Insulin pump and continuous glucose monitoring system

Part of the bolus amount delivered 
immediately and the remainder 
delivered evenly over time period.
Bolus amount delivered evenly 
over specified time period.
Entire bolus amount 
delivered immediately.
Turning on the Dual Wave/Square Wave option 
It is important that you consult with your healthcare professional before using a Square Wave or Dual Wave
bolus. You should be familiar with the basic functions of your pump before exploring these options.
 
To set up a Dual Wave or Square Wave bolus, you must first turn on the dual/square bolus option.
1
Go to the DUAL/SQUARE OPTION screen.
Main > Bolus > Dual/Square Bolus
2
Select On, then press ACT. The feature is now on. Exit the menus.
Square Wave or Dual Wave bolus without Bolus Wizard feature 
1
Make sure the dual/square option is on.
2
Calculate your food and/or correction bolus amount.
3
Go to the BOLUS TYPE screen.
Press 
 on your pump, or follow this path:
Main > Bolus > Set Bolus
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4
For a Square Wave bolus, do these steps:
a. Select Square Wave Bolus, then press ACT. The SET SQUARE BOLUS screen appears.
b. Enter the desired amount for the Square Wave bolus units, then press ACT.
c. Continue to step 5.
For a Dual Wave bolus, do these steps:
a. Select Dual Wave Bolus, then press ACT. The SET DUAL BOLUS TOTAL screen appears.
b. Enter the desired amount for the total dual bolus units. This amount is the total of Normal and
Square Wave bolus units. Press ACT.
c. The next screen flashes the amounts of Now (Normal) and Square Wave portions of the Dual Wave
bolus. The screen also shows the percentage amount of each portion. Press 
 or 
 to change
the percentage/number of units. Continue to step 5.
5
The SQUARE DURATION screen appears. Enter the amount of time you want the Square Wave bolus to
last, then press ACT.
If you have BG Reminder turned On, the BG REMINDER DURATION screen displays. It allows you to set
the duration before you are reminded to check your blood glucose after a bolus.
6
The BOLUS DELIVERY screen appears with an open circle indicating that your pump is in Special mode.
The pump beeps/vibrates at the start of the bolus. During bolus delivery, the pump will return to the
HOME screen. The pump beeps/vibrates at the end of the bolus and the open circle disappears.
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Square Wave bolus practice
Your target pre-meal blood glucose range is ______ to _______.
Check your pre-meal blood glucose. Are you within your target? _____ If yes, continue. If no, wait to try
the following test until your pre-meal blood glucose is within your target range:
TEST: Choose a meal that is high in fat (hot dogs, pizza, cheese enchiladas). Determine your meal bolus
amount. Set the Square Wave bolus to deliver the determined amount of insulin over two hours. (This
duration time is an example. As always, consult with your healthcare professional for guidance.)
Check your blood glucose and record:
Pre-meal ________
1 hour post meal ________
2 hours post meal ________
3 hours post meal ________
4 hours post meal ________
Did your blood glucose return to your pre-meal target within 4 hours post meal? ________
If yes, then repeat this test with the same meal on another day to verify your results.
If no, discuss this with your healthcare professional for guidance.
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Dual Wave bolus practice
Can you think of any meals where this feature would help you with blood glucose control?
Your target pre-meal blood glucose range is ______ to _______
Check your pre-meal blood glucose. Are you within your target? _____ If yes, continue. If no, try this
test when your pre-meal blood glucose is within your target range:
TEST: Choose a meal that has a combination of both rapidly absorbed and slowly absorbed
carbohydrates. Determine your meal bolus amount. Set the Dual Wave bolus to deliver the determined
amount of insulin. Program your pump to deliver one-half over 2-hours*, and the other half immediately.
(* This duration of time and ratio is an example. As always, consult with your healthcare professional for
guidance.)
Check blood glucose and record:
Pre-meal________
1 hour post meal________
2 hours post meal________
3 hours post meal________
4 hours post meal________
Did your blood glucose return to your pre-meal target within 4 hours post meal? ________*
If yes, repeat this test with the same meal on another day to verify results.
If no, discuss this with your healthcare professional for guidance.
Using the Bolus Wizard feature for a Square Wave or Dual Wave bolus
If you are using the Bolus Wizard feature to calculate your Square Wave or Dual Wave bolus amounts, you
will be prompted to enter your blood glucose reading and/or the (gram or exchange) units you will eat.
The Bolus Wizard feature will use this input to calculate your suggested correction and/or food bolus
amount. If you do not want to use the Bolus Wizard feature estimate, you can change it.
The Bolus Wizard feature must be turned on and the settings must be programmed (see the How to
program the Bolus Wizard feature section of the Using the Bolus Wizard chapter). Also, make sure the
dual/square option is turned on (see the Turning on the Dual Wave/Square Wave option of this chapter).
If you want to use the pump-to-meter link, make sure the meter option is on. Refer to the Meter option
section in the Using the Bolus Wizard feature chapter for instructions.
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1
Go to the ENTER BG screen.
Press 
 on your pump, or use the following path:
Main > Bolus > Use Bolus Wizard
2
Enter your blood glucose value, then press ACT.
3
The ENTER FOOD screen appears. Enter your food, then press ACT.
4
The ESTIMATE DETAILS screen appears. Scroll down to review the information there. Press ACT to
continue to step 5.
If you need to make any changes, press ESC to return to the ENTER BG screen. Make changes as
necessary.
5
The BOLUS EST screen appears with Normal Bolus, Square Wave Bolus, and Dual Wave Bolus options. If
your Bolus Wizard feature calculates that your bolus includes a portion to correct your high blood
glucose, the Square Wave Bolus option will not be available. This helps you to select a bolus type
(Normal or Dual Wave) that has an immediate delivery option to cover your high blood glucose.
6
To set a Square Wave bolus, do these steps:
a. In the BOLUS EST screen, select Square Wave Bolus, then press ACT.
b. The SET SQUARE BOLUS screen flashes the estimated bolus amount. Change the amount if needed.
Press ACT to accept the bolus amount.
To set a Dual Wave bolus, do these steps:
a. The SET DUAL BOLUS TOTAL screen flashes the estimated bolus amount. This amount is the total of
both the Normal and Square Wave bolus units. Change the amount if needed. Press ACT to accept
the bolus amount.
b. The next screen flashes the amounts of Now (Normal) and Square portions of the Dual Wave bolus.
The screen also shows the percentage amount of each portion. Press ACT to accept the Bolus
Wizard's suggested portions. You can also press 
 or 
 to change these portions, then press
ACT. 
The Bolus Wizard feature recommends splitting the food portion of your bolus 50/50 between the
Square and Now portions. The entire correction amount is always recommended to the Now
portion. In this example the NOW portion consists of half of the food insulin plus the correction
amount less the active insulin (1.5U + 2.5U - 1.5U). This gives 2.5U or 62% of total insulin of 4.0U.
The Square portion consists of the other half of the food insulin (1.5U), which is 38% of total
insulin of 4.0U.
7
The SQUARE DURATION screen appears. Enter the amount of time you want the Square Wave bolus to
last, then press ACT.
If you have BG Reminder turned On, the BG REMINDER DURATION screen displays. It allows you to set
the duration before you are reminded to check your blood glucose after a bolus.
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8
Press ACT to accept and deliver the bolus. The BOLUS DELIVERY screen appears with an open circle
indicating that your pump is in Special Mode. The pump beeps or vibrates at the start of the bolus.
During bolus delivery, the pump returns to the HOME screen. If you want to see the progress of the
delivery, press ESC to see the STATUS screen. The pump beeps or vibrates at the end of the bolus, and
the open circle disappears.
Easy bolus
The EASY BOLUS button 
 allows a quick way to deliver a Normal bolus. You will pre-set the settings for
this feature in the EASY BOLUS OPTION screen in the BOLUS MENU. Your pump is sent from the factory with
the Easy Bolus feature set to on. If you do not want to use Easy Bolus, turn it off.
After you set up Easy Bolus, with each 
 press, you can increase the Normal bolus amount by a fixed
amount, called a step. Before you can deliver an Easy Bolus, you must set the amount in the EASY BOLUS
ENTRY screen. This amount equals the number of units of insulin for each step. The maximum number of
steps can equal up to your maximum bolus limit. When using vibrate mode, EASY BOLUS is limited to 20
steps or maximum bolus, whichever comes first.
After you set your step amount, you can program your Easy Bolus. When you are in the HOME screen, each
time you press 
 the Easy Bolus amount increases by one step. You will hear a beep or feel a vibration
for each step increase. Each beep is a different tone. This makes it easy for you to count the beeps while
you are programming your Easy Bolus.
Easy bolus setup
1
Go to the EASY BOLUS OPTION screen. 
Main > Bolus > Easy Bolus
Select On/Set, then press ACT. If you do not want to use Easy Bolus, select Off and press ACT.
NOTE: 
If you are using the remote control, the Easy Bolus must be set to on.
 
Step value setup 
You can set the step value from 0.1 to 2.0 units, or to the set maximum bolus limit of less than 2.0 units
(factory setting: 0.1). Set the step to a number that is convenient to use and easy to multiply. 
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Example:
2.0 unit Easy bolus with a step 
amount set at 0.5 units
Total # Steps = 4
Total # Button Presses = 4
1 Step = 0.5 units
1 Step = 0.5 units
1 Step = 0.5 units
1 Step = 0.5 units
4
3
2
1
0
0
0.5
1.0
1.5
2
Total # Units
1
The EASY BOLUS ENTRY screen flashes the step value. Change the value, then press ACT. The step
value is the increment you will use for your Easy bolus.
2
The screen will return to the BOLUS MENU. Your step amount is now programmed and Easy Bolus is
ready to use. Exit the menus.
Delivering Easy Bolus 
Practice using the Easy Bolus feature while looking at the pump screen as you count the beeps. This
feature only works from the HOME screen. After you are familiar with Easy Bolus, you can use the audible
tones for bolus delivery without having to look at the screen.
1
From the HOME screen, press 
. The SET EASY BOLUS screen appears with the single step value
flashing.
2
Press 
 the number of times needed for your bolus amount. Watch the amount change on the screen
with each press. The pump will vibrate or sound a different tone for each 
 press.
3
When your total bolus amount appears on the SET EASY BOLUS screen, press ACT. Listen/feel to count
the steps without looking at the screen.
For example: You need to deliver a 2.0 unit bolus, and your step size is set to 0.5. Each time you press
, the units increase by the step amount of 0.5 units. To deliver 2.0 units, you need to press the 
button four times. (4 X 0.5 = 2.0) The screen will show 2.0 units.
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NOTE: 
For your safety, you cannot use the 
 to select the Easy Bolus values. Pressing 
 or ESC
will cancel the Easy bolus. 
 
4
If this amount is correct, press ACT to start the Easy Bolus delivery. The BOLUS DELIVERY screen will
show the units being delivered. When the total bolus is finished, the pump will beep or vibrate.
If this amount is wrong, press ESC or 
 to start over. The pump will return to the HOME screen.
Example 1: Easy bolus
Alexander is a busy executive with an accounting firm. He wears his Paradigm pump on his belt and does
not want to take it off to give himself a bolus. Alex can easily reach down and feel for the Easy Bolus
button 
 to give a bolus.
He previously programmed his pump to deliver an Easy Bolus in steps of 0.5 unit increments. From the
HOME screen, with each press of the 
, the pump will sound a different tone so he can keep track of
the number of button presses.
He wants to give himself 2.0 units for a snack, so he will press 
 4 times (4 presses x 0.5 units/press =
2.0 units) and then press the ACT button. The pump counts back 4 beeps because he pressed 
 4
times. He simply presses ACT to confirm the amount, and his pump delivers the 2.0 units.
When Alexander wants to be more discreet, or does not want his pump to beep in an important meeting,
he can set the pump to Vibrate mode and feel for vibrations rather than listening for the tones. (See the
Setting your alert type section in the Utilities chapter for details.)
Your turn: Easy bolus practice
The factory default setting for the Easy Bolus feature is 0.1 unit steps. You can change the step level as
necessary to a value that is more convenient for you to use and easier to multiply.
Give your next bolus by using the Easy Bolus feature on your pump.
How many units did you give? _______
How many tones did you count? _______
Your step level is ________.
It might be a good idea to look at your pump's screen to see the bolus amount as well as counting the
steps the first few times you try this until you become familiar and comfortable with the feature.
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Chapter 7

Basal patterns
The Basal Patterns feature is optional for pump users. You can set your pump to deliver a standard basal
and two additional basal patterns to meet your individual daily, weekly, or monthly needs. Keep a paper
copy of your programmed patterns with you at all times in case you need to reprogram your pump. To
select and use pattern A or pattern B, the patterns option must be turned on and programmed. 
NOTE: 
You may want to explore this option after you become familiar with the basic pump functions. It
is important that you consult your healthcare professional before using a pattern other than your
standard pattern.
 
•
Standard pattern: Your normal basal that supports your usual day-to-day activity. When the Patterns
feature is off, the pump uses your standard basal pattern. 
•
Pattern A/B: Basal pattern that supports activity levels that are not a part of your day-to-day routine,
but are normal in your lifestyle. Such activities could be a sport that you do once a week or a change
in your sleep pattern over the weekend, extended periods of higher or lower activity, or menses.
Turning on the patterns 
Your pump is set at the factory with the basal patterns feature turned off. After you turn on patterns, you
still have to program and select a pattern (A or B), as described in the next sections, before the patterns
feature is active. If you turn off the patterns feature, your pump will automatically select your standard
basal pattern.
1
Go to the PATTERNS OPTION screen.
Main > Basal > Patterns
2
Select On, then press ACT. The patterns feature is now on. Exit the menus.
Programming a pattern 
Your pump will keep your pattern settings even when the Patterns option is turned off. However, the
patterns feature must be on to program a basal pattern.
 
To program your patterns, do these steps:
1
Go to the EDIT BASAL screen.
Main > Basal > Set/Edit Basal
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2
Select the basal pattern you want to program, then press ACT.
3
The SET BASAL RATE 1 screen appears. The basal rate flashes, indicating that it can be changed. Set
your first rate, then press ACT.
The start time for your first basal rate is midnight and cannot be changed.
4
The SET START TIME 2 screen appears. The dashes under the screen name flash. The first basal rate is
now set.
If you want to use the same rate for the whole day, press ESC and skip to step 10. If you want to
program another basal rate, follow steps 5 through 8.
5
In the SET START TIME 2 screen enter the time of the day you want this basal rate to become active.
6
Press ACT. The SET BASAL RATE 2 screen appears.
7
The previously set basal rate or dashes flash on the screen. Select the value for this basal rate.
8
Press ACT. The SET START TIME 3 screen appears. The second basal rate is now set.
9
If you do not need to set up any more basal rates, press ESC. If you need to set up more basal rates,
repeat steps 5 through 8 above for each rate.
10 After you press ESC, the BASAL RATE screen appears. The screen will show:
•
the current basal pattern and basal rate,
•
time it started, and
•
the 24-hour basal total.
After you make changes to a pattern, the pump will use that pattern as the current basal. Make sure
the basal you want is selected in the SELECT PATTERN screen.
Select a pattern 
Before you select a pattern to be active, make sure the Patterns feature is turned on. After your standard
pattern and/or pattern A or B are set, do these steps to select a pattern to be the active one:
1
Go to the SELECT PATTERN screen.
Main > Basal > Select Patterns
2
Select the desired pattern, then press ACT.
3
The screen will return to the BASAL MENU. Your basal pattern is now active. Exit the menus.
NOTE: 
If pattern A or B is active, the pump is in Special mode. An open circle appears at the top of the
screen.
 
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Example 1: 
Basal patterns
Ken has had his insulin pump for about a month. He tests his blood glucose 4 - 6 times a day and records
his results in his logbook. He is happy with his glucose control during the week but on the weekends, he
noticed that he has to eat more food to prevent his blood glucose from running too low.
Ken has realized that during the week while he is at work, he is very inactive and sits at a desk most of
the time. On the weekends, though, he is busy with yard work, running errands and playing with his
kids. He determines that he needs to have lower basal settings to receive less insulin during active
times, such as his weekend.
He can use the Basal Patterns feature to support his weekend change in activity. During the week, he
can set his pump to deliver in the standard setting, and on Saturday morning, he can switch over to
Pattern A, which he can set with lower basal rates for the weekend. On Monday morning, he can return
his pump to the Standard setting for his weekday insulin needs.
Example 2: 
Basal patterns
Cynthia has had diabetes for about 12 years and has been on her Paradigm pump for several weeks.
Every Monday, Wednesday and Friday, Cynthia goes on a 3 kilometer walk in the morning. To prevent
hypoglycemia on these days, she uses the patterns feature. For those days, she simply switches over to
Pattern A, which she has programmed with a lower set of basal rates. Before she learned to use the
patterns feature, she would have to eat more food throughout the day to keep her blood glucose at a
safe level. Cynthia has also noticed that a few days prior to menstruation, her blood glucose levels seem
to rise, requiring more insulin. She has programmed Pattern B on her Paradigm pump with higher basal
rates for this time. For her usual schedule, she uses the standard basal pattern.
Your turn:
Can you think of situations where you might require different basal rate settings on different days?
Temp basal rates
Temp basal should be used based on the guidance of your healthcare professional. This feature is useful to
manage blood glucose levels during unusual short-term activities or conditions. These conditions could be
an illness or physical activity.
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A temporary basal rate allows an immediate short-term change to your basal insulin for a specified period
of time (30 minutes to 24 hours). This rate can be up to your Maximum basal rate setting. It offers an easy
way to immediately meet short-term insulin needs for temporary activities or situations. When your blood
glucose is temporarily high or low, a temp basal rate allows you to set a temporarily higher or lower basal
to accommodate your blood glucose. For ongoing periods of increased or decreased activity, the patterns
feature may be more suitable.
How does temp basal work?
During a temp basal delivery, all other basal programming is temporarily overridden. After the temp basal
delivery is completed, your pump will return to the programmed basal. A temp basal is delivered only
once and does not repeat. If you want another temp basal, you must program the temp basal again. This
feature may be useful to temporarily increase or decrease basal insulin during illness, exercise or similar
unusual situations.
Temp basal types
Based on your preference, you can select either Percent of Basal or Insulin Rate.