the screen displays “No active Pod. Would you like to activate a Pod now?” (See Chapter 5, Using the Pod, for details on activating a Pod.)
Figure 1-5
Figure 1-6
You can go to the Status screen at any time by pressing St
atus from the Home screen.
Page 22
Your New OmniPod Insulin Management System
8
1
Safety Features
The OmniPod System’s state-of-the-art design includes the latest safety technology. Its built-in safety features include:
Automatic priming, safety checks, and insertion
Every time you activate a new Pod, the System automatically primes and performs a safety check on the Pod, then inserts and primes the cannula (see Chapter 5, Using the Pod). Microprocessor technology makes it possible to complete thousands
of safety checks in only a few seconds.
The OmniPod System also performs safety checks on the PDM. If it
detects any problems in the PDM or the Pod—or in communication between them—it informs you with beeps and on-screen messages.
Occlusion detection
An occlusion is a blockage or interruption in insulin delivery. If the OmniPod System detects an occlusion, it sounds a hazard alarm and prompts you to deactivate and change your Pod (see Chapter 5, Using the Pod).
A hazard alarm sounds when an average o
f 3 to 5 units of missed insulin occurs. This table depicts occlusion detection for 3 different situations when using U100 insulin. If an occlusion is cleared, a volume of insulin could be released. That volume would not exceed 3.9 U.
Alerts and alarms
For your safety, the OmniPod System provides a range of alerts and alarms to tell you that your attention is needed, or to warn you of hazardous situations.
See Chapter 6, Using the Personal Diabetes Manager, for a description of notifications and how to set them. See Chapter 10, Alerts and Alarms, for a list of safety alarms built into the OmniPod System and how to respond to them.
At very low flow rates checking your blood glucose fr
equently may give you an early indication of an
occlusion (refer to Chapter 9).
Confirm on ID scr
een - alerts/alarms do not show on
PDM until after ID screen is confirmed.
5.00 U Bolus
1.00 U/hr basal
0.05 U/hr basal
200 seconds
2.4 hr
48 hr
Minimum time
202 seconds
3.7 hr
74 hr
Typ ica l time
300 seconds
5.0 hr
80 hr
Maximum time
(Pod expiration)
Page 23
9
CHAPTER 2
Getting Started
The OmniPod Starter Kit
Your initial shipment contains everything you need to begin using the OmniPod System.
If you are a OmniPod System user, you need to meet with your healthcar
e provider for training and System setup before using it.
To get a head start on learning about your new OmniPod System, review this User Guide and
complete the Pre-Training
section of OmniPod's online Interactive Training Program, found in the Customer Care section of www.MyOmnipod.ca.
If you have a basic understanding of the System in advance, you will
get more out of your training sessions.
After you unpack the Starter Kit, use the “Contents” label on the sided
of the box to make sure you have everything.
Set Up the Personal Diabetes Manager (PDM)
If you are a first-time OmniPod System user, you need to meet with your healthcare provider for training and System setup before using it. To get a head start on learning about your new OmniPod System, review this User Guide. If you have a basic understanding of the System in advance, you will get more out of your training sessions.
You can complete the Warranty form online at www.MyOmniPod.ca. 5 year limited Warranty.
Do NOT use the OmniPod® Insulin Management System until you have been trained by your healthcare pr
ovider. He or she will initialize the System based on your individual needs. Inadequate training or improper setup could put your health and safety at risk.
Prepare and keep an emergency kit with you at all times t
o quickly respond to any diabetes emergency. For
details, see Chapter 9, Living with Diabetes.
Page 24
Getting Started
2
10
Chapter 6 describes the PDM options in detail. The instructions in this chapter are simplified to help you get started.
Turn on the PDM
1. Open the battery compartment on the back of the PDM by pushing the compartment latch and lifting upward (Figure 2-1). No special tools are necessary.
2. Insert two (2) new AAA alkaline batteries into the
compartment.
3. Replace the battery door.
4. Turn the PDM face up. The PDM has begun to power on auto­matically.
The Setup Wizard
The first time you turn on the Personal Diabetes Manager, the Setup Wizard comes on automatically. Although setup is easy with the Wizard, if you are a first-time user, your healthcare pro­vider must guide you through the process. Setup takes only a f
ew minutes and is easy to do:
Use the Up/Do
wn Controller buttons to increase or
decrease a number, or to move up or down a list.
Figure 2-1
Figure 2-2
Hard
Reset
The diagram inside the compartment shows you which direction to insert the batteries (Figure 2-2).
Do not use any other type of batteries than AAA alk
aline batteries to power the PDM. Never use old
or used batteries; the PDM may not work properly.
Initial settings are “---” [blank] for target blood glucose value
, insulin-to-carbohydrate ratio, correction factor,
and duration of insulin action.
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Getting Started
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2
Press the Soft Key labeled Next, Select, Done, or Save to
continue to the next screen.
Press Back to return to the previous screen.
To get started, press Next on the Wizard's Welcome Screen to begin setting up your PDM.
Enter your PDM ID
1. Use the Up/Down Controller buttons to scroll through the
list of characters. An up-and-down-arrow symbol on the screen indicates the character you are changing.
2. Press the middle Soft Key (labeled with the right arrow) to move the underscore to the next character.
3. Enter each character one at a time. For example, if you want to enter your name, you might enter J, a, n, e, [space], S, m, i, t, h. (A blank character or space is the first and last option in the scrolling menu.)
4. Press Next.
Select the ID screen color
1. Use the Up/Down Controller buttons to choose a color, then press Next.
Set date and time
1. Use the Up/Down Controller buttons to increase or decrease the time. (Press 12/24hr if you prefer a different time format.) Then press Next.
2. Enter the current year, then press Next.
3. Choose the current month, then press Next.
4. Enter the current day of the month, then press Next.
5. Choose the date format you prefer, then press Next.
Enter basal settings
1. Choose a maximum basal rate, then press Next. (The default maximum basal rate is 3 U/hr.)
2. Choose the initial basal rate to use, then press Next. The initial basal program created with the Setup Wizard is
named basal 1. You can change the name in the Settings > Basal Programs menu (see Chapter 3, Understanding and Adjusting Basal Rates).
You can adjust these settings la
ter as your needs change
or as you fine-tune your OmniPod System.
Your ID and the chosen color will be displayed on an identification (ID) screen that you must acknowledge every time you turn on the PDM. Always be sure you properly identify your PDM before using it.
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Getting Started
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12
3. Press Done to confirm the basal program shown on the
screen. To add more basal segments to the program, or to change the rate shown, see Chapter 3, Understanding and Adjusting Basal Rates.
4. To see the basal program as a list, press List. To return to the graphic view, press Graph.
5. Press Save to accept the basal program you have set.
6. Choose a temporary basal feature, then press Next. Choose % to show temporary basal rates as a percent increase or decrease of your current basal rate. Choose U/hr to show temporary basal rates in units per hour. Or choose Off to turn off the temporary basal feature. For details about setting tem­porary basals, see Chapter 3, Understanding and Adjusting Basal Rates.
Enter blood glucose sound setting and BG goal
1. To set the sound for the blood glucose meter, choose On or Off, then press Next.
2. Use the Up/Down Controller buttons to enter the lower limit for your blood glucose (BG) goal, then press Next.
3. Enter the upper limit for your BG goal, then press Next.
4. Press Save to accept the BG goal.
Set the suggested bolus calculator
1. To set the suggested bolus calculator feature, choose On or Off, then press Next.
Enter target blood glucose value
1. Use the Up/Down Controller button to enter a target blood glucose (BG) value, then press Next.
You can add up to 7 basal programs and set 24 segments per program.
The lower and upper BG limits are only used when viewing BG History (see
Chapter 8, Understanding
Your Records).
Check with your healthcare provider before adjust­in
g these settings.
If the suggested bolus calculator is set to On, pe
rform
the following steps. If set to Off, you will be prompted to “Select bolus increment” and “Enter maximum bolus.”
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Getting Started
13
2
2. Use the Up/Down Controller buttons to enter the “correct
above” value or correction threshold (the BG value above which you want the PDM to suggest a correction bolus), then press Next.
3. To save the target BG value, press Done. To change these set­tings, select the segment you wish to change and press Edit.
You can define up to 8 target BG time segments. To enter additional segments, choose [add new], then:
a. Press New. b. Enter a start time for the target BG segment, then press
Enter.
c. Enter an end time for the target BG segment, then press
Next.
d. Enter a target blood glucose value, then press Next.
Use the Up/D
own Controller buttons to enter the “cor-
rect above” value or “correction threshold” (the BG value abov
e which you want the PDM to suggest a correction
bolus), then press Next.
e. When you have finished entering segments, press Done.
4.
To see the segments as a list, press List. To return to the graphic view, press Graph.
5. Press Save to accept the target BG profile you have set.
Enter minimum BG allowed for use in bolus calculation
1. Use the Up/Down Controller buttons to enter a minimum
blood glucose value, below which the System will not calcu­late a suggested bolus. The values are in 0.1 mmol/L incre­ments and range from 2.8 to 3.9 mmol/L.
2. Press Next.
Enter insulin-to-carbohydrate ratio
1. Use the Up/Down Controller buttons to enter your insulin­to-carbohydrate ratio, then press Next. (Insulin-to-carbohy-
drate ratio is the number of carbs covered by 1 unit of insulin.)
2. To save the ratio, press Done. To change the ratio, select the segment you wish to change and press Edit.
You can define up to 8 insulin-to-carbohydrate time seg­ments. To enter additional ratios, choose [add new], then:
a. Press New. b. Enter a start time for the segment, then press Next. c. Enter an end time for the segment, then press Next. d. Enter the insulin-to-carb ratio for the new time segment,
then press Next.
If the suggested bolus calculator is On, a c
orrection bolus will be suggested only when your BG is above the value shown in brackets on the screen.
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Getting Started
2
14
e. To save the new ratio, press Done.
3. To see the ratios as a list, press List. To return to the graphic view, press Graph.
4. Press Save to accept the ratios you have set.
Enter correction factor
1. Use the Up/Down Controller buttons to enter how much one unit of insulin decreases your blood glucose, then press Next.
2. To save the correction factor, press Done. To change the factor, select the segment you wish to change and press Edit.
You can define correction factors for up to 8 time segments. To enter additional correction factors, choose [add new], then:
a. Press New. b. Enter a start time for the segment, then press Next. c. Enter an end time for the segment, then press Next. d. Enter the correction factor, then press Next. e. To save the new correction factor segment, press Done.
3. To see the factors as a list, press List. To return to the graphic view, press Graph.
4. Press Save to accept the correction factors you have set.
Set reverse correction
1. To set reverse correction, use the Up/Down Controller
buttons to choose On or Off, then press Next.
Enter the duration of insulin action
1. Use the Up/Down Controller buttons to enter the duration
of insulin action (how long insulin lasts in your body), then
press Next.
If you enter carbs and reverse corrections are On, the S
ystem will subtract insulin from the suggested meal
bolus to compensate for a low blood glucose (below the BG target you set). With reverse corrections Off, the System will not subtract insulin from the sug­gested meal bolus dose due to a low BG. Follow your health
care provider’s recommendation to set
reverse correction On or Off.
The duration-of-insulin-action setting is used to calculate the amount of insulin on board (IOB) from a pr
evious correction bolus or meal bolus when you
use the suggested bolus calculator.
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Getting Started
15
2
Select bolus increment and enter maximum bolus
1. Choose a bolus increment (how much each press of the
Up/Down Controller buttons will increase or decrease a bolus amount)—either 0.05, 0.10, 0.50, or 1.00 units of insu­lin—then press Next.
2. Choose the maximum bolus you can give at one time, then
press Next.
Set extended bolus doses
1. To set the units for an extended bolus dose, choose % for per­cent of the total bolus, or choose Units for units of insulin. To turn off the extended bolus feature, choose Off. Then press
Next.
Set low reservoir advisory
1. Choose the level of insulin in the reservoir at which the PDM should give you an alarm. Choose from 10 to 50 units in 5-unit increments, then press Next.
Set expiration notification
1. Choose the number of hours before a Pod expires when the
PDM should give you a notification, then press Next. The values are in 1-hour increments and range from 1 to 24 hours. (The default is 4 hours.)
The PDM asks whether you want to activate a Pod.
Press Ye
s if you are ready to activate a new Pod. See Chapter
5, Using the Pod, to learn how to activate a new Pod.
Press No if you do not want to activate a Pod at this time. The PDM displays the Home screen.
The maximum bolus default is 10 units. Check with y
our healthcare provider before adjusting these set-
tings.
You can press and hold the Power button to turn off the PDM at any time during setup. Otherwise, it turns off automatically after 5 minutes. If you do not complete the entire setup within 60 minutes, when you turn on the PDM again you will return to the beginning of the Setup Wizard.
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Getting Started
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16
Your healthcare provider will help you fill and apply your first Pod. The process is easy because on-screen messages walk you through every step. Please refer to Chapter 5, Using the Pod, for detailed instructions.
You may want to adjust the PDM screen time-out and backlight time-out. For more information on how to do this, see Chapter 6, Using the Personal Diabetes Manager.
Use the form at the end of this User Guide to
write down all your settings from the Setup Wizard. If you ever need to reset or replace your PDM, having these settings handy will make setup very easy.
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17
CHAPTER 3
Understanding and Adjusting Basal Rates
What Is a Basal Rate?
A basal rate is a small base or background amount of insulin that is delivered, at a preset rate, continuously for a specified period of time.
Even without eating, our bodies need a small, constant supply of insulin for normal daily living. I
n people without diabetes, the pancreas continuously delivers this basal insulin. For people using the OmniPod
®
Insulin Management System, the Pod mimics a healthy pancreas by delivering insulin at the rate that you’ve programmed into the Personal Diabetes Manager (PDM).
Personalized Basal Programs
Insulin needs vary throughout the day. Therefore, most people set their basal rates to deliver slightly more or less insulin at
certain times. For example, one person may need to deliver a higher rat
e of insulin during the early morning and a lower rate during the late evening. A basal program describes the amount of insulin to be delivered during an entire 24-hour period.
A basal program contains at least one basal rate for the 24-hour period
, but for most people it will be broken into several time segments, or basal segments, each delivering a different rate of insulin. A sample basal program with three basal segments might be:
Approximately 50% of a person’s total daily insulin dose t
ypically comes from basal insulin delivery; the remaining 50% typically comes from bolus doses (see Chapter 4, Understanding and Delivering Bolus Doses).
12:00 am–8:00 am 0.60 U/hr Between 12:00 am (midnight)
and 8:00 am, the Pod delivers
0.60 units of insulin per hour.
8:00 am–3:00 pm 0.80 U/hr Between 8:00 am and 3:00 pm,
the P
od delivers 0.80 units of
insulin per hour.
3:00 pm–12:00 am 0.70 U/hr Between 3:00 pm and 12:00 am
(midnigh
t), the Pod delivers
0.70 units of insulin per hour.
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Understanding and Adjusting Basal Rates
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18
In addition to normal daily changes, insulin needs can vary with different routines or days of the week. For example, regular school or workday routines may differ from weekend routines, and insulin needs may differ, too. With your healthcare provider, you will decide on the basal rates that best match your lifestyle and insulin needs. You will enter at least one basal program (your Basal 1 Program) into your PDM during the setup process (see Chapter 2, Getting Started). You can add other programs later as you fine-tune your System settings or when your needs change.
You can also create temporary basal presets to use on occasions when y
ou need to adjust your basal rate for a short period of time. See “Temporary Basal Rates and Presets” later in this chapter.
Create a basal program
The Personal Diabetes Manager can store up to 7 different basal programs. Each program can contain 24 rates, programmed in half-hour increments. Once you enter a basal program into the PDM, you only need to press a few buttons to pick the program you want. The Pod continues to deliver insulin at those rates until you change that program or switch to another one.
1. On the Home sc
reen, use the Up/Down Controller buttons
to choose Settings; then press Select.
2. Choose Basal programs (Figure 3-1), then press Select.
3. Choose [add new] (Figure 3-2), then press New.
4. To use the default naming system, simply press Next. The
default naming system automatically assigns program names in numerical order, such as basal 1, basal 2, basal 3.
If you want to give a different name to the program: a. Press the Up/Down Controller buttons to scroll through
the list of characters. An up-and-down arrow symbol on the screen indicates the character you are changing.
Check with your healthcare provider before adjusting t
hese settings.
Figure 3-1
Figure 3-2
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Understanding and Adjusting Basal Rates
19
3
b. Press the middle Soft Key (labeled with the right arrow) to
move the underscore to the next character.
c. Enter each character one at a time. For example, if your
weekend schedule is different from your weekday schedule, you might enter W, e, e, k, e, n, d (Figure 3-3). (A blank character or space is the first and last option in the scrolling menu.)
d. Press Next.
5. Enter the rate, in U/hr, for the first basal segment (from 0.05 to
the maximum you entered during setup), then press Next.
6. Review the list showing your new basal program. To use the same basal rate for the entire 24-hour program,
press Done and continue with step 7. Or, to add basal segments and rates (for example, a higher
basal rate between 8:00 am and 3:00 pm): a. Choose an existing basal segment, then press Edit.
Or, choose [add ne
w], then press New.
b. Enter the start time (for example, 8:00 am), then press
Next. Basal segments are in 30-minute increments.
c. Enter the end time (for example, 3:00 pm), then press
Next.
d. Enter the rate for the new basal segment (for example,
0.80U/hr), then press Next.
Figure 3-3
Figure 3-4
As a safety feature, the words “Invalid basal program name” (Figure 3-4) appear if the name you entered does not have at least one character or if the name is being used f
or another basal program. Capitals and
lowercase letters are considered the same. Press OK to return to the previous screen and enter a different name.
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Understanding and Adjusting Basal Rates
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20
e. Repeat steps a–d for each new segment and rate you
want, then press Done.
7. Review the graph of the new basal program (Figure 3-5).
8.
To see the program as a list, press List (Figure 3-6). To see the graph again, press Graph.
The total daily basal that will be delivered is shown at the bottom of each “Basal programs” graph and list.
9. To add the program to the PDM’s memory, press Save. Repeat steps 1 through 9 (above) for each basal program (up to 7
pr
ograms) you want to create.
Enable an existing basal program
1. On the Home screen, use the Up/Down Controller buttons to choose Settings; then press Select.
2. Choose Basal programs, then press Select.
Basal rates outside the changed segment do not ch
ange.
Press and hold the Po
wer button to turn the screen
back on. In some cases, if it has been less than 5 minutes since the screen timed out, pressing the
Po
wer button returns you to the same screen you
were using. If it has been longer than 5 minutes, the PDM brings you to the Status screen.
Figure 3-5
Figure 3-6
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Understanding and Adjusting Basal Rates
21
3
3. Choose the program you want from the list (Figure 3-7), then
press Enable.
4. Press Enable again to start the selected basal program. If a
Pod is active, the PDM beeps to indicate that the chosen basal program is running.
Change, rename, copy, or delete a basal program
1. On the Home screen, use the Up/Down Controller buttons to choose Settings; then press Select.
2. Choose Basal programs, then press Select.
3. Choose a program from the list, then press Select.
To view the segments of the basal program
1. Choose View, then press Select (Figure 3-8).
Figure 3-7
A diamond icon () appears next to the program that is active. You cannot select the active program to enable it, because it is already running.
As a safety feature, you cannot enable a new basal pr
ogram while a temporary basal program is in process (see “Temporary Basal Rates and Presets” later in this chapter); you must first cancel the active temporary basal program.
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Understanding and Adjusting Basal Rates
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22
To edit or add a segment or rate in the basal program
1. Choose Edit, then press Select.
2. Choose the segment to change, then press Edit (Figure 3-9). Or, choose [add new], then press New.
3. Enter a start time for the segment you want to change, then
press Next.
4. Enter an end time for this segment, then press Next.
5. Enter a basal rate for the new segment, then press Enter.
6. To save the newly entered segment into the basal program,
press Save (Figure 3-10). If you want to make additional edits, repeat steps 2–5.
7. To see the program as a list, press List. To see the graph again, press Graph.
As a safety feature, you must suspend insulin delivery bef
ore editing an active basal program (see Chapter 5, Using the Pod). Remember to resume delivery after the edits are made.
Figure 3-8
Figure 3-9
Figure 3-10
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Understanding and Adjusting Basal Rates
23
3
To renam e a bas al pro gra m
1. After choosing a program from the list, choose Rename, then press Select.
2. Press the Up/Down Controller buttons to enter the characters that spell out the new name you want. Press the middle soft key (labeled with the right arrow) to move the underscore to the next character, then press Save.
To copy a basal pr og ram
1. After choosing a program from the list, choose Copy, then press Select.
2. Press the Up/Down Controller buttons to enter the characters that spell out the name you want for the copied file. Press the middle soft key (labeled with the right arrow) to move the underscore to the next character, then press Next.
3. To use the same basal program for the entire 24-hour period, press Save.
To edit or add segments to the newly copied basal program, follow the steps under “To edit or add a segment or rate in the basal program” earlier in this chapter.
To delete a basal program
1. After choosing a program from the list, choose Delete and then press Select.
2. Press Delete to permanently delete the program.
Temporary Basal Rates and Presets
What is a temporary basal rate?
A temporary basal rate lets you adjust your basal rate for a pre­determined period of time.
On occasion, you may need to chan
ge the active basal rate for only a short time. For example, if you are going cross-country skiing for several hours, you may want to lower the basal rate dur
ing and after you exercise. This is called a “one-time
temporary basal rate.” Some temporary changes are easy to predict and respond to.
T
hey happen routinely and you may know from experience how they affect your insulin needs. For example, you might take the same exercise class twice a week for a few weeks or months, or join a summer soccer league. For women, a monthly hormonal change that affects blood glucose is an example of predictable change. To easily handle predictable, short-term changes, you can “preset” a temporary basal rate, so it is ready whenever you need it. The PDM can remember up to 7 temporary basal presets.
Instead of suspending, changing, and then resuming the ac
tive basal program, try this: Copy the active
program, rename it, make the changes, save it, then enable it.
As a safety feature, you cannot delete the active basal program.
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Understanding and Adjusting Basal Rates
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24
You can set a temporary basal rate for a duration of 30 minutes to 12 hours. Once the time limit is reached, the Pod automatically returns to the active basal program.
When using units per hour, the OmniPod System allows you to set
temporary basal rates from 0.0 U/hr, up to your max basal
rate. When using percent rate, you can set temporary basal rates from Off (-100%) to +95% of your active rate, as long as the temporary rate is less than or equa
l to your max basal rate.
See the sections below on creatin
g, enabling, cancelling, and
changing temporary basal presets.
Enable a one-time temporary basal rate
1. On the Home screen, use the Up/Down Controller buttons to choose Temp ba sa l, then press Select.
2. If you have created temp basal presets, choose [enter manually] from the list, then press Select.
If you have not created any temp basal presets, the PDM skips this step.
3. Enter the temporary basal rate in either units per hour (Figure 3-11) or percent change (Figure 3-12), depending on how you choose to show the rates, then press Enter.
4. Enter the duration for the temporary rate, then press Enter.
5. Press Confirm to start the temporary basal rate shown on the
screen. The Pod beeps to indicate that the temporary basal rate is running.
During initial setup, you and your healthcare provider either tu
rned Off temporary basal rates, or chose to
show the rates as % or U/hr. T
o change this setting, see
Chapter 6, Using the Personal Diabetes Manager.
Figure 3-11
Figure 3-12
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Understanding and Adjusting Basal Rates
25
3
Cancel a one-time temporary basal rate
1. On the Home screen, use the Up/Down Controller buttons to choose Suspend/cancel, then press Select.
2. Choose Cancel temp basal (Figure 3-13), then press Select.
3. Press Confirm to cancel the temporary basal shown on the screen.
Create a temporary basal preset
1. On the Home screen, use the Up/Down Controller buttons to choose Settings, then press Select.
2. Choose Presets, then press Select.
3. Choose Temp basal presets, then press Select.
4. Choose [add new], then press New.
5. To use the OmniPod System’s default naming system, simply press Next. The default naming system automatically assigns program names in numerical order, such as temp basal 1, temp basal 2, temp basal 3.
Or, to give a different name to the program: a. Press the Up/Down Controller buttons to scroll through
the list of characters. An up-and-down arrow symbol on the screen indicates the character you are changing.
b. Press the middle Soft Key to move the underscore to the
next character.
c. Enter each character one at a time. For example, if you
take an aerobics class two nights a week, you might enter A, e, r, o, b, i, c, s (Figure 3-14 ). (A blank character or space is the first and last option in the scrolling menu.)
Figure 3-13
Capitals and lowercase letters are considered the same.
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Understanding and Adjusting Basal Rates
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26
d. Press Next.
6. Enter the new temporary basal rate (or percent change), then
press Next.
7. Enter the duration of the temporary basal rate, from 0.5 hours
to 12 hours, then press Next.
8. Review the temporary basal name, rate, and duration, then
press Save to accept it.
Enable an existing temporary basal preset
1. On the Home screen, use the Up/Down Controller buttons to choose Temp basal, then press Select.
2. Choose the temporary basal preset you want to use from the list (Figure 3-15), then press Select.
3. If you want, change the duration for the temporary rate, in half-hour increments, then press Enter (Figure 3-16).
4. Press Confirm to begin the temporary basal rate shown on the screen. The Pod beeps to indicate that the chosen temporary basal preset is running.
Figure 3-14
Figure 3-15
Figure 3-16
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Understanding and Adjusting Basal Rates
27
3
Cancel an active temporary basal preset
1. On the Home screen, use the Up/Down Controller buttons to choose Suspend/cancel;, then press Select.
2. Choose Cancel temp basal, then press Select.
3. Press Confirm to cancel the actively running temporary basal preset.
Change, rename, or delete a temporary basal preset
1. On the Home screen, use the Up/Down Controller buttons to choose Settings, then press Select.
2. Choose Presets, then press Select.
3. Choose Temp basal presets, then press Select.
4. Choose a temporary preset from the list, then press Edit.
To change a temporary basal preset
1. Choose Edit, then press Select (Figure 3-17).
2. Enter a new rate (or new percent change), for the preset, then
press Next.
3. Enter a new duration for the preset, then press Save.
4. Press Done.
If you suspend insulin delivery while a temp basal is running
, the temp basal will be cancelled when you
suspend.
You cannot edit, change, or delete a temporary basal pr
eset that is actively running.
Figure 3-17
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Understanding and Adjusting Basal Rates
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28
To rename a temporary basal preset
1. Choose Rename, then press Select.
2. Press the Up/Down Controller buttons to enter the characters that spell out the name you want, then press Save.
3. Press Done.
To delete a temporary basal preset
1. Choose Delete, then press Select.
2. Press Delete to permanently delete the preset.
Maximum Basal Rate
What is the maximum basal rate?
The maximum basal rate is a safety feature that limits the basal rate (U/hr) that the Pod can deliver. Once you enter it into the PDM memory, the maximum applies to both regular basal programs and temporary basal rates.
You and your healthcare provider will enter an initial maximum basal rate into your PDM during the setup process (see Chapter 2, Getting Started). You can change it later as you fine-tune your System settings or when your needs change.
Change the maximum basal rate
1. On the Home screen, use the Up/Down Controller buttons to choose Settings, then press Select.
2. Choose System setup, then press Select.
3. Choose Bolus/basal/calcs, then press Select.
4. Choose Max basal, then press Select.
5. Enter a new maximum basal rate, then press Enter.
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29
CHAPTER 4
Understanding and Delivering Bolus Doses
What Is a Bolus?
A bolus is an extra dose of insulin, delivered when needed to:
•Match the ca
rbohydrates (sugar content) in a meal or snack—
also known as a meal bolus
•Lower blood glucose when it gets too high—also known as a correction bolus
This extra dose is in addition to the ba
sal rate delivered throughout the day and night (see Chapter 3, Understanding and Adjusting Basal Rates).
The size of a bolus dose depen
ds on the current factors at the
time you deliver the bolus:
•Your bl
ood glucose level
•Your insulin-to- carbohydrate ratio
•Your correction factor
Your target blood glucose and correct above threshold
The amount of insulin on board (IOB) (active insulin) from
previous meal and correction boluses
•Your correction threshold, the BG level above which you would like to take insulin to reduce an elevated blood glucose
•Your activity level
The type and amount of food you eat
With the OmniPod System, it is easy to adapt to any situation. W
ith just a few button presses, you can adjust to unexpected or
changing insulin needs. During setup, you entered bolus dose settings in the PDM (see
Chapter 2, Getting Started). You can adjust these settings as you fine-tune your System or when your needs change (see Chapter 6, Using the Personal Diabetes Manager).
Check with your healthcare provider before adjust
ing these settings.
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Understanding and Delivering Bolus Doses
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30
Bolus Dose Options
So that you can fully enjoy freedom and flexibility in your life, the OmniPod System offers the following bolus dose options:
Suggested bolus calculator: W
hen you want the System to
calculate your sugg
ested bolus, based on your personal settings, your current blood glucose, the amount of insulin still active in your body from previous boluses, and the grams of carbohydrate (“carbs” for short) you are about to eat.
Normal bolus: When y
ou need a dose of insulin right away to cover a meal or snack you are about to eat or to reduce a high blood glucose level
Extended bolus: When
you are eating high-fat or high-protein
foods (which take longer to digest and are slower to affect blood glucose), or when you are eating for an extended period (f
or example, at a party or during a holiday meal).
Suggested Bolus Calculator
The suggested bolus calculator lets the OmniPod System recommend your bolus based on your personal settings. To review or adjust these settings—including turning the suggested bolus calculator On or Off—see Chapter 6, Using the Personal Diabetes Manager.
If the suggested bolus calculator is turned On, t
he System automatically calculates a bolus dose. If the suggested bolus ca
lculator is turned Of
f, you must enter a bolus amount
manually.
The bolus features in the OmniPod System are designed for flexibility and convenience. You can easily transition from a normal to an extended bolus with just a few button presses.
The suggested bolus calculator will display a suggested bolus dose based on the settings you have programmed into the PDM. Check with your healthcare provider before using this feature or adjusting these settings.
If a suggested bolus exceeds the max bolus you have set, the suggested bolus screen displays “Exceeds max bolus.” (Figure 4-1) If you select
Extend or En
ter, the following confirmation is
displayed “WARNING: Exceeds max bolus of nn.nn U. Accept this bolus and temporarily override your limit?” (Figure 4-2). Consult your healthcare provider before changing the setting.
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4
How a suggested bolus is calculated
The suggested bolus calculator estimates the suggested amount for each bolus portion based on your personal settings and inputs.
The settings used to calculat
e a suggested bolus are:
•Target BG
Insulin-to-carbohydrate (IC) ratio
Correction factor (CF)
Duration of insulin action
The inputs used to calculate a suggested bolus are:
current BG
•c
arbs entered
insulin on board (IOB) A suggested bolus can have a correc
tion bolus only, a meal bolus
only, or both. Correction bolus: T
he correction bolus, as the name suggests, “corrects” for a blood glucose (BG) level above your target BG level.
Meal bolus: The meal bolus
provides insulin for the
carbohydrates you enter into the System. Insulin on board (IOB): I
nsulin on Board (IOB) the amount of insulin still working in your body from previous meal and correction boluses. The amount of time the insulin remains “on board” or “active” depends on what you set for your duration of insulin action.
For formulas for each element of the suggested bolus calculation, de
tailed examples, and additional guidelines of how
the suggested bolus calculator works, see the Appendix.
Figure 4-1
Figure 4-2
The OmniPod System can only subtract insulin on board (IOB) from a suggested bolus when the current BG is known.
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Deliver a Normal Bolus
Deliver a bolus when suggested bolus calculator is On
1. After you check your blood glucose, the PDM displays the results (Figure 4-3; see the end of Chapter 7, Checking Your Blood Glucose). Press Next.
Figure 4-3
A blood glucose value is current for up to 10 minutes after it is tested. So you can wait up to 10 minutes, restart the bolus process, and not have to retest your blood glucose in order to include it in the suggested bolus calculator.
When your blood glucose result reads “HIGH” or “L
OW,” the suggested bolus calculator will be
disabled.
If you use a separate blood glucose meter—not the P
ersonal Diabetes Manager (PDM)—you will need to
enter your blood glucose manually. On the Home screen, choose Bolus, then press Select. Use the Up/ Down Controller buttons to enter your current BG value, then press Ye s if you want this value to be used by the suggested bolus calculator.
You can also enter a BG manually by choosing the
Mor
e actions menu, then choosing Add BG
Reading. See the end of Chapter 7, Checking Your
Blood Glucose.
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4
2. If you are not going to eat now, press No (Figure 4-4). The Suggested Bolus screen appears (Figure 4-5). Press Enter to accept the suggested bolus.
Or, if you wish, press the Up/Down Controller buttons to increase or decrease the suggested bolus. Then press Enter to accept the bolus.
3. If you are going to eat now:
a. Press Ye s (Figure 4-5), enter the number of carbohydrates
you are about to eat, then press Enter. If you’ve previously entered a carb preset, then either:
Use the Up/Do
wn Controller buttons to choose
[enter manually], then press Select. Enter the
number of carbohydrates that you are going to eat, then press Enter.
Use the Up/Do
wn Controller buttons to choose
favorites, snacks, or meals. From there, select a carb preset you have previously entered (see “Carb Presets” later in this chapter), then press Se
lect.
b. Press Enter
to accept the suggested bolus (Figure 4-6).
Or press the U
ser Info/Support (?) button to view
calculation information used for this suggested bolus. Press Close to return to the Suggested Bolus screen, then press Enter.
In the Su
ggested Bolus screen (Figure 4-5), “adjusted
for Insulin on Board (IOB)” appears only when Insulin on Board (IOB) is a factor in the calculation.
Figure 4-4
Figure 4-5
To view detailed information about the calculations used for this suggested bolus, press the User Info/Support button and scroll through the information screens. Press Close to return to the Suggested Bolus screen.
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34
4. If you have set the blood glucose reminder option to On and
you want to add a reminder: a. Press Ye s . b. Enter the time for the reminder, then press OK.
5. Press Confirm to begin the bolus delivery.
Deliver a bolus manually (suggested bolus calc is Off)
1. On the Home screen, use the Up/Down Controller buttons to choose Bolus, then press Select.
2. Enter the number of units you want to deliver, then press Enter.
3. If the blood glucose reminders feature is turned On, you can now set a blood glucose reminder.
4. Press Confirm to begin the bolus delivery.
If the reverse correction feature is turned On and if your blood glucose level is below your target, the System subtracts a correction amount from the meal por
tion of the bolus.
If the reverse correction setting is turned Of
f, the
System does not subtract anything for a blood glucose lev
el below your target.
Figure 4-6
As a safety feature, the OmniPod System only allows you to give a bolus at or below the maximum bolus dose you have set. See
Chapter 6, Using the Personal
Diabetes Manager, for information on resetting your maximum bolus dose. If suggested bolus calc is On, y
ou can enter a temporary manual override to make an adjustment above your max bolus limit (Figure 4-1 and Figure 4-2). Consult your healthcare provider before changing this setting.
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Understanding and Delivering Bolus Doses
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4
Deliver an Extended Bolus
The extended bolus feature lets the OmniPod System deliver some (or no) insulin now and the remainder over a period of time you choose.
Deliver an extended bolus instead of a normal bolus
1. After you get your suggested bolus, press Extend instead of Enter (see Figure 4-7).
2. Enter the units of insulin or percentage of the bolus that you
want to take immediately (Figure 4-8), then press Enter.
3. Enter the time (up to 8 hours, in 30-minute increments) over
which to deliver the remainder of the bolus, then press Enter (Figure 4-9). In Figure 4-10 you can see a detailed view of the extended bolus.
If you have set the Extended bolus option to Off, the PDM will not display the Extend Soft Key. For information on turning this feature On and Off see Chapter 6, Using the Personal Diabetes Manager.
Figure 4-7
To learn how to set extended boluses in percentages or units, see
Chapter 6, Using the Personal Diabetes
Manager.
Figure 4-8
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36
4. If the blood glucose reminders feature is turned On, you
can now set a blood glucose reminder.
5. Press Confirm to begin the bolus delivery.
Figure 4-9
Figure 4-10
As a safety feature, the correction bolus is always delivered first and cannot be extended. Only the meal bolus can be extended. For example:
Total bolus = 5 units
Correction bolus 1 unit Meal bolus 4 units
Deliver now = 2 units correction bolus 1 unit
meal bolus 1 unit
Extend = 3 units meal portion 3 units
As a safety feature, you cannot
deliver two extended boluses at the same time. You can, however, cancel the first extended bolus and replace it with another (see “Replace an Extended Bolus” on page 37). You can deliver a normal bolus while an extended bolus is being deliv
ered.
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4
Cancel Active Boluses
The OmniPod System is extremely flexible, so you can use it to respond to your changing insulin needs. It is easy to cancel an active bolus (one that is currently being delivered), even after insulin delivery has started.
1. To check the Pod status, refer to Page 54 for detailed ins
tructions. The ID screen must be confirmed before you can
check Pod status. An on-screen message appears for as long as a normal bolus is being delivered (Figure 4-11).
2. Press Cancel.
The Pod beeps to confirm the bolus is cancelled. An on-screen message tells you how much insulin was delivered before you cancelled the bolus (Figure 4-12).
3. Press OK to return to the Status screen.
Replace an Extended Bolus
You can replace one extended bolus with another. The System tells you how much of the first bolus has not yet been delivered.
1. After you see your suggested bolus, press Ex
tend instead of
Enter (see Figure 4-7).
Figure 4-11
Figure 4-12
If the bolus has already been completely delivered, the “Delivering bolus” message and Cancel do not appear, but the Status screen does appear.
If your suggested bolus contains both a correction bolus and a meal
bolus, the correction bolus is always
delivered first.
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38
2. Press Ye s to cancel the active extended bolus (Figure 4-13). Or press Back to return to the Suggested Meal Bolus screen.
3. Press Confirm (Figure 4-14).
4. The screen displays the amount of the old extended bolus that has yet to be delivered (Figure 4-15). Press Next to return to the Suggested Meal Bolus screen.
Bolus Presets
Bolus presets are bolus amounts that you program for frequent use. For example, if you often take the same bolus at lunchtime, you can create a bolus preset for that amount and name it “Lunch.”
You can add what remained of the old extended bolus to the new one.
Figure 4-13
Figure 4-14
Bolus presets are available only when the suggested bolus calculator feature is turned Off. (If the suggested bolus calculator is turned On, you can still use carb presets. See “
Carb Presets” on Page 39.)
Figure 4-15
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Understanding and Delivering Bolus Doses
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4
Create a bolus preset
1. On the Home screen use the Up/Down Controller buttons to choose Settings; then press Select.
2. Choose Presets, then press Select.
3. Choose Bolus presets, then press Select.
4. Choose [add new], then press New.
5. To use the OmniPod System’s default naming system, simply press Next. The default naming system automatically assigns program names in numerical order, such as bolus 1, bolus 2, bolus 3.
Or, to give a different name to the program: a. Press the Up/Down Controller buttons to enter the
characters that spell the name you want. An up and down arrow symbol on the screen indicates which character you are changing.
b. Press the middle Soft Key (labeled with the right arrow) to
move the underscore to the next character.
c. Enter each character one at a time. For example, if you
frequently take the same bolus at lunchtime, you might enter L, u, n, c, h (Figure 4-16).
d. Press Next.
6. Enter the new bolus preset amount, up to the maximum bolus you entered during setup; then press Next.
7. Review the bolus preset name and amount, then press Save
to accept it.
Enable an existing bolus preset
1. On the Home screen, use the Up/Down Controller buttons to choose Bolus; then press Select.
2. Choose the bolus preset you want to use from the list (Figure 4-17), then press Select.
3. Press Enter to confirm the bolus preset amount, or, if necessary, use the Up/Down Controller buttons to adjust the bolus amount.
4. Press Confirm to deliver the bolus shown on the screen.
Figure 4-16
Figure 4-17
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40
Change, rename, or delete a bolus preset
1. On the Home screen, use the Up/Down Controller buttons to choose Settings, then press Select.
2. Choose Presets, then press Select.
3. Choose Bolus presets, then press Select.
4. Choose a preset from the list, then press Edit.
Change a bolus preset
1. Choose Edit, then press Select.
2. Enter a new insulin amount for the bolus, then press Save.
Rename a bolus preset
1. Choose Rename, then press Select.
2. Press the Up/Down Controller buttons to enter the characters that spell out the name you want, then press Next.
Delete a bolus preset
1. Choose Delete, and then press Select.
2. Press Delete to permanently delete the preset.
Cancel an active bolus preset
1. Press and hold the Power button to turn on the PDM (To check the Pod status, refer to Page 54 for detailed instructions. The ID screen must be confirmed before you can check Pod status.), if it is not already on. An on-screen message appears as long as a bolus is being delivered.
2. Press Cancel.
The Pod beeps to confirm the bolus is cancelled. An on-screen message tells you how much insulin was delivered before you cancelled the bolus.
3. Press OK to return to the Status screen. For more details, see “Cancel Active Boluses” earlier in this
chapter.
Carb Presets
Carb presets are favorite food items, snacks, or meals that you eat frequently. After you enter these items, you can quickly select one when entering carb amounts during the suggested bolus calculator process.
Create a carb preset
1. On the Home screen, use the Up/Down Controller buttons to choose Settings, then press Select.
2. Choose Presets, then press Select.
3. Choose Carb presets, then press Select.
4. Choose the category for this carb preset: (Favor ite s, Snacks, or Meals), then press Select.
5. Choose [add new], then press New.
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4
6. To use the OmniPod System’s default naming system, simply
press Next. The default naming system automatically assigns program names in numerical order, such as carb preset 1, carb preset 2, carb preset 3.
Or, to give a different name to the program: a. Press the Up/Down Controller buttons to enter the
characters that spell the name you want. An up and down arrow symbol on the screen indicates the character you are changing.
b. Press the middle Soft Key (the right arrow) to move the
underscore to the next character.
c. Enter each character one at a time. For example, if you
frequently eat a breakfast consisting of plain low-fat yogurt with blueberries, sweetener, and cinnamon, you might enter B, l, u, e, [space], Y, o, g, u, r, t (Figure 4-18).
d. Press Next.
7. Enter the grams of carbohydrate in the meal, then press Next.
8. If you want, enter the grams of fiber, fat, and protein in the
meal, and the total calories. Press Next after each entry.
9. Press Save to add the preset to the category.
Change or edit a carb preset
1. On the Home screen, use the Up/Down Controller buttons to choose Settings, then press Select.
2. Choose Presets, then press Select.
3. Choose Carb presets, then press Select.
These additional units are not required. If you prefer not to
enter them, simply press Next repeatedly to skip
through the screens.
If you do include grams of fiber in step 8 to the left, the suggested bolus calculator u
ses carbs minus fiber. Alternatively, in step 7, you can enter the total grams of carbs minus the fiber yourself. Your healthcare provider can best advise you on how to make this entry.
Figure 4-18
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Understanding and Delivering Bolus Doses
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42
4. Choose the category of the preset you want to change, then
press Select (Figure 4-19).
To change the category for a carb preset
1. Choose the carb preset you want to move to another
category, then press Tag (Figure 4-20).
2. Choose a new category, then press Select.
To edit a carb preset
1. Choose the carb preset you want to change, then press Edit.
2. Press Edit again on the next screen.
3. To rename the carb preset, press the Up/Down Controller
buttons to enter the characters that spell out the name you want, then press Next.
To “erase” characters, press either Up or Down until you reach the end of the characters, which gives you the option to choose a blank space.
4. Enter the grams of carbohydrate in the meal, then press Next.
5. If you want, enter the grams of fiber, fat, and protein in the
meal, and the total calories. Press Next after each entry.
6. Press Sa
ve to update the preset.
Delete a carb preset
1. On the Home screen, use the Up/Down Controller buttons to choose Settings, then press Select.
2. Choose Presets, then press Select.
3. Choose Carb presets, then press Select.
4. Choose the category of the preset you want to change, then press Select.
5. Choose the carb preset you want to delete, then press Edit.
6. Press Delete.
7. Press Delete again to permanently delete the preset.
Figure 4-19
Figure 4-20
These additional units are not required. If you prefer not to enter them, simply press Next repeatedly to skip through the screens.
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43
CHAPTER 5
Using the Pod
The Pod Change Process
Replace the Pod at least once every 72 hours or up to 200 units of insulin (3 days).
Refer to the insulin labeling and follow your healthcare provider’s directions for how often to replace your Pod. If you like, you can set the Personal Diabetes Manager (PDM) to notify you when it is time to replace the Pod (see Chapter 6, Using the Personal Diabetes Manager).
WAR NI NG S!
Do NOT apply or use a Pod if the sterile packaging is open or
damaged
, or if the Pod has been dropped after removal from the package as this may increase the risk of infection. Pods are sterile unless packaging has been opened or damaged.
Do NOT apply or use a Pod if it is damaged in any way. A damaged Pod may not work properly.
To minimize the possibility of site infection, do NOT apply a Pod without first using aseptic technique. This means to:
wash your hands
clean the insulin vial with an alcohol prep swab
clean the infusion site with soap and water
keep sterile materials away from any possible germs
Do NOT use a Pod if you are sensitive to or have allergies to acrylic adhesives, or have fragile or easily damaged skin.
Check often to make sure the Pod and soft cannula are securely attached and in place. A loose or dislodged cannula may interrupt insulin delivery. Verify there is no wetness or scent of insulin, where as may indicate the cannula has dislodged.
Do NOT apply a new Pod until you have deactivated and removed the old Pod. A Pod that has not been deactivated properly may continue to deliver insulin as programmed, putting you at risk of over infusion and possible hypoglycemia.
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44
Because insulin Pods use only rapid-acting insulin, users are at increased risk for developing hyperglycemia (high blood glucose) if insulin delivery is interrupted. If it is untreated, severe hyperglycemia can quickly lead to diabetic ketoacidosis (DKA). DKA can cause symptoms such as breathing difficulties, shock, coma, or death. If insulin delivery is interrupted for any reason, you may need to replace the missing insulin usually with an injection of rapid-acting insulin. Ask your healthcare provider for instructions on handling interrupted insulin delivery.
Gather equipment and supplies
Gather the following before you begin:
A vial of rapid-acting U-100 insulin (See the warning on page x of
the Introduction for a list of insulin’s approved for
use in the OmniPod System.)
An unopened Pod
An alcohol prep swab
Deactivate the current Pod
1. On the Home screen, use the Up/Down Controller buttons to choose More actions, then press Select.
2. Choose Change Pod (Figure 5-1), then press Select.
3. Press Confirm (Figure 5-2) to deactivate the current Pod.
NEVER use insulin that is cloudy
; it may be old or inactive. Failure to use rapid-acting U-100 insulin, or using insulin that is expired or inactive, may lead to hyperglycemia or diabetic ketoacidosis (DKA).
If you are a first-time OmniPod System user, your healthcare provider will guide you through the steps for initializing and applying your first Pod. Do NOT attempt to apply or use a Pod until you have been trained by your healthcare provider. Use of the System with inadequate training or improper setup could put your health and safety at risk.
Figure 5-1
Figure 5-2
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5
4. If an extended bolus or temporary basal or both are actively running, you will see the message in Figure 5-3. Press Confirm to accept the cancellation.
Or press Back to return to the More actions menu.
5. After you press Confirm, you will see the message in Figure 5-4.
To remove the old Pod: a. Gently lift the edges of the adhesive tape from your skin
and remove the entire Pod (Figure 5-5).
b. Use soap and water to remove any adhesive that remains
on the skin or, if necessary, use an adhesive remover.
c. Discard the used Pod according to local waste disposal
regulations.
6. After removing the old Pod, press Next.
7. Press Ye s to fill and activate a new Pod (Figure 5-6).
.
Removing the Pod slowly will help to avoid possible skin irritation.
Figure 5-3
Figure 5-4
Check the infusion site for signs of infection. See “Avoid Infusion Site Infections” later in this chapter.
Figure 5-5
Figure 5-6
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46
Fill a new Pod
1. Use an alcohol prep swab to clean the top of the insulin vial, then discard the prep swab.
2. Securely twist the fill needle onto the syringe (Figure 5-7).
3. Pull outward to remove the protective cap from the needle (Figure 5-8). Save the cap; you will need it later.
Before filling a Pod, ensure that no other Pods are being activated within 24 inches of your PDM.
Before filling a Pod with insulin, ensure that the Pod is
above 10° Celsius (50° Fahrenheit). If the Pod has
been exposed to temperatures below 10 °C (50 °F), then allow the Pod to be brought back to room temperature before filling it with insulin.
Use care after removing the needle cap and exposin
g the fill needle.
Only use room temperature insulin when filling the P
od.
Figure 5-7
Figure 5-8
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5
4. Determine the amount of insulin you need to insert into the Pod. For example, if you will use this Pod for 48 hours, you need enough insulin to last you 48 hours. Your healthcare provider will help you determine the correct amount.
5. Draw air into the syringe up to the amount of insulin you want.
6. Insert the needle into the insulin vial and inject the air. This makes it easier to withdraw insulin from the vial.
7. Turn the vial and syringe upside down. Withdraw insulin from the vial into the syringe, expelling any and all air or air bubbles. Fill at least to the MIN (minimum) fill line (Figure 5-9). Refer to the Care Giver Guide as an additional reference.
8. Remove the needle from the vial and insert it straight down
into the insulin fill port on the underside of the Pod (Figure 5-10).
The Pod requires a minimum of 85 units of insulin to begin operation.
The Pod can deliver up to 200 units of insulin.
Any air bubbles present in the fill syringe could be tran
sferred into the reservoir during the fill process. The pod does not purge air that is introduced into the reservoir by way of customer fill.
Failure to expel air bubbles from the fill syringe may result in interrupted insulin delivery.
Make sure there is no air in the syringe before attempting to fill a Pod with insulin.
Be sure to only insert the fill syringe into the fill port. Attempting to inject insulin into any other location on the Pod may result in damage to the Pod or loss of insulin.
Figure 5-9
Figure 5-10
Fill port
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48
9. Depress the syringe plunger to completely empty the insulin into the Pod. The Pod will beep, indicating that the System is ready to proceed to the next step.
10. Remove the needle from the insulin fill port. The port is self­sealing; insulin will not leak after the needle is removed.
11. Place the protective cap back on the needle and remove the needle from the syringe.
12. After you fill the Pod, it will beep twice. After hearing the beeps
, PDM and Pod should be adjacent and touching, either in or out of tray to ensure proper communication during priming (Figure 5-11). Press Next.
13. The Pod will only beep if you have f
illed it with at least 85 units of insulin. If you have filled the Pod with more than 85 units and still do not hear the 2 beeps, please call Customer Care.
To ensure proper fill, do not insert the fill syringe at
an angle into the fill port.
Do not use any other type of needle or filling device bes
ides the syringe provided with each
Pod.
NEVER use a Pod if you hear a crackling noise or f
eel resistance when you depress the plunger. These conditions can result in interrupted insulin delivery of insulin.
Do not insert the fill syringe into the fill port more than once
.
NEVER inject air into the fill port. Doing so may result in unintended or interrupted insulin delivery.
The fill syringe is intended for single use only and should be used only with the OmniPod System.
As a safety feature, the communication distance be­t
ween the Pod and PDM is reduced during activation. Once a Pod is primed and communicates with the PDM, the full communication range is restored and the Pod can receive commands only from that PDM.
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5
14. The System performs a series of safety checks and automatically primes the Pod (Figure 5-12). Once complete, the PDM beeps, letting you know that the priming and safety checks were successful.
Select the infusion site
Before applying a new Pod, you must first select an appropriate infusion site. Due to ease of access and viewing, the abdomen is often used. Your healthcare provider may suggest other potential sites that, like the abdomen, typically have a layer of fatty tissue, such as the hip, back of upper arm, upper thigh, or lower back (Figure 5-13).
After filling the Pod with insulin, you should complete the Pod change process within 60 minutes. As a reminder that the Pod has been filled, it will beep every 5 minutes to indicate that time is passing. If you do not set up the Pod within 60 minutes, you must deactivate and discard it.
Figure 5-11
Figure 5-12
Once a Pod is activated and communicates with the PDM, it can only receive commands from that PDM, not from any other.
Avoid sites where belts, waistbands, or tight clothing may rub against, disturb, or dislodge the Pod. Also avoid sites where the Pod will be affected by folds of skin.
Change the site each time you apply a new Pod. A new infusion site should be
at least 2.5 cm (1") away from the last site. (Using the same location repeatedly may reduce insulin absorption.)
Do NOT apply the Pod within 5.0 cm (2") of your nav
el or over a mole or scar, where insulin
absorption may be reduced.
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50
Prepare the infusion site
You can reduce the risk of infection at the infusion site by following aseptic technique and disinfecting the infusion site. Before applying a new Pod, always:
1. Wash hands with soap and water.
2.
Use soap to wash the infusion site.
3. Dry the site with a clean towel.
4. Use an alcohol prep swab to disinfect the infusion site. Start at the center of the site and gently rub outward in a circular motion.
5. Let the site air-dry thoroughly. Do not blow on the site to dry it.
Figure 5-13: Pod placement options
Front Back
To help avoid condensation from occurring in the viewing window, make sure both your Pod and your insulin are at room temperature.
Antibacterial soap may irritate skin, especially at the infusion site. Ask your healthcare provider how to treat any skin irritation.
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5
Apply the new Pod
Prepare the Pod for applying to your infusion site:
1. To remove the needle cap on the underside of the Pod, place y
our thumb on the bottom (flat edge) of the needle cap and
pull it upwards (Figure 5-14). The needle cap will snap off.
2. Verify that the Pod is ready to be applied:
Pod is clean and dry.
Adhesive pad is intact and undamaged.
Pod is intact and in its original condition.
If Pod is accidentally dropped, discard it; sterility may be compromised.
If you are unsure the Pod is ready to be applied to the site, press “Discard” and do not use it (Figure 5-17). Select a new Pod.
3. Using the pull tabs, remove and discard the white paper backing from the adhesive tape (Figure 5-15).
4. Apply the Pod to the prepared infusion site. Press firmly to secure it to your skin.
Figure 5-14
Figure 5-15
Verify cannula does not extend beyond adhesive backing once needle cap is removed.
Do not remove the needle cap until you are instruc
ted to do so by the PDM. When you remove the needle cap, a drop of insulin may be visible at the end of the cannula or in the well.
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52
5. After you securely apply the Pod, press Next (Figure 5-17).
For the Pod to work best, apply it: a. Crosswise or at a slight angle on your
abdom
en, hip, lower back, or buttocks
(in Figure 5-16)
b. Up and down or at a slight angle on your
upper arm or thigh (in Figure 5-17)
c. At least one inch away from the last site
Figure 5-13
a.
b.
Figure 5-16
Figure 5-17
The Pod’s adhesive keeps it securely in place for up to 3 days. However, if necessary, several products are available to enhance adhesion. Ask your healthcare provider about these products. Avoid getting body lotion, creams, or oils near the infusion site; these products may loosen the adhesive.
The adhesive is designed for one-time use. Once r
emoved, a Pod cannot be reapplied.
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5
Insert cannula and begin insulin delivery
1. To insert the soft cannula, press Start (Figure 5-18).
The Pod automatically inserts the soft cannula below your skin. It takes a few seconds to complete the insertion process. Once the cannula is inserted, the Pod delivers a prime bolus to fill the cannula with insulin (Figure 5-20).
Once the soft cannula is inserted, the PDM indicates that the Pod is active (Figure 5-21).
If you are applying a Pod in a place that does not have a lot of fatty tissue or is very lean, pinch the skin around the Pod (Figure 5-19) after you press Sta
rt
and hold it until the cannula inserts. Occlusions may r
esult in lean areas if you do not use this technique.
The soft cannula is tinted light blue to improve visibility at the inser
tion site.
Figure 5-18
Figure 5-19
You will hear a click when the cannula inserts.
Figure 5-17
Figure 5-20
Figure 5-21
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54
Figure 5-21 also displays a reminder to check the infusion site and cannula. Make sure the Pod is securely attached to your skin. You can see the cannula through the small viewing window on the Pod.
When you see the pink slide insert in this position, it means that the cannula is inserted (Figure 5-23).
2. Press Ye
s if you can see that the cannula is properly inserted.
The PDM returns to the Status screen. Press No if you see a problem with the cannula. The PDM
instructs you to deactivate the new Pod (Figure 5-23). Press Discard to restart the process with a new Pod.
Check the infusion site after insertion to ensure that
the cannula was properly inserted. You should check your blood glucose 1.5 to 2 hours after each Pod change and check the infusion site periodically. If the cannula is not properly inserted, hyperglycemia may result. Verify there is no wetness or scent of insulin, where as may indicate the cannula has dislodged.
If you observe blood in the cannula, check your bloo
d glucose more frequently to ensure insulin delivery has not been affected. If you experience unexpected elevated blood glucose levels, change your Pod.
To help avoid condensation from occurring in the view
ing window, make sure both your Pod and your
insulin are at room temperature.
Condensation may occur in the viewing window, fr
om sweating and perspiration.
Figure 5-22
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Or press Back to return to the previous screen.
Check Pod Status
To check Pod status, if the PDM is turned Off, press and hold the Power button to display the ID screen, then press Confirm to
display the Status screen. If the PDM is On, press Back until you reach the Status screen. (If you press and hold the Power button, you will turn off the PDM instead.) Or, from the Home screen, press Status.
The PDM automatically checks the status of the Pod. The PDM then display
s the current reservoir volume, PDM battery level, last blood glucose, last bolus dose, active basal program, and any alarm conditions. See Chapter 6, Using the Personal Diabetes Manager, for details of what you see on the St
atus screen.
If the Pod goes into hazard alarm condition and the PDM is unable to communicate with it to turn off the alarm, you can turn it off manually. See the end of Chapter 10, Alerts and Alarms, for instructions.
Suspend Insulin Delivery
Sometimes you may need to briefly stop insulin delivery (for example, when editing an active basal program or changing the time or date). The OmniPod System lets you suspend all insulin delivery for up to 2 hours. While in suspension, the Pod beeps once every 15 minutes, reminding you that insulin delivery is suspended.
NEVER inject insulin (or anything else) into the fill port while the Pod is on your body. Doing so may r
esult in unintended or interrupted insulin delivery.
Figure 5-19
Figure 5-23
Once a Pod is activated and communicates with the PDM, it can only receive commands from that PDM, not from any other.
At any time during a suspension period, press Resume to resume the basal program that was running when you suspended insulin delivery.
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1. On the Home screen, use the Up/Down Controller buttons to choose Suspend; then press Select.
2. Enter how long you want to stop all insulin delivery, from 30 minutes to 2 hours, in 30-minute increments (Figure 5-24), then press Enter.
3. Press Confirm to confirm that you want to halt all insulin delivery (basal and bolus). The PDM beeps and an on-screen message lets you know that insulin delivery is indeed suspended (Figure 5-25).
The Pod beeps every 15 minutes until the end of the suspension period. The Status screen shows INSULIN SUSPENDED until you resume insulin delivery (see “Resume Insulin Delivery” on the next page).
4. At the end of the suspend time, a Pod Advisory alarm occurs (Figure 5-26).
Extended boluses and temporary basal rates will be cancelled when you suspend insulin delivery.
If a temporary basal or ex
tended bolus is in process, the
menu item will read Suspend/cancel instead, and options for cancelling these programs also appear in the menu. If these options appear, choose Suspend insulin
delivery.
Figure 5-20
Figure 5-24
Figure 5-25
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5. To resume your programmed basal rate, press OK.
Resume Insulin Delivery
1. On the Home screen, use the Up/Down Controller buttons to choose Resume (Figure 5-27), then press Select.
2. Press Confirm to restart the basal program for that time segment.
The Advisory alarm repeats every 15 minutes until you press OK.
Insulin delivery will not
resume until you press OK. If
you do not press OK to resume insulin delivery, you could develop hyperglycemia (high blood glucose).
Figure 5-22
Figure 5-26
Figure 5-23
Figure 5-27
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Avoid Infusion Site Infections
Always wash your hands and use the aseptic technique to prepare the infusion site before applying a Pod.
Do not apply a Pod to any area of the skin with an active infection. If you are unsure whether to use a specific site, ask your healthcare provider.
At least once a day, use the Pod’s viewing window to check the site for signs of infection and to confirm that the soft cannula is securely in place.
Be aware of the signs of infection, including pain, swelling, redness, discharge, or heat at the site. If you suspect an infection, immediately remove the Pod and apply a new one in a different location. Then call your healthcare provider.
Change the Pod as instructed by your healthcare provider.
Get the Most From Your Pod
Avoid extreme temperatures
The Pod’s operating temperature is between 4.4 °C and 40 °C (between 40 °F and 104 °F).
Under normal circumstances, your body temperature will keep the P
od well within this range.
Water and your Pod
The Pod is waterproof up to a depth of 7.6 meters (25 feet) for up to 60 minutes (IPX8). After exposure to water, rinse off the Pod with clean water and gently dry it with a towel.
Do NOT expose a Pod to direct sunlight for long periods of time. It is recommended that you remove your Pod prior to using hot tubs, whirlpools, or saunas. These conditions could expose the Pod to extreme temperatures and may also affect the insulin inside the Pod.
Remember to check your blood glucose levels frequently bef
ore and after removing the Pod. Check with your healthcare provider for guidelines on removing the Pod for extended periods.
Insulin degrades at high temperatures and will fr
eeze near 0 °C (32 °F). Check the insulin
manufacturer’s instructions for use.
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Safe storage
Store unopened Pods in a cool, dry place. Extreme heat or cold can damage Pods and cause them to malfunction. If Pods are exposed to extreme temperatures, allow them to return to room temperature before use
.
Do not expose your Pod to water at depths greater than 7.6 meters (25 feet) or for more than 60 minutes. Check often to make sure the Pod and soft cannula are securely attached and in place. If the cannula is not properly inserted, hyperglycemia may result. Verify there is no wetness or scent of insulin, where as may indicate the cannula has dislodged.
The PDM is not waterproof. Do not place it in or near wa
ter.
Pods are sterile unless their packaging is opened or damaged
. Do NOT apply or use a Pod if its sterile packaging is opened or damaged, or if the Pod has been dropped after removal from the package as this may increase the risk of infection or serious injury.
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CHAPTER 6
Using the Personal Diabetes Manager
The ID Screen
When you first turn on the PDM, it displays the identification (ID) screen (Figure 6-1), which allows you to identify
that the PDM is yours. You can personalize the ID screen by adding your name and choosing its color
. You must acknowledge the ID screen
before you can use the PDM.
The Status Screen
When a Pod is active and the PDM is turned on, the PDM establishes communication with the Pod to obtain a status check. During the status check, the PDM collects information from the Pod about bolus deliveries, active basal programs, and Pod expiration. The information obtained is then displayed in the status screen, which shows the System’s current operating status.
The Status screen (Figure 6-2) displays:
Time, date, and result of last blood glucose checked or ent
ered manually
Time, date, and total amount of last bolus delivered
It is important that you always identify the PDM as y
ours before you use it.
Figure 6-1
Figure 6-2
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Amount of insulin on board (IOB), if suggested bolus calculator is in use
Name and rate of active basal program or temp basal program
“Ext bolus,” the amount of insulin and the delivery time remaining if an extended bolus is being delivered
“INSULIN SUSPENDED” if insulin delivery has been suspended
Time and date when the Pod will expire
Insulin gauge and display
One of the important icons on the Status screen is the insulin gauge at the top of the screen. It indicates how much insulin is left in the Pod’s reservoir. As the reservoir empties, the icon changes to indicate the amount of insulin remaining.
Next to the insulin gauge, the PDM displays the number of units r
emaining in the Pod. As long as more than 50 units remain, the gauge displays “50+ U.” Once the reservoir volume drops to 50 units, the gauge counts down unit by unit. When the volume falls below 5 units, the display changes to “LOW.”
PDM settings
You can adjust the PDM settings to meet your individual needs.
1. From the St
atus screen, press Home.
2. Use the Up/Down Controller buttons to choose Settings,
then press Select.
3. Choose System setup, then press Select.
4. Choose an option from the System setup list, then press
Select (Figure 6-3). Check with your healthcare provider before making any changes.
If a Pod has not yet been activated (as in during Pod changes), the screen displays “No active Pod. Would you like to activate a Pod now?” (See Chapter 5, Using the Pod, for details on activating a Pod.)
Regularly checking the insulin gauge enables you to plan Pod changes easily. For example, if you know you will need approximately 20 units during your work day and the insulin gauge shows only 17 units remaining, you can either take a new Pod with you or change it before you leave for the day.
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The System Setup Menu
The System setup menu lets you personalize the settings that control the OmniPod System. These include:
Date and time
Bolus doses, ba
sal rates, and bolus calculator settings
Alerts and reminders
Blood glucose meter settings and tags
PDM options
Diagnostics
You and your healthcare provider entered initial System settings using th
e Setup Wizard (see Chapter 2, Getting Started). After
setup, you can use the Sys
tem setup menu to customize or
change those settings, as described in this chapter.
Reset the Date or Time
Occasionally, you need to change date and time settings (for example, to adjust for daylight savings time or after resetting the PDM). As a safety feature, you can change date and time settings only when the Pod is deactivated or when insulin delivery is suspended (see Chapter 5, Using the Pod).
1. Suspend insulin delivery.
2. On the Home screen, use the Up/Down Controller buttons to choose Settings; then press Select.
3. Choose System setup, then press Select.
4. Choose Date/time, then press Select.
5. Choose either Date or Time, then press Edit.
Figure 6-3
If you are changing the Pod, you can reset the date or time without suspending by changing the date or time before activating the new Pod.
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Reset the time
1. To enter the current time, press the Up/Down Controller
buttons. Press and hold the button to increase or decrease the time faster.
2. Press 12/24 hr to choose either a 12-hour or 24-hour clock, then press Enter (Figure 6-4).
3. Press Confirm to accept the new time (Figure 6-5).
Reset the date
1. Press the Up/Down Controller buttons to choose the current year, then press Next.
2. Choose the current month, then press Next.
3. Choose the current day, then press Next.
4. Choose the date format to be displayed by the PDM, then press Select.
5. Press Confirm to accept the new date and format.
Change Bolus and Basal Settings
You and your healthcare provider entered initial bolus and basal System settings using the Setup Wizard. Using the System setup menu, you can edit all the OmniPod System bolus and basal settings as your needs change. Check with your healthcare provider before making any changes.
1. On the Home sc
reen, use the Up/Down Controller buttons
to choose Settings, then press Select.
2. Choose System setup, then press Select.
Figure 6-4
Figure 6-5
If you suspended insulin delivery to change the time or date, remember to resume insulin delivery. If you changed the time or date during the Pod change process, remember to activate a new Pod.
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3. Choose Bolus/basal/calcs, then press Select.
4. Choose one of the options (Figure 6-6a and Figure 6-6b), then
press Select. Each option is described below.
Bolus calcs
When the suggested bolus calculator is turned Off and you want to turn it On, press On and follow these steps:
1. T
arget BG and correct-above value—You can edit existing
time segments and add segments, up to a total of 8.
a. To edit an existing target BG time segment, choose the
segment, then press Edit. Use the Up/Down Controller buttons to choose a new start time, end time, target BG value, and correct-above value (correction threshold). Press Next after each entry.
b. To add a segment, choose [add new], then press New.
Use the Up/Down Controller buttons to choose a start time, end time, target BG value, and correct-above value (correction threshold). Press Next after each entry.
c. When you have completed all the time segments you
want, press Done, then Save.
2. Min BG for calcs (minimum blood glucose value allowed for calculating boluses)—Use the Up/Down Controller buttons to enter a new minimum BG, then press Next.
3. Insulin-to-carb (IC) ratio—You can edit existing time segments and add segments, up to a total of 8.
a. To edit an existing IC ratio time segment, choose the
segment, then press Edit (Figure 6-7). Use the Up/Down Controller buttons to choose a new start time, end time, and IC ratio. Press Next after each entry.
b. To add a segment, choose [add new], then press New.
Use the Up/Down Controller buttons to choose a start time, end time, and IC ratio. Press Next after each entry.
c. When you have completed all time segments, press
Done, then Save.
Figure 6-6a
Figure 6-6b
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4. Correction factor—You can edit existing time segments and
add segments, up to a total of 8. a. To edit an existing correction factor time segment, choose
the segment, then press Edit. Use the Up/Down Controller buttons to choose a new start time, end time, and correction factor. Press Next after each entry.
b. To add a segment, choose [add new], then press New.
Use the Up/Down Controller buttons to choose a start time, end time, and correction factor. Press Next after each entry.
c. When you have completed all time segments, press
Done, then Save.
5. Reverse correction—Choose On or Off, then press Next.
6. Insulin action (duration)—Use the Up/Down Controller
buttons to choose a duration of insulin action, then press Done.
7. Press OK.
Ratios/factors/targets
When the suggested bolus calculator is turned On, you can view and change all the settings using the Ratios/factors/targets menu option. Choose Review all settings, then press Select (Figure 6-8a) or choose one setting from the menu, then press Select (Figure 6-8b). The steps are the same whether you choose all settings or individual ones.
Figure 6-7
Figure 6-8a
Figure 6-8b
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1. Target BG and correct-above value—You can edit existing
segments and add segments, up to a total of 8. a. To edit an existing target BG time segment, choose the
segment, then press Edit. Use the Up/Down Controller buttons to choose a new start time, end time, target BG value, and correct-above value (correction threshold). Press Next after each entry.
b. To add a segment, choose [add new], then press New.
Use the Up/Down Controller buttons to choose a start time, end time, target BG value, and correct-above value (correction threshold). Press Next after each entry.
c. When you have completed all the time segments you
want, press Done, then Save.
2. Min BG for calcs (minimum blood glucose value allowed for calculating boluses)—Use the Up/Down Controller buttons to enter a new minimum BG, then press Enter.
3. Insulin-to-carb (IC) ratio—Number of grams of carbohydrate covered by one unit of insulin. You can edit existing time segments and add segments, up to a total of 8.
a. To edit an existing IC ratio time segment, choose the
segment, then press Edit. Use the Up/Down Controller
buttons to choose a new start time, end time, and IC ratio. Press Next after each entry.
b. To add a segment, choose [add new], then press New.
Use the Up/Down Controller buttons to choose a start time, end time, and IC ratio. Press Next after each entry.
c. When you have completed all time segments, press
Done, then Save.
4. Correc tion factor—You can edit existing time segments and
add segments, up to a total of 8. a. To edit an existing correction factor time segment, choose
the segment, then press Edit. Use the Up/Down Controller buttons to choose a new start time, end time, and correction factor. Press Next after each entry.
b. To add a segment, choose [add new], then press New.
Use the Up/Down Controller buttons to choose a start time, end time, and correction factor. Press Next after each entry.
c. When you have completed all time segments, press
Done, t
hen Save.
5. Reverse correction—Choose On or Off, then press Select.
6. Insulin action (duration) or Insulin on Board (IOB)—Use the Up/Down Controller buttons to choose a duration of insulin action, then press Enter.
When the suggested bolus calculator is turned Off, the
Ratios/factors/targets option does not appear in the Bolus/basal/calcs menu.
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Temp ba sa l
Choose %, U/hr, or Off to set the mode for temporary basal rates and presets, then press Select.
Extended
Choose %, Units, or Off to set the mode for extended boluses, then press Select.
Bolus increment
Choose 0.05, 0.10, 0.50, or 1.00 units for bolus increments, then press Select.
Max bolus
Use the Up/Down Controller buttons to enter the maximum bolus dose you can take, then press Enter.
Max basal rate
Use the Up/Down Controller buttons to enter the maximum basal rate you can choose, then press Enter.
Alerts and Reminders
In addition to automatic safety alarms (see Chapter 10, Alerts and Alarms), the OmniPod System offers a number of personal settings to help you manage your diabetes. These features are optional. You can turn them on or off at any time, except for the alerts. Those you can set at levels that you find convenient to remind you to change your Pod.
Notifications you can use are: BG (blood glucose) reminder: R
eminds you to check your blood
glucose. Choose from On or Off. The default setting is Off. When the reminder is on, the PDM asks you each time you enter a bolus dose whether you want to set a BG reminder, and you can then choose a time interval, in 30-minute increments.
Pod expiration: R
eminds you when the Pod is nearing the 72­hour expiration time. Choose a period from 1 to 24 hours before expiration, in 1-hour increments. The default setting is 4 hours. You will hear 2 sets of beeps every minute for 3 minutes. The notification will repeat every 15 minutes until you press OK to acknowledge it.
Low reser voir:
Alerts you when insulin in the Pod reaches a certain level, so you can plan ahead to change the Pod. Choose a level from 10 to 50 units, in 5-unit increments. The default setting is 10 units.
Some settings have preset defaults, but all settings ar
e changeable. See the Appendix for a list of System specifications, including preset default settings
.
For additional details on bolus and basal settings, see Chapter 3, Understanding and Adjusting Basal Rates, and Chapter 4, Understanding and Delivering Bolus Doses.
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Auto-off: Alerts you if the PDM does not receive a Pod status within a predefined period of time. Obtain Pod status by pressing and holding the PDM’s Power button. Choose a time period from 1 to 24 hours, in 1-hour increments, or choose Off. The default setting is Off. Refer to page 54 to check Pod status and to Confirm ID.
This alert can be especially reassuring if you are prone to h
ypoglycemia unawareness. Ask your healthcare provider about
using this alert and where to set it.
Bolus reminders: Notifies y
ou if you have not delivered a meal
bolus, manually or using the suggested bolus calculator, between the times you specify. Choose On or Off and choose up to 6 time segments.
Program reminders: P
od beeps when a program is in process (see Chapter 3, Understanding and Adjusting Basal Rates; and Chapter 4, Understanding and
Delivering Bolus Doses, for
details). These include:
Temporary basal in process
Extended bolus in process
Choose On or Of
f. The default setting is On.
Confidence reminders: The
Pod or PDM beeps in response to your instructions, so you become familiar with the operation of the OmniPod System and feel confident that you are getting the insulin you need. These notifications include:
Bolus delivery started
•B
olus delivery completed
Extended bolus started
Extended bolus completed
Temporary basal rate started
Temporary basal completed Choose On or Of
f. The default setting is On.
The Low reservoir alert will escalate to an Empty r
eservoir hazard alarm when insulin is depleted. Be
sure to respond to the alert when it occurs.
The Auto-off alert will escalate to a hazard alarm if ig
nored and will result in the deactivation of your active Pod. Be sure to respond to the alert when it occurs.
Turning the PDM on by inserting a blood glucose t
est strip does not send a Pod status to the PDM.
If you use the Auto-off feature, always turn on the PDM with
the Power button before using the system.
This allows the PDM to obtain a Pod status. Refer to page 54 to check Pod status and to Confirm ID.
FF
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Custom reminders: Displays text reminders that you enter, at times that you select. You can choose to receive a notification Daily, One time only, or Off. You can change or delete these notifications at any time.
Set alerts and reminders
1. On the Home screen, use the Up/Down Controller buttons to choose Settings, then press Select.
2. Choose System setup, then press Select.
3. Choose Alerts/reminders, then press Select.
4. Choose the option you want to set (Figure 6-9), then press Select.
5. For all except Bo
lus reminders and Custom reminders,
choose the desired option or set the desired value, then press Select or Enter.
6. For Bolus reminders
Use the Up/Down Controller buttons to choose On or Off, then press Select.
•If you chose On, you are taken to a new screen where you can add, edit or delete reminders:
To add a Bolus reminder
a. Use the Up/Dow
n Controller buttons to choose [add
new], then press New.
b. Choose a start time, then press Ne
xt.
c. Choose an end time, then press Sa
ve.
To edit a Bolus reminder
a. Choose the bolus reminder you wish to edit, then
pr
ess Edit.
b. Choose Edit, th
en press Select.
c. Enter a new start time, then press Ne
xt.
d. Enter a new end time, then press Sa
ve.
Figure 6-9
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To delete a Bolus reminder
a. Choose the bolus reminder y
ou wish to delete, then
press Edit.
b. Choose Delete then pr
ess Select.
c. Press Delete t
o remove the bolus reminder.
7. For Cu
stom reminders
Use the Up/Down Controller buttons to choose
[add new], then press New.
To use the OmniPod System’s default naming system, simply press
Next
. The default naming system automatically assigns
names in numerical order, such as alert 1, alert 2, alert 3. If you want to give a different name to the reminder: a. Use the Up/Do
wn Controller buttons to scroll
through the list of characters. An up-and-down arrow symbol on the screen indicates the character you are changing.
b. Press the middle So
ft Key (the right arrow) to move the
underscore to the next character.
c. Enter each character one at a time. For example, for a
r
eminder to pick up a prescription, you might enter
R, x (Figure 6-10). (A blank character or space is the first and last option in the scrolling menu.)
d. Press Ne
xt.
Enter the time of day for the reminder, in 30-minute in
crements, then press Next.
Choose Daily, One time only, or Off, then press Select.
Custom reminders will repeat every 15 minutes until acknowledged.
Figure 6-10
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Change Blood Glucose Meter Settings
You can adjust blood glucose (BG) meter settings:
BG goal lower and upper limits (for BG history)
Manage BG tags list
BG sound—On or Off
1. On the Home screen, use the Up/Down Controller buttons to choose Settings, then press Select.
2. Choose System setup, then press Select.
3. Choose BG meter, then press Select.
4. Choose the setting you want to change (Figure 6-11), then press Select.
Change BG goal limits
To change the BG goal limits, press Edit, change either or both values, then press Save.
Manage the blood glucose tags list
You can create up to 15 custom blood glucose tags and hide any of the standard tags you do not plan to use. Standard BG tags are shown first on the screen (Figure 6-12a), followed by custom tags, and then [add ne
w] (Figure 6-12b). For more information
about tagging BG readings, see Chapter 7, Checking Your Blood Glucose.
Figure 6-11
Figure 6-12a
Figure 6-12b
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1. To hide or show a standard BG tag, choose the tag, and press
Show (if it is marked as hidden) or Hide. Tags you choose to show will be check marked; hidden ones
will not be.
2. To add a custom tag, choose [add new] at the end of the list of custom tags, then press New.
In the Edit name screen, either: a. Press Save to save the new tag with the default name,
custom tag1, custom tag2, and so on; or
b. Use the Up/Down Controller buttons to choose letters
and numbers for a name, followed by the middle Soft Key (the right arrow) to move forward one space. Then press Save.
3. To delete a custom tag, choose the tag, press Delete, then press Delete again. Or press Cancel to leave the tag unchanged.
Change BG sound
To change BG sound, choose On or Off, then press Select.
Customize the Personal Diabetes Manager
Additional options let you customize how the PDM operates: ID screen: Identify
your PDM by adding your name and choosing
a color. The options you set will be shown on the ID screen every time you turn on the PDM.
PDM lock: “L
ocks” the buttons on the PDM. The default setting is
Off. This safety feature can help avoid accidentally changing basal rates or giving boluses.
Screen time-out: The scr
een turns off after a time interval that you set, which occurs if you have not pressed any buttons on the PDM. This setting preserves battery power by turning off the screen when you are not using it. Set it at the lowest setting to maximize battery life.
Press and hold
the Power button to turn the screen back
on. In some cases, if it has been less than 5 minutes since the screen timed out, pressing the Power button returns you to the same screen you were using. If it has been longer than 5 minutes, the PDM brings you to the Status screen. To check the Pod status, refer to page 55 for detailed instructions. The ID scr
een must be confirmed
before you can check Pod status.
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Backlight time-out: The backlight is on by default while you are using the PDM. The time-out setting dims the backlight and causes the screen to dim when you have not used it within the time interval that you set. Set at the lowest setting to maximize battery life.
Set PDM options
1. On the Home screen, use the Up/Down Controller buttons to choose Settings, then press Select.
2. Choose System setup, then press Select.
3. Choose PDM options (Figure 6-13), then press Select.
4. Choose one of the options (Figure 6-14), then press Select.
Set ID screen
To chan ge the I D:
1. Choose ID, then press Select.
2. Press the Up/Down Controller buttons to scroll through the list of characters. An up-and-down arrow symbol on the screen indicates the character you are changing.
3. Press the middle Soft Key (labeled with the right arrow) to move the underscore to the next character.
4. Enter each character one at a time. For example, if you want to enter your name, you might enter J, a, n, e, [space], S, m, i, t, h. (A blank character or space is the first and last option in the scrolling menu.)
5. Press Save.
For extra brightness on the PDM screen, press and hold th
e User Info/Support button (?) for 2 seconds.
This enables a “bright mode.” The screen will remain in this mode until the PDM times out or you turn it off. T
o preserve battery life, use this feature only when
necessary.
As a safety feature, an ID must be entered to enable the PDM to be identified.
Figure 6-13
Figure 6-14
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To change the ID screen color:
1. Choose Screen color, then press Select.
2. Use the Up/Down Controller buttons to choose a color, then press Select.
Set PDM lock
Choose On or Off, then press Select.
Set the Screen time-out
Choose a time interval, then press Select. When the screen times out and goes black
, turn it on again by
pressing the Home/Power button.
Set the Backlight time-out
Choose a time interval, then press Select. When the screen dims, turn it on again by pressing any button.
T
he PDM will ignore the usual command and re-light the screen.
Set Diagnostic Functions
The Diagnostics screen allows you to instantly confirm how the System is working or to completely update settings entered during setup (see Chapter 2, Getting Started). Options include:
Check alarms:
Confirms that all alarms work properly when needed. When you select this function, the PDM beeps and vibrates, then the Pod beeps. This function cannot be executed unless insulin delivery is suspended.
Reset PDM (soft reset): R
estores all settings in the PDM to the
factory defaults.
If you choose On,
other PDM options and most
other soft keys are locked and will not respond to button presses. To use them, you must first set PDM lock to Off.
The lowest setting will drain the battery the least.
If the PDM fails to beep, immediately call Customer Care. If a Pod is active and fails to beep, change the Pod immediately (see
Chapter 5, Using the Pod). Continuing to use the System in these situations ma
y put your health and safety at risk.
Resetting the PDM deletes all basal programs, temp basal
presets, carb presets, bolus presets, and all suggested bolus settings. Before you use this feature and delete these settings, be sure you have a written record of the information you need. History records will not be deleted.
As a safety feature, you cannot reset the PDM when a P
od is active. You must first deactivate the Pod.
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Diagnostic options
1. On the Home screen, use the Up/Down Controller buttons to choose Settings, then press Select.
2. Choose System setup, then press Select.
3. Choose Diagnostics, then press Select.
To check a la rm s
1. Choose Check alarms, then press Select.
2. Press OK. The PDM beeps three times and vibrates three times. If a Pod is active, it then beeps three times.
To reset the PDM
1. Choose Reset PDM, then press Select.
2. If the Pod is deactivated, the PDM asks for confirmation and reminds you that you will lose all user settings (Figure 6-15). Press Confirm to reset the PDM.
If the Pod is still active, you will be unable to reset the PDM (Figure 6-16). Press OK to return to the Diagnostics menu.
Be sure to check the alarm function at every Pod change.
Use the form at the end of this User Guide to write down all your settings from the Setup Wizard. If you ever need to reset your PDM, having these settings handy will make setup very easy.
Figure 6-15
Figure 6-16
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Set a Reminder to Vibrate
For certain reminders, you can choose vibration instead of beeps or vibration followed by beeps, instead of only beeps. If you activate it, the PDM will vibrate for:
Blood Glucose reminders
Missed Bolus reminders
Custom reminders
“No active Pod” reminders
To change the type of notification
1. Use the Up/Down Controller buttons to choose Settings, then press Select.
2. Choose Vibr ation, then press Select.
3. Choose Vibrate, Vibrate then beep, or Off (beep only), then press Select. (Vibrate then beep means the PDM will repeat the reminder twice using vibration. After that, it uses beeps.)
Or press Back to return to the Settings menu.
Get the Most from Your PDM
Keep it handy
Wireless communication technology means you don’t have to keep the PDM right next to the Pod for the Pod to work. Once you set your basal program, the Pod continues to deliver your basal program 24 hours a day, regardless of the location of the PDM. However, you still need the PDM to deliver a bolus, change the basal rate, and so on. You can store the PDM conveniently inside an article of clothing (like a shirt pocket) or put it discreetly into a drawer, briefcase, or purse.
Communicating with the Pod
When you use the PDM to communicate with the Pod, hold the PDM within 1.5 meters (5 feet) of the Pod.
Water and your PDM
The PDM cannot be set to vibrate for hazard or advisory alarms.
Do NOT use IV Prep wipes, alcohol swabs, soap, detergent, or solvents to clean the screen or any other part of the PDM. The PDM is NOT waterproof. Do NOT immerse it or place it in or near water.
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Avoid extreme temperatures
Extreme operating temperatures can affect PDM batteries and interfere with System operation. Avoid using the PDM in temperatures below 4.4 °C (40 °F) or above 40 °C (104 °F).
Electrical interference
The PDM is designed to withstand normal radio interference and electromagnetic fields. However, as with all wireless c
ommunication technology, certain operating conditions can interrupt communication. For example, electric appliances such as microwave ovens and electric machinery located in manufacturing environments may cause interference. In most cases, interruptions are easy to resolve (see Chapter 11, Communication Failures).
Do not store or leave the PDM where it may be exposed to
extreme temperatures, such as inside a car. Extreme heat or cold can cause the device to malfunction.
Never attempt to test your blood glucose while your PDM
is connected via USB cable to a computer.
Doing so could result in electrical shock.
Only connect a USB cable to your PDM when downloading data to a computer. Other PDM functions are disabled while a USB cable is connected, and the PDM cannot communicate with the Pod.
When you connect a USB cable to the PDM, only use a cable that is less than or equal to 2.7 meters (9 feet) in length.
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CHAPTER 7
Checking Your Blood Glucose
The Built-in FreeStyle® Blood Glucose Meter
With the FreeStyle® blood glucose meter, checking your blood glucose requires a very small sample size, 0.3 microliter of blood. Refer to your FreeStyle test strip instructions for use for important test strip information.You may want to test for low blood glucose:
When you feel symptoms such as weakness, sweating, ner
vousness, headache, or confusion
When you have delayed a meal after taking insulin
When your healthcare provider advises you to do so
Keep the system and the FreeStyle® accessories away from young children, as they contain small parts that may be dangerous if swallowed.
Only use FreeStyle® test strips and FreeStyle® control solution with the System. Using other brands of test strips and control solutions with the System can produce inaccurate results.
Never attempt to test your blood glucose while your PDM is connected via USB cable to a computer. Doing so could result in electrical shock.
This Device is intended for self-testing by the user.
Please read all the instructions provided in this User Guide and practice the testing procedures before using the system and FreeStyle® accessories. Follow the guidance of a healthcare professional for proper blood glucose monitoring.
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The FreeStyle® Blood Glucose Test Strips
Important test strip information
Store the blood glucose test strip package between 4.4° and 30° C (40° and 86° F).
Use test strips only when the system is within its operating temperature range, between 4.4° and 40° C (40° and 104° F).
Keep test strips away from direct sunlight and heat.
Store test strips in their original vial only; never transfer them to another vial or any other container.
Never store individual test strips outside the vial.
After removing a blood glucose test strip from the vial, immediately close the vial cap tightly.
With clean, dry hands, you can gently touch the test strip anywhere when removing it from the vial or inserting it into the test strip port.
Do not bend, cut, or alter blood glucose tests strips in any way.
The FreeStyle® Control Solution
The FreeStyle® control solution (Figure 7- 1) is a red liquid that contains a fixed amount of glucose
and has two important uses:
To ensure that your meter and test strips ar
e working together properly
To practice testing without having to use your own blood
Three levels of control solution are available: L
ow, Normal, and High. For information on
how to obtain control solution, call Customer Care (24 hours/7 days): 1 855 POD INFO (1 855 763 4636). When calling from outside of C
anada: 647-788-3132.
Complete information on the FreeStyle® test strips (such as
interferences and performance) can be found in the test strip package insert. Please read all instructions provided on the test strip package insert before using the OmniPod System and FreeStyle accessories.
Do not use strips beyond the expiration date printed on the package, as this may cause inaccurate results.
For detailed storage and usage information, refer to the package insert in the box containing the test strip vial.
The cap or vial contains drying agents that may be harmful if inhaled or swall
owed and may cause skin
or eye irritation.
Figure 7-1
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When to perform a control solution test
You should perform a control solution test:
When you suspect that your meter or test strips are not wo
rking properly
When you think your test results are not accurate or if your test results are not consistent with how you feel
When you drop or damage your PDM or expose it to liquids
When your healthcare provider advises you to do so
Check that the meter and test strips are working
A control solution test follows the same procedure as a blood glucose reading, except that you use a sample of control solution instead of a drop of blood. (See “Performing a Blood Glucose Reading” later in this chapter.)
When you perform a control solution test, if the reading is within the c
ontrol solution acceptable range, the meter is working
properly.
Control solution expiration date
FreeStyle® control solution is good for 3 months after opening the bottle, or until the expiration date printed on the label, whichever comes first. Count forward 3 months from the date you open a new bottle of control solution. This is your discard date. Write this date on the side of the control solution bottle. For example, if you open the control solution on January 15, count forward 3 months to April 15. This is the discard date to record
on the bottle, as well as the date to discard it and begin using a new bott
le.
Ensure accurate control solution results
Replace the cap on the control solution bottle immediately after using it.
Do not add water or any liquid to control solution.
Control solution tests are specified to be accurate only when performed between 15° and 40 °C (59° and 104 °F).
The control solution test results should fall within the range print
ed on the test strip vial label.
Use only FreeStyle® control solution with the S
ystem. Other brands of control solution may
produce inaccurate results with this System.
Do not use control solution past the expiration date or you may get inaccurate results.
Results from FreeStyle® control solution tests do not
reflect your blood glucose level.
The control solution range is a target range for control solution
only. It is not a target range for your blood
glucose.
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If control solution results are out of this range, REPEAT THE TEST.
Out-of-range control solution results
Out-of-range test results may be caused by:
Expired or bad control solution
Expired or bad test strip
Error in performing test
Code on test strip vial does not match code set in the PDM
Malfunction of the System
Control solution test done outside 15° and 40 °C (59° and
104 °F)
If your control solution test results continue to fall outside the r
ange printed on the test strip vial:
1. The System may not be working properly.
2.
Do not use the System to test your blood glucose.
3. Call Customer Care (24 hours/7 days): 1 855 POD INFO (1 855 763 4636). When calling from outside of Canada: 647-788-3132.
Performing a Control Solution Test
1. Grasp the bottom of the test strip with the printed side facing up (Figure 7-2).
2. Insert the top of the test strip into the test strip port (Figure 7-3) until it stops. This turns on the PDM and displays the code number on the screen. Refer to page 55 to check Pod status and to Confirm ID.
Figure 7-2
Top, to insert into meter
FreeStyle® test strip
Bottom edges, for blood sample
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3. To help you see the test strip port in reduced lighting, when you insert a test strip into the PDM, you can turn on the port light. Press the middle Soft Key labeled Light. To turn the light off, press Light again.
4. Wait for the PDM to display “Apply a blood sample to the strip” on the screen (Figure 7-5).
Always verify and be prepared to adjust the code on the PDM to match the code number on the test strip vial (Figure 7-4).
If you need to adjust the code number after the PDM has moved to the next screen, just press the Up/Down Controller buttons. The code screen reappears and you can adjust the number.
The code number remains on the PDM screen for your reference until you have completed the control test.
Figure 7-3
Figure 7-4
From some PDM screens, you cannot access the Freestyle® blood glucose meter. For example, you cannot use the meter while you are activating a Pod or when an alert, alarm or communication error screen is displayed. In these cases, if you insert a test strip, the PDM beeps to alert you.
The code number on the screen should match the code number on the side of your test strip vial (Figure 7-4). They must always match or your results will be inaccurate. (See “Set the blood glucose test strip code” later in this chapter.)
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5. Gently touch only ONE EDGE of the test strip to the control solution. Specifically, apply the control solution to the test strip edge next to one of the dark-colored half-circles (Figure 7-6). If BG sound is set to On, the PDM beeps when the test strip is full.
If you do not apply the sample within 10 seconds, the strip port light turns off. To turn it on again, press Light.
The “Checking” screen appears while the sample is processing (Figure 7-7). The strip port light turns off when the sample is accepted.
If BG sound is set to On, the PDM beeps twice. The result appears on the screen.
6. To mark the result as a control solution result rather than a blood glucose test:
a. Press Ta g. b. Use the Up/Down Controller buttons to select Control
(Figure 7-8), then press Select. You can select a second tag for the test result in the same way.
Figure 7-5
Figure 7-6
Do not apply control solution to both edges of the test strip.
Figure 7-7
Figure 7-8
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c. Press OK.
7. If you do not want to mark the test as a control solution test,
press Next instead of Tag .
8. Compare the control solution test result to the range printed on the test strip vial label. If the result does not fall within the range, repeat the test. If the result still does not fall within the range, call Customer Care (24 hours/7 days): 1 855 POD INFO (1 855 763 4636). When calling from outside of Canada: 647-788-3132.
9. Remove the test strip. If the strip port light was turned on, it now turns off.
If you remove the test strip before this step, you will still see the available soft keys.
Performing a Blood Glucose Reading
Figure 7-9 shows the parts of the lancing device.
You can select a maximum of 2 tags.
If the suggested bolus calculator feature is turned Off, the Bolus soft key appears instead of Next.
If you mark a test as a control solution test by mistake, you can unmark it: Press Tag , select Control, then press Clear.
Be sure to discard used test strips. (You can only use test strips once.) Used test strips are considered biohazardous material.
To ensure accurate results, wash your hands and the test site (for example, your upper arm) with soap and water. Do not leave any cream or lotion on the test site. Thoroughly dry your hands and the test site.
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Prepare the lancing device
1. Snap off the cap on the lancing device at an angle
(Figure 7-10).
2. Insert a new lancet firmly into the white lancet holder cup (Figure 7-11). Pushing the device into the cup may cock the device, which is fine.
3. Hold the lancet firmly in place with one hand. With your other hand, twist off the rounded top (Figure 7-12).
Release button
Depth indicator window
Depth settings dial
Gray cap, for testing on the fingers
Cocking handle
Figure 7-9
Clear cap, for testing sites other than the finger
Figure 7-10
Figure 7-11
Lancing device depicted in Figures 7-9, 7-10 and 7-11 is representative only. Please follow the instructions included with your specific lancing device.
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