Insulin pump and continuous glucose monitoring system

Insulin rate (U/H) 
Insulin rate is a fixed basal in units per hour (U/H). This temp basal type is independent of your current
basal. When you select Insulin rate (U/H) for your temp basal type, your pump will deliver the fixed
amount you have set for the duration as set. The amount of your temp basal insulin rate can be set up to
your Maximum basal rate setting.
If you make changes to your normal basal rate, your U/H temp basal is not affected and will continue to
deliver as programmed.
Optimizing pump therapy
103
Chapter 7

1.50 U/H
(rate 1)
2.55 U/H
(rate 2)
1.95 U/H
(rate 3)
1.25 U/H
temp basal rate
7:00 a.m.
(7:00)
1:05 p.m.
(13:05)
3:00 p.m.
(15:00)
5:05 p.m.
(17:05)
12:00 a.m.
(00:00)
Temp Basal Settings
Temp basal type: Insulin rate (U/H)
Duration: 4 hours (1:05 p.m.-5:05 p.m.)
Rate: 1.25 U/H
1.25 
U/H
1.25 
U/H
Optimizing pump therapy
104

Percent of basal
Unlike insulin rate, the percent of basal is dependent on your current basal rates. Percent temp basal is a
percentage of your current basal (0 - 200 percent limited to your Maximum basal rate setting). The temp
basal amount is rounded down to the next 0.025 or 0.05 U/H increment based on the basal rate.
The maximum percent limit is based on the largest basal rate segment with your programmed temp basal
rate time.
For example: It is 06:00 a.m. and your current basal rate is 1.50 U/H. You want to set a temp basal rate of
130 percent for seven hours. The maximum percent temp basal rate you can set is 125 percent. Anything
larger would make #2 segment exceed your Maximum basal setting of 2.0 U/H.
Your current basal rates:
Your Maximum basal rate setting: 2.0 U/H
Segment #1: 00:00
1.50 U/H
Segment #2: 11:00
1.60 U/H (largest)
Segment #3: 16:00
1.30 U/H
If your current basal changes (for example, from rate 1 to rate 2), your percent temp basal amount will
also change. The pump will deliver the percentage for the duration that you have set.
You cannot make changes to your normal basal rate while a percent temp basal is active. You must either
wait until the temp basal is finished or cancel the temp basal in order to reprogram your normal basal rate
setting(s).
NOTE: 
The pump delivers basal amounts in 0.05 U/H increments. Because of this, your temp basal
amount will be rounded down to the next 0.05 U/H increment.
 
Optimizing pump therapy
105
Chapter 7

1.50 U/H
(rate 1)
2.55 U/H
(rate 2)
1.25 
U/H
1.95 U/H
(rate 3)
(50% x rate 3 = 0.975)
0.975 rounded down to 
the next 0.05 increment 
is 0.95 U/H
(50% x rate 2 = 1.275)
1.275 rounded down to 
the next 0.05 increment is 
1.25 U/H
7:00 a.m.
(07:00)
1:05 p.m.
(13:05)
3:00 p.m.
(15:00)
5:05 p.m.
(17:05)
temp basal stop time
12:00 a.m.
(00:00)
Temp Basal Settings
Temp basal type: Percent of basal
Duration: 4 hours (1:05 p.m. - 5:05 p.m.)
Rate: 50%
temp basal start time
0.95 
U/H
Optimizing pump therapy
106

Selecting temp basal type 
Your pump will remember the temp basal type setting. Once the type is set, you do not have to set it
again. To select a temp basal type, do these steps:
1
Go to the SET TEMP BASAL AS screen.
Main > Basal > Temp Basal Type
2
The SET TEMP BASAL AS screen appears. Select Insulin Rate (U/H) or Percent of Basal, then press
ACT.
3
The screen will return to the BASAL MENU screen. The temp basal type is now set. Exit the menus.
If you select Percent of Basal as your temp basal type, changes to your basal rate are not allowed
until after temp basal is completed or cancelled.
Delivering a temp basal 
A temp basal cannot exceed your programmed Max basal rate.
1
Go to the BASAL MENU.
Main > Basal
2
Select Set/Edit Temp Basal, then press ACT.
3
The SET DURATION screen appears. The duration will flash. Duration is the amount of time it will take
for the pump to deliver the temporary basal. Enter the desired minutes or hours (30 minutes to 24-
hours), then press ACT.
4
If you have selected insulin rate as your temp basal type, the SET TEMP BASAL U/H screen appears. If
you have selected percent of basal as your temp basal type, the SET TEMP BASAL % screen appears.
The temporary basal rate will flash. Enter your temp basal rate, then press ACT.
5
The BASAL MENU screen appears with an open circle at the top of the screen. Your pump is in Special
mode; temp basal is now set and delivering. Exit the menus.
Optimizing pump therapy
107
Chapter 7

Verifying temp basal delivery 
Press down button 
to  scroll
Temp Basal of 
0.6 units per hour 
is now active
Temp Basal delivery 
will last 30 minutes
4 minutes remaining 
before Temp Basal 
delivery is finished
Regular programmed 
basal rate will 
resume after the 
Temp Basal delivery 
is finished
Temporary basal information is available in the STATUS screen only.
During a temporary (temp) basal, the pump is in Special mode (an open circle appears). This open circle
will remind you that a temp basal is active. Additionally, your pump will beep/vibrate three times every
hour during delivery. During delivery, go to the STATUS screen to see the current temp basal information.
Canceling a temp basal 
Use the Cancel Temp Basal function in the BASAL MENU to cancel a temporary basal. This function
immediately stops the temp basal and resumes the regular programmed basal delivery.
 
To cancel a temp basal, do these steps:
1
Go to the BASAL MENU.
Main > Basal
2
Select Cancel Temp Basal, then press ACT.
The screen will return to the BASAL MENU. Your temp basal is cancelled and open circle has
disappeared from the top of the screen. The programmed basal is now active again. Exit the menus.
Optimizing pump therapy
108

Example 1: 
Temp Basal for a decreased temporary basal rate
Ramon and his friends got together for an unplanned game of soccer. Before using the pump, he was
taking shots to manage his diabetes. Ramon experienced frequent low blood glucose reactions
sometimes during, and very often after, he played games with his friends. Now that he is using his
Paradigm pump, he can use the Temporary Basal Rate feature to help prevent low blood glucose. He
simply programs his pump to temporarily deliver less basal insulin during the time that he is playing, and
often for several hours after play, as well.
Ramon was able to determine how to set his Temporary Basal rates by frequent blood glucose testing,
both during and after activity, and recording his results. The first time he tried using the pump, his
healthcare professional advised him to program his pump to deliver one-half of his usual basal rate for
the amount of time that he was playing and for an hour after he was done. He made small adjustments
of the temporary basal rate and the duration of time, each time he tried to use the feature. After
several different attempts with similar activity for the same amount of time, (such as his soccer game
that lasted two hours), he found a temporary basal rate that worked well for him.
Example 2: 
Temp Basal for an increased temporary basal rate
Gail has had a cold with a cough for a couple of days. Because she is not feeling well, she tests her
blood glucose more frequently. She finds that her blood glucose levels are running above target range
before meals and she has needed several correction boluses to keep her blood glucose levels within her
normal limits. Gail decides to use the Temporary Basal Rate to increase her basal rate during the day
today. As advised by her healthcare professional, she will continue to check her blood glucose more
frequently until she is feeling well.
Optimizing pump therapy
109
Chapter 7

Your turn:
Think of an activity where you might need to use a Temporary Basal Rate.
At what rate is your current basal rate running? ____________
What Temporary Basal Rate would you try using at this time? ___________________
How long will you be active?___________________
What duration will you set for the Temporary Basal Rate?________________
Test your blood glucose before and during activity and several times after as well. What are your blood
glucose results?
Pre-activity______________
During activity______________
1 hour after activity______________
Several hours after activity______________
What Temporary Basal Rate changes will you make for the next time you try this?
Optimizing pump therapy
110

Sensor features
The optional sensor and transmitter can provide continuous glucose measurements to help you control
your glucose levels better. The sensor measures the glucose levels in the fluid under your skin. The
transmitter receives this measurement from the sensor and sends it wirelessly to the pump. To take
advantage of your pump sensor features, call 800-646-4633, [phone] (outside U.S.), or visit our
web site at www.medtronicdiabetes.com to purchase your sensor and transmitter.
The sensor glucose and meter blood glucose measurements are not identical. To see the accuracy of the
sensor glucose measurements, see the Sensor accuracy appendix.
Entering your sensor settings
Enter your pump sensor settings in the order they appear below, as some of the settings are dependent
upon other settings being made first. When you complete each setting, your pump will automatically
display the screen for the next setting in the sequence. When a screen item flashes, you may change the
value of the flashing item by pressing 
 or 
. 
Turning on the sensor
The sensor must be turned on, started and initialized to report glucose measurements.
1
Go to the EDIT SETTINGS screen.
Main > Sensor > Sensor Setup > Edit Settings
The EDIT SETTINGS screen appears with Sensor: Off selected.
2
Press ACT. The SENSOR ON/OFF screen appears. 
3
Select On, then press ACT. The EDIT SETTINGS screen appears showing the sensor is now turned on.
You are now ready to set up the sensor features.
Sensor features
111
Chapter 8

Selecting the BG units
You must select the blood glucose units (BG Units) for the system (either mmol/L or mg/dL). All BG
measurements will show in the BG unit type you select.
If you have turned on your Bolus Wizard feature, BG units will not be available for sensor setup. Please go
to the Setting the BG units section of the Using the Bolus Wizard feature chapter for details.
1
Make sure the EDIT SETTINGS screen is open.
Main > Sensor > Sensor Setup > Edit Settings
2
Select BG Units, then press ACT. The BLOOD GLUCOSE UNITS screen shows mg/dL and mmol/L.
3
Select your BG units.
4
Press ACT. The EDIT SETTINGS screen shows the BG Units type you selected.
You are now ready to set up your High Glucose limit.
High Glucose Alert
Your High Glucose alert must be turned on if you want your pump to alert when the sensor glucose
measurement reaches or goes above your set High Glucose limit.
 
To turn on your High Glucose alert, and to set the High Glucose limit:
1
Make sure the EDIT SETTINGS screen is open.
Main > Sensor > Sensor Setup > Edit Settings
2
Select High Glucose, then press ACT.
3
Select On, then press ACT. The SET HIGH GLUCOSE screen flashes the default High Glucose limit of
200 mg/dL (11.2 mmol/L).
4
Select your High Glucose limit between 110–400 mg/dL (2.8–22.2 mmol/L). Your High Glucose limit
must be at least 10 mg/dL (0.6 mmol/L) above your Low Glucose limit.
5
Press ACT. The EDIT SETTINGS screen shows the High Glucose value you selected. You are now ready
to set up your High Snooze.
Sensor features
112

Setting the High Snooze
After you receive and clear a High Glucose alert, it will repeat until the high glucose condition is resolved.
The High Snooze feature allows you to set how frequently you want the High Glucose alert to repeat after
you clear it the first time. For example, if your blood glucose levels usually take one to two hours to fall
after a correction bolus, you may want to set the High Snooze to one or two hours to avoid unnecessary
alerts.
Example
You set your High Snooze to 15 minutes. You receive an alert at 1:00 pm and immediately clear it.
However, the high glucose condition that caused the alert still exists, so you will receive a second alert at
1:15 pm, 15 minutes after you cleared the first alert. If you immediately clear the alert again, then the
alert will repeat at 1:30 pm and continue to repeat every 15 minutes until you resolve the condition that
caused the alert. (This example also applies to the Low Snooze.)
 
To set up your High Snooze:
1
Make sure the EDIT SETTINGS screen is open. 
Main > Sensor > Sensor Setup > Edit Settings
2
Select High Snooze, then press ACT. The SET HIGH SNOOZE screen flashes the default High Snooze
time of 1 hour (1:00).
3
Select your High Snooze time. The time must be between five minutes (0:05) and three hours (3:00).
4
Press ACT. The EDIT SETTINGS screen shows the High Snooze time set.
You are now ready to set up your Low Glucose limit.
Low Glucose Alert
Your Low Glucose alert must be turned on if you want your pump to alert when the sensor glucose
measurement reaches or goes below your set Low Glucose limit.
 
To turn on your Low Glucose alert, and to set the Low Glucose limit:
1
Make sure the EDIT SETTINGS screen is open.
Main > Sensor > Sensor Setup > Edit Settings
2
Select Low Glucose, then press ACT.
3
Select On, then press ACT. The SET LOW GLUCOSE screen flashes the default Low Glucose limit of 50
mg/dL (2.8 mmol/L).
Sensor features
113
Chapter 8

4
Select your Low Glucose limit between 40–390 mg/dL (2.2–21.6 mmol/L). Your Low Glucose limit must
be at least 10 mg/dL (0.6 mmol/L) below your High Glucose limit.
5
Press ACT. The EDIT SETTINGS screen shows the Low Glucose value set. You are now ready to set up
your Low Snooze.
Setting the Low Snooze
After you receive and clear a Low Glucose alert, it will repeat until the low glucose condition is resolved.
The Low Snooze feature allows you to set how frequently you want the Low Glucose alert to repeat after
you clear it the first time. The Low Snooze feature works similar to the High Snooze. See the Setting the
High Snooze section in this chapter for an example. 
1
Make sure the EDIT SETTINGS screen is open.
Main > Sensor > Sensor Setup > Edit Settings
2
Select Low Snooze, then press ACT. The SET LOW SNOOZE screen flashes the default Low Snooze time
of 20 minutes (0:20).
3
Select your Low Snooze time. The time must be between 5 minutes (0:05) and 1 hour (1:00).
4
Press ACT. The EDIT SETTINGS screen shows the Low Snooze time you selected. You are now ready to
set up the Alarm Snooze.
Setting the Alarm Snooze 
After you receive and clear a METER BG NOW alert, the device will repeat the alert until you enter a new
meter blood glucose measurement. The Alarm Snooze feature allows you to set how frequently you want
the alert to repeat after you clear it.
1
Make sure the EDIT SETTINGS screen is open.
Main > Sensor > Sensor Setup > Edit Settings
2
Select Alarm Snooze, then press ACT. The SET ALARM SNOOZE screen flashes the default Alarm
Snooze time of 30 minutes (0:30). 
3
Set your Alarm Snooze time between 5 minutes (0:05) and 1 hour (1:00).
4
Press ACT. The EDIT SETTINGS screen shows the Alarm Snooze time you selected. You are now ready to
set your Cal Reminder.
Sensor features
114

Setting the Cal Reminder
The Cal Reminder feature allows you to set a reminder to calibrate your system. For example, if you set
your reminder to four hours, then you will receive a METER BG BY alert (Cal Reminder) four hours before
the next meter blood glucose (BG) entry is due (eight hours after your last successful sensor calibration). 
 
To set up the Cal Reminder:
1
Make sure the EDIT SETTINGS screen is open.
Main > Sensor > Sensor Setup > Edit Settings
2
Select Cal Reminder, then press ACT. The CAL REMINDER screen shows On.
3
Press ACT. The SET CAL REMINDER screen flashes the Cal Reminder default time of 1 hour (1:00).
4
Select your Cal Reminder time between 5 minutes (0:05) and 4 hours (4:00).
5
Press ACT. The EDIT SETTINGS screen shows the Cal Reminder time you selected. You are now ready to
enter the ID number of your transmitter.
Entering the transmitter ID
The transmitter ID (serial number) starts with 2 and is found on the flat side of your transmitter. You must
enter the transmitter ID so that the transmitter and the pump can communicate with each other.
Write the Transmitter ID of the transmitter you are using here: __________________.
1
Make sure the EDIT SETTINGS screen is open.
Main > Sensor > Sensor Setup > Edit Settings
2
Select Transmtr ID, then press ACT. The SET TRANSMITTER ID screen appears. The screen shows seven
dashes for the Transmitter ID, the first of which (on the left) is flashing.
3
Select the first number of the Transmitter ID (the number on the screen must
match the first number of the Transmitter ID). The transmitter ID is located on
the transmitter label, as shown.
4
Press ACT. The second dash flashes.
5
Select the next number of the Transmitter ID, then press ACT.
6
Repeat step 5 until all seven digits of the Transmitter ID have been selected.
Sensor features
115
Chapter 8

7
A message shows that the Transmitter ID has been changed. After about 30 seconds, the EDIT
SETTINGS screen appears. It shows the Transmitter ID you entered.
You are now ready to set up the Missed Data.
Setting up the Missed Data feature
The Missed Data feature allows you to determine how quickly you will receive a WEAK SIGNAL alert when
there is no communication between the transmitter and the pump. For example, if you set the Missed Data
value to 30 minutes, you will receive a WEAK SIGNAL alert 30 minutes after loss of communication. 
 
To set up the Missed Data feature:
1
Make sure the EDIT SETTINGS screen is open.
Main > Sensor > Sensor Setup > Edit Settings
2
Select Missed Data, then press ACT. The SET MISSED DATA screen flashes the default time of 30
minutes (0:30). 
3
Select your Missed Data time between 5 minutes (0:05) and 40 minutes (0:40).
4
Press ACT. The EDIT SETTINGS screen shows the length of time you entered for the Missed Data option.
5
You are now ready to review your sensor glucose monitoring settings.
Reviewing your settings 
Make sure that all the settings you have made are correct before you use the system. Use the following
procedure to review your settings:
1
Open the REVIEW SETTINGS screen. 
Main > Sensor > Sensor Setup > Review Settings
2
Press 
 to scroll through all settings to make sure that they are correct.
3
To change any settings, return to the EDIT SETTINGS menu.
Main > Sensor > Sensor Setup > Edit Settings
4
Save your settings after you have set your preferences. This will allow you to restore the settings you
have saved if you receive an alarm or error that resets your settings.
Sensor features
116

The transmitter
The Medtronic MiniLink Transmitter (MMT-7703) is a device that takes electronic signals generated by the
glucose sensor and sends them by radio frequency to the pump. It has a tester (MMT-7706) and a charger
(MMT-7705).
MiniLink 
Transmitter
MiniLink 
Tester
MiniLink 
Charger
Transmitter charger
The transmitter contains a non-replaceable, rechargeable battery that you can recharge as needed with
the charger. The charger has a green light that shows the charging status and a red light that
communicates any problems during charging. If you see a red light, see the Understanding your
transmitter, tester, and charger section in the Troubleshooting and alarms chapter. The charger needs a
AAA or LR-03 battery to operate. A new AAA battery contains enough power to recharge the transmitter
more than 40 times.
Charging the transmitter
Before using the transmitter for the first time, you must fully charge the transmitter battery, which may
take up to eight hours. It is recommended to recharge the transmitter after each sensor use. If you choose
to recharge the transmitter after each sensor use, the charging time will be less than 20 minutes. A fully
charged transmitter battery will work more than 14 days without recharging. After 14 days of use, the
transmitter will fully recharge in less than two hours.