Paradigm 522, 722 User Manual

Paradigm

®

522 and 722 Insulin Pumps

User Guide

©2008 Medtronic MiniMed, Inc. All rights reserved.

Bolus Wizard

®

, Dual Wave®, Guardian®, MiniLink®, Paradigm®, Paradigm Link®, Quick-serter®, Quick-set® , Silhouette®,

Sof-set

®

, and Square Wave® are registered trademarks of Medtronic MiniMed, Inc.

CareLink™ Personal, Enlite™, and Easy Bolus™ are trademarks of Medtronic MiniMed, Inc.

Energizer

®

is a registered trademark of Eveready Battery Company.

Glucagon Emergency Kit

®

is a registered trademark of Eli Lilly and Company.

6025646-021_a

REF MMT-522 MMT-722

Contacts:
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Tel: [phone]

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Tel: [phone] (product orders)
Tel: [phone] (customer help)

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or ([phone]

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Medtronic GmbH
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To order supplies: [phone]

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Important Safety Information

Regarding Your Paradigm Insulin Pump

(includes all models)

Avoid Immersing Your Pump In Water

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

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

Electrostatic Discharge

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

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

Please contact your local helpline or representative to report any error alarms or other problems that occur
with your pump.

Warranty

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

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

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

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

the date of manufacture.

• If non-Medtronic infusion sets and/or reservoirs are being used with the pump.

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

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

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

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

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

The remedies provided for in this warranty are the exclusive remedies available for any breach hereof.
Neither Medtronic Diabetes nor its suppliers or distributors shall be liable for any incidental,
consequential, or special damage of any nature or kind caused by or arising out of a defect in the product.
Notwithstanding the foregoing, the terms of this warranty do not affect the statutory rights of consumers
or seek to exclude any liability which is not permitted by law.

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

Contents

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

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

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

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

Accessories .................................................................................................... 2

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

How to use this guide ........................................................................................ 3

User safety ..................................................................................................... 4

Indications .................................................................................................. 4

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

Warnings .................................................................................................... 5

Reservoir and infusion sets ............................................................................ 5

Sensor ..................................................................................................... 5

Transmitter .............................................................................................. 5

Magnetic fields .......................................................................................... 5

X-rays, MRIs and CT scans .............................................................................. 6

Precautions ................................................................................................. 6

Avoid extreme temperatures .......................................................................... 6

Infusion sets and sites .................................................................................. 7

Sensor ..................................................................................................... 7

Adverse reactions .......................................................................................... 7

Notice .......................................................................................................... 7

Insulin pump and RF accessories ........................................................................ 7

RF interference from other devices ..................................................................... 8

Chapter 2: Introduction to pump therapy ............................................. 11

Theory of insulin pump therapy ........................................................................... 11

Understanding pump therapy ............................................................................. 12

Contents vii

Basal rate .................................................................................................. 12

Meal bolus ................................................................................................. 12

Gram counting ......................................................................................... 12

Exchange counting ..................................................................................... 12

BG targets ................................................................................................. 12

Insulin sensitivity ......................................................................................... 12

Active Insulin .............................................................................................. 13

Blood glucose and A1C testing ............................................................................ 13

BG testing ................................................................................................. 13

A1C ......................................................................................................... 13

Low blood glucose (hypoglycemia) ....................................................................... 14

Hypoglycemia protocol: the rule of 15 ................................................................ 15

High blood glucose (hyperglycemia) ..................................................................... 16

Hyperglycemia protocol ................................................................................. 16

Diabetes ketoacidosis (DKA) ............................................................................... 17

Preventing DKA ........................................................................................... 17

Sick day management ...................................................................................... 18

Sick day protocol ......................................................................................... 18

Sick day supplies .......................................................................................... 18

Nutrition ...................................................................................................... 19

Carbohydrate counting .................................................................................. 19

Carbohydrate gram counting ......................................................................... 19

Carbohydrate exchange system ..................................................................... 19

Reading a food label ..................................................................................... 20

Fat and blood glucose ................................................................................... 21

Protein and blood glucose .............................................................................. 21

Other things that affect blood glucose ............................................................... 22

Healthy eating habits .................................................................................... 22

Exercise ....................................................................................................... 22

Chapter 3: The basics ...................................................................... 25

Your pump .................................................................................................... 25

Install battery ................................................................................................ 26

Pump buttons ................................................................................................ 27

The pump screen ............................................................................................ 29

HOME screen ................................................................................................. 29

Screen icons ............................................................................................... 29

Contentsviii

Battery .................................................................................................. 29

Time display ............................................................................................ 30

Reservoir volume ...................................................................................... 30

Alert and alarm icons ................................................................................. 30

Sensor icons ............................................................................................ 30

Scroll bar .................................................................................................. 31

Screen backlight .......................................................................................... 31

Beep/vibrate ................................................................................................. 31

Operating modes ............................................................................................ 31

Normal mode .............................................................................................. 32

Special mode .............................................................................................. 32

Attention mode ........................................................................................... 32

Menus ......................................................................................................... 33

MAIN MENU ................................................................................................ 33

BOLUS MENU ............................................................................................... 33

SUSPEND ................................................................................................... 33

BASAL MENU ............................................................................................... 33

SENSOR ..................................................................................................... 33

PRIME MENU ............................................................................................... 34

UTILITIES MENU ........................................................................................... 34

STATUS screen ............................................................................................... 34

If you remove your pump .................................................................................. 35

Chapter 4: Basic programming ........................................................... 37

Setting the time and date ................................................................................. 37

Selecting the language ..................................................................................... 39

Bolus .......................................................................................................... 39

Setting the Normal bolus ................................................................................ 40

Normal meal bolus using the exchange system ...................................................... 41

Bolus practice: ............................................................................................ 41

Normal meal bolus practice using exchanges ........................................................ 42

Normal meal bolus using carbohydrate counting .................................................... 42

Normal meal bolus practice using carbohydrates ................................................... 43

Meal bolus, correction bolus and insulin sensitivity ................................................ 43

Practice: Meal bolus ..................................................................................... 44

Review your bolus deliveries .............................................................................. 44

Bolus details ............................................................................................... 45

Contents ix

Maximum bolus limit ........................................................................................ 47

Example 1: Max bolus .................................................................................... 47

Example 2: Max bolus .................................................................................... 47

BG Reminder ................................................................................................. 47

Basal .......................................................................................................... 48

Start and stop times ..................................................................................... 49

Your basal settings ....................................................................................... 50

Basal programming and delivery .................................................................... 50

Current basal delivery ................................................................................... 51

Daily basal rate(s) ........................................................................................ 51

Setting the Max basal rate ................................................................................. 52

Example 1: Max basal .................................................................................... 52

Example 2: Max basal .................................................................................... 53

Stopping your pump ........................................................................................ 53

Resume pump delivery ..................................................................................... 54

Example: Suspend function ............................................................................. 54

Practice: Suspend function ............................................................................. 55

Practice: Resume basal delivery after a suspend ................................................... 55

Chapter 5: Starting on insulin ............................................................ 57

Prepare your pump for use ................................................................................ 57

Filling the reservoir ......................................................................................... 57

Filling the reservoir ...................................................................................... 58

Changing your infusion set ................................................................................. 60

Removing the reservoir .................................................................................. 60

Rewinding your pump .................................................................................... 60

Inserting the reservoir in your pump .................................................................. 62

Manual prime .............................................................................................. 63

Inserting the infusion set ................................................................................ 64

Quick-set infusion set (with Quick-serter

®

) .......................................................... 66

Fixed prime ................................................................................................ 66

Prime history .............................................................................................. 67

Disconnecting Quick-set ................................................................................. 68

Reconnecting Quick-set ................................................................................. 68

Record keeping for diabetes management .............................................................. 69

Determining your pump settings .......................................................................... 69

Contentsx

Chapter 6: Using the Bolus Wizard feature ............................................ 71

What is it? .................................................................................................... 71

Carbohydrate counting .................................................................................. 71

Your blood glucose reading ............................................................................. 71

Your personal Bolus Wizard feature settings ......................................................... 71

How the Bolus Wizard feature works ..................................................................... 74

Bolus Wizard warnings ...................................................................................... 75

HIGH BG .................................................................................................... 75

LOW BG .................................................................................................... 75

MAX BOLUS EXCEEDED ................................................................................... 75

How to program the Bolus Wizard feature .............................................................. 75

Turning on the Bolus Wizard feature .................................................................. 76

Selecting the Carb units ................................................................................. 76

Setting the Carb/Exch ratios ........................................................................... 77

Setting the BG units ...................................................................................... 78

Insulin sensitivity ......................................................................................... 78

Setting the BG Targets .................................................................................. 79

About active insulin ...................................................................................... 80

Active insulin time ..................................................................................... 81

Review your Bolus Wizard feature settings ............................................................. 81

Meter option ................................................................................................. 82

Meter rules ................................................................................................ 82

Add, delete, review meter IDs ......................................................................... 83

Normal bolus using Bolus Wizard feature ................................................................ 84

Bolus Wizard feature examples ........................................................................... 85

Example 1: Blood glucose on target (normal blood glucose) and no active insulin ............ 86

Example 2: Blood glucose above target (high blood glucose) and no active insulin ........... 87

Example 3: Blood glucose below target (low blood glucose) and no active insulin ............ 88

Example 4: Blood glucose above target (high blood glucose) with active insulin .............. 89

Example 5: Blood glucose below target (low blood glucose) with active insulin ............... 90

Chapter 7: Optimizing pump therapy ................................................... 91

Square Wave and Dual Wave bolus ....................................................................... 91

Turning on the Dual Wave/Square Wave option ..................................................... 92

Square Wave or Dual Wave bolus without Bolus Wizard feature .................................. 92

Square Wave bolus practice ............................................................................ 94

Dual Wave bolus practice ............................................................................... 95

Contents xi

Using the Bolus Wizard feature for a Square Wave or Dual Wave bolus ......................... 95

Easy bolus .................................................................................................... 97

Easy bolus setup .......................................................................................... 97

Step value setup .......................................................................................... 98

Delivering Easy Bolus .................................................................................... 98

Example 1: Easy bolus ................................................................................... 99

Your turn: Easy bolus practice ........................................................................ 100

Basal patterns .............................................................................................. 100

Turning on the patterns ................................................................................ 101

Programming a pattern ................................................................................ 101

Select a pattern ......................................................................................... 102

Example 1: Basal patterns ............................................................................. 102

Example 2: Basal patterns ............................................................................. 103

Your turn: ................................................................................................ 103

Temp basal rates .......................................................................................... 103

How does temp basal work? ........................................................................... 103

Temp basal types ....................................................................................... 104

Insulin rate (U/H) .................................................................................... 104

Percent of basal ...................................................................................... 105

Chapter 8: Sensor features .............................................................. 111

Entering your sensor settings ............................................................................ 111

Turning on the sensor .................................................................................. 111

Selecting the BG units .................................................................................. 112

High Glucose Alert ...................................................................................... 112

Setting the High Snooze ................................................................................ 112

Low Glucose Alert ....................................................................................... 113

Setting the Low Snooze ................................................................................ 114

Setting the Alarm Snooze .............................................................................. 114

Setting the Cal Reminder .............................................................................. 115

Entering the transmitter ID ............................................................................ 115

Setting up the Missed Data feature .................................................................. 116

Reviewing your settings ................................................................................ 116

The transmitter ............................................................................................ 117

Transmitter charger ....................................................................................... 117

Installing a battery in the gray charger ............................................................. 117

Installing a battery in the blue charger ............................................................. 118

Contentsxii

Charging the transmitter ................................................................................. 118

Starting the sensor ........................................................................................ 119

Inserting the Enlite™ sensor .............................................................................. 119

Connecting the transmitter to the sensor ............................................................. 124

Preparing the sensor for communication .............................................................. 125

Calibrating the sensor ..................................................................................... 125

Entering meter BG ......................................................................................... 126

Re-starting the sensor after three days ................................................................ 127

Chapter 9: Using your sensor ........................................................... 129

Status screens .............................................................................................. 129

Reading the sensor glucose graphs ...................................................................... 130

Opening and viewing the graphs ...................................................................... 131

The graphs ............................................................................................... 132

Examples of continuous sensor glucose graphs ..................................................... 133

3-hour graph .......................................................................................... 133

24-hour graph ......................................................................................... 134

How to check for rapid changes in sensor glucose ................................................... 135

The rapid change arrows ............................................................................... 135

Calibration history ......................................................................................... 136

Sensor alarm history ....................................................................................... 136

Disconnecting the transmitter and removing the sensor ............................................ 136

Disconnecting the sensor from the transmitter .................................................... 136

Removing the sensor ................................................................................... 137

Storage ...................................................................................................... 137

Using your system in water ............................................................................... 137

Chapter 10: Utilities ...................................................................... 139

Alarm review ............................................................................................... 139

Setting your alert type .................................................................................... 139

Auto-off ..................................................................................................... 140

LOW RESV WARNING (Low reservoir warning) ......................................................... 140

Review daily insulin totals ............................................................................... 141

Pump data management .................................................................................. 142

Meter blood glucose information ..................................................................... 142

Personal reminders ........................................................................................ 145

Alarm clock .............................................................................................. 145

Contents xiii

Remote control option .................................................................................... 145

Turn on remote control option ....................................................................... 146

Add, delete, review remote control IDs ............................................................. 146

Block feature ............................................................................................... 147

Turning block on ........................................................................................ 147

Example 1: Block ........................................................................................ 147

Example 2: Block ........................................................................................ 147

Lock keypad feature ...................................................................................... 148

Locking the keypad ..................................................................................... 148

Unlocking the keypad .................................................................................. 148

Selftest ...................................................................................................... 148

User settings ................................................................................................ 149

Saving the settings ...................................................................................... 150

Restoring the settings .................................................................................. 150

Clearing the settings ................................................................................... 151

History .................................................................................................... 151

Chapter 11: Therapy management software ........................................ 153

CareLink Personal Software .............................................................................. 153

Reports ................................................................................................... 153

Logbook ................................................................................................... 154

Chapter 12: Insulin pump therapy follow-up ........................................ 155

Recommended follow-up ................................................................................. 155

Everyday .................................................................................................. 155

Every month ............................................................................................. 155

Every three months ..................................................................................... 155

Laboratory tests ......................................................................................... 156

Every visit ................................................................................................ 156

Annually .................................................................................................. 156

Chapter 13: Troubleshooting, alerts and alarms ................................... 157

My pump has a NO DELIVERY alarm ..................................................................... 157

What happens if I leave the pump battery out too long? ............................................ 158

Why doesn't my pump battery last very long? ......................................................... 158

What is a CHECK SETTINGS alarm? ...................................................................... 159

My screen appears distorted ............................................................................. 159

Contentsxiv

I cannot get out of the priming loop .................................................................... 159

The pump is asking me to rewind ....................................................................... 160

My bolus stopped .......................................................................................... 160

My pump buttons are not acting right during a bolus ................................................ 160

My pump will not display my blood glucose reading from my meter .............................. 160

I dropped my pump ........................................................................................ 161

I submerged my pump in water ......................................................................... 161

I cannot get to the USER SETTINGS screen ............................................................ 162

Alerts ........................................................................................................ 162

Example: ................................................................................................. 163

What to do ............................................................................................... 163

Pump alert conditions .................................................................................. 163

LOW RESERVOIR ...................................................................................... 163

LOW BATTERY ......................................................................................... 163

Sensor alert conditions ................................................................................. 164

WEAK SIGNAL .......................................................................................... 164

LOST SENSOR .......................................................................................... 164

LOW TRANSMTR ....................................................................................... 165

BAD TRANSMTR ....................................................................................... 165

BAD SENSOR ........................................................................................... 165

SENSOR END ........................................................................................... 165

CAL ERROR ............................................................................................ 166

METER BG NOW ....................................................................................... 166

METER BG BY .......................................................................................... 166

LOW X.X MMOL/L (XX MG/DL) ...................................................................... 166

HIGH XX.X MMOL/L (XXX MG/DL) .................................................................. 167

SENSOR ERROR ........................................................................................ 167

Alarms ....................................................................................................... 167

What to do ............................................................................................... 168

Alarm conditions ........................................................................................... 168

A (ALARM) ................................................................................................ 168

AUTO OFF ................................................................................................ 168

BATT OUT LIMIT ......................................................................................... 168

BOLUS STOPPED ......................................................................................... 168

BUTTON ERROR .......................................................................................... 169

CHECK SETTINGS ........................................................................................ 169

E (ERROR) ................................................................................................ 169

Contents xv

EMPTY RESERVOIR ....................................................................................... 169

FAILED BATT TEST ...................................................................................... 169

MAX DELIVERY ........................................................................................... 170

MOTOR ERROR ........................................................................................... 170

NO DELIVERY ............................................................................................. 170

NO RESERVOIR ........................................................................................... 170

OFF NO POWER .......................................................................................... 170

RESET ..................................................................................................... 170

WEAK BATTERY .......................................................................................... 170

Testing the transmitter ................................................................................... 171

Connecting the tester .................................................................................. 171

Disconnecting the tester ............................................................................... 172

Troubleshooting sensor features ........................................................................ 172

Reconnect old sensor ................................................................................... 172

Find lost sensor .......................................................................................... 173

Understanding your transmitter, tester, and charger ............................................. 173

Chapter 14: Maintenance ................................................................ 175

Battery ...................................................................................................... 175

Storage ...................................................................................................... 176

Cleaning your pump ....................................................................................... 176

Cleaning the transmitter ................................................................................. 176

Cleaning the Serter ........................................................................................ 177

Chapter 15: Pump specifications ....................................................... 179

Alarms and error messages ............................................................................... 179

Alarm history ............................................................................................... 179

Audio frequency ........................................................................................... 179

Backlight .................................................................................................... 179

Basal ......................................................................................................... 180

BG target .................................................................................................... 180

Bolus delivery .............................................................................................. 180

Bolus history ................................................................................................ 181

Bolus units .................................................................................................. 181

Bolus Wizard feature ...................................................................................... 181

Carb ratios .................................................................................................. 181

Carb units ................................................................................................... 181

Contentsxvi

Daily totals .................................................................................................. 181

Default screen .............................................................................................. 181

Delivery accuracy .......................................................................................... 182

Pump motor ................................................................................................ 182

Dual Wave bolus ........................................................................................... 183

Easy bolus ................................................................................................... 183

Infusion pressure ........................................................................................... 183

Insulin sensitivity .......................................................................................... 183

Low resv (reservoir) warning ............................................................................. 184

Meter value ................................................................................................. 184

Normal bolus ............................................................................................... 184

Occlusion detection ....................................................................................... 184

Percent temp basal ........................................................................................ 184

Power supply ............................................................................................... 185

Prime function ............................................................................................. 185

Prime history ............................................................................................... 185

Program safety checks .................................................................................... 185

Pump size ................................................................................................... 185

Pump weight ................................................................................................ 185

Remote control ............................................................................................ 185

Reservoir .................................................................................................... 186

Square Wave bolus ........................................................................................ 186

Temporary (temp) basal rate ............................................................................ 186

Time and date screen ..................................................................................... 186

Environmental conditions ................................................................................ 186

Status screen ............................................................................................... 186

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

Bolus Wizard feature examples .......................................................................... 191

Insulin delivery default settings ......................................................................... 194

Bolus Wizard feature default settings .................................................................. 195

Sensor features default settings ......................................................................... 196

Guidance and manufacturer's declaration ............................................................. 197

Icon table ................................................................................................... 203

Glossary ...................................................................................... 205

Index ......................................................................................... 213

Contents xvii

Contentsxviii

Introduction

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

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

®

pump. We strongly recommend that you work closely with your healthcare professional

for a safe and complete pump start.

Assistance

Please contact your local help line or representative for assistance. Refer to the Medtronic Diabetes
International Contacts list at the beginning of this user guide for the help line or representative in your area.

Emergency kit

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

• Fast-acting glucose tablets

• Blood glucose monitoring supplies

• Urine ketone monitoring supplies

• Extra Paradigm

®

compatible infusion set and Paradigm reservoir

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

• Wallet card

• Dressing and adhesive

• Glucagon Emergency Kit

®

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

Introduction 1

Chapter 1

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

Consumables

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

• Reservoirs — The 522 pump is only used with the 176-unit Paradigm reservoir (MMT-326A). The 722 pump

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

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

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

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

Accessories

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

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

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

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

• Medtronic MiniLink

®

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

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

Introduction2

• Sensor — The sensor (MMT-7002/MMT-7003/MMT-7008) continuously converts tiny amounts of glucose

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

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

the Paradigm 522 or 722 pump data to the diabetes management software using a USB port on your
computer.

Not all devices or accessories are available in all countries where the pump is approved.

To order supplies, contact your local representative. Refer to the enclosed contact card for the Medtronic
Diabetes office in your area.

How to wear your pump

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

• Holster — To wear the pump on your belt.

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

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

disconnecting.

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

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

How to use this guide

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

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

Conventions

Meaning

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

Select

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

Exit the menus press ESC until the HOME screen appears

Introduction 3

Chapter 1

Conventions Meaning

Pump buttons always bold and uppercase; for example, ESC, ACT
Screen and menu names always uppercase; for example, MAIN MENU, REWIND screen
Menu selections always bold; for example, 24-Hour Setup, On, Off

Flashing (blinking) screen item

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

NOTE and TIP additional helpful information

CAUTION

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

WARNING

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

Go to the...screen.

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

Main > Utilities > Alarm

1 From the MAIN MENU, select Utilities and press ACT.
2 In the UTILITIES MENU, select Alarm and press ACT.
3 The ALARM MENU appears.

User safety

Indications

The Paradigm 522/722 pump systems are indicated for the continuous delivery of insulin, at set and variable
rates, for the management of diabetes mellitus in persons requiring insulin. In addition, the pump system is
indicated for continuous or periodic monitoring of glucose levels in the fluid under the skin, and possible low
and high blood glucose episodes. The pump displays continuous glucose values and stores this data so that it
can be analyzed to track patterns and improve diabetes management. Pump history can be downloaded to
a computer for analysis of historical glucose values.

Introduction4

The continuous glucose values provided by the Paradigm 522/722 pump systems are not intended to be used
directly for making therapy adjustments. Rather, they provide an indication that a confirmation fingerstick
measurement may be required. All therapy adjustments should be based on measurements obtained using a
home glucose monitor and not based on the value displayed by the pump.

Contraindications

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

Warnings

Reservoir and infusion sets

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

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

Sensor

The sensor may create special needs regarding your medical conditions or medications. Please discuss these
conditions and medications with your doctor before using the sensor.

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

Transmitter

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

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

Magnetic fields

Do not use pump cases that have a magnetic clasp.

Do not ex pose you r in sulin pu mp to MRI equipme nt or oth er d evices t hat gene rat e very st rong mag net ic fi elds.
The magnetic fields in the immediate vicinity of these devices can damage the part of the pump’s motor
that regulates insulin delivery, possibly resulting in over-delivery and severe hypoglycemia.

Introduction 5

Chapter 1

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

If your pump is inadvertently exposed to a strong magnetic field, discontinue use and contact your local help
line or representative for further assistance.

X-rays, MRIs and CT scans

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

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

Precautions

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

Avoid extreme temperatures

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

(34°F).

2 Insulin solutions freeze near 0°C (32°F) and degrade at high temperatures. If you are outside in cold

weather, wear your pump close to your body and cover it with warm clothing. If you are in a warm
environment, take measures to keep your pump and insulin cool.

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

Introduction6

Infusion sets and sites

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

Sensor

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

Adverse reactions

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

Notice

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

Insulin pump and RF accessories

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

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

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

Introduction 7

Chapter 1

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

1 This device has been tested and found to comply with the regulations governing such devices in your

area. For the specific regulation and test results for your area, please contact your local representative.

2 This device generates, uses, and can radiate radio frequency energy and, if installed and used in

accordance with the instruction, may cause harmful interference to radio communications. If the device
does cause interference to radio or television reception, you are encouraged to try to correct the
interference by one or more of the following measures:

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

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

device that is receiving/emitting interference

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

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

Main > Sensor > Sensor Start > Find Lost Sensor

If you have questions, please contact your local Medtronic Diabetes representative.

RF interference from other devices

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

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

Introduction8

Communication problems can usually be resolved by:

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

include RF glucose meters;

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

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

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

• turning the cell phone off; or

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

meter when a glucose measurement is being transmitted.

If you have questions, please contact your local Medtronic Diabetes representative.

Introduction 9

Chapter 1

Introduction10

Introduction to pump therapy

Theory of insulin pump therapy

Insulin pumps deliver insulin closer to the way the human pancreas delivers insulin than any other method
of treating diabetes.

All people, with or without diabetes, need background insulin for normal functions of the body without food.
They also need a dose of insulin on demand - when food is eaten. People without diabetes can trust that
their pancreas will produce this insulin for them. People with diabetes need to take insulin in a way that is
most like the way a pancreas produces it.

Most people with diabetes who take more than one daily injection, use long-acting insulin. This takes care
of their background insulin needs. They take fast-acting insulin for food. When using an insulin pump, only
fast-acting insulin is used. You control when and at what rate your insulin is delivered.

Insulin pump therapy allows you to set a basal rate, or background insulin. This is delivered all throughout
the day and night for normal body function without food. When you exercise, you can reduce the basal rate
so that your blood glucose (BG) does not drop too low. When you are sick or have an infection, you can
increase the basal rate. This will keep your BG from going up too high.

Insulin pump therapy allows you to give a bolus, or dose of insulin on demand - when you eat. You can also
increase or decrease your meal bolus based on the foods you choose to eat. A bolus may also be used to lower
an elevated BG. This is called a correction bolus.

The Paradigm pump also contains an optional feature called the Bolus Wizard. This does the math for the
required bolus amount based on your personal settings. The Bolus Wizard will use your BG reading,
carbohydrate intake, and active insulin when coming up with your bolus amount.

Remember, the pump uses only fast-acting insulin. This means you will not need to follow as rigid a schedule
as you did before. There is no long-acting insulin telling you when you should eat or when you will need more
insulin.

Sound exciting? It is exciting because not only can you manage your blood glucose more easily, your lifestyle
can be easier too.

Introduction to pump therapy 11

Chapter 2

As long as you are ready to learn how to use the pump, the pump can work for you.

Understanding pump therapy

If you are new to pump therapy, you will need the following data from your healthcare professional. Gather
this before going to your pump start appointment. If you are unsure, contact your healthcare professional or
pump trainer for guidance.

Basal rate

Basal insulin is needed to maintain your target glucose values when you are not eating. Your pump allows up
to 48 basal rates to be programmed. Your healthcare professional may only have you program one or two
basal rates when you start pump therapy.

Meal bolus

Deliver a meal bolus before eating carbohydrates. Your insulin to carbohydrate ratio is the amount of insulin
required to cover a given number of carbohydrates or exchanges. This ratio gives you an idea of how much
of an insulin bolus you should take when eating carbohydrates.

Gram counting

1.0 unit of insulin for __________ grams of carbohydrate

Exchange counting

__________ units of insulin for each carbohydrate exchange

BG targets

The Bolus Wizard will use your BG targets to calculate a correction dose. Keeping your BG within target range
is key to living well with diabetes. Your healthcare professional should help you decide these targets.

Insulin sensitivity

Insulin sensitivity is used to decide a correction bolus for a high BG. This is how much your blood glucose will
be dropped with 1 unit of insulin.

1 unit of insulin will lower BG __________ mmol/L (mg/dL).

Introduction to pump therapy12