Insulin pump and continuous glucose monitoring system

Nutrition Facts
Serving Size 1 piece (20g)
Serving per Container 22
Amount Per Serving:
Calories: 50
Fat Calories: 0
Total Fat 0g
Sodium 0g
Total Carbohydrates 12g
Sugars 11g
Protein 0g
Fat and blood glucose
Although fat does not have carbohydrate, it may affect your blood glucose level. Your blood glucose can be
normal two hours after a meal with high fat foods. However, four to six hours later your blood glucose will
increase. That is because the fat slows down the rate the carbohydrates are absorbed in that meal.
Foods with fat include:
•
margarine
•
oils
•
mayonnaise
•
salad dressing
•
nuts
•
fried foods
•
butter
•
sour cream
•
whole milk
•
cream cheese
•
bacon
•
high fat meats
Doctors and health experts suggest that all people, with or without diabetes, eat less total fat—namely
less saturated fat. If you have high cholesterol or are trying to lose weight, it is key to limit the amount of
fat you eat per day.
Introduction to pump therapy
24

There are bolus type options available on your pump that can be helpful in handling the rare high-fat
meal. Before using bolus type options, you should be at ease using basic pump features and consult with
your healthcare professional.
Protein and blood glucose
Protein has little effect on blood glucose when eaten in moderate amounts, and normally does not require
any insulin.
Sources of protein include:
•
meat
•
fish
•
poultry
•
eggs
•
cheese
•
peanut butter
•
tofu
•
dried beans
•
dried peas
Protein needs are the same for people with and without diabetes, unless kidney disease is present. Most
people eat more protein than they need. Protein does not need to be part of every meal. In general,
140-200 grams of protein a day is enough. If you have high cholesterol or are trying to lose weight, eat
leaner proteins such as chicken and fish.
Other things that affect blood glucose
Fiber may slow down the rise in blood glucose after a meal. Fiber grams are not absorbed. They can be
subtracted from the Total Carbohydrate amount for foods or meals with more than 5 grams of fiber. Fiber
is an important part of a healthy diet. Suggestions for fiber intake are the same for people with and
without diabetes.
Sodium (salt) has no effect on blood glucose. Moderate sodium intake is suggested for people with or
without diabetes. If you have high blood pressure or are affected by sodium, limit the amount of sodium in
your diet.
Alcohol can cause low blood glucose by slowing down the release of glucose from the liver. This glucose
release keeps blood glucose in target between meals. Therefore, food should be eaten while having a
drink with alcohol. The carbohydrate content of different types of alcohol can be found in carbohydrate
counting books. Consult your healthcare professional for guidelines on bolusing for alcohol.
Vitamins and minerals have no effect on blood glucose.
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25
Chapter 2

Healthy eating habits
Insulin pump therapy gives you the choice of when, what and how much to eat without impacting blood
glucose control. This gives you the flexibility to sleep-in, postpone or skip meals, and eat snacks—the same
as people who do not have diabetes. Be careful to not abuse this freedom and compromise your nutritional
health. All people need to make healthy food choices to be mentally and physically healthy.
It is not an exact science to figure your meal bolus based on carbohydrate counting. Sometimes it takes
trial and error to figure the correct meal bolus for certain foods. If you are unsure how certain foods will
affect your blood glucose, test your blood glucose two hours after you eat. Keep records of foods that you
eat on regular basis. Note the bolus amounts and post-prandial readings for each entry. If your reading is
too high or too low, adjust your meal bolus the next time you make that food choice.
Exercise
Your body needs insulin and carbohydrate to provide cells with energy during exercise. How much insulin
and carbohydrates you need varies with the types of exercise and with how often you exercise. Using an
insulin pump during exercise allows you to reduce your basal rate instead of eating extra carbohydrate.
Before, you needed to eat extra carbohydrate to make up for the glucose lowering effect exercise often
has on blood glucose. It takes trial and error to get the balance right.
The body needs insulin during exercise. Therefore, it is not suggested that you stop the pump unless the
exercise is for a short amount of time (one hour or less). If you need to remove the pump for more than
one hour, refer to the If you remove your pump section in The basics chapter.
If you do an exercise that on average lowers your blood glucose, you can use the temporary basal rate
feature. You can use this feature to lower the amount of insulin delivered and reduce the risk of
hypoglycemia. You may also choose to change your basal rate pattern for the days you exercise.
It takes a period of time to determine how much to adjust your basal rate during exercise. Record your
blood glucose before, during and after exercise to figure the proper reduction in your basal rate. Record
any carbohydrates that you have eaten during the exercise period. There is no magic formula that will tell
you just what to do. You have to test often to figure out the basal rate that you need during exercise.
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26

The basics
Your pump
CAUTION: Never use sharp objects to press the buttons on your Paradigm pump as this can damage the
buttons or compromise the seal of the pump. Some examples of sharp objects that may damage your
keypad are fingernail files, pens or pencils, paper clips, knives, scissors, and keys. 
Take a look at your pump. The reservoir window allows you to view the insulin in the reservoir. The
reservoir, with the tubing connector attached, is inserted into the reservoir compartment of the pump. 
ACT
ESC
reservoir
window
screen
tubing
connector
reservoir
compartment
battery
compartment
buttons
ACT
ESC
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27
Chapter 3

Install battery
CAUTION: Do not use a rechargeable or carbon zinc battery in your pump. For best results use a new
Energizer AAA alkaline battery, size E92, type LR03.
Medtronic Diabetes designed the pump to only accept a new battery. As a safety measure, if you install a
battery that does not have full power, the WEAK BATTERY or FAILED BATT TEST alarm may sound. If you
receive a WEAK BATTERY alarm, respond to the alarm and continue. The pump will still operate normally,
but with a decreased battery life. The pump uses one AAA alkaline battery.
1
Make sure all the following apply:
•
Clear (ESC, ACT) any alarms and/or alerts before removing and replacing the battery.
•
Make sure the pump is at the HOME (idle) screen when you remove the battery.
•
Do NOT remove the battery during a bolus or prime delivery.
2
Use the edge of a coin to remove the battery cap. Turn the cap in a counter-clockwise direction.
3
Remove the old battery and dispose of it per
the disposable requirements of your state or
country. Put the new battery in the pump with
the negative end [(-) symbol] going in first.
Check the label on the back of the pump to
make sure the battery is inserted correctly.
NOTE: 
Do not use batteries that have been in
cold storage, such as in the refrigerator or in your car during winter in cold climates.
 
4
Place the battery cap in the pump and tighten so the slot is aligned
horizontally with the pump as shown here:
CAUTION: Do NOT over-tighten the battery cap. You should not turn
the cap more than four half turns. If you over-tighten the cap you
may not be able to remove it, and you can damage your pump.
battery cap
battery
one half-turn
one half-turn
The basics
28

5
While the pump turns on, it will show one or more screens until
the HOME screen appears.
If the HOME screen does not appear, do these steps:
a. Check that the battery is inserted correctly. If the battery has
been installed backwards, remove the battery and install it
properly.
b. If your pump still does not turn on or you get a FAILED BATT TEST alarm, remove and replace the
battery with a new one.
c. If the pump is still not on, call your local help line or representative.
6
Check to make sure the time and date are correct. If more than five minutes have passed since you
removed the battery, you will be prompted to check the time and date. Refer to the Setting the time
and date section in the Basic programming chapter for programming instructions.
7
Press ESC to view the STATUS screen, making sure no alarms are active. If an alarm is active, follow
the instructions on the screen.
Pump buttons
The buttons on the pump are used to navigate through the menus and screens, and to program the
features of the pump. 
EXPRESS
BOLUS
button
ESC
button
ACT
button
DOWN
button
UP button
From the HOME
screen, this is the
EASY BOLUS button 
HOME screen
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29
Chapter 3

The following table describes how to use the buttons on your pump from the HOME screen:
Button
Description
EASY BOLUS™ button—Shortcut to set and deliver an Easy Bolus.
Turns the backlight on or off.
Opens the MAIN MENU.
•
Opens the pump STATUS screen if the sensor feature is turned off.
•
Opens the following screens and graphs from the HOME screen if the sensor feature is turned on:
•
1 press opens the 3–hour sensor glucose graph.
•
2 presses open the 24–hour sensor glucose graph.
•
3 presses open the pump STATUS screen.
•
4 presses open the SENSOR STATUS screen.
EXPRESS BOLUS button—Shortcut to the SET BOLUS screen or the ENTER BG screen of Bolus
Wizard to set up any bolus.
The following table describes how to use the buttons on your pump from the menus and programming
screens:
Button
Description
Increases or decreases the value of a flashing item. Scrolls up or down the items in a list.
Accepts a selected menu item or activates a selected setting.
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30

Button
Description
•
Returns to previous screen or exits the menu.
•
Backs out of unintentional menu selections if the ACT button has not been pressed yet.
•
Press simultaneously with 
 to turn on backlight when in the menus.
•
Use as a Shift button by pressing it in combination with another button to access certain features.
The pump screen
The screen shows five lines of text at one time. The first is the operating mode. The second is the current
open menu or function. The last three lines show either information or text that you can select for the
current function.
NOTE: 
The screen text in the examples used in this guide might not exactly match the text on your
pump screen. Please follow your pump screen instructions. If you have any questions, contact your local
representative.
 
HOME screen
The HOME screen serves as the starting point to access the
programming screens. When no buttons are pressed for about 30
seconds, the pump returns to this screen.
When you press ACT from the HOME screen, the MAIN MENU will
appear. 
When the pump is on, the following icons always appear across the top of the screen: reservoir volume
icon, the time (12- or 24-hr), and the battery icon. If these do not appear, the pump is not operating.
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31
Chapter 3

Screen icons
There are various icons that appear at the top of your pump screen, like the time, battery and reservoir
icons mentioned above. The next sections describe what the icons mean.
Battery
The battery icon tells you how much usable life is left in your battery. There are
four segments in the icon. Each segment represents approximately 25 percent of
the usable battery life you have left until you reach Low Battery point. So if you
only have one segment left you want to make sure you have a new battery
available.
Time display
The current time of day is displayed across the top of the pump screen in the 
format you select—12-hour or 24-hour. The AM or PM is only displayed for 
the 12-hour format. For instructions on setting the time on your pump, see 
the Setting the time and date section in the Basic programming chapter.
Reservoir volume
The reservoir volume icon tells you how much insulin is in your pump. This icon is
also divided into four segments. Each segment represents approximately 25 percent
of the reservoir volume you have left. This allows you to be aware of how much
insulin you have left in your pump. Refer to your STATUS screen to view the number
of units left in the reservoir.
At least 75% left
Low battery
Time Display
24-Hr
12-Hr
Less than 25% left
75 to 100% left
NOTE: 
For the Paradigm 722/722K, your reservoir icon will only appear full if using a filled 300-unit
Paradigm reservoir. The icon will not appear full if you use the 176-unit Paradigm reservoir.
 
Alert and alarm icons
An open circle (alert) or a solid circle (alarm) are displayed in the upper part of
your pump screen only when there is an alert or alarm condition on your pump.
For alarm and alert information, see the Troubleshooting and alarms chapter. 
Alarm icon
Alert icon
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32

Sensor icons
A dark sensor icon means that the sensor is on and the pump is receiving
sensor data. A light-colored sensor icon with a dark circle around it
means that the sensor is on, but the pump is not receiving sensor data.
For information about the sensor, see the Sensor features chapter.
Scroll bar
If there is more text than the screen can show, a scroll bar appears on the right side of the screen. Press
 to view any additional text.
Screen backlight
When you press 
 from the HOME screen, the light on the screen turns on or off. During programming,
the backlight can be turned on by pressing the 
 and the 
 together. The light will stay on while you
are pressing any of the pump buttons. It will stay on as long as the current screen is active.
To conserve your battery, the backlight will turn off automatically while the pump is vibrating. After the
vibration is finished, the light will turn back on. The backlight cannot be turned on in a low or dead
battery condition. 
Beep/vibrate
Your pump will beep or vibrate to indicate activity. Refer to the Setting your alert type section in the
Utilities chapter for setup instructions.
Operating modes
The screen lets you know when a special feature is active or if there is a condition that needs your
attention. The active features and pump status will determine the operating mode. The screens for the
three modes are shown in the following sections.
Sensor is on and the pump 
is receiving sensor data
  
Sensor is on but the pump 
is not receiving sensor data  
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33
Chapter 3

Normal mode
Mode for standard pump operations for normal basal and bolus
delivery. No special features are active (such as basal patterns, temp
basal, and others). No alarms and no alerts exist.
Special mode
Indicates a special feature is active or an alert condition(s) exists.
Special mode does not restrict any of the pump functions. When the
pump is in Special mode, an open circle appears at the top of the
screen and it beeps or vibrates periodically to remind you of the
condition. The conditions and features that put the pump in Special
mode are:
•
Low Reservoir condition
•
Low Battery condition
•
Block feature is on
•
Dual or Square Wave bolus delivery
•
Basal pattern A or B is active
•
Sensor alerts
•
Temporary basal delivery
Attention mode
WARNING: When the pump is in Attention mode, showing a solid circle icon, all insulin deliveries are
stopped.
Indicates insulin delivery has stopped. This can mean that the pump is
in Suspend mode. It can also mean an alarm is active or an alarm
condition exists that needs immediate attention for insulin delivery to
resume. A solid circle appears at the top of the screen and the pump
will beep periodically until either the pump is taken out of Suspend
mode or the condition is cleared. The screen will show text describing the condition that put the pump in
Attention mode. For example, if the reservoir is empty, EMPTY RESERVOIR will appear on the screen.
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34

When the pump is in Attention mode, it will beep or vibrate periodically to remind you of the condition.
The beep or vibrate frequency varies depending on the condition that put the pump in Attention mode.
Refer to the Alarm conditions section in the Troubleshooting and alarms chapter for alarm conditions that
will trigger the Attention mode. See the Stopping your pump section in the Basic programming chapter to
learn about Suspend mode.
Menus
The MAIN MENU is the highest level menu. There are submenus, functions, status and programming screens
in the lower menu levels. The menus are described in the following paragraphs. 
Tip: 
If a screen item is flashing (blinking), during programming, press 
 or 
 to change the value.
 
MAIN MENU
Highest menu level in the menu system. When you press ACT from the HOME screen, the MAIN MENU will
appear.
BOLUS MENU
Contains the settings and functions for bolus deliveries. The 
 button allows direct access to MANUAL
BOLUS or to the BOLUS WIZARD feature without having to navigate through the menus. Refer to the Basic
programming chapter for the manual bolus information or to the Using the Bolus Wizard feature chapter
for bolusing using the Bolus Wizard feature.
SUSPEND
Stops all current insulin deliveries. Refer to the Stopping your pump section in the Basic programming
chapter for more information.
BASAL MENU
Contains the functions to setup and deliver your basal. Refer to the Basal section in the Basic programming
chapter for more information.
SENSOR
Contains the functions to setup the interface between the sensor and the pump and access to the pump's
sensor features.
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35
Chapter 3

PRIME MENU
Contains the functions to change your reservoir and fill the infusion set with insulin. Refer to the Changing
your infusion set section in the Starting on insulin chapter for more information.
UTILITIES MENU
Contains features for your safety and convenience. Refer to the Utilities chapter for more information.
STATUS screen
The STATUS screen shows information about what your pump is doing. Only check your pump status (press
ESC) when you are not programming your pump. If you press ESC during programming, you will cancel the
settings you are trying to enter. 
The information that shows on the STATUS screen depends on the current activities and conditions of your
pump.
•
To open the STATUS screen, press ESC until the STATUS screen appears.
•
To view more text on STATUS screen, press 
 or 
 to scroll and view all of the information.
•
To exit the STATUS screen, press ESC until the STATUS screen disappears.
The screen includes information about:
•
Recent bolus insulin delivery
•
Current basal insulin delivery
•
Special features that are turned on
•
Last alarm/alert that was cleared within 24 hours
•
Most recent BG meter reading received within 24 hours
•
Reservoir status
•
Battery status
•
Time and date
Refer to the Pump specifications chapter for a complete list of the information that is available in the
STATUS screen.
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36

If you remove your pump
You may have an occasion when you need or want to remove your pump. If you have to remove and store
your pump, it is recommended that you do the following:
•
Store your pump with the battery in place
•
Keep a record of your current basal rates and use the Save Settings feature (see the Saving the
settings section in the Utilities chapter).
•
To preserve battery life, reset the basal rates to 0 (zero), turn off the RF options (meter, remote), and
set Auto-off to dashes or zeroes.
Remember, your body still needs insulin while your pump is removed.
It is important that you consult with your healthcare professional to determine an alternate method of
receiving your insulin. You can remove your pump for up to one hour without taking insulin. If you remove
your pump for more than one hour, you will have to use another way to take your insulin, such as
injections of fast-acting insulin, or reconnecting your pump to take boluses. Take the injection or bolus
approximately every four hours. Calculate the amount of insulin to take based on the total of your basal
insulin in four hours. Include the amount you need for meal and correction boluses. If you will have your
pump off for several days, you will need to return to a multiple injection regimen.
The basics
37