Medtronic MiniMed Paradigm REAL-Time Revel User manual

Paradigm

®

REAL-Time

Revel™ Insulin Pump

User Guide

This product is covered by U.S. Patents. Other U.S. and/or foreign patents may be pending. Please visit

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

Bolus Wizard

®

, CareLink

®

, Dual Wave

®

, Guardian

®

, Guardian RT

®

, MiniLink

®

, Paradigm

®

, Paradigm Link

®

, Quick-serter

®

,

Quick-set

®

,Sen-serter

®

,Silhouette

®

,Sof-set

®

, and Square Wave

®

are registered trademarks of Medtronic MiniMed, Inc.

Easy Bolus™ and Revel™ are trademarks of Medtronic MiniMed, Inc.

CONTOUR

®

is a registered trademark of Bayer.

Energizer

®

is a registered trademark of Eveready Battery Company.

Glucagon Emergency Kit

®

is a registered trademark of Eli Lilly and Company.

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

OneTouch

®

, OneTouch

®

Ultra

®

, and OneTouch

®

UltraLink

®

are registered trademarks of

LifeScan, Inc

.

6025306-018_d

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

Contacts:

Africa:

Medtronic Africa (Pty) Ltd.

Tel: +27 (0) 11 677 4800

Australia:

Medtronic Australasia Pty. Ltd.

Tel: 1800 668 670 (product orders)

Tel: 1800 777 808 (customer help)

Azerbaijan:

Albatros Health Care

Tel: +994 12 498 9537

Bangladesh

Sonargaon Healthcare Pvt Ltd.

Mobile: (+91)-9903995417

or (+880)-1714217131

Belarus:

Badgin Ltd

Tel: +375 (172) 665128

België/Belgique:

N.V. Medtronic Belgium S.A.

Tel: 0800-90805

Bosnia and Herzegovina

Intermedical

Tel: +387 33 202 183

Fax: +387 33 202 183

Brasil:

Medtronic Comercial Ltda.

Tel: +(11) 3707-3707

Bulgaria

Interagro-90 Ltd

Tel: +359 888 636 033

Canada:

Medtronic of Canada Ltd.

Tel: 1-800-284-4416 (toll free/sans-

frais)

China:

Medtronic (Shanghai) Ltd.

24 Hour Help (Cell): +86

400-820-1981

24 Hour Help (Landline): +86

800-820-1981

Croatia

Oktal Pharma

Tel: +385 1 659 57 77

Fax: +385 1 659 57 01

Croatia

Medtronic B.V.

Tel: +385 1 488 11 20

Fax: +385 1 484 40 60

Danmark:

Medtronic Danmark A/S

Tel: +45 32 48 18 00

Deutschland:

Medtronic GmbH

Geschäftsbereich Diabetes

Telefon: +49 2159 8149-370

Telefax: +49 2159 8149-110

24-Stdn-Hotline: 0800 6464633

Eire:

Accu-Science LTD.

Tel: +353 45 433000

España:

Medtronic Ibérica S.A.

Tel: +34 91 625 05 42

Fax: +34 91 625 03 90

24 horas: +34 901 120 335

Europe:

Medtronic Europe S.A. Europe, Middle

East and Africa Headquarters

Tel: +41 (0) 21-802-7000

France:

Medtronic France S.A.S.

Tel: +33 (0) 1 55 38 17 00

Hellas:

Medtronic Hellas S.A.

Tel: +30 210677-9099

Hong Kong:

Medtronic International Ltd.

Tel: +852 2919-1300

To order supplies: +852 2919-1322

24-hour helpline: +852 2919-6441

India:

India Medtronic Pvt. Ltd

Tel: (+91)-80-22112245 / 32972359

Mobile: (+91)-9611633007

Indonesia:

Medtronic International Ltd.

Tel: +65 6436 5090

or +65 6436 5000

Israel:

Agentek

Tel: +972 3649 3111

Italia:

Medtronic Italia S.p.A.

Tel: +39 02 24137 261

Fax: +39 02 24138 210

Servizio assistenza tecnica: Nº verde

24h: 800 712 712

Japan:

Medtronic Japan Co. Ltd.

Tel: +81-3-6430-2019

Kazakhstan:

Medtronic Kazakhstan B.V.

Tel: +77273110580

Latin America:

Medtronic, Inc.

Tel: 1(305) 500-9328

Fax: 1(786) 709-4244

Latvija:

Ravemma Ltd.

Tel: +371 7273780

Macedonia:

Kemofarm

Tel: +389 2 260 36 03

Fax: +389 2 260 36 49

Magyarország:

Medtronic Hungária Kft.

Tel: +36 1 889 0688

Malaysia:

Medtronic International Ltd.

Tel: +603 7946 9000

Middle East and North Africa:

Regional Office

Tel: +961-1-370 670

Montenegro:

Glosarij

Tel: +382 20 642 495

Fax: +382 20 642 540

Nederland, Luxembourg:

Medtronic B.V.

Tel: +31 (0) 45-566-8291

Gratis: 0800-3422338

New Zealand:

Medica Pacifica

Phone: 64 9 414 0318

Free Phone: 0800 106 100

Norge:

Medtronic Norge A/S

Tel: +47 67 10 32 00

Fax: +47 67 10 32 10

POCCИЯ:

Medtronic B. V.

Tel: +7 495 580 73 77

24h: 8-800-200-76-36

Philippines:

Medtronic International Ltd.

Tel: +65 6436 5090

or +65 6436 5000

Polska:

Medtronic Poland Sp. Z.o.o.

Tel: +48 22 465 6934

Portugal:

Medtronic Portugal Lda

Tel: +351 21 7245100

Fax: +351 21 7245199

Puerto Rico:

Medtronic Puerto Rico

Tel: 787-753-5270

Republic of Korea:

Medtronic Korea, Co., Ltd.

Tel: +82.2.3404.3600

Romania:

Trustmed SRL

Tel: +40 (0) 21 220 6477

Schweiz:

Medtronic (Schweiz) AG

Tel: +41 (0)31 868 0160

24-Stunden-Hotline: 0800 633333

Fax Allgemein: +41 (0)318680199

Serbia

Epsilon

Tel: +381 11 311 5554

Fax: +381 11 311 5554

Singapore:

Medtronic International Ltd.

Tel: +65 6436 5090

or +65 6436 5000

Slovenija:

Zaloker & Zaloker d.o.o.

Tel: +386 1 542 51 11

Fax: +386 1 542 43 32

Slovenská republika:

Medtronic Slovakia o.z.

Tel: +421 26820 6986

Fax: +421 268 206 999

Sri Lanka

Swiss Biogenics Ltd.

Mobile: (+91)-9003077499

or (+94)-777256760

Suomi:

Medtronic Finland Oy

Tel: +358 20 7281 200

Help line: +358 400 100 313

Sverige:

Medtronic AB

Tel: +46 8 568 585 10

Fax: +46 8 568 585 11

Taiwan:

Medtronic-Taiwan Ltd.

Tel: +886.2.2183.6068

Toll Free: +886.0800.005.285

Thailand:

Medtronic (Thailand) Ltd.

Tel: +662 232 7400

Turkiye:

Medtronic Medikal Teknoloji

Ticaret Ltd. Sirketi.

Tel: +90 216 4694330

USA:

Medtronic Diabetes Global

Headquarters

Tel: +1-800-826-2099

24 Hour HelpLine: +1-818-576-5555

To order supplies: +1-800-843-6687

Ukraine:

Med EK Service Ltd.

Tel: +380445457705

United Kingdom:

Medtronic Ltd.

Tel: +44 1923-205167

Österreich:

Medtronic Österreich GmbH

Tel: +43 (0) 1 240 44-0

24 – Stunden – Hotline: 0820 820 190

Česká republika:

Medtronic Czechia s.r.o.

Tel: +420 233 059 401

Non-stop help line:

+420 233 059 059

Important Safety Information

Regarding Your Paradigm Insulin Pump

(includes all models)

Avoid Immersing Your Pump In Water

Although it is unlikely that water damage will occur if your pump is splashed or briefly dunked, you should

avoid immersing your Paradigm insulin pump in water. To swim or participate in other water activities,

always disconnect from your Paradigm pump and reconnect after you are out of the water.

If you inadvertently submerge your pump in water, dry the pump quickly using a soft, clean towel and verify

that it is working properly by selecting Selftest from the pump's Utilities Menu. If you believe that water has

entered your pump or you observe any other possible pump malfunction, please check your blood glucose,

treat high blood glucose (if necessary) with an injection and contact our 24 Hour HelpLine at 1-800-646-4633

for further assistance. Symptoms of high blood glucose include fatigue, excessive thirst and nausea. You

should always contact your healthcare professional if you experience excessively high or low blood glucose

levels, or if you have any questions about your care.

Electrostatic Discharge

Although your Paradigm pump is designed to be unaffected by typical levels of electrostatic discharge (ESD),

very high levels of ESD can result in a reset of the pump's software with an associated pump error alarm. In

most cases, exposure to high levels of ESD will trigger the pump's A-13 alarm although, under certain

circumstances, high level ESD exposure can cause A-44, Bolus Stopped or Max Delivery alarms. High levels of

ESD are more likely in situations where the relative humidity is very low, such as inside a heated building

during the winter in areas where it is cold outside.

If your pump experiences an A-13 or other error alarm, press the ESC and ACT buttons to clear the alarm. If

you are unable to clear the alarm by pressing ESC and ACT, you may need to remove and replace the pump's

battery to clear the alarm. After clearing the alarm, you should always verify that your pump is set to the

correct date and time and that all other settings (basal rate, max basal and bolus limits, etc.) are programmed

to the desired values, since the software reset could erase your previously programmed settings. Please see

the Alarms and Alerts section of this User Guide for more details regarding what to do if your pump displays

an error alarm or other alert message.

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

occur with your pump.

Warranty

Medtronic Diabetes warrants the Medtronic MiniMed Insulin Pump against defects in materials and

workmanship for a period of 4 years from the date of purchase.

During the warranty period, Medtronic Diabetes will, at its discretion, either repair or replace (with a new

or recertified pump, at Medtronic Diabetes’ discretion) any defective pump or motor, subject to the

conditions and exclusions stated herein. In the event that a pump is repaired or replaced, the warranty period

will not be extended.

This warranty is valid only if the Medtronic MiniMed Insulin Pump is used in accordance with the

manufacturer’s instructions. This warranty will not apply:

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

the date of manufacture.

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

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

manufacturer.

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

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

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

This warranty shall be personal to the original user. Any sale, rental or other transfer or use of the product

covered by this warranty to or by a user other than the original user shall cause this warranty to immediately

terminate. This warranty does not apply to batteries, infusion sets, reservoirs, and other accessories.

The remedies provided for in this warranty are the exclusive remedies available for any breach hereof.

Neither Medtronic Diabetes nor its suppliers or distributors shall be liable for any incidental,

consequential, or special damage of any nature or kind caused by or arising out of a defect in the

product.

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

agreement.

All other warranties, expressed or implied, are excluded, including the warranties of merchantability

and fitness for a particular purpose.

Contents

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Contents

ix

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Contents

x

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Contents

xi

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

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

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

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

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

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

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

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

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

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

Quick-set infusion set (with Quick-serter

®

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Contents

xii

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Contents

xiii

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Contents

xiv

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Contents

xv

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

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

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

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

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

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

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

CareLink

®

Personal Software ............................................................................ 149

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Contents

xvi

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Contents

xvii

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Contents

xviii

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Contents

xix

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Contents

xx

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Medtronic MiniMed Paradigm REAL-Time Revel User manual

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