Insulin pump and continuous glucose monitoring system

Suspend, you can only resume your basal or view the STATUS screen. No other functions are available.
 
To suspend the pump:
1
Select Suspend from the MAIN MENU, and press ACT.
Main > Suspend
2
SUSPEND will flash on your screen. Press ACT to stop your pump.
3
The screen will show that the pump is suspended and the time that it stopped. After less than one
minute, the pump will return to the HOME screen with a solid circle.
You can verify on your pump STATUS screen that your pump is suspended.
Resume pump delivery
When the pump is suspended, it defaults to the HOME screen with a solid circle.
 
To resume your pump and basal delivery, do these steps:
1
From any screen, press ACT until the RESUME screen appears.
Press ACT again.
2
Your pump will beep once, then the HOME screen will appear without the solid circle.
NOTE: 
A bolus or fixed prime that was stopped by suspend will not restart when you resume your
pump. You must reprogram and activate it to finish delivery.
 
Basic programming
55
Chapter 4

Example: 
Suspend function
Helen is ready to eat her lunch. She has just programmed her pump to deliver a meal bolus when the
phone rings. Helen wants to talk on the phone and not eat her lunch right away. She knows that if she
lets the bolus continue and she does not eat her lunch soon, she may be at risk for low blood glucose.
Helen suspends delivery of her pump to stop the bolus, but then resumes delivery to restart her basal
insulin. When she is off the phone and ready to eat, she checks her STATUS screen to see how much
insulin she received from the partially delivered bolus before she suspended her pump. She will
reprogram a new bolus for the remainder of her bolus amount.
Practice: 
Suspend function
1
Make sure you are NOT connected to your pump while practicing.
Program your pump to deliver a Normal bolus of 3.0 units. Once the bolus begins, stop the bolus by
suspending your pump.
Remember, when you stop the bolus delivery with SUSPEND, all insulin delivery will stop.
2
Now, RESUME delivery, so that your basal insulin will continue.
3
Check the STATUS screen.
4
How much insulin did the bolus deliver before you Suspended delivery? _______.
5
If you wanted to take the rest of the bolus later, how much would you take to equal 3.0 units?
_______.
Practice: 
Resume basal delivery after a suspend
Make sure you are not connected to your pump while practicing.
1
Give a 3.0 unit bolus now. While it is delivering, suspend the bolus.
2
Check here if you were able to suspend the bolus. 
3
Now restart the pump.
4
Check here if you were able to restart the pump. 
Basic programming
56

Starting on insulin
The Paradigm pump is intended for use with U100 insulin.
Prepare your pump for use
We recommend that you watch the training CD-ROM enclosed with your pump, and complete your pump
start training, before continuing with the steps in this chapter.
When you are done practicing and ready to use your pump with insulin, you must make sure the time and
date are correct on your pump. You must also program your settings as instructed by your healthcare
professional.
You will need these items:
•
Pump
•
Insulin (U100)
•
Paradigm reservoir and user guide
•
Paradigm compatible infusion set and user guide 
Starting on insulin
57
Chapter 5

Filling the reservoir
Warning: Do not use the reservoir or infusion set if any liquid gets on the top of the reservoir or inside
the tubing connector (as shown in the image). Liquid can temporarily block the vents. This may result
in the delivery of too little or too much insulin, which can cause hypoglycemia or hyperglycemia. If
any liquid gets on the top of the reservoir or inside the tubing connector, start over with a new
reservoir and infusion set.
Tubing
connector
Top of
reservoir
WARNING: Using cold insulin can cause air bubbles in the reservoir and tubing. If your insulin is stored
in the refrigerator, allow it to reach room temperature before filling your reservoir. When filling the
reservoir, take care to remove air bubbles.
CAUTION: Insulin comes in different vial types, depending on your country. If your vial is different
than the one described in the User Guide, consult with your healthcare professional on how to fill
your reservoir.
1
Remove reservoir from package. Make sure plunger rod is fully extended.
2
Swab vial with alcohol (not shown).
3
Making sure you do not push down on the plunger, press the transfer guard onto the vial.
Starting on insulin
58

plunger
rod
transfer
guard
reservoir
vial
3
1
4
Push down on the plunger to pressurize the vial. Hold down the plunger rod.
5
While still holding the plunger rod, flip the  vial over so the vial  is on top, slowly pull down on the
plunger  to fill the reservoir.
6
Gently tap the side of the reservoir to make any air bubbles  rise to the top of the reservoir.
7
Slowly push up on the plunger  just enough to remove any air  bubbles from the reservoir.
8
Slowly pull down on the plunger  to fill the reservoir to the  number of units desired.
9
To avoid getting liquid on the top of the reservoir, flip the vial over so that it is upright. Turn the
reservoir counter-clockwise, then pull straight up to remove the reservoir from the transfer guard.
10 Place the tubing connector onto the reservoir. Turn the connector clockwise, pressing gently against
the reservoir until you feel it slide in. Push in and continue turning until the reservoir and the
connector lock with a click.
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59
Chapter 5

11 Tap the side of the reservoir to remove  any air bubbles.
12 To purge air bubbles that have  risen to the top of the reservoir,  push up on the plunger until  you see
insulin in the tubing.
13  Without pulling, turn the  plunger counter-clockwise  to remove it from the  reservoir.
Changing your infusion set
Removing the reservoir 
 
Each time you remove and replace a reservoir in your pump, you have to rewind your pump, and fill
the infusion set with insulin.
1
Remove the entire infusion set from your body.
2
If attached, remove the activity guard.
Starting on insulin
60

3
Turn the tubing connector half-turn counter
clockwise, then pull the reservoir and connector
out from the pump.
tubing connector
half-turn counter-clockwise
4
Safely dispose of the used reservoir and infusion set item in a sharp's container.
5
You must now rewind your pump as described in the next section.
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61
Chapter 5

Rewinding your pump 
Before you continue, make sure the infusion set is NOT connected to your body and the reservoir is NOT in
the pump.
WARNING: Make sure the infusion set is disconnected from your body before you rewind your pump or
fill the infusion set tubing. Never insert the reservoir into the pump while the tubing is connected to
your body. Doing so could result in an accidental infusion of insulin.
1
If you removed your reservoir and are replacing it, go to the REWIND screen.
Main > Prime > Rewind
2
In the REWIND screen, press ACT to start the rewind process. The REWINDING screen will appear while
the pump rewinds.
3
After the pump rewinds the PREPARING TO PRIME screen will appear.
If you are practicing:
a. Do NOT insert the reservoir in your pump. Make sure the red shipping cap is installed in the
reservoir compartment as shipped.
b. Press ACT, then continue with the manual prime instructions described in the Manual prime
section of this chapter.
If you are not practicing, continue to the next section to insert the reservoir in your pump.
Inserting the reservoir in your pump 
If your reservoir is already inserted in your pump, continue to the next section.
You must do these steps in the order described. If you are practicing, do NOT insert the reservoir in your
pump.
CAUTION: You must rewind your pump before installing a new reservoir. As part of the pump's
function, it calculates the reservoir volume. To ensure correct volume calculations, your pump has
been designed to require a rewind before you insert your reservoir.
1
If you are using the pump for the first time, remove the red shipping cap from the reservoir
compartment.
Starting on insulin
62

WARNING: Do not insert the reservoir in the pump if you did not rewind. Doing so could result
in inaccurate insulin delivery.
Never insert the reservoir into the pump while the tubing is connected to your body. Doing so
could result in an accidental infusion of insulin.
2
Insert the reservoir into the top of the pump case.
3
Turn the tubing connector approximately 1/2 -turn clockwise until the connector is seated. The tubing
connector should be aligned horizontally with the pump case as shown here.
tubing connector
4
Attach the activity guard, if desired.
5
You must now do a manual prime as described in the next section.
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63
Chapter 5

Manual prime
Manual prime fills the infusion set tubing with insulin before you insert the set into the body. Manual prime
is only available after you rewind your pump.
WARNING: Make sure that the infusion set is disconnected from your body before you press ACT to
prime the pump. Never insert the reservoir into the pump while the tubing is connected to your body.
Doing so could result in an accidental infusion of insulin.
1
After you rewind your pump, the PREPARING TO PRIME screen appears.
The pump may automatically return to the HOME screen while you install the reservoir. Press ACT to
return to the PREPARING TO PRIME screen.
2
Press and hold ACT to start the prime. The pump will beep six times when the prime starts.
3
While you hold ACT, the pump will again beep six times when the screen begins counting the prime
units being used.
4
Continue to hold ACT until insulin droplets form on the tip of the infusion set needle, then release.
Make sure there are no bubbles in the tubing.
WARNING: If the PRIMING-HOLD ACT screen does not display, do NOT insert the infusion set in
your body. Please contact your local representative for assistance.
If your manual prime uses more than 30U insulin, the pump will show the following screen: IS PRIMING
COMPLETE? When you get this message, do the following:
a. Make sure you are not connected to the pump.
b. Read the message on the screen, then press ESC, ACT to clear.
c. If your manual prime is complete (you see droplets on the tip of the infusion set needle), press
ESC and continue to step 5.
5
Press ESC. Your manual prime is complete.
6
You can now insert the infusion set into your body as described in the next section.
Starting on insulin
64

Inserting the infusion set
WARNING: While the infusion set is connected to your body, do not unscrew and retighten the tubing
connector on the reservoir.
After you complete all of the following, you will be ready to insert the infusion set into your body:
•
fill your reservoir
•
rewind your pump
•
insert the reservoir into pump
•
and fill the infusion set with insulin
Shown here are the best body areas (shaded) for infusion set insertion. Avoid the 2-inch (5.0 cm) area
around the navel. 
It is important that you change your infusion set every two to three
days. Be sure to rotate the infusion set insertion sites so that they do
not become overused. The abdominal area is the most common site
for set insertions because absorption is very consistent. To keep
abdominal sites healthy, some people find it helpful to use a visual
scheme to help them rotate their insertion sites in an organized way.
For maximum effectiveness, use the following two commonly used
methods:
•
Visualize an imaginary clock drawn on your abdomen surrounding your belly button.
Rotate infusion set insertion sites by starting at 12 o’clock and then rotate the site
clockwise to 3 o’clock, 6 o’clock, and so on.
•
Imagine a letter M or a letter W on either side of your belly button. Start at the end of
one letter and proceed through the letter, rotating to each intersection in turn.
Medtronic Diabetes offers a number of different infusion sets for your pump. Instructions for the Quick-
set
®
 begin on the next page as an example. Always refer to the instructions that shipped with your
infusion set.
After your infusion set is inserted, see the Fixed prime section in this chapter to prime your pump.
Starting on insulin
65
Chapter 5

Quick-set infusion set (with Quick-serter
®
)
Always refer to the instructions that shipped with your infusion set.
Starting on insulin
66

Fixed prime
A fixed prime fills the soft cannula with insulin and is required after the infusion set is inserted into your
body and the introducer needle removed. The prime amount depends on your infusion set type, so read
your infusion set instructions for the fixed prime amount.
1
Go to the PRIME MENU screen.
Main > Prime
2
Select Fixed Prime and press ACT.
3
In the FIXED PRIME screen, enter the insulin amount for your infusion set type, then press ACT.
4
After the prime begins, the PRIME DELIVERY screen will count the units as they are delivered. The
pump will beep after priming is complete.
Prime history
 
Do these steps to see a list of the delivered primes.
1
Go to the PRIME HISTORY.
Main > Prime > Prime History
2
Scroll through the list of prime deliveries. The letter F at the end of the text line indicates a fixed
prime.
The letter M indicates a manual prime. Exit the menus.
Disconnecting Quick-set
The Quick-set allows you the freedom to temporarily disconnect from your pump without removing the
infusion set from your body.
1
Hold the side grips of the connector part with your fingers.
2
Twist the connector counter-clockwise.
3
Remove the connector from the site.
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67
Chapter 5

Reconnecting Quick-set
A fixed prime is used before reconnecting the infusion set to your body to ensure that insulin has filled the
infusion set. See the instructions in this chapter.
Place the connector part (flat side facing down) on the infusion site until it is fully seated. Do not grip the
connector part by the flat-side grips.
Record keeping for diabetes management
Now that you are using the pump, we will be asking you to test your blood glucose regularly. It is
important to test often and write down your blood glucose readings, the food you eat, any exercise you
perform and any other notes to explain your blood glucose results.
You must test at the recommended times and any other time that you feel your blood glucose is high or
low. Be sure to include your meal boluses, correction boluses, the amount of carbohydrate you eat, basal
rate and any other information that will be helpful in assisting your healthcare professional in adjusting
your pump settings.
Starting on insulin
68

It is very important to look at your blood glucose readings as feedback regarding your diabetes
management, not as statements about you or your self-worth. Try not to have an emotional reaction to the
numbers and do not judge them too harshly. You will soon learn how to modify the numbers easily and
precisely through insulin pump therapy. Test at least four to six times per day.
These are the recommended times to test to determine control:
•
Overnight (occasionally, at approximately 2:00 a.m. - 3:00 a.m.)
•
Pre-breakfast (fasting)
•
Post-breakfast (approximately two hours after eating)
•
Pre-lunch
•
Post-lunch (approximately two hours after eating)
•
Pre-dinner
•
Post-dinner (approximately two hours after eating)
•
Bedtime
•
Before driving
Determining your pump settings
Your healthcare professional will use your daily blood glucose journal records to program your pump. It is
very important to keep good records during the first weeks after you start on pump therapy. Not only must
you record your blood glucose readings, but it will be important to eat regularly scheduled meals and to
keep your activity as consistent as possible.
Until you and your healthcare professional determine the pump settings that will work best for you, it is
important to eat meals for which it is easy to count the carbohydrates. After your correct basal rate is
determined, you will be able to experiment with varied food choices and amounts.
After you and your healthcare professional are satisfied with your initial pump settings, you may begin to
experiment with different food choices, meal times and exercise schedules.
Starting on insulin
69
Chapter 5

Starting on insulin
70

Using the Bolus Wizard feature
What is it?
Bolus Wizard is a feature that calculates an estimated bolus to support your food intake or to correct a
high blood glucose. To use this feature, you need the following information:
Carbohydrate counting
You need to know which foods contain carbohydrates and how to count these.
Your blood glucose reading
You need to know your blood glucose (BG) reading. When
using the Bolus Wizard feature, the pump can work with blood
glucose meter powered by MWT1 technology to automatically
receive your blood glucose reading. MWT1 is the wireless
Radio Frequency (RF) technology that is used to transmit
information from the meter to the pump. You can program
your pump to automatically receive your BG reading from this
meter. All meters referenced in this user guide are blood
glucose meters supported by MWT1 technology. The Meter
option section in this chapter has more information. If you are
not using this meter, you will manually enter your blood
glucose. 
Meter
BG readings
Using the Bolus Wizard feature
71
Chapter 6

Your personal Bolus Wizard feature settings
In addition to your blood glucose reading and/or your food entry, the Bolus Wizard feature uses personal
settings that you program into the pump. (For instructions see the How to program the Bolus Wizard
feature section in this chapter.) 
•
carb units (grams or exchanges)
•
carb ratios (in carbohydrate grams/unit of insulin or insulin units/carb exchanges)
•
BG units (mmol/L or mg/dL)
•
insulin sensitivity
•
target blood glucose range
•
active insulin time (hours)
Get this information from your healthcare professional, and, for best results, talk to your healthcare
professional before making any changes. Keep a record of your settings in the following Bolus Wizard
feature settings table:
Using the Bolus Wizard feature
72

Bolus Wizard feature settings
Information
Setting
Carb units:
_____ grams or ____ exchanges
Carb ratios:
Bolus Wizard feature uses this for your food bolus
calculations. 
If you count carbs:
this ratio is the amount of carbohydrate grams covered by
one unit of insulin.
range: 3 - 150 grams/unit
If you count exchanges:
this ratio is the amount of insulin you need to cover one
(carb) exchange.
range: 0.1 - 5.0 units/exchange
NOTE: 
Your carb ratios may vary throughout the day. Your
pump allows you to program up to eight different carb
ratios.
 
#1: __________
#2: __________
#3: __________
(additional settings, if
needed)
#4: __________
#5: __________
#6: __________
#7: __________
#8: __________
start time
(midnight)
BG units: (how you measure your blood glucose) 
_____ mg/dL or _____ mmol/L
Using the Bolus Wizard feature
73
Chapter 6

Bolus Wizard feature settings
Information
Setting
Insulin sensitivity:
This ratio is used for your correction bolus calculations. 
This ratio is the BG units reduced by 1.0 unit of insulin.
range: 10 - 400 mg/dL or 0.5 - 22.2 mmol/L
NOTE: 
Your insulin sensitivity may vary throughout the
day. Your pump allows you to program up to eight different
insulin sensitivities.
 
BG units reduced / 
1 unit of insulin
#1: __________
#2: __________
#3: __________
(additional settings, if
needed)
#4: __________
#5: __________
#6: __________
#7: __________
#8: __________
start time
(midnight)
BG Target range:
If your current blood glucose is above the BG Target range,
the Bolus Wizard feature will calculate a correction dose. If
your current blood glucose is below the BG Target range, the
Bolus Wizard feature will calculate a negative correction and
subtract it from your food bolus. 
range: 60 - 250 mg/dL or 3.3 - 13.9 mmol/L
NOTE: 
Your pump will allow you to program up to eight
different BG Target ranges.
 
#1: __________
#2: __________
#3: __________
(additional settings, if
needed)
#4: __________
#5: __________
#6: __________
#7: __________
(midnight)
Using the Bolus Wizard feature
74

Bolus Wizard feature settings
Information
Setting
#8: __________
Bolus Wizard feature settings
Information
Setting
Active insulin time:
The Bolus Wizard feature uses this time to calculate the
active insulin in your system (see the About active insulin
section in this chapter). Use your healthcare professional's
recommendation for the active insulin time that best
represents the insulin type you use and your physiological
insulin absorption rate. 
range: 2-8 hours
Number of Hours: _____
How the Bolus Wizard feature works
1
If you want your current blood glucose to be factored in, enter your BG Reading.
•
automatically from the meter (refer to the Meter option section in this chapter), or
•
manually by selecting the 
 button.
2
If you are going to eat, enter your food amount in grams or exchanges.
3
The Bolus Wizard feature will calculate a bolus for you. An ESTIMATE DETAILS screen will appear with
your estimated total bolus amount.
Bolus Wizard warnings
When using the Bolus Wizard feature, the pump may display a HIGH BG, LOW BG, and MAX BOLUS
EXCEEDED warnings.
HIGH BG
If your blood glucose in the ENTER BG screen is above 250 mg/dL (13.9 mmol/L), the Bolus Wizard feature
displays a HIGH BG warning. Read the instructions, then press ACT or ESC to clear the message. You can
then continue programming to deliver your bolus.
Using the Bolus Wizard feature
75
Chapter 6

LOW BG
If your blood glucose in the ENTER BG screen is below 70 mg/dL (3.9 mmol/L), the Bolus Wizard feature
displays a LOW BG warning. Read the instructions, then press ACT or ESC to clear the message. You can
then continue programming to deliver your bolus.
MAX BOLUS EXCEEDED
Bolus Wizard feature will not deliver more than the limit set for your maximum bolus. If the Bolus Wizard
feature calculates a bolus amount that is larger than your max bolus limit setting, the message, MAX
BOLUS EXCEEDED will appear. If this happens, do these steps:
1
In the MAX BOLUS EXCEEDED screen, press ACT to continue your bolus programming. The EST : MAX
screen appears with the estimated and maximum bolus amounts. Continue to the next step.
If you do not want to continue, press ESC to cancel and the screen will return to the ENTER BG screen.
2
In the EST : MAX screen, press ACT again to continue your bolus programming.
3
The SET BOLUS screen appears with the maximum bolus amount flashing. Enter the bolus amount. This
amount cannot be more than the max bolus amount. Press ACT.
4
The BOLUS DELIVERY screen appears showing the insulin units being delivered.
5
The pump will beep/vibrate after it has completed the insulin delivery.
How to program the Bolus Wizard feature
You need your personal settings from the Bolus Wizard feature settings table to setup the Bolus Wizard
feature. Your Bolus Wizard feature settings are programmed in the EDIT SETTINGS screen.
Main > Bolus > Bolus Wizard Setup > Edit Settings
Once the settings are programmed, you do not have to program them again unless the values change.
After you program one setting, the screen will automatically go to the next required setting. After you
program all your settings, review them as described in this section to make sure they are set correctly.
Instructions for programming the Bolus Wizard feature settings are in the next paragraphs. Program your
settings in the order described to make sure you program all the settings. If you have not completed
setting up all of the required settings, MISSING INFO screen appears. It lists the required settings for this
feature. You must program the listed settings before you can use the Bolus Wizard feature.
Using the Bolus Wizard feature
76

Turning on the Bolus Wizard feature 
1
Go to the EDIT SETTINGS screen.
Main > Bolus > Bolus Wizard Setup > Edit Settings
2
The EDIT SETTINGS screen appears with Wizard: Off selected. Press ACT.
3
The WIZARD ON/OFF screen appears. Select On, then press ACT.
4
The EDIT SETTINGS screen appears, showing that the wizard is now turned on. You are now ready to
select your carb units.
Selecting the Carb units 
The carb unit setting lets the pump know which way to count your carbohydrates (grams or exchanges).
Any time you make changes to the carb units, you must also reprogram the carb ratios. Refer to the Bolus
Wizard feature settings table in this chapter for your carb ratio settings.
1
Make sure the EDIT SETTINGS screen is open.
Main > Bolus > Bolus Wizard Setup > Edit Settings
2
Select Carb Units, then press ACT.
3
The CARB UNITS screen appears. Select Grams or Exchanges, then press ACT.
4
The EDIT SETTINGS screen shows the carb units you selected. You are now ready to set your carb/
exchange ratios.
Setting the Carb/Exch ratios
Your pump allows you to set up to eight Carb/Exch ratios because this ratio may vary throughout the day.
Your healthcare professional may only have you program one or two carb ratios when you first start using
the Bolus Wizard feature.
 
To set the Carb/Exch ratios:
1
Make sure the EDIT SETTINGS screen is open.
Main > Bolus > Bolus Wizard Setup > Edit Settings
Using the Bolus Wizard feature
77
Chapter 6

2
Select Carb Ratios, then press ACT.
•
If you use grams as your carb units: Carb ratio is the number of carb grams that are covered by
one (1.0) unit of insulin. 
•
If you use exchanges as your carb units: Carb ratio is the number of insulin units that are needed
to cover one (1.0) carb exchange. 
3
The SET CARB RATIO 1 (if you are using grams) or SET EXCH RATIO 1 (if using exchanges) screen
appears. The default ratio flashes on the screen.
4
Set your first ratio, then press ACT. Carb ratio values are normally between 5-50 grams/u or 0.3-3.0
u/exch. If your ratio value is outside the range, a warning message will appear on the screen. This
message warns that the entered carb ratio is valid but outside the usual range. Press ESC to correct or
ACT to continue.
The start time for your first ratio is midnight and cannot be changed.
5
The SET START TIME 2 screen appears. The dashes under the screen name flash. The first Carb Ratio or
Exchange Ratio is now set.
If you do not need a second ratio, press ESC and skip to the next section. If you need to set up another
ratio, follow steps 6 through 9.
6
In the SET START TIME 2 screen, enter the time of the day you want this ratio to become active.
7
Press ACT. The SET CARB RATIO 2 screen (if using grams) or SET EXCH RATIO 2 screen (if using
exchanges) appears.
8
The default ratio flashes. Select your ratio.
9
Press ACT. The SET START TIME 3 screen appears. The second carb or exchange ratio is now set.
10 If you do not need to set up any more ratios, press ESC. If you need to set up more ratios, repeat steps
6 through 9 above for each ratio.
You are now ready to set up the BG units.
Setting the BG units 
You can select mmol/L or mg/dL as your Blood Glucose Unit (measurement type). If you make changes to
your BG settings, you must reprogram your insulin sensitivity and BG targets.
1
Make sure the EDIT SETTINGS screen is open.
Main > Bolus > Bolus Wizard Setup > Edit Settings
2
Select BG Units, then press ACT.
3
The BLOOD GLUCOSE UNITS screen displays. Select mmol/L or mg/dL, then press ACT.
4
The EDIT SETTINGS screen shows the BG units you selected. You are now ready to set your insulin
sensitivity.
Using the Bolus Wizard feature
78

Insulin sensitivity 
Your insulin sensitivity is the amount your blood glucose (BG) level is reduced by one unit of insulin. This
value is used to calculate a suggested insulin dose to correct a high BG. Because this sensitivity may vary
throughout the day, your pump lets you set up to eight sensitivity settings. Your healthcare professional
may only have you program one or two insulin sensitivities when you first start using the Bolus Wizard
feature. Record your settings in the Bolus Wizard feature settings table in this chapter.
Insulin sensitivity values are normally between 20 - 100 mg/dL (1.1 - 5.6 mmol/L). If your value is outside
this range, a warning message will appear on the screen.
1
Make sure the EDIT SETTINGS screen is open.
Main > Bolus > Bolus Wizard Setup > Edit Settings
2
Select Sensitivity, then press ACT.
3
The INS SENSITIVITY 1 screen appears. The default sensitivity value flashes on the screen.
4
Set the value for your first insulin sensitivity setting, then press ACT.
The start time for your first insulin sensitivity is midnight and cannot be changed.
5
The SET START TIME 2 screen appears. The dashes under the screen name flash. The first insulin
sensitivity is now set.
If you do not need a second insulin sensitivity, press ESC and skip to the next section. If you need to
set up another insulin sensitivity, follow steps 6 through 9.
6
In the SET START TIME 2 screen enter the time of the day you want this insulin sensitivity to become
active.
7
Press ACT. The INS SENSITIVITY 2 screen appears.
8
The default sensitivity value flashes. Select the value for this insulin sensitivity.
9
Press ACT. The SET START TIME 3 screen appears. The second insulin sensitivity is now set.
10 If you do not need to set up any more insulin sensitivities, press ESC. If you need to set up more
insulin sensitivities, repeat steps 6 through 9 above for each insulin sensitivity.
You are now ready to set up the BG Target.
Using the Bolus Wizard feature
79
Chapter 6

Setting the BG Targets 
The BG Target setting allows you to set
glucose targets. The Bolus Wizard will use
these targets to calculate a correction dose.
Because the targets may vary throughout the
day, your pump allows you to set up to eight
BG targets each day. If you want to set just
one target value, instead of a range, set
both the low and high values to the same
number.
If your current BG is above the BG Target
range, the Bolus Wizard feature may
calculate a correction dose. A correction
dose will deliver enough insulin to bring your
BG down to your current high end of the BG
Target range. If your current BG is below the BG Target range, the Bolus Wizard may calculate a negative
correction and subtract it from your food bolus. This will bring your BG to the low end of the BG Target
range.
Pumps are sent from the factory with default BG target range of 100-100 mg/dL (5.6-5.6 mmol/L).
1
Make sure the EDIT SETTINGS screen is open.
Main > Bolus > Bolus Wizard Setup > Edit Settings
2
Select BG Target, then press ACT.
3
The TARGET RANGE 1 screen appears. The low end of your BG Target range flashes on the screen.
4
Set the BG Target, then press ACT.
5
The high end of your BG Target range flashes on the screen. Enter the BG Target, then press ACT.
The start time for your first BG Target is midnight and cannot be changed.
6
a. If you adjust your BG Targets outside of 90-140 mg/dL (5.0-7.8 mmol/L), the pump screen displays
a warning that the values are acceptable but outside normal range. Press ESC to change your BG
target or press ACT to set this range.
b. If your BG target is within 90-140 mg/dL (5.0-7.8 mmol/L), the SET START TIME 2 screen appears.
The dashes under the screen name flash. The first BG target range is now set.
If you do not need a second BG Target range, press ESC and skip to the next section. If you need to
set up another BG Target range, follow steps 7 through 11.
Glucose Concentration
22.2
13.9
5.6
3.8
400
250
100
70
mmol/L
mg/dL
Correct down to the upper 
limit of 100 mg/dL
Correct up to the lower limit 
of 70 mgl/dL
Target Range
Using the Bolus Wizard feature
80

7
In the SET START TIME 2 screen enter the time of the day you want this BG Target range to become
active.
8
Press ACT. The TARGET RANGE 2 screen appears.
9
The low end of your BG Target range flashes on the screen. Set the BG Target, then press ACT.
10 The high end of your BG Target range flashes on the screen. Enter the BG Target, then press ACT.
11 The SET START TIME 3 screen appears. The second BG Target range is now set.
12 If you do not need to set up any more BG Target ranges, press ESC. If you need to set up more BG
Target ranges, repeat steps 7 through 11 above for each one.
You are now ready to set up the Active insulin time.
About active insulin
Active insulin is the bolus insulin that has already been delivered to your body, but has not yet been used.
The pump considers your active insulin time setting in determining any active insulin still in your body
from prior boluses. This may help prevent hypoglycemia caused by over-correcting for high blood glucose.
The Bolus Wizard feature automatically tracks active insulin for you, based on your active insulin time,
and subtracts the appropriate amount when your blood glucose is above your target range. The details will
appear in the ESTIMATE DETAILS screen during the bolus programming steps.
Your Paradigm pump is shipped from the factory with an active insulin time setting of six hours, which
most closely matches the published scientific data. If your healthcare professional prescribes a different
time for you, the active insulin time setting can be adjusted in the Bolus Wizard menu in one-hour
increments from two to eight hours.
For more details about active insulin, see the Bolus Wizard feature specifications section in the Pump
specifications chapter.
CAUTION: If you give yourself insulin by using a syringe, the Bolus Wizard feature will not be able to
correctly determine the active insulin in your system. Consult with your healthcare professional on
how long you need to wait after a manual injection before you can rely on the active insulin
calculation of your Bolus Wizard feature.
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81
Chapter 6

Active insulin time
The active insulin time setting lets the pump know which active insulin time to use in calculating the
amount of active insulin to subtract before estimating a bolus. Your healthcare professional should
determine the active insulin time that is best for you. 
 
To set the Active insulin time, do the following steps:
1
Make sure the EDIT SETTINGS screen is open.
Main > Bolus > Bolus Wizard Setup > Edit Settings
2
Select Active Ins Time, then press ACT.
3
The ACTIVE INS TIME screen appears. The default time of six hours flashes on the screen.
4
Set the number of hours for the active insulin time, then press ACT.
5
The EDIT SETTINGS screen shows the new Active insulin time setting. You have now completed the
Bolus Wizard setup. Press ESC or wait to see the message: Bolus Wizard setup is complete.
Review your Bolus Wizard feature settings
Check your Bolus Wizard feature settings in the REVIEW SETTINGS screen. If necessary, compare this
information with your information in the Bolus Wizard feature settings table.
1
Go to the REVIEW SETTINGS screen.
Main > Bolus > Bolus Wizard Setup > Review Settings
2
Scroll through the text to view your Bolus Wizard settings.
3
Exit the menus when you are done.
Using the Bolus Wizard feature
82

Meter option
Paradigm Link
™
 and OneTouch
®
 UltraLink
™
 glucose meters can
be programmed to communicate wirelessly to the Paradigm
®
insulin pump. When the wireless feature is turned on, glucose
values transmitted from these meters to the pump are stored
in memory and used for glucose sensor calibration.
Your monitor is set at the factory with the meter option
turned off. If you have turned your meter option on, you
should turn off the wireless feature when using your glucose
sensor. By doing so, you can manually enter calibration
glucose values when glucose is stable and not changing
rapidly.
Instructions for turning the wireless feature OFF are outlined below.
•
From the MAIN MENU, select UTILITIES and press ACT
•
Scroll to METER OPTION and press ACT
•
Select OFF and press ACT
You can set up your pump to automatically receive your blood glucose reading from a LifeScan OneTouch
®
UltraLink™ Meter or the BD Paradigm Link
®
 Meter. This meter may not be available in all countries.
Programming your meter ID links your pump to the meter. If you do not link the meter to your pump, you
will enter your blood glucose readings manually. Each meter has its own unique ID. You can link up to
three meters to your pump.
When the pump is idle (at the HOME screen), it will beep or vibrate when it receives a blood glucose
reading from the meter. The reading will appear on the pump screen.
Meter
BG readings
NOTE: 
The use of RF (radio frequency) devices with the pump reduces pump battery life.
 
You have to turn on the meter option to add, delete or review the meter ID(s) programmed in your pump.
The meter ID is the serial number printed on the back of the meter. See the user guide that came with
your meter for detailed information on how to use it.
Using the Bolus Wizard feature
83
Chapter 6

Meter rules 
 
If you want your pump to communicate with the meter, the following conditions must apply:
1
The meter option must be turned on and programmed. Refer to the instructions in this section.
2
Your pump must be within 4 feet (1.2 meters) of your meter to receive the blood glucose reading.
3
The pump cannot have a LOW BATTERY alert condition.
4
When programming a bolus, the blood glucose measurement from the meter will appear as the default
blood glucose value on the ENTER BG screen. The pump will not display a reading that is older than 12
minutes on the ENTER BG screen.
5
Do not use the RF meter to send your blood glucose readings to the pump while onboard aircraft.
Manually enter your blood glucose.
CAUTION: The pump will not receive signals from the meter while it has a LOW BATTERY condition. To
ensure the meter communicates with the pump, make sure the pump does not have a low battery.
(Replacing the low battery with a new battery will restore meter-pump communication.) 
Add, delete, review meter IDs 
The meter programming screens are very similar to those for the remote control. Make sure to select
Meter Options in the UTILITIES MENU screen when programming your meter.
If you are not sure that your meter ID is entered in your pump, check the REVIEW METER ID screen.
You have to turn on the meter option to add, delete, or review the meter ID(s) programmed in your pump.
1
Go to the METER OPTION screen.
Main > Utilities > Meter Options
2
Select On, then press ACT. The METER ID MENU appears. 
3
Add, delete or review your meter ID(s) as desired.
Adding meter IDs
a. Select Add ID, then press ACT.
b. Use the up and down arrow buttons to enter each of the six ID characters. Press ACT after each
entry.
c. After you set the last character of the ID, the screen will return to the METER ID MENU.
Using the Bolus Wizard feature
84

Deleting meter IDs
a. Select Delete ID, then press ACT.
b. Select the meter ID that you want to delete and press ACT.
c. The selected ID is now deleted.
Reviewing meter IDs
a. Select Review ID, then press ACT.
b. The programmed IDs will show in the REVIEW METER ID screen.
4
Exit the menus when you are done.
Normal bolus using Bolus Wizard feature
After the Bolus Wizard feature is turned on and programmed, this feature can calculate an estimate of
insulin you need for your correction bolus and/or your food bolus. You have the option of using the
estimate or changing it as necessary. Additionally, your pump can receive your blood glucose reading from
the meter, if they are linked. 
Use the 
 button to deliver a Normal bolus at any time except during another Normal bolus. A Normal
bolus will temporarily interrupt a Square Wave or Dual Wave bolus that is delivering. After the Normal
bolus is finished, the Square Wave or Dual Wave bolus delivery will resume.
NOTE: 
If you want to use the pump-to-meter link, make sure the meter option is on. Refer to the
Meter option section in this chapter for instructions.
 
1
If you want a correction bolus, check your blood glucose with your blood glucose meter and go to step
2. If you want to bolus for food, go to step 2.
2
Press 
 on your pump, or go to the BOLUS MENU, select Use Bolus Wizard, and press ACT.
3
The ENTER BG screen will appear.
a. If you are not using the meter:
Enter your blood glucose value. Press ACT and continue to step 4. If you are not entering a blood
glucose and want to bolus for food, select the dashes in the ENTER BG screen. The Bolus Wizard
feature will calculate the insulin needed for your food entry without considering your blood
glucose level. Press ACT and continue to step 4.
b. If you are using the meter, you must program your bolus within 12 minutes of the pump receiving
the reading from the meter. If more than 12 minutes have passed, the reading will no longer be
available from the screen and you must enter your blood glucose manually.
Using the Bolus Wizard feature
85
Chapter 6

Your pump checks if the entered BG is within your target range. Press ACT to accept the Blood
glucose value. You can change this blood glucose value, if necessary, then press ACT. Continue to
step 4.
4
The ENTER FOOD screen appears.
a. If this is a food bolus, enter the food value you will eat, then press ACT.
b. If this is a correction bolus, select 0 (zero) as the value, then press ACT.
5
The ESTIMATE DETAILS screen appears. Review the information on this screen. If you need to make any
changes, press ESC to return to the ENTER BG screen (step 3) and make changes as necessary.
6
Press ACT in the ESTIMATE DETAILS screen. The SET BOLUS screen appears with the estimated bolus
amount flashing. Change the amount if desired. Press ACT to accept and start delivering your bolus.
NOTE: 
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. See the
BG Reminder section in the Basic programming chapter for information about this feature.
 
7
The BOLUS DELIVERY screen appears. The pump will beep or vibrate at the start and end of the bolus.
As the bolus is delivered, the screen shows the bolus type and amount until the total units have been
delivered. The screen then returns to the HOME screen.
Bolus Wizard feature examples
For the scenarios that follow, Michael has his Bolus Wizard feature turned on with the following settings:
Carb ratio: 15 grams per unit of insulin
Insulin Sensitivity: 40 mg/dL (2.2 mmol/L) per unit of
insulin
BG Target: 90 - 120 mg/dL (5.0 - 6.6 mmol/L)
Active Insulin Time: 6 hours
NOTE: 
If you want to see details of the formulas the Bolus Wizard feature uses to calculate estimate
boluses like the ones in the following examples, see the Bolus Wizard feature specifications section in the
Pump specifications chapter.
 
Using the Bolus Wizard feature
86

Example 1: Blood glucose on target (normal blood glucose) and no active insulin
Michael awakens in the morning before school and his mother has breakfast waiting for him. Before he
begins eating, he tests his blood glucose with his meter and his blood glucose result of 6.6 mmol/L (120
mg/dL) is automatically sent to his pump.
He estimates that his meal consists of 60 grams of carbohydrates. When prompted by the Bolus Wizard
feature, he enters this amount in the ENTER FOOD screen. Based on his Bolus Wizard feature settings,
the pump will suggest that he take 4.0 units of insulin.
(food estimate)
60 g
15 g/u
= 4 units
+
(correction estimate)
= 4 + 0
= 4 units
bolus estimate
Correction is 0 because the 
current blood glucose reading 
is within the BG Target Range.
Example 2: Blood glucose above target (high blood glucose) and no active insulin
The next day, Michael wakes up before school. Before eating the same breakfast, he tests his blood
glucose with his meter and finds it to be 200 mg/dL (11.1 mmol/L), which is above his target of 120
mg/dL (6.6 mmol/L). His blood glucose reading is automatically sent to his pump.
When prompted by the Bolus Wizard feature, he enters his carbohydrate amount of 60 grams in the
ENTER FOOD screen. Based on his settings, the pump will suggest that he take 6.0 units of insulin.
(food estimate)
60 g
15 g/u
= 4 units
= 2 units
+
(correction estimate)
= 4 + 2
= 6 units
bolus estimate
11.1 mmol/L - 6.6 mmol/L
2.2 mmol/L/u
= 2 units
200 mg/dL - 120 mg/dL
   40 mg/dL/u
Using the Bolus Wizard feature
87
Chapter 6

Example 3: Blood glucose below target (low blood glucose) and no active insulin
On another morning, Michael sits down before eating the same breakfast. He tests his blood glucose
with his meter and finds it to be at 70 mg/dL (3.9 mmol/L), which is below his Low BG Target of v (5.0
mmol/L). His reading is automatically sent to his pump.
When prompted by the Bolus Wizard feature, he enters his carbohydrate amount of 60 grams in the
ENTER FOOD screen. Based on his settings, the pump will suggest that he only take 3.5 unit of insulin.
(food estimate)
60 g
15 g/u
= 4 units
= -0.5 units
+
(correction estimate)
= 4 + (-0.5)
= 3.5 units
bolus estimate
3.9 mmol/L - 5.0 mmol/L
2.2 mmol/L/u
= -0.5 units
70 mg/dL - 90 mg/dL
   40 mg/dL/u
Example 4: Blood glucose above target (high blood glucose) with active insulin
Michael is at school and wants to eat a snack in the late morning. He tests his blood glucose with his
meter and finds it to to be at 200 mg/dL (11.1 mmol/L), which is above his target of 120 mg/dL (6.6
mmol/L). He estimates that his snack contains 60 grams of carbohydrate, so he enters 60 into the pump
when prompted by the Bolus Wizard feature. Based on his settings, and as a result of 1.5 units of active
insulin, his pump will suggest that he take 4.5 units.
(food estimate)
60 g
15 g/u
= 4 units
- 1.5 units (active insulin) = 0.5 units
+
(correction estimate)
= 4 + 0.5
= 4.5 units
bolus estimate
11.1 mmol/L - 6.6 mmol/L
2.2 mmol/L/u
- 1.5 units (active insulin) = 0.5 units
200 mg/dL - 120 mg/dL
   40 mg/dL/u
Using the Bolus Wizard feature
88

Example 5: Blood glucose below target (low blood glucose) with active insulin
Another day at school, Michael is getting ready to eat lunch. He tests his blood glucose with his meter
and finds it to be at 70 mg/dL (3.9 mmol/L), which is below his Low BG Target of 90 mg/dL (5.0
mmol/L). His reading is automatically sent to his pump.
When prompted by the Bolus Wizard feature, he enters his carbohydrate amount of 60 grams in the
ENTER FOOD screen. Based on his settings, and despite 1.5 units of active insulin, his pump will suggest
that he take 3.5 units of insulin.
(food estimate)
60 g
15 g/u
= 4 units
- 0* units (active insulin) = 0.5 units
+
(correction estimate)
= 4 + (-0.5)
= 3.5 units
bolus estimate
3.9 mmol/L - 5.0 mmol/L
2.2 mmol/L/u
- 0* units (active insulin) = 0.5 units
70 mg/dL - 90 mg/dL
   40 mg/dL/u
NOTE: 
*When the current blood glucose is below the target low blood glucose, the active insulin
amount is not considered in the Bolus Wizard feature calculations.
 
Using the Bolus Wizard feature
89
Chapter 6

Using the Bolus Wizard feature
90

Optimizing pump therapy
Square Wave and Dual Wave bolus
Square Wave bolus delivers a bolus evenly over a period of time (30 minutes to 8 hours). This bolus can be
used for insulin delivery when you have eaten a long meal with extended snacking. It can also be useful if
you have delayed food digestion due to gastroparesis or meals high in fat. A Square Wave bolus can be
useful if a Normal bolus drops your blood glucose too rapidly. Since the Square Wave portion extends over
a period of time, the insulin is more likely to be available to match your individual needs. 
NOTE: 
During delivery of a Square Wave bolus, you will not be able to do the following pump functions:
change the max bolus amount, disable or deliver Dual and Square Wave boluses, rewind or do a fixed
prime, change the active insulin time, run a self-test, or access the User Settings menu. All other pump
functions are still available during the Square Wave bolus.
 
Dual Wave bolus delivers a combination of an immediate Normal bolus followed by a Square Wave bolus.
The Square Wave portion is delivered evenly over a period of time. A Dual Wave bolus is useful for meals
with both rapidly and slowly absorbed carbohydrates. For example, a Dual Wave bolus would be
appropriate for fruit and crackers followed by pasta. The Dual Wave option meets both immediate and
extended insulin needs. A Dual Wave bolus is also useful for correcting elevated blood glucose before a
meal. 
Optimizing pump therapy
91
Chapter 7

See the following graphic for a description of the different bolus types:
TIME
INSULIN
1
2
3
DUAL WAVE
BOLUS
SQUARE WAVE
BOLUS
NORMAL
BOLUS
Now
Portion
Square
Portion