Insulet 002 iXL Remote Controller User Manual

Insulet Corporation iXL Remote Controller Users Manual

Contents

Users Manual

DoctorName:Address:Telephone Number(s):Nurse/EducatorName:Address:Telephone Number(s):InsuranceName:Address:Telephone Number(s):Policy Number:PharmacyPharmacist:Address:Telephone Number(s):PrescriptionsScript # Name Dosage Times Per DayEmergency ServicesDial 911 (USA only; not available in all communities)Insulet Corporation100 Cummings Center • Suite 239G • Beverly, MA 01915 USACustomer Support: (800) 591-3455 (24 hours/7days)Sales/Supplies: (800) 591-9948Web Site: www.insulet.comi iXL™ Diabetes Management System User Guide: Contacts and Important InformationUse the spaces below to record important health and product information.10776 Rev AContacts and Important Information
ContentsIntroduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi About This User Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi Conventions and terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viBefore You Get Started . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .viiIndication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viiContraindications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii Your Important Role in Successful Pump Therapy . . . . . . . viii Your Personal Diabetes Management Information . . . . . . . . ixMy Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x1: Your New iXL™ Diabetes Management System . . . . . . . . . . 1 Insulin-Delivery with the iXL™System . . . . . . . . . . . . . . . . . . 1How Does the iXL™ System Work? . . . . . . . . . . . . . . . . . . . . . 2 RediSet™ System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Wireless Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Data Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 The iXL™ Pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 The iXL™ Remote Controller . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Buttons that program and control the iXL™ System . . . . . 4 Entering and changing text . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Primary screens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 My Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 2: Getting Started . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 The iXL™ Startup Kit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Set Up the iXL™ Remote Controller . . . . . . . . . . . . . . . . . . . . 10 Turn on the remote . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 The iXL™ Setup Wizard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 My Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133: Basal Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 What is a Basal Rate? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Personalized Basal Programs . . . . . . . . . . . . . . . . . . . . . . . . 15 Create a basal program . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Enable an existing basal program . . . . . . . . . . . . . . . . . . . 19 Change or delete a basal program . . . . . . . . . . . . . . . . . . 20 Preset Temporary Basal Rates . . . . . . . . . . . . . . . . . . . . . . . . 22 What is a temporary basal rate? . . . . . . . . . . . . . . . . . . . . 22 Create a temporary basal preset . . . . . . . . . . . . . . . . . . . . 22 Enable an existing temporary basal preset . . . . . . . . . . . . 23 Cancel an active temporary basal preset . . . . . . . . . . . . . 23 Change or delete a temporary basal preset . . . . . . . . . . . 23 One-Time Temporary Basal Rates . . . . . . . . . . . . . . . . . . . . . 24 Enable a one-time temporary basal rate . . . . . . . . . . . . . . 24 Cancel a one-time temporary basal rate . . . . . . . . . . . . . . 25 Maximum Basal Rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 What is the maximum basal rate? . . . . . . . . . . . . . . . . . . . 25 Set a maximum basal rate . . . . . . . . . . . . . . . . . . . . . . . . . 25 My Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 iXL™ Diabetes Management System User Guide: Contents ii
4: Bolus Doses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 What is a Bolus? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Bolus Dose Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Deliver Bolus Doses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Deliver a normal bolus . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Deliver an extended bolus . . . . . . . . . . . . . . . . . . . . . . . . . 29 Deliver an iBolus™ (audio bolus) . . . . . . . . . . . . . . . . . . . . 31 Cancel Active Boluses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 My Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 5: The iXL™ Pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 The Pump Change Process . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Deactivate current pump . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Activate a new pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Fill the new pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39Select the infusion site . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Prepare the infusion site . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Attach the new pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Insert cannula and begin insulin delivery . . . . . . . . . . . . . 42 Check Pump Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Suspend Insulin Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43Resume Insulin Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45Avoid Infusion Site Infections . . . . . . . . . . . . . . . . . . . . . . . . . 46 Get the Most From Your Pump . . . . . . . . . . . . . . . . . . . . . . . . 46 Avoid extreme temperatures . . . . . . . . . . . . . . . . . . . . . . . 46 Water and your pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Safe storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 My Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 6: iXL™ Remote Controller Features . . . . . . . . . . . . . . . . . . . . . 49 The Status Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Insulin Gauge and Display . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 System Setup Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Reset the Date or Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Reset the time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 Reset the date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 Change Bolus and Basal Settings . . . . . . . . . . . . . . . . . . . . . 52 Set Alerts and Reminders . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Choose alerts and reminders . . . . . . . . . . . . . . . . . . . . . . . 54 Customize the Remote . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 Set remote options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Set Diagnostic Functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Set diagnostic options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Get the Most from Your Remote . . . . . . . . . . . . . . . . . . . . . . . 58 Keep it handy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 Communicating with the pump . . . . . . . . . . . . . . . . . . . . . . 58 Water and your remote . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 Avoid extreme temperatures . . . . . . . . . . . . . . . . . . . . . . . 58 Electrical interference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 My Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 iii iXL™ Diabetes Management System User Guide: ContentsContents
Contents7: My Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Record Keeping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Insulin Delivery History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 View insulin delivery history . . . . . . . . . . . . . . . . . . . . . . . . 61 Alarm History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 User and Product Information . . . . . . . . . . . . . . . . . . . . . . . . 64 Add or change user information . . . . . . . . . . . . . . . . . . . . 64 My Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 8: Achieve Healthy, Safe Pumping . . . . . . . . . . . . . . . . . . . . . . 67 Your Role in Safe Pumping . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Safety Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Automatic priming, safety checks, and insertion with RediSet™ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Continuous monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Rapid occlusion detection . . . . . . . . . . . . . . . . . . . . . . . . . 68 Alerts and advisory and hazard alarms . . . . . . . . . . . . . . . 68 Daily Diabetes Management Activities . . . . . . . . . . . . . . . . . 68 Check blood glucose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 Inspect the infusion site . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 Water and Your Pump . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 Traveling and Vacationing . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 Plan for changing time zones . . . . . . . . . . . . . . . . . . . . . . . 69 Take enough supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 Minimize airport security delays . . . . . . . . . . . . . . . . . . . . 70 Keep supplies accessible . . . . . . . . . . . . . . . . . . . . . . . . . . 71 Avoid Adverse Reactions . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 General precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 Hypoglycemia (low blood glucose) . . . . . . . . . . . . . . . . . . 72 Hyperglycemia (high blood glucose) . . . . . . . . . . . . . . . . . 75 Diabetic ketoacidosis (DKA) . . . . . . . . . . . . . . . . . . . . . . . . 78 Handling Special Situations . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Prepare for emergencies . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Sick days . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Exercising, playing sports, or working hard . . . . . . . . . . . 80 Short-term removal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 X-rays, MRIs, and CT scans . . . . . . . . . . . . . . . . . . . . . . . . 81 Surgery or hospitalization . . . . . . . . . . . . . . . . . . . . . . . . . . 81 My Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82 9: Be Aware: Hazard and Advisory Alarms . . . . . . . . . . . . . . . 83 Safety Checks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 Hazard Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 Respond to hazard alarms . . . . . . . . . . . . . . . . . . . . . . . . . 87Advisory Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88Respond to advisory alarms . . . . . . . . . . . . . . . . . . . . . . . . 91My Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9210:Troubleshoot Communication Failures . . . . . . . . . . . . . . . . . 93 The Communication Failure Sequences . . . . . . . . . . . . . . . . 93Failure at start up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93Failure during operation . . . . . . . . . . . . . . . . . . . . . . . . . . . 94My Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96iXL™ Diabetes Management System User Guide: Contents iv
Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 The iXL™ Pump Care and Maintenance . . . . . . . . . . . . . . . . 97Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97The iXL™ Remote Controller Care and Maintenance . . . . . 97 Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97Replacing batteries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98If the remote becomes submerged in water . . . . . . . . . . . 99If you drop the remote . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99Insulin and Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 Ordering supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 Limited Warranty for the iXL™ Remote Controller . . . . . . . 101 Limited warranty coverage . . . . . . . . . . . . . . . . . . . . . . . . 101 Warranty claim procedure . . . . . . . . . . . . . . . . . . . . . . . . 101 Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101Exclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101 Miscellaneous . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101iXL™ System Options and Settings . . . . . . . . . . . . . . . . . . . 102 iXL™ Pump Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . 103iXL™ Remote Controller Specifications . . . . . . . . . . . . . . . . 103iXL™ System Label Symbols . . . . . . . . . . . . . . . . . . . . . . . . . 104 iXL™ Remote Controller Icons . . . . . . . . . . . . . . . . . . . . . . . 104 iXL™ System Federal Communications Commission (FCC) Notice Concerning Interference . . . . . . . . . . . . . . . . . . . . 105Helpful Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105My Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106 Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111© 2003 Insulet Corporation. All rights reserved. iXL, RediSet, and iBolus are trademarks of Insulet Corporation.Patents pending.viXL™ Diabetes Management System User Guide: ContentsContents
IntroductionAbout This User GuideConventions and TermsConvention/Term MeaningBold Names of buttons, soft keys, menus, and screens are bold.Italics Words in italics are defined in the Glossaryat the end of this User Guide.Press Press and release a button or soft key.Hold Keep pressing a button until its functionis complete.Menu A list of options on the remote. Options allow you to perform tasks.Screen Displays programming, operating, andalarm/alert information.Button A physical button on the remote, such asthe Power button.Soft key A button on the remote whose label orfunction appears on the screen directlyabove the button. The label changes depending on the task you are performing.Icon An image on the remote screen that indicatesa menu option or item of information. A tableof screen icons appears in the Appendices.SymbolsSymbol MeaningWarning Describes potential serious adversereactions, or indicates conditions thatcould cause death or serious injury. Caution Indicates conditions that could cause minor or moderate injury to you ordamage to the device.Note Provides helpful information.Tip Offers a suggestion for successfulpumping.iXL™ Diabetes Management System User Guide: Introduction vi
Before You Get StartedUS Federal law restricts this device to sale by or on theorder of a physician.IndicationThe Insulet iXL Diabetes Management System is intended forthe continuous subcutaneous delivery of insulin at set andvariable rates for the management of diabetes mellitus inpersons requiring insulin.ContraindicationsInsulin pump therapy is NOT recommended for people who are either:•Unable to perform at least four (4) blood glucose checks per day. •Unable to maintain contact with their healthcare provider.•Unable to use the system according to instructions.If you are unable to use the system according to instructions, you may be putting your health and safety at risk. Talk with your healthcare provider if you havequestions or concerns about using the system properly.Work with your healthcare provider to establish diabetesmanagement guidelines that best fit your needs. These mayinclude:Insulin-to-Carbohydrate Ratio: Number of grams of carbohydratecovered by one unit of insulin. For example, if your insulin-to-carbohydrate ratio is 1:10, then you need to deliver one unit ofinsulin to cover every ten grams of carbohydrate you eat.Correction Factor or Sensitivity Factor: How much one unit ofinsulin will lower blood glucose. For example, if your sensitivityfactor is 40, one unit of insulin will lower your blood glucose by40mg/dl.Target Blood Glucose Range: A range of blood glucose levelsthat you are trying to achieve during a certain period of the day.For example, you may want one range before meals, a differentrange two hours after meals, and yet another range for bedtime.Your individual needs influence the initial settings you and your healthcare provider will enter into the iXL’s Remote Controllerduring setup (see Chapter 2, Getting Started). Although your healthcare provider must assist you in enteringthese initial settings, soon you will be entering and changingyour own settings with confidence and ease. Don’t be intimidated by the new technology. The iXL System is moreuser-friendly than most electronic devices you use every day. In fact, technology is what makes the iXL System so easy to use. vii iXL™ Diabetes Management System User Guide: IntroductionIntroduction
IntroductionYour healthcare provider is a valuable resource. You are goingto rely on him/her for a lot of critical information about your iXL System, especially during the first few weeks and months. If you have questions about diabetes management after startingon the iXL System, do not hesitate to talk with your healthcareprovider. You can call us 24 hours a day, 7 days a week foremergencies or for technical questions about iXL System setupor operation.Customer Support: (24 hours/7 days) (800) 591-3455Sales and Supplies: (800) 591-9948Web Site: www.insulet.comDo NOT attempt to use the iXL Diabetes ManagementSystem without first meeting with your healthcareprovider to receive training. Your Important Role in Successful PumpTherapyYour healthcare provider will give you all the tools and trainingyou need to be successful with insulin pump therapy. However,in the end, your success depends on YOU. You must becomeactively involved in your own diabetes management if you wantto enjoy the outstanding control, freedom, and flexibility that ispossible with the iXL System. Being actively involved means:•Frequently monitoring and recording blood glucose levels.•Learning how to operate your iXL System and practicingproper pumping techniques.•Regular visits with your healthcare provider.iXL™ Diabetes Management System User Guide: Introduction viii
Your Personal Diabetes ManagementInformationBasal ProgramsName Time Segment Rate______________ 12:00 am to _______ _______ U/hr_______ to _______ _______ U/hr_______ to _______ _______ U/hr_______ to _______ _______ U/hr_______ to _______ _______ U/hr______________ 12:00 am to _______ _______ U/hr_______ to _______ _______ U/hr_______ to _______ _______ U/hr_______ to _______ _______ U/hr_______ to _______ _______ U/hr______________ 12:00 am to _______ _______ U/hr_______ to _______ _______ U/hr_______ to _______ _______ U/hr_______ to _______ _______ U/hr_______ to _______ _______ U/hrTemp Basal PresetsName Adjustment______________ _______ U/hr______________ _______ U/hr______________ _______ U/hrInsulin-to-Carbohydrate Ratio1.0 unit of insulin covers _______ grams of carbohydrateCorrection (Sensitivity) Factor1.0 unit of insulin lowers blood glucose by about _______ mg/dlTarget Blood Glucose RangeBefore meals: Between _______ and _______ mg/dl2 hours after meals: Less than _______ mg/dlBedtime: Between _______ and _______ mg/dl2–3am: More than _______ mg/dlHemoglobin A1c Target: _________Date: __________ Result: _________ Date: __________ Result: _________ Date: __________ Result: _________ Date: __________ Result: _________ ix iXL™ Diabetes Management System User Guide: IntroductionIntroduction
IntroductionMy Notes:iXL™ Diabetes Management System User Guide: Introduction x
My Notes:xi iXL™ Diabetes Management System User Guide: IntroductionIntroduction
Your New iXL™ Diabetes Management System 1Insulin Delivery with the iXL™ SystemThe iXL System is more than just a pump. It is a completediabetes management system.The long-term health benefits of better blood glucose control are well known. Maintaining near-normal blood glucose canhelp you live a longer, healthier life with fewer diabetes-relatedcomplications. However, good health is not the only advantageenjoyed by people who use the iXL Diabetes ManagementSystem. There are many practical, everyday benefits having to do with convenience, freedom, and flexibility.Continuous insulin delivery, possible only with an insulin pump, most closely mimics the insulin release of a healthypancreas. Since the landmark 10-year Diabetes Control andComplications Trial (DCCT), the long-term health benefits ofmaintaining near-normal blood glucose levels have beenwidely recognized.Continuous insulin delivery at preset rates eliminates the needfor scheduled daily injections and the interruptions that comewith them. Continuous delivery of rapid-acting, U-100 insulin also gives you the freedom to eat what you want and when youwant. You don’t have to plan snacks or meals around when yourinsulin is peaking. In addition, with the iXL System, insulin delivery can be changed with the press of a button to adapt tosnacks or unexpected changes in daily routine. The iXL Systemis ideal for all kinds of people, because it fits every lifestyle. The iXL Diabetes Management System works much like thepancreas of a person without diabetes by delivering insulin in two ways:•A small, constant background supply of insulin (called abasal rate) is delivered automatically at a programmed ratethroughout the day and night.•An extra dose of insulin (called a bolus) can be deliveredwhen needed to match the carbohydrates (sugar content) in a meal or snack, or to correct a high blood glucose.iXL™ Diabetes Management System User Guide: Your New iXL™ Diabetes Management System 1
2 iXL™ Diabetes Management System User Guide: Your New iXL™ Diabetes Management SystemYour New iXL™ Diabetes Management System1How does the iXL™ System Work?The iXL Diabetes Management System is a two part system: a pump and a remote. The iXL Pump is small and has a low, thinprofile. The pump is worn on the body and is comfortable towear. An adhesive holds the pump against the skin. The pumpcan hold up to 200 units of deliverable insulin. Each time youactivate a new pump, you fill it with the amount of insulin youneed. The iXL System stores insulin right inside the pump. Insulinenters your body from the pump through a short thin tube (calleda cannula). With the iXL Pump, there is no long tubing to gettangled or caught on things. Deactivate the used pump andapply a new one every 48-72 hours or as instructed by yourhealthcare provider.RediSet™SystemThe iXL Pump uses the RediSet system, a built-in infusion setwith an automatic inserter. With other systems, you have toeither insert the infusion set manually or carry around a separateinserter. With the RediSet feature, once the iXL Pump is attachedto your skin, you simply press a button on the remote and theautomatic inserter does the rest. Wireless TechnologyThe iXL System is wireless. The remote is small, lightweight, and not attached to the pump, so you can carry it inside anarticle of clothing or put it in a backpack, briefcase, or purse. All pump operations are programmed and controlled through the iXL Remote Controller. You use the remote to make insulindelivery adjustments, respond to alarms and alerts and obtain the pump status. The remote uses on-screen messages to guideyou through menu options. The menu options are clear and easy to understand and there are only a few buttons on the remote to learn and use.Data StorageAnother part of the iXL System’s convenience is data storage.Paper charts are useful, but sometimes they can be inconvenient to carry or use. The remote’s electronic datastorage and retrieval system displays up to 90 days’ worth of information on the remote screen.
Your New iXL™ Diabetes Management System 1The iXL™ PumpThe iXL Pump attaches to your skin with an adhesive backing,similar to a bandaid.The iXL™ Remote ControllerAll pump operations are programmed and controlled through the palm-sized iXL Remote Controller. The remote “talks” to thepump using wireless technology, similar to a mobile phone.iXL™ Diabetes Management System User Guide: Your New iXL™ Diabetes Management System 3Up/Down ControllerSoft keysiBolusFill portNeedle capUser info/supportStatus PowerAdhesive backingViewing window
Your New iXL™ Diabetes Management System1Buttons that program and control the iXL™ SystemButton ActionPower Pressing turns the screen on and off. Holding activates the backlight, which lets you read thescreen in the dark. To preserve battery life, usethe backlight only when necessary.Status Brings you to the Status screen (shown later inthis chapter). Among other things, the Statusscreen tells you what basal rate or bolus dose iscurrently running, the time and amount of the lastbolus delivered, how much insulin is in the pumpreservoir, and how much power remains in theremote’s batteries.User Info/ Brings you to the User Info/Support screen,Support which shows Insulet Corporation information,product information, and–if you or your healthcare provider enter it–any personalizeduser information you want.Button ActionSoft Keys Called “soft” because they do not have a “hard”label or definite purpose. Soft key labels andfunctions depend on the menu or screen you areviewing. The label appears on the screen directlyabove the physical button you press. For example,when you are in the Main menu, the left soft keyis labeled Status and pressing it brings you to theStatus screen. However, when you are in theStatus screen, the same soft key is labeled Menuand pressing it brings you to the Main menu.Up/Down Pressing scrolls through a list of available menuController options or numbers so you can pick the one youwant. Holding the button scrolls faster.In some lists, the Up/Down Controller buttoncannot be used for scrolling, because it isbeing used for another purpose. In this case,press the soft key labeled More to go to thenext screen.iBolus™ Lets you easily and discreetly deliver a bolus dose(Audio Bolus) “on the go,” without having to look at the screen.4 iXL™ Diabetes Management System User Guide: Your New iXL™ Diabetes Management System
Your New iXL™ Diabetes Management System 1Entering and changing textTo enter text, numbers, or characters (for example, when entering your personal contact information), use the Up/DownController button to scroll to the character you want, and thenpress Select. Repeat for each character needed to spell theword or name you want to add. To change a number, time, or date, select the number and usethe Up/Down Controller button to increase or decrease it.iXL™ Diabetes Management System User Guide: Your New iXL™ Diabetes Management System 5
Your New iXL™ Diabetes Management System16 iXL™ Diabetes Management System User Guide: Your New iXL™ Diabetes Management SystemPrimary ScreensMessages on the screen tell you how the system is operating,list menu choices, or explain how to perform certain tasks. The system’s two primary screens are:Status Screen ActionView the system’s currentoperating status•Date and time.•Remote battery level.•Insulin reservoir volume (howmuch insulin is in the pump).•When an extended bolus isbeing delivered, how muchinsulin has been delivered.•Name and rate of current basal program, unless a bolus doseis currently being delivered (see above).•Whether a temporary basal program is in use.If a pump is in Suspend mode, the Status screen displays “INSULIN SUSPENDED.” If a pump has not yetbeen activated (as during pump changes), the screendisplays “No active pump. Would you like to activate apump now?” (see Chapter 5, The iXL Pump, for details).You can go to the Status screen at any time by pressingthe Status button.Main Menu Screen ActionGo to all the major submenus:•Bolus menu to deliver bolusdoses.•Temp basal menu to delivertemporary basal rates.•My records menu to reviewinsulin delivery records, alarmrecords, and personal userinformation.•Settings menu to customize system settings and to set andname basal and temporary basal programs that meet yourpersonal needs.•Suspend menu to suspend, cancel, or resume insulin deliveryprograms.
Your New iXL™ Diabetes Management System 1iXL™ Diabetes Management System User Guide: Your New iXL™ Diabetes Management System 7My Notes:
Your New iXL™ Diabetes Management System1My Notes:8 iXL™ Diabetes Management System User Guide: Your New iXL™ Diabetes Management System
Getting StartedThe iXL™ Startup KitYour kit contains: •This User Guide•One (1) iXL Remote Controller•Ten (10) iXL Pumps (filling syringe and needle is providedwith each pump)•Two (2) AAA alkaline batteries•Registration card (postage paid)If you are a first-time iXL System user, you need to meet with yourhealthcare provider for training and system setup before usingit. To get a head start on learning about your new iXL System,review this User Guide before your first training session. Havinga basic understanding of the System in advance will help youget more out of your training sessions. After unpacking your startup kit, use the list above to make sureyou have everything. Then, complete the registration card andpromptly mail it to us. Returning the card allows us to contactyou with important product updates or warranty information. Do NOT use the iXL Diabetes Management System untilyou have been trained by your healthcare provider. He/shewill initialize the system based on your individual needs.iXL™ Diabetes Management System User Guide: Getting Started 92
Set Up The iXL™ Remote ControllerChapter 6 describes the remote’s options in detail. The instructions in this chapter are simplified to help you get started.Turn on the remote1. Open the battery compartment on the back of the remote by gently pressing down on the ribbed side of the compartment door until it opens (Figure 2-1). No special tools are necessary.2. Insert two (2) new AAA alkaline batteries into the compartment.The diagram inside the compartment shows you whichdirection to insert the batteries.Use only new AAA alkaline batteries to power theremote. Never use old or used batteries; the remote may not work properly.3. Replace battery door.4. Turn the remote face-up.5. Press the Power button.The iXL™ Setup WizardThe first time you turn on the iXL Remote Controller, the SetupWizard comes on automatically. Although setup is easy with theWizard, if you are a first-time user, your healthcare providermust guide you through the process. Setup takes only a fewminutes and is easy to do:•Use the Up/Down Controller button to increase or decreasea number or to move up or down a list.•Press the soft key labeled Next to continue to the next screen.•Press the Back soft key to return to previous screens.You can adjust these settings later as your needs changeor you fine-tune your iXL System.10 iXL™ Diabetes Management System User Guide: Getting StartedGetting Started2Figure 2-1
Getting StartedThe Wizard’s Welcome screen (Figure 2-2) gets you started.Press the Continue soft key to begin setting time and day, bolusand basal options, and indicators.1. Use the Up/Down Controller button to increase or decreasethe time. (If you prefer a 24-hour clock, press the 12hr/24hrsoft key.) Then press Next.2. Enter the current year, then press Next.3. Choose the current month, then press Next.4. Enter the current day, then press Next.5. Choose the date format you prefer, then press Next.6. Choose a bolus increment (how much each press of theUp/Down Controller button will increase or decrease a bolusdelivery), either 0.10, 0.50, or 1.00 units of insulin, then pressNext.7. Choose the maximum bolus you can give at one time, up to 30 units in 0.10-unit increments, then press Next.8. Choose the maximum basal rate you can set, up to 30 unitsper hour, then press Next.9. Choose the initial basal rate to use, then press Next.The initial basal program established with the SetupWizard is named Basal 1. You can change the name in the Settings > Basal programs menu (see Chapter 3, Basal Rates).10.Press Done to confirm the basal program shown on thescreen. To add more basal segments to the program, or tochange the rate shown, press Edit (see Chapter 3, BasalRates, for details).11.Press Confirm to confirm the basal program you have set. To see the basal program as a list, press List. To return to thegraphic view, press Graph.To avoid confusion, since “midnight” both begins andends a 24-hour period, the end of the day is representedas 11:59 pm.12.Choose the maximum daily dose of insulin you should take,from 0 to 200 units in 5-unit increments, then press Next.13.Choose the level of insulin in the reservoir at which theremote should give you an alarm. Choose from 10 to 50 unitsin 5-unit increments, then press Next.iXL™ Diabetes Management System User Guide: Getting Started 112Figure 2-2
14.The remote now asks whether you want to activate a pump (Figure 2-3). You can:•Press Yes if you are ready to activate a new iXL Pump.•Press No if you do not want to activate a pump at this time. The remote displays the Main menu.You can press the Power button to turn off the remote at any time during setup. Otherwise, it turns off automatically after a screen time-out period you set (see Chapter 6, iXL Remote Controller Features). If youturn the remote on again within 5 minutes, you will returnto the same Setup Wizard screen you last saw. If youturn it on after 5 minutes, you will return to the beginningof the Setup Wizard.Your healthcare provider will help you fill and attach your first iXL Pump. The process is easy because on-screen messageswalk you through every step. Please refer to Chapter 5, The iXLPump, for detailed instructions.12 iXL™ Diabetes Management System User Guide: Getting StartedGetting Started2Figure 2-3
Getting StartedMy Notes:iXL™ Diabetes Management System User Guide: Getting Started 132
My Notes:14 iXL™ Diabetes Management System User Guide: Getting StartedGetting Started2
Basal RatesWhat is a Basal Rate?A basal rate is a small base or background amount of insulinthat is delivered, at a preset rate, continuously for a specifiedperiod of time.Even without eating, our bodies need a small, constant supply of insulin for normal cell activity. In people without diabetes, thepancreas continuously delivers this background supply ofinsulin. For people using the iXL Diabetes Management System,the iXL Pump mimics a healthy pancreas by delivering insulin ata programmed basal rate.Approximately 50% of a pumper’s total daily dose comesfrom basal insulin delivery; the remaining 50% comesfrom bolus doses (see Chapter 4, Bolus Doses).Personalized Basal ProgramsInsulin needs vary throughout the day. Therefore, most peopleset their basal rates to deliver slightly more (or less) insulin atcertain times. For example, one person may need to deliver ahigher rate of insulin during the early morning and a lower rateduring the late evening. A basal program describes the amountof insulin to be delivered during an entire 24-hour period. A basal program contains at least one basal rate for the 24-hourperiod, but for most people it will be broken into several timesegments, or basal segments, each delivering a different rate ofinsulin. A sample basal program with three basal segmentsmight be:Basal Segment Basal Rate Meaning12:00am – 8:00am 0.60U/hr Between midnight and8:00am, the pump delivers0.60 units of insulin per hour.8:00am – 3:00pm 0.80U/hr Between 8:00am and 3:00pm,the pump delivers 0.80 unitsof insulin per hour.3:00pm – 11:59pm* 0.70U/hr Between 3:00pm and 11:59pm(midnight), the pump delivers0.70 units of insulin per hour.*To avoid confusion, the end of a day is represented as 11:59pm.iXL™ Diabetes Management System User Guide: Basal Rates 153
In addition to normal daily changes, insulin needs can vary with different routines or days of the week. For example, regularschool or workday routines may differ from weekend routines,and insulin needs may differ, too. With your healthcare provider,you will decide on the basal rates that best match your lifestyleand insulin needs. You will enter at least one basal program(your Basal 1 program) into your remote during the setup process(see Chapter 2, Getting Started). You can add other programslater as you fine-tune your system settings or when your needschange. You can preset basal rates to use for regular occasionswhen you need a different rate than the Basal 1 programprovides, such as exercise times or school nights. Create a basal programThe iXL Remote Controller can store up to seven different basalprograms. Each program can contain 48 rates, programmed inhalf-hour increments. Once you enter a basal program into theremote, pressing a few buttons is all it takes to pick the programyou want. The iXL Pump continues to deliver insulin at thoserates until you change that program or switch to another one.For up to 72 hours, you get insulin delivery that’s customized toyour personal needs.1. In the Main menu, use the Up/Down Controller button tochoose Settings (Figure 3-1); then press the soft keylabeled Select.16 iXL™ Diabetes Management System User Guide: Basal RatesBasal Rates3Figure 3-1
Basal Rates2. Choose Basal programs (Figure 3-2), then press Select.3. Choose [new program] (Figure 3-3), then press Create.4. To use the iXL System’s default naming system, simply pressNext.The default naming system automatically assignsprogram names in numerical order, such as Basal 1, Basal 2,Basal 3.Or, to give a different name to the program:(a)Press the Up/Down Controller button to enter the characters that spell the name you want. An underscore (_)on the screen indicates which character you are changing.Press the soft key labeled with the arrow to move theunderscore to the next character. For example, if you haveschool three nights a week and eat early those nights, youmight enter S, c, h, o, o, l, space, N, i, g, h, t (Figure 3-4). (A blank character/space is the first and last option in thescrolling menu.)(b)Press Next. iXL™ Diabetes Management System User Guide: Basal Rates 173Figure 3-2Figure 3-3Figure 3-4
As a safety feature, the words “Invalid basal programname” (Figure 3-5) appear if the name you entered doesnot have at least one character or if the name is beingused by another basal program. Press OK to return to theprevious screen and enter a different name.5. Enter the rate, in U/hr, for the first basal segment (from Off to the maximum you entered during setup), then press Next.6. Review the list showing your new basal program.New programs show the first basal rate during the timeperiod 12:00am-11:59pm. The end of the day is represented by 11:59pm.To use the same basal rate for the entire 24-hour program,press Done and continue with step 7. Or, to add basal segments and rates (for example, a higherbasal rate between 8:00am and 3:00pm):(a)Press Edit.(b) Enter the start time (for example, 8:00am), then press Next.Basal segments are in 30-minute increments.(c)Enter the end time (for example, 3:00pm), then press Next.(d)Enter the rate for the new basal segment (for example,0.80U/hr), then press Next.Basal rates outside the changed segment do not change.(e) Repeat steps a-d for each new segment and rate you want.(f) Press Done.18 iXL™ Diabetes Management System User Guide: Basal RatesBasal Rates3Figure 3-5
Basal Rates7. Review the graph of the new basal program (Figure 3-6).To see the program as a list, press List (Figure 3-7). To seethe graph again, press Graph. To add the program to the remote’s memory, press Save.Or press Cancel to cancel the newly entered program.Repeat the steps above for each basal program (up to 7) youwant to create. Enable an existing basal program1. In the Main menu, use the Up/Down Controller button tochoose Settings; then press the soft key labeled Select.2. Choose Basal programs, then press Select.3. Choose the program you want from the list (Figure 3-8), thenpress Enable.To see a graph of the basal program, press Graph.iXL™ Diabetes Management System User Guide: Basal Rates 193Figure 3-6 Figure 3-7Figure 3-8
4. Press Enable to start the selected basal program. The pumpbeeps to indicate that the chosen basal program is running.Or press Cancel to return to the list and select a differentprogram.A diamond icon (♦) appears next to the program that iscurrently running. You cannot select the current programto enable, because it is already running.As a safety feature, you cannot enable a new basalprogram while a temporary basal preset is in process(see “Preset Temporary Basal Rates” later in thischapter); you must first cancel the current temporarybasal preset. If you try to activate a new program beforeyou cancel the temporary preset, the screen displays anerror message (Figure 3-9). Press OK to return to the listof available basal programs.Change or delete a basal program1. In the Main menu, use the Up/Down Controller button tochoose Settings; then press the soft key labeled Select.2. Choose Basal programs, then press Select.3. Choose a program from the list, then press Edit.4. Follow the steps below, then press Done.To change a segment or rate in the basal program:1. Choose Edit segment, then press Select (Figure 3-10).Or press Done to back out of this process.2. To edit the program, press Edit.3. Enter the start time for the segment you want to change thenpress Enter.4. Enter an end time for this segment, then press Enter.20 iXL™ Diabetes Management System User Guide: Basal RatesBasal Rates3Figure 3-9Figure 3-10
Basal Rates5. Enter a basal rate for the new segment, then press Enter.6. To save the newly entered segment into the basal program,press Save. If you want to make additional edits, press Editand repeat steps 3-5.7. If this is the currently active basal program, press Confirm(Figure 3-11) to update. (The pump beeps to indicate that theactive basal program has been updated.)Press Save (Figure 3-12) for any other basal program.Or, press Cancel to ignore the edits you made to the basalprogram and return to the edit screen.To rename a basal program:1. After choosing a program from the list, choose Rename andthen press Select.2. Press the Up/Down Controller button to enter the charactersthat spell out the name you want; then press Save.Or press Back to back out of this process.To delete a basal program:1. After choosing a program from the list, choose Delete andthen press Select.2. Press Delete to permanently delete the program.Or press Cancel to back out of the deletion process.As a safety feature, you cannot delete the current basalprogram. If you try to delete the current program, thescreen displays an error message (Figure 3-13). Press OKto return to the list of editing options.iXL™ Diabetes Management System User Guide: Basal Rates 213Figure 3-11 Figure 3-12Figure 3-13
Preset Temporary Basal RatesWhat is a temporary basal rate?A temporary basal rate lets you adjust your basal rate for a short period of time. If a temporary change later becomespermanent, you can create a new basal program for it. Sometemporary changes are easy to predict and respond to; theyhappen routinely and you may know from experience how theyaffect your insulin needs. For example, you might take the sameexercise class twice a week for eight weeks, or join a summersoccer league. For women, a monthly hormonal change thataffects blood sugars is an example of predictable change. Toeasily handle predictable but short-term changes, you can preseta temporary basal rate, so it is ready whenever you need it. Theremote can remember up to seven (7) temporary basal presets.Create a temporary basal preset1. In the Main menu, use the Up/Down Controller button tochoose Settings; then press the soft key labeled Select.2. Choose Temp basal presets, then press Select.3. Choose [new preset], then press Create.4. To use the iXL System’s default naming system, simply pressNext. The default naming system automatically assignsprogram names in numerical order, such as Temp basal 1,Temp basal 2, Temp basal 3.Or, to give a different name to the program:(a)Press the Up/Down Controller button to enter thecharacters that spell the name you want. An underscore(_) on the screen indicates which character you arechanging. Press the arrow key to move the underscore tothe next character. For example, if you take an aerobicsclass two nights a week, you might enter a, e, r, o, b, i, c, s(Figure 3-14).(b)Press Next.5. Enter the new temporary basal rate, from Off to the maximumbasal rate you entered during setup; then press Next.22 iXL™ Diabetes Management System User Guide: Basal RatesBasal Rates3Figure 3-14
Basal Rates6. Review the temporary basal name and rate; press Save toaccept it.Or press Back to return to the previous screen and enter a different rate.Enable an existing temporary basal preset1. In the Main menu, use the Up/Down Controller button tochoose Temp basal (Figure 3-15); then press the soft keylabeled Select.2. Choose the temp basal preset you want to use from the list, then press Select.3. Enter the duration for the temporary rate, in increments of 30 minutes, then press Enter.4. Press Start to begin the temporary basal rate shown on thescreen.Or press Back to return to the previous screen if you want toenter a different duration.Cancel an active temporary basal preset1. In the Main menu, use the Up/Down Controller button tochoose Suspend/cancel; then press the soft key labeledSelect.2. Choose Cancel temp basal, then press Select.3. Press Confirm to cancel the currently running temporarybasal preset.Or press Back to back out of this process.Change or delete a temporary basal preset1. In the Main menu, use the Up/Down Controller button tochoose Settings; then press the soft key labeled Select.2. Choose Temp basal presets, then press Select.3. Choose a temporary program from the list, then press Edit.4. Follow the steps in the next section, then press Done.iXL™ Diabetes Management System User Guide: Basal Rates 233Figure 3-15
To change a temporary basal preset:1. Choose Edit rate, then press Select (Figure 3-16).Or press Done to back out of this process.2. Enter a new rate for the program, then press Save.To rename a temporary basal preset:1. Choose Rename and then press Select.2. Press the Up/Down Controller button to enter the charactersthat spell out the name you want; then press Save.Or press Back to back out of this process.To delete a temporary basal preset:1. Choose Delete and then press Select.2. Press Delete to permanently delete the preset.Or press Cancel to back out of this process.One-Time Temporary Basal RatesOn occasion, you may need to change the current basal rate fora short time. For example, if you are going cross-country skiingfor several hours, you may want to lower the basal rate duringand after you exercise.Enable a one-time temporary basal rate1. In the Main menu, use the Up/Down Controller button tochoose Temp basal; then press the soft key labeled Select.2. Choose [enter manually] from the list of temp basal presets.(If you have not created any temp basal presets, the remoteskips this step.)3. Enter the temporary basal rate in units per hour, then pressEnter.4. Enter the length of time for the temporary rate, in incrementsof 30 minutes, then press Enter.5. Press Start to start the temporary basal rate shown on thescreen.Or press Back to back out of this process.24 iXL™ Diabetes Management System User Guide: Basal RatesBasal Rates3Figure 3-16
Basal RatesCancel a one-time temporary basal rate1. In the Main menu, use the Up/Down Controller button tochoose Suspend/cancel; then press the soft key labeledSelect.2. Choose Cancel temp basal (Figure 3-17); then press Select.3. Press Confirm to cancel the temporary basal shown on thescreen.Or press Back to back out of this process.Maximum Basal RateWhat is the maximum basal rate?The maximum basal rate is a safety feature. It limits the basalrate (U/hr) that the iXL Pump can deliver. Once it is entered intothe remote’s memory, the maximum applies to both regular basalprograms and temporary basal rates. You and your healthcare provider will enter an initial maximumbasal rate into your remote during the setup process (seeChapter 2, Getting Started). You can change it later as you fine-tune your system settings or when your needs change. Set a maximum basal rate1. In the Main menu, use the Up/Down Controller button tochoose Settings; then press the soft key labeled Select.2. Choose System setup, then press Select.3. Choose Bolus/basal setup, then press Select.4. Choose Max basal rate, then press Select.5. Enter a new maximum basal rate, then press Enter.6. You can press Back at any screen to back out of this process.iXL™ Diabetes Management System User Guide: Basal Rates 253Figure 3-17
My Notes:26 iXL™ Diabetes Management System User Guide: Basal RatesBasal Rates3
Bolus DosesWhat is a Bolus?A bolus is an extra dose of insulin, delivered when needed tomatch the carbohydrates (sugar content) in a meal or snack, orto lower blood glucose when it gets too high. This extra dose isin addition to the basal rate delivered throughout the day andnight (see Chapter 3, Basal Rates).The size of a bolus dose depends on many variables. These variables include your blood glucose level, insulin-to-carbohydrate ratio, activity level, and the type and amount offood you eat. With the iXL System, it is easy to adapt to anysituation, because – with the press of a few buttons – you canadjust to unexpected or changing insulin needs.During setup, you enter bolus dose settings in the remote (see Chapter 2, Getting Started). However, you can adjust thesesettings as you fine-tune your system settings or when yourneeds change (see Chapter 6, iXL Remote Controller Features).Bolus Dose OptionsSo you can fully enjoy the freedom of eating what and when you want, the iXL System offers the following bolus dose options:Normal Bolus: When you need a dose of insulin right way (tocover a meal or snack you are about to eat or to reduce a highblood glucose level).Extended Bolus: When you are eating high-fat or high-proteinfoods (which take longer to digest and are slower to affectblood glucose) or when you are eating for an extended period(for example, at a party or during a holiday meal).iBolus™ (Audio Bolus): When you want to give yourself a bolus “on the go,” without looking at the remote screen. Thisfeature is especially handy if you want to give yourself a bolusdiscreetly or without having to stop what you are doing (forexample, when attending classes or meetings, eating out, orentertaining).The bolus features in the iXL System are designed forflexibility and convenience. You can easily transition from a normal to an extended bolus simply by pressing a few buttons.Although you cannot deliver an extended bolus while anotherextended bolus is active, you can deliver a normal or an iBoluswhile an extended bolus is being delivered.iXL™ Diabetes Management System User Guide: Bolus Doses 274
Deliver Bolus DosesDeliver a normal bolus1. In the Main menu, use the Up/Down Controller button tochoose Bolus (Figure 4-1); then press the soft key labeledSelect.2. Enter the number of units you want to deliver.3. Press Enter.As a safety feature, the remote only allows you to give abolus at or below your maximum bolus dose. If the dose you enter would put you over your maximumtotal daily dose, an on-screen message appears (Figure4-2). Press OK and request a smaller amount; or increasethe system setting for maximum daily dose (see Chapter6, iXL Remote Controller Features).28 iXL™ Diabetes Management System User Guide: Bolus DosesBolus Doses4Figure 4-1Figure 4-2
Bolus Doses4. If you have set the blood glucose reminder option to Audibleor Vibrate (see Chapter 6, iXL Remote Controller Features),the remote asks whether you want to schedule a reminder(Figure 4-3). Reminders that have been set previously appearat the bottom of this screen.If you want to set a reminder:(a)Press Yes.(b)Enter the time for the reminder.(c)Press OK.If you do not want to set a reminder, press No.If you have set the blood glucose reminder to Off, the remotewill not ask you to set a reminder.5. Press Start to begin the bolus delivery.Or press Back if you decide not to deliver the bolus.Deliver an extended bolus1. In the Main menu, use the Up/Down Controller button tochoose Bolus; then press the soft key labeled Select.2. Enter the number of units you want to deliver.3. Press Extended.4. Enter the units of insulin (if any) that you want to takeimmediately, then press Enter.5. Enter the time (up to 8 hours, in 30-minute increments) overwhich to deliver the remainder of the bolus (the amountshown on the screen, Figure 4-4); then press Enter.iXL™ Diabetes Management System User Guide: Bolus Doses 294Figure 4-3Figure 4-4
6. If you have set the blood glucose reminder option to Audibleor Vibrate (not Off) and you want to add a reminder: (a)Press Yes.(b)Enter the time for the reminder.(c)Press OK.If you do not want to set a reminder, press No.If you have set the blood glucose reminder to Off, the remotewill not ask you to set a reminder.7. Press Start to begin the bolus delivery.Or press Back if you decide not to deliver the bolus.As a safety feature, if you try to set an extended boluswhile another extended bolus is being delivered, an on-screen message appears (Figure 4-5). Press OK andwait until the extended bolus is complete, or cancel theextended bolus (see “Cancel Active Boluses” later in thischapter). You can deliver a normal bolus while anextended bolus is being delivered.30 iXL™ Diabetes Management System User Guide: Bolus DosesBolus Doses4Figure 4-5
Bolus DosesDeliver an iBolus™ (audio bolus)The iXL System’s exclusive iBolus feature lets you deliver abolus conveniently and discreetly, without having to look at theremote screen. The iBolus button is located on the right side ofthe remote (Figure 4-6).The iBolus increment depends on the bolus increment that you select during setup. For example, if your normal bolusincrement is 1.0 unit, the iBolus increment will be the same.When delivering an iBolus dose, the blood glucose checkreminder feature defaults to Off. 1. Press the iBolus button.The remote beeps once to confirm that the iBolus feature isactive.2. Press the iBolus button once for each increment of insulin todeliver. For example, if you want to deliver 3 units and your increment is set to 1 unit, press the iBolus button 3 times .3. After a brief pause, the remote beeps once for each increment entered, so you can confirm the dose by countingthe number of beeps.If you press the iBolus button during the counting period, theremote cancels the operation and returns to the Status screen.4. Within 3 seconds of hearing the final beep, press Start toconfirm the dose (Figure 4-7). If you do not press Start within 3 seconds, the remoteautomatically cancels the iBolus and returns to the Mainmenu.5. After you confirm the dose, the pump beeps once to signalthat bolus delivery has begun.iXL™ Diabetes Management System User Guide: Bolus Doses 314Figure 4-6Figure 4-7iBolus button
Cancel Active BolusesThe iXL System is extremely flexible and can respond almost immediately to your changing insulin needs. It is easy to cancelan active bolus (one that is currently being delivered), evenafter insulin delivery has started.1. Press the Power button to turn on the remote, if it is notalready on. An on-screen message appears as long as abolus is being delivered (Figure 4-8).2. Press the soft key labeled Cancel.The pump beeps to confirm the bolus is canceled. An on-screen message tells you how much insulin was delivered before you canceled the bolus (Figure 4-9).If the bolus has already been completed, the “Deliveringbolus” message and the Cancel soft key label do notappear.3. Press OK to return to the Status screen.32 iXL™ Diabetes Management System User Guide: Bolus DosesBolus Doses4Figure 4-8Figure 4-9
Bolus DosesMy Notes:My Notes:iXL™ Diabetes Management System User Guide: Bolus Doses 334
My Notes:34 iXL™ Diabetes Management System User Guide: Bolus DosesBolus Doses4
The iXL™ PumpThe Pump Change ProcessYou should replace the pump at least once every 48-72 hours, oras instructed by your healthcare provider. (You can also chooseto have the remote alert you when you need to replace thepump (see Chapter 6, iXL Remote Controller Features andChapter 9, Hazard and Advisory Alarms).WARNINGS!•Do NOT attach or use a pump if its sterile packaging is open or damaged, as this may increase the risk of infection.Pumps are sterile unless packaging has been opened ordamaged.•Do NOT attach or use a pump if it is damaged in any way. A damaged pump may not work properly.•Do NOT attach a pump without first using aseptic techniqueto clean the infusion site.•Do NOT use the iXL Pump if you are sensitive to or haveallergies to acrylic adhesives or have fragile or easilydamaged skin.•Check often to make sure the pump and soft cannula aresecurely attached and in place. A loose or dislodged cannulamay interrupt insulin delivery.IMPORTANT!Because insulin pumps use rapid-acting insulin, pump users are at increased risk for developing hyperglycemia (high bloodglucose) if insulin delivery is interrupted. If it is untreated, severehyperglycemia can quickly lead to diabetic ketoacidosis (DKA),which can cause coma, shock, breathing difficulties, or death. If insulin delivery is interrupted for any reason, you may need toreplace the missing insulin–usually with an injection of rapid-acting insulin. Ask your healthcare provider for instructionson handling interrupted insulin delivery.Gather the following equipment and supplies:•Vial of rapid-acting U-100 insulinUse ONLY rapid-acting U-100 insulin with iXL Pumps.NEVER use insulin that is cloudy; it may be old orinactive. Failure to use rapid-acting U-100 insulin, or usinginsulin that is old or inactive may lead to hyperglycemiaor diabetic ketoacidosis (DKA).•An unopened iXL Pump (including filling syringe and needleprovided with each pump)•Alcohol prep swabIf you are a first-time iXL System user, your healthcareprovider will guide you through the steps for systemsetup, including steps for initializing and attaching yourfirst pump. Do NOT attempt to attach or use an iXL Pumpuntil you have been trained by your healthcare provider.iXL™ Diabetes Management System User Guide: The iXL™ Pump 355
Deactivate current pump1. In the Main menu of the remote, select Settings (Figure 5-1).2. In the Settings menu, select Pump change (Figure 5-2).3. In the Confirm Pump change screen, press Confirm(Figure 5-3).36 iXL™ Diabetes Management System User Guide: The iXL™ PumpThe iXL™ Pump5Figure 5-1Figure 5-2Figure 5-3
The iXL™ Pump4. At the message, “Pump deactivated. Remove and discardthe pump, and then press Continue” (Figure 5-4), remove theold pump.(a)Lift the edges of the adhesive tape from your skin andremove the entire pump (Figure 5-5).(b)Use soap and water to remove any adhesive that remainson the skin or, if necessary, use an adhesive remover.(c)Discard used pump according to local waste disposalregulations.5. After removing the old pump, press Continue.iXL™ Diabetes Management System User Guide: The iXL™ Pump 375Figure 5-4Figure 5-5
Activate a new pump1. Remove the new pump from its sterile package.2. Place the remote against the new pump (Figures 5-6A/5-6B).3. Press Activate (Figure 5-7).After you press Activate, the pump beeps, indicating that theremote has successfully activated the pump. The iXL Systemsafety features ensure that the remote works only with the newly activated pump.38 iXL™ Diabetes Management System User Guide: The iXL™ PumpThe iXL™ Pump5Figure 5-6AFigure 5-7Figure 5-6B
The iXL™ PumpFill the new pump1. Use an alcohol prep swab to clean the top of the insulin vial; discard the prep swab.2. Lock the filling needle onto the syringe by turning it clockwise (Figure 5-8).3. Remove protective cap from needle.Use care after removing the needle cap and exposing the fill needle.4. Draw air into syringe equal to the amount of insulin beingwithdrawn.5. Insert needle into vial and inject the air. This makes it easierto draw the insulin out of the vial.6. Withdraw insulin from vial, expelling any air bubbles. Fillsyringe with enough insulin for 72 hours, or at least to theMIN (minimum) fill line (Figure 5-9).Avoid using insulin from more than one vial, which mayintroduce air into the syringe.iXL™ Diabetes Management System User Guide: The iXL™ Pump 395Figure 5-8Figure 5-9
7. Remove needle from vial and insert into the insulin fill port onthe underside of the pump body (Figure 5-10).8. Depress syringe plunger to completely empty syringe into thepump.9. Remove needle from insulin fill port. Port is self-sealing;insulin will not leak after needle is removed.Do NOT insert the fill syringe into the fill port more thanonce.10.Place protective cap on needle and remove needle fromsyringe.11.Place capped needle in sharps container. Dispose of usedneedles according to local waste disposal regulations.The fill syringe is intended for single use only and shouldbe used only with iXL Pumps.12.After you fill the pump, press Continue (Figure 5-11). Thepump’s RediSet system performs a series of safety checksand automatically primes the pump. Once complete, theremote beeps, letting you know that the priming and safetychecks were successful.40 iXL™ Diabetes Management System User Guide: The iXL™ PumpThe iXL™ Pump5Figure 5-10Figure 5-11
The iXL™ PumpSelect the infusion siteBefore attaching a new pump, you must first select an appropriate infusion site. Due to ease of access, viewing, andreliable insulin absorption, the abdomen is often preferred. Yourhealthcare provider may suggest other potential sites, includingthe hip or upper thigh.•Avoid sites where belts, waistbands, or tight clothing mayrub against, disturb, or dislodge the pump.•Rotate infusion sites with each pump change. A new infusionsite should be at least 1“ away from the last site. (Using thesame location can lead to scarring, which reduces insulinabsorption.)•Do NOT attach the pump within 2“ of your navel or over amole or scar, where insulin absorption may be reduced.Prepare the infusion siteYou can reduce the risk of infusion site infection by followingaseptic technique and disinfecting the infusion site. Beforeattaching a new pump, always:1. Wash hands with soap and water.2. Use soap to wash the infusion site. Antibacterial soap may irritate skin, especially at theinfusion site. Consult with your healthcare provider onguidelines for treating any skin irritation.3. Dry the site with a clean towel.4. Use an alcohol prep swab to disinfect the infusion site. Startat the center of the site and move outward in a circular motion.5. Let the site air-dry thoroughly. Do NOT blow on the site to dry it.Attach the new pump1. Prepare the pump for attaching to your infusion site. Usingthe pull tabs, remove and discard the white paper backingfrom the adhesive tape (Figure 5-12). The protective needlecap will come off in this process.When the needle cap comes off, a few drops of insulinmay escape from the needle.iXL™ Diabetes Management System User Guide: The iXL™ Pump 415Figure 5-12
Figure 5-14 Figure 5-152. Attach pump to the prepared infusion site; press firmly tosecure it to your skin.Under normal conditions, the iXL Pump’s adhesive keepsit securely in place for up to 3 days. A variety of productsare available to help secure the pump to the skin. Askyour healthcare provider about these products. Avoidgetting body lotion, creams, or oils near the infusion site;these products may loosen the adhesive.3. After you securely attach the pump, press Continue(Figure 5-13).The adhesive is designed for one-time use. Once removed, a pump cannot be reattached.Insert cannula and begin insulin delivery1. To insert the soft cannula, press Start (Figure 5-14).The pump’s RediSet system automatically inserts the soft cannula and delivers a prime bolus to fill the cannula withinsulin (Figure 5-15).42 iXL™ Diabetes Management System User Guide: The iXL™ PumpThe iXL™ Pump5Figure 5-13
The iXL™ PumpThe remote will alert every 5 minutes until the pumpchange process is complete. You must complete thepump change process within one hour. Once the soft cannula is inserted and the prime bolus has filledthe cannula, the pump will beep, indicating that it is active anddelivering insulin at the programmed basal rate (Figure 5-16).2. Press OK to return to the Status screen.Check Pump StatusTo check pump status:•From the Main menu, press Status. The remote automaticallychecks the status of the pump. The remote then displays the current reservoir volume, basal and bolus rates, and anyalarm conditions. (See Chapter 6, iXL Remote ControllerFeatures, for details of what you see on the Status screen.)Suspend Insulin DeliverySometimes you may need to briefly stop insulin delivery (forexample, during exercise). The iXL System lets you suspendinsulin delivery for up to 2 hours. While in suspension, the pumpbeeps once every 15 minutes, reminding you of the pump’ssuspend status.At any time during a suspension period, press Resumeto resume the basal program that was running when yoususpended insulin delivery.iXL™ Diabetes Management System User Guide: The iXL™ Pump 435Figure 5-16
Figure 5-181. In the Main menu, use the Up/Down Controller button tochoose Suspend (Figure 5-17); then press the soft keylabeled Select.If a temporary or extended bolus is in process, the menu itemwill be Suspend/cancel instead, and cancel options for theseprograms will also appear in the menu.2. Choose Suspend insulin delivery.3. Enter how long you want to stop all insulin delivery, from 30 minutes to 2 hours in 30-minute increments.4. Press Enter.5. Press Suspend to confirm that you want to halt all insulindelivery (basal and bolus). The pump beeps and an on-screenmessage lets you know that insulin delivery is indeedsuspended (Figure 5-18).Or press Back to enter a different time period or to cancelthe suspension.The pump beeps every 15 minutes until the end of the suspensionperiod. The Status screen shows “INSULIN SUSPENDED” untilyou resume insulin delivery (see Resume Insulin Delivery on thenext page).44 iXL™ Diabetes Management System User Guide: The iXL™ PumpThe iXL™ Pump5Figure 5-17
The iXL™ PumpAt the end of the suspend period, a pump Advisory alarm willoccur.To resume your programmed basal rate, press OK (Figure 5-19).The Advisory alarm will repeat every 15 minutes until youpress OK.Resume Insulin Delivery1. In the Main menu, use the Up/Down Controller button tochoose Resume (Figure 5-20); then press the soft key labeled Select.2. Press Resume to restart the basal program that was previously running. Or press Back if you want to continuethe suspension.iXL™ Diabetes Management System User Guide: The iXL™ Pump 455Figure 5-19Figure 5-20
Avoid Infusion Site Infections•Always wash your hands and use aseptic technique toprepare the infusion site before attaching a pump.•Do not apply a pump to any area of skin with an active infection. If you are unsure whether to use a specific site,consult your healthcare provider.•At least once a day, use the pump’s infusion site viewingwindow to check the site for signs of infection and to confirmthat the soft cannula is securely in place.•Be aware of the signs of infection, including pain, swelling, redness, discharge, or heat at the site. If you suspect aninfection, immediately remove the pump and attach a newone in a different location. Then contact your healthcareprovider.•Change the pump at least once every 48-72 hours, or asinstructed by your healthcare provider.Get the Most From Your PumpAvoid extreme temperaturesDo NOT expose the iXL Pump to extreme operating temperatures.Exposing pumps to temperatures below 41°F (5°C) or above104°F (40°C) can cause pump malfunction. Do NOT expose yourpump to direct sunlight for extended durations. It is recommendedthat you remove your pump prior to using hot tubs, whirlpools,or saunas. These conditions would expose the pump to extremetemperatures and may also affect the insulin inside the pump. Remember to check your blood glucose levels frequentlybefore and after removing the pump. Check with yourhealthcare provider for guidelines on removing the pumpfor extended periods.Insulin degrades at high temperatures and will freezenear 32°F (0°C). Check the insulin manufacturer’sinstructions for use.46 iXL™ Diabetes Management System User Guide: The iXL™ PumpThe iXL™ Pump5
The iXL™ PumpWater and your pumpThe iXL Pump is watertight to a depth of 8 feet for up to 30minutes (IPX8). After exposure to water, rinse off the pump withclean water and dry it with a towel.Do NOT expose your iXL Pump to water at depths greaterthan 8 feet or for durations exceeding 30 minutes. Check often to make sure the pump and soft cannula aresecurely attached and in place.The iXL Remote Controller is not waterproof. Do NOTplace it in or near water.Safe StorageStore unopened iXL Pumps in a cool, dry place. Extreme heat or cold can damage pumps and cause them to malfunction. If pumps are exposed to extreme temperatures, inspect themcarefully before use. Do NOT attach or use pump if its sterilepackaging is opened or damaged. Pumps are sterile unlesspackaging is opened or damaged.iXL™ Diabetes Management System User Guide: The iXL™ Pump 475
My Notes:48 iXL™ Diabetes Management System User Guide: The iXL™ PumpThe iXL™ Pump5
iXL™ Remote Controller FeaturesThe Status ScreenThe top of the iXL Remote Controller Status screen (Figure 6-1) displays the “communicating” icon, an icon showing how fullthe battery is, and the current date and time. The center of thescreen provides information on current insulin delivery (orsuspension). The bottom of the screen shows an insulin gaugeand the soft key for the Main menu.Insulin Gauge and DisplayOne of the important icons on the Status screen is the insulingauge in the lower lefthand corner. It indicates how much insulinis left in the pump’s reservoir. As the reservoir empties, the iconchanges to indicate the amount of insulin remaining. Next to the insulin gauge, the remote displays the number of unitsremaining in the pump. As long as more than 50 units remain,the gauge displays “50+ U.” Once the reservoir volume drops to50 units, the gauge counts down unit by unit. When the volumefalls below 5 units, the display changes to “Low Reservoir.”Regularly checking the insulin gauge enables you to planpump changes easily. For example, if you know you willneed approximately 20 units during your work day andthe insulin gauge shows only 17 units remaining, you caneither take a new pump with you or change it before youleave for the day. iXL™ Diabetes Management System User Guide: iXL™ Remote Controller Features 496Figure 6-1
System Setup MenuThe System setup menu lets you personalize the settings thatcontrol the iXL System. These include:•Date and time•Bolus doses and basal rates•Alerts and reminders•Remote options: remote lock, screen time-out, and backlighttime-out•Diagnostics: check alarms and reset remoteYou and your healthcare provider entered initial system settingsusing the Setup Wizard (see Chapter 2, Getting Started). Aftersetup, however, you can use the System setup menu to customizeor change those settings, as described in this chapter.Reset the Date or TimeOccasionally, you need to change date and time settings (for example, to adjust for daylight savings time or after resetting the remote). As a safety feature, you can change date and timesettings only when the pump is deactivated or when insulindelivery is suspended (see Chapter 5, The iXL Pump).1. Either suspend insulin delivery or deactivate the pump.2. In the Main menu, use the Up/Down Controller button tochoose Settings; then press the soft key labeled Select.3. Choose System setup, then press Select (Figure 6-2).4. Choose Date/time, then press Select.5. Choose either Time or Date, then press Edit.6. Follow the steps below, then press Done.50 iXL™ Diabetes Management System User Guide: IXL™ Remote Controller FeaturesiXL™ Remote Controller Features6Figure 6-2
iXL™ Remote Controller FeaturesReset the time1. Enter the current time.2. Choose either a 12-hour or 24-hour clock, then press Enter.3. Press Confirm to accept the new time (Figure 6-3).Or press Cancel to back out of this process.Reset the date1. Enter the current year, then press Enter.2. Choose the current month, then press Enter.3. Enter the current day, then press Enter.4. Choose the date format to be displayed by the remote, then press Select.5. Press Confirm to accept the new date and format.Or press Cancel to back out of this process.Remember to resume insulin delivery or activate a newpump after changing the date or time.iXL™ Diabetes Management System User Guide: IXL™ Remote Controller Features 516Figure 6-3
Change Bolus and Basal SettingsYou can reset the bolus increment, the maximum bolus dose, the maximum basal rate, and the maximum daily dose.1. In the Main menu, use the Up/Down Controller button tochoose Settings; then press the soft key labeled Select.2. Choose System setup, then press Select.3. Choose Bolus/basal setup, then press Select.4. Choose one of the following (Figure 6-4) and then press Select:• Bolus increment • Max bolus • Max basal rate• Max daily dose5. Use the Up/Down Controller button to enter a value, thenpress Select.Some settings have preset defaults, but all settings are changeable. See the Appendices for a list of systemspecifications, including preset default settings.6. Repeat steps 4 and 5 for each setting you want to change.For details on basal rate and bolus dose settings, seeChapter 3, Basal Rates, and Chapter 4, Bolus Doses.If the remote’s clock becomes corrupted and the clock is reset, then the max daily dose checks will only applymoving forward. If a clock reset is required due to aRemote error, the max daily dose will be reset and themax daily dose checks will only apply to insulin deliveriesmoving forward from this point in time (see Chapter 9,Hazard and Advisory Alarms). 52 iXL™ Diabetes Management System User Guide: IXL™ Remote Controller FeaturesiXL™ Remote Controller Features6Figure 6-4
iXL™ Remote Controller FeaturesSet Alerts and RemindersIn addition to automatic safety alarms (see Chapter 9, Hazardand Advisory Alarms), the iXL System offers a number of alertsand reminders that you can set to help you manage yourdiabetes. These features are optional. You can turn alerts andreminders on or off at any time. They include:BG (blood glucose) reminder: Reminds you to check your blood glucose. Choose from Off, Audible, or Vibrate. The default settingis Off. When the reminder is on, the remote reminds you eachtime you enter a bolus dose, and you can then choose a timeinterval.Expiration: Alerts you when a pump is nearing expiration (72 hours). Choose an alert period from 3 to 18 hours beforeexpiration in 1-hour increments, or choose Off. The defaultsetting is Off. (This optional alert is in addition to two advisoryalarms, at 2 and 1 hours before expiration, and a hazard alarmat actual expiration time, as described in Chapter 9, Hazard and Advisory Alarms.)Low reservoir: Alerts you when insulin in the pump reaches acertain level, so you can plan ahead to change the pump.Choose a level from 10 to 50 units, in 5-unit increments. Thedefault setting is 10 units.Auto off: Alerts you if no buttons have been pressed within acertain time period. This alert can be especially reassuring forusers who are prone to hypoglycemia unawareness. Choose atime period from 1 to 24 hours, in 1-hour increments, or chooseOff. Choose from an audio-only or an audio-plus-vibration alert.The default setting is Off.Reminders: Pump beeps when a program is in process (seeChapter 3, Basal Rates, and Chapter 4, Bolus Doses, for details).These include:• Temporary basal in process• Extended bolus in processChoose On or Off. The default setting is On. Confidence alerts: Pump beeps in response to your instructions,so you become familiar with the operation of the iXL System andfeel confident that you are getting the insulin you need. Thesealerts include:• Bolus delivery started• Bolus delivery completed• Extended bolus started• Extended bolus completed• Temporary basal rate started• Temporary basal completedChoose On or Off. The default setting is On. iXL™ Diabetes Management System User Guide: IXL™ Remote Controller Features 536
Choose alerts and reminders1. In the Main menu, use the Up/Down Controller button tochoose Settings; then press the soft key labeled Select.2. Choose System setup, then press Select.3. Choose Alerts/reminders, then press Select.4. Choose the reminder or alert you want to set (Figure 6-5),then press Select.5. Choose the desired option or set the desired value and press Select or Enter.Repeat steps 1-5 to set more alerts or reminders.Customize the RemoteAdditional options let you customize how the iXL RemoteController operates:Remote lock: “Locks” the buttons on the remote. The defaultsetting is Off. This safety feature can help avoid accidentallychanging basal rates or giving boluses.Screen time-out: The screen goes blank after a time intervalthat you set, during which you have not pressed any buttons onthe remote. This setting preserves battery power by turning offthe screen when you are not using it. Choose an interval of 15,30, or 60 seconds. Set it at the lowest setting (15 seconds) tomaximize battery life. The default is 30 seconds.Press the Power button to turn the screen back on. If it has been less then 5 minutes since the screen timedout, pressing the Power button returns you to the samescreen you were using. If it has been longer than 5minutes, the remote brings you to the Status screen.Backlight time-out: The backlight allows you to see the screenin the dark and remains on while you are using the remote. Toturn it on, hold the Power button for three seconds. This settingturns off the backlight when you have not used it for a timeinterval that you set. Choose an interval of 15, 30, or 60 seconds.Set at the lowest setting (15 seconds) to maximize battery life.The default is 30 seconds.54 iXL™ Diabetes Management System User Guide: IXL™ Remote Controller FeaturesiXL™ Remote Controller Features6Figure 6-5
iXL™ Remote Controller FeaturesSet remote options1. In the Main menu, use the Up/Down Controller button tochoose Settings; then press the soft key labeled Select.2. Choose System setup, then press Select.3. Choose Remote options (Figure 6-6), then press Select.4. Choose one of the following, then press Select:• Remote lock• Screen time-out• Backlight time-outTo set Remote lock:1. Choose Off or On, then press Select.If you choose On, other remote options and most othersoft keys are locked (Figure 6-7) and will not respond tobutton presses. To use them, you must first set Remotelock to Off.To set time-outs:1. Choose a time interval of 15, 30, or 60 seconds, then pressSelect. iXL™ Diabetes Management System User Guide: IXL™ Remote Controller Features 556Figure 6-6 Figure 6-7
Set Diagnostic FunctionsThe Diagnostics screen allows you to instantly confirm how thesystem is working or to completely update settings enteredduring setup (see Chapter 2, Getting Started). They include:Check alarms: Confirms that all alarms work properly whenneeded. When you select this function, the remote beeps, thenvibrates, and then the pump beeps.If the remote fails to beep and/or vibrate, call Insuletimmediately at (800) 591-3455. If a pump is active and failsto beep, change pump immediately (see Chapter 5, TheiXL Pump).Reset remote (soft reset): Restores all settings in the remote tothe factory defaults. Resetting the remote deletes all history records, basalprograms, temporary basal presets, and user informationfrom memory. Before using this feature, be sure you havea written record of the information you need before it isdeleted.As a safety feature, you cannot reset the remote from theDiagnostics screen when a pump is active. You must firstdeactivate the pump.Set diagnostic options1. In the Main menu, use the Up/Down Controller button tochoose Settings; then press the soft key labeled Select.2. Choose System setup, then press Select.3. Choose Diagnostics, then press Select (Figure 6-8).To check alarms:1. Choose Check alarms, then press Select.2. Press Confirm. The remote beeps three times, then vibrates.If a pump is active, it then beeps three times.Check the alarm function at every pump change.56 iXL™ Diabetes Management System User Guide: IXL™ Remote Controller FeaturesiXL™ Remote Controller Features6Figure 6-8
iXL™ Remote Controller FeaturesTo reset the remote:1. Choose Reset remote.2. If the pump is deactivated, the screen shows what informationwill be deleted. Press Confirm to reset the remote.If the pump is still active, you will be unable to reset the remote(Figure 6-9). Press OK to return to the diagnostics menu.iXL™ Diabetes Management System User Guide: IXL™ Remote Controller Features 576Figure 6-9
Get the Most from Your RemoteKeep it handyWireless communication technology means you don’t have tokeep the remote right next to the pump for the pump to work.Once you set your basal rate, the pump continues to deliverinsulin at that rate until you decide to change it or until you give yourself a bolus dose. Meanwhile, since the remote issmall, lightweight, and is not attached to the pump, you canstore it conveniently inside an article of clothing (like a shirtpocket) or put it discreetly into a drawer, briefcase, or purse.Communicating with the pumpWhen you enter or change programs, hold the remote within 12” (30.5cm) of the pump. If you wear the pump on yourabdomen, holding the remote in your hands when pressing thebuttons should be close enough.Water and your remoteThe remote is not waterproof. Do NOT place it in or near water.Avoid extreme temperaturesExtreme operating temperatures can affect remote batteriesand interfere with system operation. Avoid using the remote in temperatures below 41°F (5°C) or above 104°F (40°C).Do NOT store or leave the remote where it may be exposed toextreme temperatures, such as inside a car. Extreme heator cold can cause the device to malfunction.Electrical interferenceThe remote is designed to withstand normal radio interferenceand electromagnetic fields. However, as with all wirelesscommunication technology, certain operating conditions caninterrupt communication. For example, electric appliances such as microwave ovens and electric machinery located inmanufacturing environments may cause interference. In mostcases, interruptions are easy to resolve (see Chapter 10,Troubleshooting Communication Failures).58 iXL™ Diabetes Management System User Guide: IXL™ Remote Controller FeaturesiXL™ Remote Controller Features6
iXL™ Remote Controller FeaturesMy Notes:iXL™ Diabetes Management System User Guide: IXL™ Remote Controller Features 596
My Notes:60 iXL™ Diabetes Management System User Guide: IXL™ Remote Controller FeaturesiXL™ Remote Controller Features6
My RecordsRecord KeepingRecord keeping is an important part of successful diabetesmanagement. The iXL Remote Controller helps simplify this task.It automatically stores insulin-delivery records, alarm records,and personal information.If the remote batteries run out, data in the remote’smemory is at risk. Information will be lost if the batteriesare not changed within 2 hours. Do NOT remove thebatteries until you have new ones at hand; the longer thebatteries are removed, the more the memory is at risk.Insulin Delivery HistoryThe remote stores:•Basal rates (including any rate changes and temporary basals)•Bolus doses (normal, extended, and iBolus)•Dates, times, and how long insulin delivery was suspendedand dates and times when it was resumed•Total daily doses (total daily bolus + total daily basal) by dateThe remote can store up to 2400 insulin-delivery events (basaland bolus), or approximately 90 days of information. Informationolder than 90 days is automatically deleted as new informationis added.View insulin delivery history1. In the Main menu, use the Up/Down Controller button tochoose My records; then press the soft key labeled Select.2. Choose Insulin delivery, then press Select.The remote displays today’s information first (from 12:00am to the current time), including the total daily dose delivered,total of boluses delivered, and total basal amount delivered(Figure 7-1). The date appears in the second line of the screen.To see information for a different date, press the Up/DownController button.iXL™ Diabetes Management System User Guide: My Records 617Figure 7-1
3. Press Basal (Figure 7-2).The display indicates the time of day and whether a basalwas suspended, the pump was deactivated, or a temp basalrate was delivered. If a temp basal rate is currently running,a diamond icon (♦) appears next to it. If a temp basal ratewas cancelled, the screen shows how long it ran beforebeing cancelled.Press the Up/Down Controller button for different dates.If not all the information fits onto one screen, a page iconappears at the bottom center of the screen. Press More to go to the next screen of information. Continue to press Moreuntil you return to the first screen.4. Press Bolus (Figure 7-3).The display indicates whether the bolus was normal, extended(ext), or an iBolus (i). (Normal and extended boluses aredisplayed separately even if they were programmed at thesame time.) Extended boluses are shown with time andduration. If an extended bolus is currently running, a diamondicon (♦) appears next to it. If a bolus was cancelled, only theamount delivered before cancellation is shown. The amount shown after cancellation may be in 0.05 unitincrements, even though the smallest dose you canprogram is 0.10 units.Press the Up/Down Controller button for different dates. PressMore for additional screens.62 iXL™ Diabetes Management System User Guide: My RecordsMy Records7Figure 7-2Figure 7-3
My RecordsAlarm HistoryThe remote lists the entire alarm history for the device, fromthe current date to when the remote was first activated. Theremote can store up to 128 alarm records.1. In the Main menu, use the Up/Down Controller button tochoose My records; then press the soft key labeled Select.2. Choose Alarm history, then press Select.The remote displays the type, date, and time of each alarm.3. Press the shift key labeled More for additional screens.iXL™ Diabetes Management System User Guide: My Records 637
User and Product InformationYou or your healthcare provider may have entered your personalcontact information (name, address, telephone numbers, andemail address) during your pump-start visit. To view that information, press the User Info/Support button (?) in the upperright corner of the remote. You can add or change user information at any time (see below).The user information screen also displays contact informationfor Insulet Corporation and product information for your iXLSystem (make, model, serial number). The factory enters thecorporate and product information and you cannot change it.Add or change user information1. In the Main menu, use the Up/Down Controller button tochoose My records; then press the soft key labeled Select.2. Choose My info, then press Select.3. Choose name, address1, address2,phone1, phone2, or email,then press Select.4. Press the Up/Down Controller button to enter the charactersthat spell the name, address, phone number, or emailaddress. An underscore (_) on the screen indicates whichcharacter you are changing. Press the arrow key to move theunderscore to the next character. For example, if you live at1234 Main Street, you might enter 1, 2, 3, 4, space, M, a, i, n,space, S, t., (Figure 7-4).5. Press Done.6. Repeat steps 3 through 5 for each line of personal informationyou want to enter.64 iXL™ Diabetes Management System User Guide: My RecordsMy Records7Figure 7-4
My RecordsMy Notes:iXL™ Diabetes Management System User Guide: My Records 657
My Notes:66 iXL™ Diabetes Management System User Guide: My RecordsMy Records7
Achieve Healthy, Safe PumpingYour Role in Safe PumpingBefore deciding on the iXL Diabetes Management System, youand your healthcare provider discussed the advantages andbenefits of the iXL System, as well as the responsibilities thatcome with insulin pump therapy. Remember: Safe pumpingbegins and ends with you. If you have questions or doubts aboutbeing able to safely use the iXL System at any time, consult yourhealthcare provider immediately.Most pump problems are easily avoided by:•Learning all you can about successful diabetes management.•Being actively involved in your treatment.•Checking your blood glucose frequently.•Washing your hands and disinfecting infusion sites to reducethe possibility of infection.•Being aware of the signs of hypoglycemia (low bloodglucose), hyperglycemia (high blood glucose), and DKA (see “Avoid Adverse Reactions” later in this chapter).•Keeping a diabetes emergency kit with you at all times (see“Prepare for Emergencies” later in this chapter).•Knowing how to contact your healthcare provider in case of an emergency.If you are unable to use the system according to instructions, you may be putting your health and safety at risk. Talk with your healthcare provider if you havequestions or concerns about using the iXL System.Safety FeaturesThe iXL System’s state-of-the-art design includes the latestsafety technology. Its built-in safety features include:Automatic priming, safety checks, and insertion with RediSet™Every time a new iXL Pump is activated, the exclusive RediSetsystem automatically primes and performs a safety check on thepump, then inserts and primes the cannula (see Chapter 5, TheiXL Pump). Micro-processor technology makes it possible tocomplete thousands of safety checks in only a few seconds. Continuous monitoringThe iXL System checks the operation of the remote and pumpand informs you if any problems are detected. For example,during setup, you entered a maximum daily dose. If you try togive a bolus that would put you over the maximum for the day,the remote alerts you. This automatic safeguard protects youfrom unintended overdelivery of insulin. The system checkscommunication between the remote and the pump as well asfunctions within each device.iXL™ Diabetes Management System User Guide: Achieve Healthy, Safe Pumping 678
Rapid occlusion detectionAn occlusion is a blockage or interruption in insulin delivery. The iXL System can detect an occlusion as small as 2 units,which may lower your risk for hyperglycemia or DKA.An occlusion may result from a blockage, pump malfunction, or from using old or inactive insulin. If insulindelivery is interrupted by an occlusion, check your bloodglucose level and follow the treatment guidelines established by your healthcare provider (see “AvoidAdverse Reactions” later in this chapter).Alerts and advisory and hazard alarmsFor your safety, the iXL System provides a range of alerts andalarms to notify you of continuing functions, tell you that yourattention is needed, or warn you of hazardous situations. Forexample, the Auto off advisory alarm alerts you when you havenot used the remote to communicate with the pump within atime period that you set. You can set a time period between 1and 24 hours, in 1-hour increments. If you do not respond to anAuto off advisory alarm within 15 minutes, the pump and remotego into a hazard alarm state.See Chapter 6, iXL Remote Controller Features, for a descriptionof alerts and reminders and how to set them, and Chapter 9,Hazard and Advisory Alarms, for a list of safety alarms built intothe iXL System and how to respond to them.Daily Diabetes Management ActivitiesTo ensure proper iXL System operation and your continued goodhealth, you should perform these activities every day:Check blood glucoseRoutine blood glucose checks allow you to identify and treat highor low blood glucose before it becomes a problem (see “AvoidAdverse Reactions” later in this chapter).•Check your blood glucose at least 4 to 6 times a day: whenyou wake up, before every meal, and before going to bed. In addition, check:•Whenever you feel nauseated or sick.•Before driving a car.•Whenever your blood glucose has been running unusuallyhigh or low.•If you suspect that your blood glucose is high or low.•Before, during, and after exercise.•As directed by your healthcare provider.68 iXL™ Diabetes Management System User Guide: Achieve Healthy, Safe PumpingAchieve Healthy, Safe Pumping8
Achieve Healthy, Safe PumpingInspect the infusion siteAt least once a day, use the iXL Pump’s viewing window toinspect the infusion site. Check the site for signs of infection,such as pain, swelling, redness, discharge, or heat.If an infusion site shows signs of infection:1. Immediately remove the pump and attach a new one at adifferent site (see Chapter 5, The iXL Pump).2. Contact your healthcare provider.3. Treat the infection according to instructions from yourhealthcare provider. (Refer to Chapter 5, The iXL Pump, fordetailed information on site care and preparation.)Consider making infusion site checks a part of yourregular daily routine (like showering or brushing yourteeth). That way, it’s easy to remember.Water and Your PumpThe iXL Pump is watertight to a depth of 8 feet for up to 30minutes (IPX8). After exposure to water, rinse off the pump withclean water and dry it with a towel.Do NOT expose your iXL Pump to water at depths greaterthan 8 feet or for durations exceeding 30 minutes. Checkthe infusion site often to make sure the pump and softcannula are securely attached and in place.The iXL Remote Controller is not waterproof. Do NOTplace it in or near water.Traveling and VacationingPlan for changing time zonesIf you’re planning a business trip or vacation to a different time zone, you may need to adjust your basal rate programs. For changes of just a few hours, basal rate adjustments areminor and easy to calculate. For long-distance travel, however,figuring out the correct program can be more challenging. Your healthcare provider can help with these adjustments.iXL™ Diabetes Management System User Guide: Achieve Healthy, Safe Pumping 698
Take enough suppliesKeeping your emergency kit with you during trips or vacations is especially important (see “Prepare for emergencies” later in this chapter). It may be difficult or impossible to get insulin or supplies in an unfamiliar place. If traveling by air, be sure topack your supplies in your carry-on luggage. When packing fortravel, be sure to include the following and take more than youthink you’ll need:•Diabetes emergency kit packed in your carry-on luggage•Enough pumps for your trip, plus a backup supply•Extra remote batteries•Insulin syringes or pens in case you need injections•Several vials of insulin or insulin cartridges if you use a pen•Glucagon kit (make sure any person you are traveling withknows how to give the injection)•Alcohol prep swabs•Written prescriptions for all medications and supplies(generic medications may be easier to find than brand namesoutside the US)When traveling outside the country or for long periods oftime, consider taking a backup remote. Call (800) 591-9948to order additional pump supplies for your trip.Minimize airport security delaysContact the airlines in advance for information on their currentsecurity requirements. To make airport security checks gosmoothly, be sure you have the following easily accessible:•A signed letter from your healthcare provider explaining thatyou need to carry insulin supplies and pump equipment•An emergency kit (see “Prepare for emergencies” later inthis chapter)•A list of the supplies you must carry, including the contentsof your emergency kit•Prescriptions for insulin and all supplies, clearly marked withtheir original pharmacy labelsIf the detector goes off, tell the security screener that you havediabetes and wear an insulin pump.iXL Pumps and Remote Controllers can safely passthrough airport X-ray machines (see the FCC notice in the Appendices).70 iXL™ Diabetes Management System User Guide: Achieve Healthy, Safe PumpingAchieve Healthy, Safe Pumping8
Achieve Healthy, Safe PumpingKeep supplies accessibleOn airplanes and trains, keep these items in your carry-onluggage, rather than checking them:•iXL Remote Controller•An emergency kit•Extra vials of insulin (cargo area temperatures may affectinsulin)•A copy of your healthcare provider’s letter (see “Minimizeairline security delays”)•Prescriptions for insulin and supplies•Snacks (in case food is not available)•Bottled water (especially on planes) to prevent dehydration•The name and phone number of a physician at your finaldestination, in case of emergencyAvoid Adverse ReactionsMost risks related to insulin pump therapy can be avoided bypracticing good pumping techniques and by acting promptly atthe first sign of trouble. You can avoid potential problems bybeing aware of the signs of hypoglycemia (low blood glucose),hyperglycemia (high blood glucose), and DKA. The easiest andmost reliable way to avoid these conditions is to check yourblood glucose often.General precautions•Keep careful records and discuss changes and adjustmentswith your healthcare provider.•Tell your healthcare provider if you have extreme highs orlows, or if highs or lows are occurring more often than usual.•If you have technical difficulties with your iXL System andare unable to resolve them, do not hesitate to contact us. Our 24-hour technical support hotline is (800) 591-3455.iXL™ Diabetes Management System User Guide: Achieve Healthy, Safe Pumping 718
Hypoglycemia (low blood glucose)Hypoglycemia can occur even when a pump is working properly.Never ignore the signs of low blood glucose (no matter how mild).If left untreated, severe hypoglycemia can cause seizures orlead to unconsciousness. If you suspect or feel that your bloodglucose level is low, check your blood glucose level to confirm.For users who are prone to hypoglycemia unawareness, acondition in which people do not realize when their bloodglucose levels are low, the iXL System’s blood glucosereminder can be especially useful.Symptoms of hypoglycemiaNever ignore these symptoms:•Shakiness•Fatigue•Sweating•Cold, clammy skin•Weakness•Blurred vision or a headache•Sudden hunger•Rapid heart rate•Confusion•Tingling in the lips or tongue•AnxietyTo avoid hypoglycemia (low blood glucose)•Make sure your blood glucose is at least 100 mg/dl beforedriving or working with dangerous machinery or equipment.Besides the risk of hypoglycemia while driving or operatingdangerous equipment, focusing on a task may cause you tomiss symptoms you might notice otherwise.•Work with your healthcare provider to establish individualizedblood glucose targets and guidelines.•Keep a fast-acting carbohydrate (such as glucose tablets,hard candies, or juice) with you at all times to respondquickly to low blood glucose.•Teach your friends, family members, and colleagues torecognize the signs of hypoglycemia, so they can help ifyou develop hypoglycemia unawareness or a severe adverse reaction.•Keep a glucagon injection kit with your emergency supplies.Teach friends and family members how to give a glucagoninjection in case you have severe hypoglycemia and becomeunconscious.Periodically check the expiration date of your glucagonkit to make sure it has not expired.Always carry medical identification and wear anemergency medical necklace or bracelet such as theMedic Alert tag. 72 iXL™ Diabetes Management System User Guide: Achieve Healthy, Safe PumpingAchieve Healthy, Safe Pumping8
Achieve Healthy, Safe PumpingAgain, frequent blood glucose checks are the key to avoiding potential problems. Detecting low blood glucose early lets youtreat it before it becomes a problem.Check with your healthcare provider for guidance in any and allareas listed above.To treat hypoglycemia (low blood glucose)Any time your blood glucose is low, treat it immediately. Check it every 15 minutes while you are treating, to make sureyou don’t over-treat the condition and cause blood glucoselevels to rise too high.Even if you cannot check your blood glucose, do NOT wait to treat symptoms of hypoglycemia, especially if youare alone.1. If blood glucose is 80 mg/dl or below, eat or drink 15 grams offast-acting carbohydrate, such as glucose tablets, juice, orhard candy (see “How much is 15 grams of carbohydrate?”).Do NOT use chocolate or candy bars to treat low bloodglucose. Their fat content slows down glucose absorption.2. Check blood glucose again after 15 minutes.3. If blood glucose remains low, take another 15 grams of carbohydrate.4. Repeat steps 2 and 3 until blood glucose is within target range.5. Investigate possible cause for hypoglycemia to avoid similar problems in the future (see “Possible causes of lowblood glucose”).How much is 15 grams of carbohydrate?Examples of fast-acting foods:•Three 5-gram glucose tablets, or four 4-gram tablets•4 ounces of orange juice•6 lifesavers or similar hard candy•1/2 can of regular (non-diet) soda•2 tablespoons of table sugar, honey, or corn syrupTeach people you trust (like family members and closefriends) how to give a glucagon injection. You will need to rely on them to give it to you if you have severehypoglycemia and become unconscious. Include a copy of the glucagon instructions in your emergency kit andperiodically review the procedure with family and friends.iXL™ Diabetes Management System User Guide: Achieve Healthy, Safe Pumping 738
Possible causes of hypoglycemia (low blood glucose)Possible cause of low Suggested actionIncorrect basal rate Check basal rate program.programPump time not set Reset time.correctlyBolus too large Check bolus size and timing.Do NOT over-correct for post-mealglucose levels.Check carb intake (consult healthcareprovider about carb counting).Consult healthcare provider to refineinsulin-to-carb ratio.Wrong bolus timing Time bolus with food intake.Check blood glucose before givingmeal bolus; if necessary, adjust bolus.Alcohol consumption Consult with your healthcare providerfor alcohol consumption guidelines.Check blood glucose before going tobed (check with healthcare provider forguidance).Unplanned activity If blood glucose is below 100 mg/dl, eata snack before activity.Possible cause of low Suggested actionProlonged or intense Adjust insulin delivery as instructedexercise by your healthcare provider.Check blood glucose before, during,and after activity and treat as necessary.Effects of exercise can last severalhours–even a full day–after activityends.Low carbohydrate Consume carbohydrate beforeintake prior to activity activity, especially if you have notdecreased insulin beforehand.Failure to use the Consult healthcare provider on settingtemporary (temp) basal temp basal rates (see Chapter 3, Basalrate feature Rates).Prone to severe Consult healthcare provider abouthypoglycemia raising target blood glucose levels.Hypoglycemia Consult healthcare provider aboutunawareness hypoglycemia unawareness and aboutraising target blood glucose levels.Incorrect target blood Consult healthcare provider aboutglucose levels raising target blood glucose levels.Incorrect correction Consult healthcare provider about factor (sensitivity correction (sensitivity) factor; adjust it factor) if appropriate.74 iXL™ Diabetes Management System User Guide: Achieve Healthy, Safe PumpingAchieve Healthy, Safe Pumping8
Achieve Healthy, Safe PumpingHyperglycemia (high blood glucose)Insulin pumps use rapid-acting insulin; therefore, if there is an interruption in insulin delivery, pump users are at risk fordeveloping hyperglycemia.Symptoms of hyperglycemia (high blood glucose)•Fatigue•Frequent urination, especially during the night•Unusual thirst or hunger•Unexplained weight loss•Blurred vision•Slow healing of cuts or soresHyperglycemia symptoms can be confusing. Always check your blood glucose before you treat for hyperglycemia.To avoid hyperglycemia (high blood glucose)Check your blood glucose at least four 4-6 times a day (when you wake up, before each meal, and before going to bed).In addition, always check it:•Whenever you feel nauseated or sick.•Before driving a car.•Whenever your blood glucose has been running unusuallyhigh or low.•If you suspect that your blood glucose is high or low.•Before, during, and after exercise.•As directed by your healthcare provider.To treat hyperglycemia (high blood glucose)Always check your blood glucose levels frequently when treating hyperglycemia to make sure you don’t over-treat thecondition and cause blood glucose levels to drop too far.1. Check your blood glucose level. The result will help you tofind out how much insulin is needed to return your bloodglucose to the target range.2. If your blood glucose is over 250 mg/dl, check for ketones. If ketones are present, follow your healthcare provider’sguidelines.3. If ketones are not present, take a correction bolus asprescribed by your healthcare provider.4. Check blood glucose again after 2 hours.iXL™ Diabetes Management System User Guide: Achieve Healthy, Safe Pumping 758
5. If blood glucose levels have not decreased, take a secondbolus by injection, using a sterile syringe. Ask your healthcareprovider whether to inject the same amount of insulin as instep 3.6. If you feel nauseated at any point, check for ketones and call your healthcare provider immediately (see “Diabeticketoacidosis” later in this chapter).7. If blood glucose remains high after another 2 hours, replacethe pump (fill the new pump using a new vial of insulin), then:•Contact your healthcare provider for guidance.•Drink eight ounces of water every 30 minutes until bloodglucose is within target range.If you need emergency attention, ask a friend or familymember to take you to the emergency room or call anambulance. Do NOT drive yourself.8. Investigate possible cause for hyperglycemia to avoid similar problems in the future (see “Possible causes ofhyperglycemia”).Possible causes of hyperglycemia (high blood glucose)Possible cause of high Suggested actionExpired insulin Deactivate and remove used pump.Attach new pump filled with insulinfrom a new vial.Insulin exposed to Deactivate and remove used pump.extreme temperatures Attach new pump filled with insulin from a new vial.Infusion site in or near Deactivate and remove used pump.a scar or mole Attach a new pump in a differentlocation.Infected infusion site Deactivate and remove used pump.Attach a new pump in a different locationand consult your healthcare provider.Dislodged cannula Deactivate and remove used pump.Attach a new pump in a differentlocation.Avoid sites near a waistband, belt,or other area where friction maydislodge the cannula.Empty pump Deactivate and remove used pump.Attach a new pump in a different location.Incorrect bolus dose Check carb intake (consult healthcareprovider about carb counting).76 iXL™ Diabetes Management System User Guide: Achieve Healthy, Safe PumpingAchieve Healthy, Safe Pumping8
Achieve Healthy, Safe PumpingPossible cause of high Suggested actionIncorrect bolus timing Time bolus with food intake.Check blood glucose before giving meal bolus; if necessary, adjust bolus.Incorrect basal rate Confirm that programmed basal rate iscorrect.Consult healthcare provider beforemaking changes to your basal rate.High-protein or Calculate protein/fat intake andhigh-fat meal account for it in your bolus timing andbolus type. (Consult your healthcareprovider for guidance.)Less activity than Use temporary (temp) basal ratenormal feature (see Chapter 3, Basal Rates).Blood glucose greater Do NOT exercise when ketones are than 250 mg/dl present (blood glucose increases with (with ketones present) exercise when ketones are present). before exercise Consult healthcare provider about exercise guidelines.Infection or illness See “Sick days“ later in this chapter.Consult healthcare provider about sick-day guidelines.Possible cause of high Suggested actionMedication change Speak with your healthcare providerabout any medication changes oradditions.Weight loss or gain Consult your healthcare provider. Premenstrual cycle Program a temp basal preset forpremenstrual cycle (see Chapter 3,Basal Rates).Pregnancy Consult your healthcare provider.Check with your healthcare provider for guidance on anyof the causes or suggested actions above.iXL™ Diabetes Management System User Guide: Achieve Healthy, Safe Pumping 778
Diabetic ketoacidosis (DKA)Insulin pumps use only rapid-acting insulin. Because there is no reserve of long-acting insulin in the body, any occlusion orinterruption in insulin delivery can rapidly lead to diabeticketoacidosis (DKA). DKA is a serious–but totally preventable– emergency that can occur if you ignore high bloodglucose levels.If left untreated, DKA can cause breathing difficulties, shock,coma, and eventually death.Symptoms of DKA•Nausea and vomiting•Abdominal pain•Dehydration•Fruity-smelling breath•Dry skin or tongue•Drowsiness•Rapid pulse•Labored breathingThe symptoms of DKA are much like those of the flu. Beforeassuming you have the flu, check your blood glucose and checkfor ketones to rule out DKA.To avoid DKAThe easiest and most reliable way to avoid DKA is by checkingyour blood glucose at least 4 to 6 times a day. Routine checksallow you to identify and treat high blood glucose before DKAdevelops.To treat DKA1. Once you have begun treatment for high blood glucose,check for ketones.2. If ketones are negative or trace, continue treating for highblood glucose.3. If ketones are positive, but you are not feeling nauseated orill, replace the pump, using a new vial of insulin.4. If ketones are present and you are feeling nauseated or ill, immediately call your healthcare provider for guidance.5. Check blood glucose again after 2 hours. If blood glucoselevel has not declined, immediately call your healthcareprovider for guidance. If you need to go to the emergencyroom for further treatment, do NOT drive yourself: either callan ambulance or have a friend or family member drive you.78 iXL™ Diabetes Management System User Guide: Achieve Healthy, Safe PumpingAchieve Healthy, Safe Pumping8
Achieve Healthy, Safe PumpingHandling Special SituationsPrepare for emergenciesPrepare and keep an emergency kit with you at all times toquickly respond to any diabetes emergency. The kit shouldinclude:•Blood glucose meter and strips•Lancet device and lancets•Ketone strips•Glucose tablets or another fast-acting source of carbohydrate•Alcohol prep swabs•A vial of rapid-acting U-100 insulin•Syringes for injecting insulin•Instructions from your healthcare provider about appropriate injection doses if insulin delivery is interrupted•Several iXL Pumps with their syringes and filling needles•Extra remote batteries (at least two AAA alkaline)•Extra blood glucose meter batteries•A copy of the letter from your healthcare provider for airlinesecurity•Contact information for reaching your healthcare providerand/or doctor in case of an emergency•Glucagon kit and written instructions for giving an injection ifyou are unconscious (see ”Avoid Adverse Reactions” earlierin this chapter).Ask your healthcare provider to help you develop plansfor handling emergency situations, including what to do if you cannot reach your healthcare provider.Sick daysAny physical stress can cause your blood glucose to rise, andillness is a physical stress. Your healthcare provider can helpyou make a specific plan for sick days. The following are onlygeneral guidelines.When you are ill, check your blood glucose more often (at leastonce every 2 hours) to avoid DKA. The symptoms of DKA aremuch like those of the flu. Before assuming you have the flu,check your blood glucose to rule out DKA (see ”Avoid AdverseReactions” earlier in this chapter).iXL™ Diabetes Management System User Guide: Achieve Healthy, Safe Pumping 798
To handle sick days:•Treat the underlying illness to promote faster recovery.•Eat as normally as you can.•Adjust bolus doses, if necessary, to match changes in carbohydrate/calorie intake.•Always continue your basal insulin, even if you are unable to eat. Contact your healthcare provider for suggested basalrate adjustments during sick days.•Check your blood glucose every two hours and keep carefulrecords of results.•Test for ketones when blood glucose is 250 mg/dl or higher.• Follow your healthcare provider’sguidelines for givingadditional insulin on sick days.•Drink plenty of noncaffeinated fluids to prevent dehydration.If you are well enough to eat, drink sugar-free beverages. However, if you are too sick to eat solidfoods, alternate between sugar-free beverages and those containing sugar.•Call your healthcare provider immediately if you have any ofthe following: persistent nausea, vomiting for more than twohours, high blood glucose or ketones that stay elevateddespite increased insulin, or low blood glucose with nauseaor vomiting.Exercising, playing sports, or working hardCheck your blood glucose levels before, during, and afterexercising, playing sports, or doing unusually hard physical labor.Under normal conditions the iXL Pump’s adhesive keeps itsecurely in place for up to three days. There are a variety ofproducts available to help secure the pump to the skin. Ask your healthcare provider about these products.For some contact sports, you may want to remove the iXL Pump(see “Short-term removal” below).Short-term removalThe iXL Pump is designed to be discreet as well as comfortable.It should be worn at all times so that you can enjoy all thebenefits of continuous insulin delivery. Occasionally, though, itmay be necessary to temporarily remove the pump.Be sure to check your blood glucose levels before removing thepump and after attaching a new one. Pumps are designed forone-time use. Do not attempt to reattach a used iXL Pump.If possible, avoid wasting pumps by planning removaltimes that coincide with a scheduled pump replacement.If you will need to remove the pump for more than 1 hour, askyour healthcare provider to recommend appropriate guidelines.80 iXL™ Diabetes Management System User Guide: Achieve Healthy, Safe PumpingAchieve Healthy, Safe Pumping8
Achieve Healthy, Safe PumpingX-rays, MRIs, and CT scansThe iXL Pump and Remote Controller may be affected by strong radiation or magnetic fields. Before having an X-ray, MRI, or CTscan (or any similar test or procedure), remove your pump andremote and put them outside the treatment area. Check withyour healthcare provider on pump removal guidelines.The pump and remote can tolerate common electromagnetic and electrostatic fields, including airportsecurity and cellular phones.Surgery or hospitalizationFor scheduled surgeries or hospitalization, you should tell thedoctor/surgeon or hospital staff about your insulin pump. It maybe necessary to remove it for certain procedures or treatmentsand replace the basal insulin that was missed while the pumpwas removed. Your healthcare provider can help you preparefor these situations.Always carry medical identification and wear anemergency medical necklace or bracelet such as theMedic Alert tag. (See the end of the Appendices foraddress, telephone, and web site information.)iXL™ Diabetes Management System User Guide: Achieve Healthy, Safe Pumping 818
Notes:82 iXL™ Diabetes Management System User Guide: Achieve Healthy, Safe PumpingAchieve Healthy, Safe Pumping8
Be Aware: Hazard and Advisory AlarmsSafety ChecksA very important safety feature of the iXL System is its ability to check its own functions and to let you know when somethingneeds attention. When you turn on the remote, the systemautomatically performs a series of safety checks. To make youaware of a serious or potentially serious condition, the systemwill sound an audible alarm and display an on-screen messagewith instructions for resolving the alarm. All alarms include adate and time indicating when the condition occurred. Alarmconditions are easy to handle, and will not be a problem if youattend to them promptly.Check your blood glucose level frequently.Hazard AlarmsHazard alarms occur either when the pump is in a hazard condition or something is wrong with the remote. Hazard alarmsare all continuous tones and each has an on-screen message(see the “Hazard Alarms” table on the following pages). Followthe instructions in the message to resolve the alarm situation.If a bolus is being delivered when a hazard alarm occursin the pump, the bolus is cancelled. (A hazard alarm inthe remote, however, does not cancel a bolus delivery.)Before the system displays the alarm’s on-screenmessage, it tells you how much insulin was deliveredbefore the bolus was cancelled. That information isstored in the system’s history records (see Chapter 7, MyRecords). After you resolve the alarm, you can check theamount of the last bolus displayed on the Status screento see how much of the bolus was delivered.iXL™ Diabetes Management System User Guide: Be Aware: Hazard and Advisory Alarms 839
84 iXL™ Diabetes Management System User Guide: Be Aware: Hazard and Advisory AlarmsBe Aware: Hazard and Advisory Alarms9Hazard AlarmsAlarm Type Source Action to resolve Alarm Type Source Action to resolveEmpty reservoir Pump Press OK to Pump expired Pump Press OK toacknowledge. acknowledge.Change pump. Change pump.Occlusion detected Pump Press OK to Auto Off Pump Press OK toacknowledge. and acknowledge.Change pump. Remote Change pump.
Be Aware: Hazard and Advisory AlarmsiXL™ Diabetes Management System User Guide: Be Aware: Hazard and Advisory Alarms 85 9Hazard AlarmsAlarm Type Source Action to resolve Alarm Type Source Action to resolvePump change interruption Pump Press OK to Stuck key detected Remote Press OK toacknowledge. acknowledge.Change pump. Remove pump.Call Insulet.(800) 591-3455Remote error Remote Press OK to Remote error Remote Press OK toacknowledge. acknowledge.Change pump. Remove pump.Call Insulet.(800) 591-3455
86 iXL™ Diabetes Management System User Guide: Be Aware: Hazard and Advisory AlarmsBe Aware: Hazard and Advisory Alarms9Alarm Type Source Action to resolvePump error Pump Press OK toor acknowledge.Remote Change pump. Hazard AlarmsAlarm Type Source Action to resolveRemote error Remote Press OK toacknowledge.System error Pump Press OK toor acknowledge.Remote Change pump.System error Press OK toacknowledge.Remove pump.Call Insulet.(800) 591-3455
Respond to hazard alarmsDue to the serious nature of hazard alarms, you must actpromptly to resolve them.1. Acknowledge the alarm condition by pressing OK, whichsilences the alarm.2. Deactivate and remove the current pump (see Chapter 5, The iXL Pump).3. Activate and attach a new pump (see Chapter 5, The iXLPump).For a hazard alarm caused by a stuck key, remote error,or system error that displays, “Call Insulet immediately,”remove the pump and call Insulet immediately forinstructions. The 24-hour support line is (800) 591-3455.Be Aware: Hazard and Advisory Alarms 9Hazard AlarmsiXL™ Diabetes Management System User Guide: Be Aware: Hazard and Advisory Alarms 87
Alarm Type Source Beep pattern and escalation process Action to resolveLow reservoir volume Pump 3 sets of beeps every minute for 3 minutes. Press OK to acknowledge. Repeats every 60 minutes untilacknowledged.Escalates to hazard alarm when is empty. (based on volume selected by user)988 iXL™ Diabetes Management System User Guide: Be Aware: Hazard and Advisory AlarmsAdvisory AlarmsAdvisory alarms tell you about a condition that requiresyour attention. When you hear an advisory alarm, turn onthe remote to display the Status screen. The screendisplays a message describing the alarm and how toresolve it.Some advisory alarms are controlled by levels you set inthe Settings screen (for example, the insulin level at whichthe low-reservoir-volume alarm sounds). All advisoryalarms are time-sensitive and require a response. Someadvisory alarms escalate to hazard alarms if you do notrespond within a certain time period (as noted in thetable below).Each advisory alarm beeps intermittently and displays an on-screen message once the remote Status screen isupdated.Be Aware: Hazard and Advisory Alarms9Advisory Alarms
Be Aware: Hazard and Advisory AlarmsiXL™ Diabetes Management System User Guide: Be Aware: Hazard and Advisory Alarms 899Advisory AlarmsAlarm Type Source Beep pattern and escalation process Action to resolvePump expiration advisory IPump 3 sets of beeps every minute for 3 minutes. Press OK to acknowledge.Repeats every 60 minutes. Change pump.Escalates to “Pump expiration advisory II”after 2 hours.Pump expiration advisory II Pump 3 sets of beeps every minute for 3 minutes. Press OK to acknowledge.Escalates to “Pump expired” hazard Change pump.alarm after 60 minutes.
Advisory Alarms90 iXL™ Diabetes Management System User Guide: Be Aware: Hazard and Advisory AlarmsBe Aware: Hazard and Advisory Alarms9Alarm Type Source Beep pattern and escalation process Action to resolveEnd of suspend Pump 3 sets of beeps every minute for 3 minutes. Press OK to resume insulin Repeats until insulin delivery is resumed. delivery at programmed basal rate.Auto off advisory Pump and 3 sets of beeps every minute for 15 minutes. Press OK to acknowledge. Remote Escalates to “Auto off” hazard alarm if notacknowledged within 15 minutes.
Be Aware: Hazard and Advisory AlarmsiXL™ Diabetes Management System User Guide: Be Aware: Hazard and Advisory Alarms 919Advisory AlarmsAlarm Type Source Beep pattern and escalation process Action to resolveStuck key detected Remote 3 sets of beeps every 3 minutes for 60 Check key to resolve.minutes. If key remains stuck, press Fail.Escalates to “Stuck key” hazard alarm if not resolved within 60 minutes of if youpress Fail.Respond to advisory alarmsFor an advisory alarm caused by a low reservoir or pump expiration:1. Acknowledge the alarm condition by pressing OK,which silences the alarm.2. Deactivate and remove the current pump (see Chapter5, The iXL Pump).3. Attach and activate a new pump (see Chapter 5, The iXLPump).For an advisory alarm caused by Auto off or End ofsuspend, simply press OK.For an advisory alarm caused by a stuck key, press thesoft key or button named in the on-screen message. If this does not resolve the problem, press Fail. This actionresults in a hazard alarm with instructions to call Insuletsupport for assistance.
92 iXL™ Diabetes Management System User Guide: Be Aware: Hazard and Advisory AlarmsBe Aware: Hazard and Advisory Alarms9My Notes:
Troubleshoot Communication FailuresEvery time you turn on or use the iXL Remote Controller, it establishes communication with the active pump. Usually,communication occurs quickly. However, communication canfail if the remote is:•Too far from the pump (it must be within 12 inches whenentering or changing settings).•Interrupted by outside interference (see FCC Notice in theAppendices). In either case, the error is easy to resolve. The remote walks youthrough the steps you need to take.The Communication Failure SequencesFailure at start upIf you turn on the remote or press Status and the remote cannotcommunicate with the pump within 10 seconds, you will see the messages in Figure 10-1, in sequence.1. At the first message, change remote position and press Retry.2. If communication still fails, you will see the second message.Change remote position and press Retry again.3. If the second retry attempt does not succeed, you see the third message. Move to a new area (across a room, to adifferent room, or away from electrical appliances) and pressRetry again.Press Cancel to return to the Status screen, which displaysinformation as of the last status check.iXL™ Diabetes Management System User Guide: Troubleshoot Communication Failures 9310Figure 10-1 1 23
Failure during operationIf the remote is unable to deliver your instructions (such as abolus delivery or a change in basal program) to the pump within6 seconds, you will see the messages in Figure 10-2, in sequence.1. At the first message, change remote position to improvecommunication. You do not need to press any soft keys. Theremote will try to communicate with the pump for another 10seconds.2. If communication still fails, you will see the second message.Change remote position to improve communication. Theremote will try for another 10 seconds (total, 26 seconds).3. If that attempt fails, and you were originally trying to Cancela bolus dose, a hazard alarm will sound.If you were not trying to cancel a bolus, you will see the third message. Move to a new area (across a room, to adifferent room, or away from electrical appliances). Thistime, press Retry.4. If you press Retry within 2 minutes, the remote will try foranother 26 seconds. If that fails, the hazard alarm will sound.If you do not press Retrywithin 2 minutes, you will seethe screen in Figure 10-3.Press OK to confirm pumpstatus. If the status checkfails, the remote will thensound a hazard alarm.See Chapter 9, Hazardand Advisory Alarms,for more informationabout hazard alarms.94 iXL™ Diabetes Management System User Guide: Troubleshoot Communication FailuresTroubleshoot Communication Failures10Figure 10-2 1 23Figure 10-3
Troubleshoot Communication Failures5. If you were entering a command when communication failed,when communication is reestablished, the system either:(a) Indicates the command was successful (Figure 10-4) anddisplays the next screen in the command sequence within 5 seconds.(b) Indicates the command was not received by the pump(Figure 10-5). Press OK. If you were activating a pump, the system returns to theprevious screen where you can continue activation.If you were issuing any other command, the system returnsto the Status screen, where you can reissue the command.For technical support, call Insulet’s 24-hour customersupport at (800) 591-3455.6. If you were deactivating a pump when communication failed,you will see the message in Figure 10-6. Remove and discardthe old pump and then press Continue to activate a new pump.iXL™ Diabetes Management System User Guide: Troubleshoot Communication Failures 9510Figure 10-4 Figure 10-5Figure 10-6
My Notes:96 iXL™ Diabetes Management System User Guide: Troubleshoot Communication FailuresTroubleshoot Communication Failures10
iXL™ Diabetes Management System User Guide: Appendices 97AppendicesiXL™ Pump Care and MaintenanceStorageStore unopened iXL Pumps in a cool, dry place. Extreme heat or cold can damage pumps and cause them to malfunction. If pumps are exposed to extreme temperatures, inspect themcarefully before use. Do not attach or use pump if its sterilepackaging is opened or damaged. Pumps are sterile unlesspackaging is opened or damaged.CleaningiXL Pumps are water tight. If you need to clean the pump, youcan gently wash it with a clean damp cloth. You can use aclean, damp cloth, or use mild soap and water. However, do notuse strong detergents or solvents. They can damage the pump’scasing or irritate the infusion site.Hold your pump securely and take care while cleaningthe pump so the catheter doesn’t get kinked and thepump doesn’t become detached.iXL™ Remote Controller Care and MaintenanceStorageWhen you are not actively using the remote to enter or changeprograms, you can store it in a convenient, nearby location. Thestorage location should be a cool, dry place.Do NOT store or leave the remote where it may beexposed to extreme temperatures, such as inside a car.Extreme heat or cold can cause the device to malfunction.If the remote is not safe from children or others who may pressthe buttons unintentionally, consider activating the optionalRemote lock safety feature that prevents accidental programchanges (see Chapter 6, iXL Remote Controller Features).CleaningYou can clean the outside of the remote with a clean, damp cloth.Do NOT use soap, detergent, or solvents. Never put any liquidinto the battery compartment.If the battery compartment becomes soiled, gently shake out thedebris or use a dry, lint-free cloth to remove it.
98 iXL™ Diabetes Management System User Guide: AppendicesAppendicesReplacing batteriesThe iXL Remote Controller uses 2 AAA alkaline batteries. Youcan purchase them at any grocery, hardware, or conveniencestore, or order them from Insulet (see “Ordering supplies” laterin this chapter).Use only new AAA alkaline batteries to power the remote.Never use old or used batteries; the remote may notwork properly. On average, a pair of batteries powers the remote controller for4 weeks. The remote automatically alerts you when its batterypower gets low (see Figure A-1). After “Low remote battery”alert, press OK to turn off the alert and replace the batteries assoon as you can.If batteries run out, data and settings stored in the remote’smemory may be lost. Replace old batteries promptly.Information may be lost if batteries are removed and notreplaced within 2 hours. Therefore, do not remove the oldbatteries until you have new ones to replace them.The remote’s backlight and vibrate features use morebattery power than other system operations. To preservebattery life, consider turning off these features if you donot use them (see Chapter 6, iXL Remote ControllerFeatures).To replace batteries:1. On the back of the remote, open the battery compartment bygently pressing down on the ribbed side of the compartmentdoor until it opens (Figure A-2). You don’t need any specialtools.2. Inspect the battery compartment to make sure there is no dustor debris that might interfere with battery terminals. Shakeout any debris or use a clean, lint-free cloth to remove it.3. Insert two (2) new AAA alkaline batteries into the compartment and close it.The diagram inside the compartment shows you thedirection to insert the batteries.4. Turn the remote face up.Figure A-1 Figure A-2
iXL™ Diabetes Management System User Guide: Appendices 99Appendices5. Press the Power button.The remote is now ready to use.If the remote becomes submerged in waterThe iXL Remote Controller is not waterproof. Do NOT place it inwater or leave it near water where it can accidentally fall in. If it becomes submerged in water:1. Dry the outside of the device with a clean, lint-free cloth.2. Open the battery compartment; remove the batteries anddiscard them.3. Use a clean, lint-free cloth to gently absorb any water in thebattery compartment.4. Leave the battery compartment door open until the device is thoroughly dry.Never use a blow dryer or hot air to dry the pump orremote. Extreme heat can damage the electronics.5. Do NOT attempt to use the remote until it has thoroughly air-dried.For technical support, call Insulet’s 24-hour customersupport at (800) 591-3455.If you drop the remoteThe iXL Remote Controller is built to withstand a lot of abuse,but shock or severe impact can damage it. If you drop theremote or if it is otherwise subjected to severe impact:1. Inspect the outside of the device for visible signs of damage.2. Press the Power button to see whether the remote comes onand whether the LCD screen is damaged.3. Inspect the inside of the battery compartment for visiblesigns of damage.4. Do NOT use the remote if it appears damaged or is notworking as it should.For technical support, call Insulet’s 24-hour customersupport at (800) 591-3455.
100 iXL™ Diabetes Management System User Guide: AppendicesAppendicesInsulin and SuppliesStorageStore all iXL System products and supplies (including unopenedpumps) in a cool, dry place. Products or supplies that have beenexposed to extreme temperatures may not function properly.It is especially important to store your insulin in a well-controlled environment. Inspect insulin before using it; never use insulinthat looks cloudy or discolored. Insulin that is cloudy or discolored may be old, contaminated, or inactive. Check theinsulin manufacturer’s instructions for use.Ordering suppliesAll iXL System products and supplies are available directly fromInsulet Corporation. You can order them at any time by calling (800) 591-9948. We use established, reliable carriers to insurefast, safe delivery. Special or overnight delivery is possible tomost parts of the continental United States.
iXL™ Diabetes Management System User Guide: Appendices 101AppendicesLimited Warranty for the iXL™ RemoteControllerLimited warranty coverageInsulet Corporation (“Insulet”) warrants to the original purchaser (“you”) that theiXL Remote Controller (the “Remote”) will be free from defects in materials andworkmanship, under normal use and conditions, for a period of two (2) years fromthe date of purchase. If Insulet determines that the Remote is defective during thewarranty period, Insulet will either repair or replace, at its option, the Remote at nocharge to you, subject to the conditions and exclusions stated herein. This Warrantyapplies only to new devices and, in the event the Remote is repaired or replaced,the warranty period shall not be extended.Warranty claim procedureYou must notify Insulet of the claimed defect within the warranty period by writingor calling: Insulet Corporation, 100 Cummings Center, Suite 239G, Beverly, MA01915; Telephone: (800) 591-3455; Facsimile: (978) 299-0301. The claim must includethe date of purchase, model number, serial number, and a description of theclaimed defect. Insulet's authorization must be obtained prior to returning theRemote. If authorized, the Remote must be properly packaged and returned toInsulet. Insulet will pay all freight and transportation charges, where applicable,incurred in shipping a Remote to be repaired or replaced under this Warranty.ConditionsProof of Purchase in the form of a bill of sale or receipted invoice showing that theRemote is within the warranty period must be presented to obtain warranty service.ExclusionsThis Warranty covers only the original purchaser and cannot be transferred with sale, rental, or other transfer of the Remote to any other person or entity. THIS WARRANTY DOES NOT APPLY IF THE REMOTE HAS BEEN:•Changed or modified by any person or entity other than Insulet;•Serviced or repaired by any person or entity other than Insulet;•Damaged by an act of God, misuse, abuse, negligence, accident, wear andtear, unreasonable use, or by other causes unrelated to defective materials or workmanship.MiscellaneousREPAIR OR REPLACEMENT AS PROVIDED UNDER THIS WARRANTY ISYOUR EXCLUSIVE REMEDY. ANY APPLICABLE IMPLIED WARRANTIES,INCLUDING WARRANTIES OF MERCHANTABILITY AND FITNESS FOR APARTICULAR PURPOSE, ARE LIMITED IN DURATION TO THE DURATIONOF THIS WARRANTY. IN NO EVENT SHALL INSULET, ITS SUPPLIERS, ORITS DISTRIBUTORS BE LIABLE FOR CONSEQUENTIAL OR INCIDENTALDAMAGES OR FOR BREACH OF ANY EXPRESS OR IMPLIED WARRANTYON THE REMOTE.Some states do not allow limitation on how long an implied warranty lasts, andsome states do not allow the exclusion or limitation of consequential or incidentaldamages, so the above limitations or exclusions may not apply to you.This Warranty gives you specific legal rights, and you may also have other rightswhich vary from state to state. This Warranty is valid only in the United States.No Other Warranty. Unless modified in a written document signed by both parties,this Warranty is understood to be the complete and exclusive agreement betweenthe parties, superceding all prior agreements, oral or written, and all other communications between the parties relating to the subject matter of this agreement.No employee of Insulet or any other party is authorized to make any warranty inaddition to those made in this Warranty.
102 iXL™ Diabetes Management System User Guide: AppendicesAppendicesiXL™ System Options and SettingsTime 12-hour or 24-hour clockDefault is 12-hourDate MM/DD/YYDD/MM/YYMM.DD.YYDD.MM.YYDefault is MM/DD/YYBolus and iBolus 0.1, 0.5, or 1.0 unitsincrement Default is 0.1 unitsExtended bolus duration 30 minutes to 8 hoursMaximum bolus size Up to 30 units in 0.1 unit incrementsDefault is 10 unitsBasal rate increment 0.05 unitsBasal programs 7Basal rate segments 48 per programMaximum basal rate 30 U/hrDefault is 3.00 U/hrTemp basal presets 7Temp basal duration 30 minutes to 24 hoursSuspend 30 minutes to 2 hoursBacklight time-out 15, 30, or 60 secondsDefault is 30 secondsScreen time-out 15, 30, or 60 secondsDefault is 30 secondsLanguage EnglishHistory storage 2400 records/90 daysRemote lock On or OffDefault is OffAuto off alert Off; 1 hour to 24 hoursDefault is OffBlood glucose reminder Off, Audible, or VibrateReminder time of 1, 2, 3, or 4 hours after every bolus doseDefault is OffLow reservoir volume 10 to 50 units in 5-unit incrementsindicator Default is 10.0 unitsPump expiration alert Off; 3 to18 hours in 1-hour incrementsDefault is 12 hours
iXL™ Diabetes Management System User Guide: Appendices 103AppendicesiXL™ Pump SpecificationsSize: 1.6” wide x 2.75” long x 0.6” high (4.1cm x 6.99cm x 1.5cm)Weight: 31 gramsOperating temperature range: 41°F to 104°F (5°C to 40°C)Storage temperature range: 14°F to 122°F (-10°C to 50°C)Reservoir volume (deliverable): 200 unitsCannula insertion depth: 6.5mmWater tight rating: IPX8Insulin concentration: U-100Alarm type: AudibleDelivery accuracy (tested per IEC 60601-2-24):Basal: +/- 5% at rates > 0.1 U/hrBolus: +/- 5% for all set valuesiXL™ Remote Controller SpecificationsSize: 2.75” wide x 4.5” long x 1.125” high (6.99cm x 11.4cm x 2.858cm)Weight: 165 gramsScreen: 2” square (5cm square) backlit LCDBattery: Powered by two (2) AAA alkaline batteriesBattery life: approximately 4 weeksOperating temperature range: 41°F to 104°F (5°C to 40°C)Storage temperature range: 14°F to 122°F (-10°C to 50°C)Communication distance: up to 12” (30.5cm)Alarm type: Audible, vibratoryWarranty: 2 years
104 iXL™ Diabetes Management System User Guide: AppendicesAppendicesiXL™ System Label SymbolsSymbol MeaningDo NOT reuse this device. Single-use only.Please read instructions for use (See User’s Guide).Sterilized by ethylene oxideManufacture date: (year–month)Lot numberExpiration date (use-by date): (year–month)Reference/record number: (reorder number)Device serial numberType BF medical device(protection from electrical shock)Latex freeNon-pyrogenicWatertight to 8 feet for 30 minutesKeep dryStorage temperatureiXL™ Remote Controller IconsIcon Menu Option Icon Menu OptionStatus Basal ProgramBattery Pump changeInsulin Gauge Hazard AlarmSetup Wizard Advisory AlarmCommunicating Confidence, Reminder,and Information AlertBolus & iBolus Blood glucose checkreminderTemp Basal Remote Lock IconMy Records Up/Down IconSettings Text entry cursorSuspend/Resume/Cancel
iXL™ Diabetes Management System User Guide: Appendices 105AppendicesiXL™ System Federal CommunicationsCommission (FCC) Notice ConcerningInterferenceThe iXL Remote Controller complies with Part 15 (RadioFrequency Devices) of the FCC Rules. As such, it is subject tothe following two conditions:1. It may not cause harmful interference.2. It must be able to accept interference, including interferencethat may cause undesirable operation of the device.The iXL Remote Controller has been tested and found to comply with the limits for a Class B digital device (according toPart 15 of the FCC Rules). These limits are designed to providereasonable protection against harmful interference in a residential setting.The iXL Remote Controller generates, uses, and can radiateradio frequency energy; and (if installed and used according to instructions) may cause harmful interference to radiocommunications. There are no guarantees that interference will not occur in a particular installation. If the remote doescause harmful interference to radio or television reception, the interference may be corrected by one or more of the following measures:•Moving or relocating the remote•Increasing the distance between the remote and the otherdevice that is emitting or receiving interference Helpful ResourcesAmerican Diabetes Association1660 Duke Street • Alexandria, VA 22314(800) 342-2383www.diabetes.orgInternational Association for Medical Assistance to TravelersList of doctors in foreign countries who speak English and whoreceived post-graduate education in the US or Great Britain417 Center Street • Lewiston, NY 14092(716) 754-4883Juvenile Diabetes Research Foundation International120 Wall Street • New York, NY 10005-4001(800) 533-2873www.jdf.orgMedic Alert FoundationTo order medical ID necklaces and braceletsPO Box 1009 • Turlock, CA 95381-1009(800) 432-5378www.medicalert.orgNational Institute of Diabetes & Digestive & Kidney Diseases(NIDDK)National Institutes of HealthBuilding 31, Center Drive, MSC 2560 • Bethesda, MD 20892-2560www.niddk.nih.gov/health/diabetes/diabetes.htm
My Notes:106 iXL™ Diabetes Management System User Guide: AppendicesAppendices
GlossaryA1c (see Hemoglobin A1c)Advisory alarmNotification by the remote that a serious condition exists.Aseptic techniqueA method for maintaining sterilization and preventing contamination.Basal programOne or more basal rates that together cover a 24-hour periodfrom midnight to midnight.Basal rateA small base or background amount of insulin that is delivered,at a preset rate, continuously for a specified period of time.Basal rates are measured in units per hour (U/hr).Basal segment (time segment)The time period during which a specific basal rate is delivered.Blood glucose (see glucose)Blood glucose levelThe amount of glucose, or sugar, in the blood. In the UnitedStates, blood glucose levels are measured in milligrams perdeciliter (mg/dl).Bolus doseA dose of insulin taken to correct an elevated blood glucose levelor to cover carbohydrates in a meal or snack.CannulaA small, thin tube inserted below the skin, which serves to introduce a liquid medication into the body.Carbohydrate (carb)One of the three main nutrients found in food. (The other twoare protein and fat.) Foods that contain carbohydrates includestarches, sugars, vegetables, fruits, and dairy products.Carbohydrate countingA method of meal planning based on counting the number ofgrams of carbohydrate in a given food.CSII (continuous subcutaneous insulin infusion)The medical term for using an insulin pump.Complications (of diabetes) Harmful effects of diabetes such as damage to the eyes, kidney, heart, blood vessels, nervous system, teeth and gums,feet, and skin.iXL™ Diabetes Management System User Guide: Glossary 107
GlossaryCorrection factor (also known as sensitivity factor)A formula for how much one unit of insulin will lower your bloodglucose. For example, if your sensitivity factor is 40, one unit ofinsulin will lower your blood glucose by 40mg/dl.Dawn phenomenonAn early morning rise in blood glucose level caused by thenormal release of hormones that block insulin’s effect.Diabetes Control and Complications Trial (DCCT)A study by the National Institute of Diabetes and Digestive andKidney Diseases, conducted from 1983 to 1993 in people withtype 1 diabetes showed that good blood glucose controlsignificantly helped prevent or delay diabetes complications.DiabetesA condition characterized by hyperglycemia (high blood glucose)resulting from the body’s inability to use blood glucose for energy.In type 1 diabetes, the pancreas no longer makes insulin andtherefore blood glucose cannot enter the cells to be used forenergy. In type 2 diabetes, either the pancreas does not makeenough insulin or the body is unable to use insulin correctly.Extended BolusA feature of the iXL System that allows a bolus dose to be givenover an extended period of time.Healthcare providerA professional who teaches people how to manage their health.Many healthcare providers are certified diabetes educators orCDEs. All healthcare providers are a resource for valuablediabetes management information.GlucoseA simple sugar (also known as dextrose) used by the body forenergy. Without insulin, the body cannot use glucose for energy.Hazard alarmNotification by the remote that a dangerous condition exists.Hemoglobin A1c (HbA1c)A test that measures a person’s average blood glucose levelover the past 2 to 3 months. Also called glycosylated hemoglobin, the test shows the amount of glucose that sticks to the red blood cell, which is proportional to the amount ofglucose in the blood.Hyperglycemia (high blood glucose)A higher-than-normal level of glucose in the blood; generally180mg/dl or higher.Hypoglycemia (low blood glucose) A lower-than-normal level of glucose in the blood; generally70mg/dl or lower.108 iXL™ Diabetes Management System User Guide: Glossary
GlossaryHypoglycemia unawarenessA condition in which a person does not feel or recognize thesymptoms of hypoglycemia.iBolus (Audio)A feature of the iXl System that allows a bolus dose to be given“on the go” without looking at the remote screen.IncrementThe act or process of increasing or decreasing a number, value,or amount.InfusionIntroducing a liquid substance under the skin into the body.Infusion sitePlace on the body where an infusion set is inserted.InsulinA hormone that helps the body use glucose for energy. The betacells of a healthy pancreas make insulin. Insulin reaction (see hypoglycemia)Insulin-to-carbohydrate ratioNumber of grams of carbohydrate covered by one unit of insulin.For example, if your insulin-to-carbohydrate ratio is 1:10, thenyou need to deliver one unit of insulin to cover every ten gramsof carbohydrate you eat.Ketoacidosis (diabetic ketoacidosis or DKA)A very serious condition in which extremely high blood glucoselevelsand a severe lack of insulin cause the body to break downfat for energy. The breakdown of fat releases ketones into theblood and urine. DKA can take hours or days to develop, withsymptoms that include stomach pain, nausea, vomiting, fruitybreath odor, and rapid breathing.It is important to rule out ketoacidosis when experiencingsymptoms that might otherwise indicate the flu.KetonesAcidic byproducts that result from the breakdown of fat forenergy. The presence of ketones indicates that the body is usingstored fat and muscle (instead of glucose) for energy.Multiple daily injections (MDIs)Introducing insulin into the body with a syringe several times a day.OcclusionA blockage or interruption in insulin delivery. Prime bolusAn amount of insulin used to fill the cannula, preparing it to begindelivering insulin under your skin.Sensitivity factor (see correction factor)iXL™ Diabetes Management System User Guide: Glossary 109
110 iXL™ Diabetes Management System User Guide: GlossaryGlossarySharpsAny medical item that may cause punctures or cuts to thosehandling them. Sharps include needles, syringes, scalpelblades, disposable razors, and broken medical glassware.Sharps containerA puncture-proof container used for storage and disposal ofused sharps.Soft keyA button on the iXL Remote whose label or function appears onthe screen directly above the button. The label changesdepending on the task you are performing.Target blood glucose rangeA range of blood glucose levels that you are trying to achieveduring a certain period of the day. For example, you may wantone range before meals, a different range two hours aftermeals, and yet another range for bedtime.Time segment (see basal segment)
AA1c (see hemoglobin A1c)activate pump . . . . . . . . . . . . . . . . . . . . 38adverse reactions, avoiding . . . . . . . . . 71airport security . . . . . . . . . . . . . . . . . . . 70advisory alarms . . . . . . . . . . . . . . . . 87,107auto off advisory . . . . . . . . . . . . . . . . 90end of suspend . . . . . . . . . . . . . . . . . 90low reservoir volume . . . . . . . . . . 11,88pump expiration advisory I . . . . . . . . 89pump expiration advisory II . . . . . . . 89stuck key detected . . . . . . . . . . . . . . 91troubleshooting . . . . . . . . . . . . . . . . . 91alarm history . . . . . . . . . . . . . . . . . . . . . 63alerts . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53aseptic technique . . . . . . . . . . . 41,46,107attach pump . . . . . . . . . . . . . . . . . . . . . . 41audio bolus (see iBolus™)automatic inserter (see RediSet™)automatic priming . . . . . . . . . . . . . . . . . 67avoiding infection . . . . . . . . . . . . . . . 41,46Bbacklight . . . . . . . . . . . . . . . . . . . . . . . 4,54time-out . . . . . . . . . . . . . . . . . . . . . 54,55basal program . . . . . . . . . . . . . . . . . 15,107change . . . . . . . . . . . . . . . . . . . . . . . . 20create . . . . . . . . . . . . . . . . . . . . . . . . . 16delete . . . . . . . . . . . . . . . . . . . . . . . . . 21edit . . . . . . . . . . . . . . . . . . . . . . . . . . . 20enable . . . . . . . . . . . . . . . . . . . . . . . . . 19personal programs . . . . . . . . . . . . . . . ixrename . . . . . . . . . . . . . . . . . . . . . . . . 21suspend . . . . . . . . . . . . . . . . . . . . . . . 43basal rate . . . . . . . . . . . . . . . . . . . . . 15,107initial . . . . . . . . . . . . . . . . . . . . . . . . . . 11maximum . . . . . . . . . . . . . . . . . . 11,25,52basal segment . . . . . . . . . . . . . . . . . 15,107change . . . . . . . . . . . . . . . . . . . . . . . . 20basal, temporary presets . . . . . . . . . . . 22cancel active . . . . . . . . . . . . . . . . . . . 23change . . . . . . . . . . . . . . . . . . . . . . . . 24create . . . . . . . . . . . . . . . . . . . . . . . . . 22delete . . . . . . . . . . . . . . . . . . . . . . . . . 22edit . . . . . . . . . . . . . . . . . . . . . . . . . . . 24enable . . . . . . . . . . . . . . . . . . . . . . . . . 23personal presets . . . . . . . . . . . . . . . . . ixrename . . . . . . . . . . . . . . . . . . . . . . . . 24basal, temporary rate . . . . . . . . . . . . . . 24cancel active . . . . . . . . . . . . . . . . . . . .25enable . . . . . . . . . . . . . . . . . . . . . . . . . 24batteries, replacing . . . . . . . . . . . . . . . . 98battery compartment . . . . . . . . . . . . . . 10blood glucose . . . . . . . . . . . . . . . . . . . 108blood glucose reminder . . . . . . . 29,30,53blood glucose targets . . . . . . . . . vii,ix,110bolus . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27cancel . . . . . . . . . . . . . . . . . . . . . . . . 32extended . . . . . . . . . . . . . . . . . 27,29,107iBolus™ (audio) . . . . . . . . . . . . . . 27,109normal . . . . . . . . . . . . . . . . . . . . . . . . . 27bolus increment . . . . . . . . . . . . . . . . 11,52bolus, maximum . . . . . . . . . . . . . . . . 11,52button . . . . . . . . . . . . . . . . . . . . . . . . . . vi,4iBolus™ . . . . . . . . . . . . . . . . . . . . . . . . 4power . . . . . . . . . . . . . . . . . . . . . . . . . . 4soft keys . . . . . . . . . . . . . . . . . . . . . . . . 4status . . . . . . . . . . . . . . . . . . . . . . . . . . 4up/down controller . . . . . . . . . . . . . . . 4user info/support . . . . . . . . . . . . . . . . . 4Ccannula . . . . . . . . . . . . . . . . . . . . . . . . . 107insert . . . . . . . . . . . . . . . . . . . . . . . . . . 42carb counting . . . . . . . . . . . . . . . . . . . . 107carbohydrate . . . . . . . . . . . . . . . . . . 73,107change pump . . . . . . . . . . . . . . . . . . . . . 35check alarms . . . . . . . . . . . . . . . . . . . . . 56cleaningpump . . . . . . . . . . . . . . . . . . . . . . . . . . 97remote . . . . . . . . . . . . . . . . . . . . . . . . . 97communication failure . . . . . . . . . . . . . 93complications, diabetes-related . . . . 107confidence alerts . . . . . . . . . . . . . . . . . 53continuous subcutaneous insuliniXL™ Diabetes Management System User Guide: Index 111Index
infusion (CSII) . . . . . . . . . . . . . . . . . . 107contraindications . . . . . . . . . . . . . . . . . . viiconventions and terms . . . . . . . . . . . . . vicorrection factor . . . . . . . . . . . . . vii,ix,107CT scans . . . . . . . . . . . . . . . . . . . . . . . . . 81Ddata storage . . . . . . . . . . . . . . . . . . . . . . . 2date . . . . . . . . . . . . . . . . . . . . . . . . . . 11,50dawn phenomenon . . . . . . . . . . . . . . . 107DCCT (Diabetes Control andComplications Trial) . . . . . . . . . . . . 1,107diabetes . . . . . . . . . . . . . . . . . . . . . . . . 107diabetic ketoacidosis (DKA) . . . . . 78,109avoiding . . . . . . . . . . . . . . . . . . . . . . . 78symptoms . . . . . . . . . . . . . . . . . . . . . . 78treatment . . . . . . . . . . . . . . . . . . . . . . 78diagnostic functions . . . . . . . . . . . . . . . 56disinfect infusion site . . . . . . . . . . . . . . 41Eelectrical interference . . . . . . . . . . . . . 58emergency kit . . . . . . . . . . . . . . . . . . . . 79enter text . . . . . . . . . . . . . . . . . . . . . . . . . 5exercise . . . . . . . . . . . . . . . . . . . . . . . . . 80extended bolus . . . . . . . . . . . . . . 27,29,107cancel . . . . . . . . . . . . . . . . . . . . . . . . . 32deliver . . . . . . . . . . . . . . . . . . . . . . . . . 29extreme temperatures . . . . . . . . . . . 46,58FFCC notice . . . . . . . . . . . . . . . . . . . . . . 105fill port . . . . . . . . . . . . . . . . . . . . . . . . . 3,40fill pump . . . . . . . . . . . . . . . . . . . . . . . . . 39fill syringe/needle . . . . . . . . . . . . . . . . . . 5Ggauge, insulin . . . . . . . . . . . . . . . . . . . . . 49glucose (see blood glucose)Hhazard alarm . . . . . . . . . . . . . . . . . . 83,108auto off . . . . . . . . . . . . . . . . . . . . . . . . 84empty reservoir . . . . . . . . . . . . . . . . . 84occlusion . . . . . . . . . . . . . . . . . . . . . . 84pump error . . . . . . . . . . . . . . . . . . . . . 86pump expiration . . . . . . . . . . . . . . . . . 84pump change interrupted . . . . . . . . . 85remote error . . . . . . . . . . . . . . . . . . . . 85stuck key . . . . . . . . . . . . . . . . . . . . . . . 85system error . . . . . . . . . . . . . . . . . . . . 86troubleshooting . . . . . . . . . . . . . . . . . 87hemoglobin A1c (HbA1c) . . . . . . . . ix,108high blood glucose (see hyperglycemia)historyalarm . . . . . . . . . . . . . . . . . . . . . . . . . . 63insulin delivery . . . . . . . . . . . . . . . . . . 61hospitalization . . . . . . . . . . . . . . . . . . . . 81hyperglycemia . . . . . . . . . . . . . . . . . 75,108avoiding . . . . . . . . . . . . . . . . . . . . . . . 75causes . . . . . . . . . . . . . . . . . . . . . . 76,77symptoms . . . . . . . . . . . . . . . . . . . . . . 75treatment . . . . . . . . . . . . . . . . . . . . . . 75hypoglycemia . . . . . . . . . . . . . . . . . 72,109avoiding . . . . . . . . . . . . . . . . . . . . . . . 72causes . . . . . . . . . . . . . . . . . . . . . . . . 74symptoms . . . . . . . . . . . . . . . . . . . . . . 72treatment . . . . . . . . . . . . . . . . . . . . . . 73hypoglycemia unawareness . . . . . . . .108IiBolus™ cancel . . . . . . . . . . . . . . . . . . . . . . . . .32button . . . . . . . . . . . . . . . . . . . . . . . . . 3,4deliver . . . . . . . . . . . . . . . . . . . . . . . . . 31increment . . . . . . . . . . . . . . . . . . . . . . 31Increment . . . . . . . . . . . . . . . . . . . . . . . 109bolus . . . . . . . . . . . . . . . . . . . . . . . . 11,52iBolus™ . . . . . . . . . . . . . . . . . . . . . . . . 31indication for use . . . . . . . . . . . . . . . . . . viiinfectionavoiding . . . . . . . . . . . . . . . . . . . . . 41,46signs of . . . . . . . . . . . . . . . . . . . . . . . . 46infusion . . . . . . . . . . . . . . . . . . . . . . . . . 109infusion site . . . . . . . . . . . . . . . . . . . . . 109disinfect . . . . . . . . . . . . . . . . . . . . . . . 41inspect . . . . . . . . . . . . . . . . . . . . . . . . 69prepare . . . . . . . . . . . . . . . . . . . . . . . . 41112 iXL™ Diabetes Management System User Guide: IndexIndex
Indexselect . . . . . . . . . . . . . . . . . . . . . . . . . 41initial basal rate . . . . . . . . . . . . . . . . . . . 11insulin . . . . . . . . . . . . . . . . . . . . . . . . . . 109insulin gauge . . . . . . . . . . . . . . . . . . . . . 49insulin deliveryhistory . . . . . . . . . . . . . . . . . . . . . . . . . 42history . . . . . . . . . . . . . . . . . . . . . . . . . 61resume . . . . . . . . . . . . . . . . . . . . . . . . 45suspend . . . . . . . . . . . . . . . . . . . . . . . 43insulin storage . . . . . . . . . . . . . . . . . . . 100insulin-to-carbohydrate ratio . . . vii,ix,109IPX8 . . . . . . . . . . . . . . . . . . . . . . . 47,69,103Kketoacidosis, diabetic (DKA) . . . . . 78,109symptoms . . . . . . . . . . . . . . . . . . . . . . 78treatment . . . . . . . . . . . . . . . . . . . . . . 78ketones . . . . . . . . . . . . . . . . . . . . . . . . . 109Llow blood glucose (see hypoglycemia)Mmain menu . . . . . . . . . . . . . . . . . . . . . . . . 6maximum basal rate . . . . . . . . . . 11,25,52maximum bolus . . . . . . . . . . . . . . . . . 11,52maximum daily dose . . . . . . . . . . . . . 11,52MIN (minimum) fill line . . . . . . . . . . . . . 39MRIs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81multiple daily injections (MDIs) . . . . . 109my records . . . . . . . . . . . . . . . . . . . . . . . 61Nneedle cap . . . . . . . . . . . . . . . . . . . . . . . . 3normal bolus . . . . . . . . . . . . . . . . . . . . . 27deliver . . . . . . . . . . . . . . . . . . . . . . . . . 28Oocclusion . . . . . . . . . . . . . . . . . . . . . . . 109detection . . . . . . . . . . . . . . . . . . . . . . . 68operating temperatures . . . . . . . . . . . 103order supplies . . . . . . . . . . . . . . . . . . . 100Ppower button . . . . . . . . . . . . . . . . . . . . . 3,4power, remote . . . . . . . . . . . . . . . . . . . . 10prepare infusion site . . . . . . . . . . . . . . . 41prime bolus . . . . . . . . . . . . . . . . . . . 42,109prime, automatic . . . . . . . . . . . . . . . . . . 67pumpactivate . . . . . . . . . . . . . . . . . . . . . . . . 38attach . . . . . . . . . . . . . . . . . . . . . . . . . 41change process . . . . . . . . . . . . . . . . . 35clean . . . . . . . . . . . . . . . . . . . . . . . . . . 97deactivate . . . . . . . . . . . . . . . . . . . . . . 36expiration . . . . . . . . . . . . . . . . . . . . . . 53fill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39illustration . . . . . . . . . . . . . . . . . . . . . . . 3operating temperatures . . . . . . . . . 103placement . . . . . . . . . . . . . . . . . . . . . . 41prime . . . . . . . . . . . . . . . . . . . . . . . . . . 40remove . . . . . . . . . . . . . . . . . . . . . . . . 37short-term removal . . . . . . . . . . . . . . 80specifications . . . . . . . . . . . . . . . . . . 103status . . . . . . . . . . . . . . . . . . . . . . . . . 43storage . . . . . . . . . . . . . . . . . . 47,97,103water . . . . . . . . . . . . . . . . . . . . . . . 47,69Rreactions, adverse (see adverse reactions)record keeping . . . . . . . . . . . . . . . . . . . 61RediSet™ . . . . . . . . . . . . . . . . . . . . 2,40,42reminders . . . . . . . . . . . . . . . . . . . . . . . . 53remote clean . . . . . . . . . . . . . . . . . . . . . . . . . . 97dropped . . . . . . . . . . . . . . . . . . . . . . . . 99icons . . . . . . . . . . . . . . . . . . . . . . . . . 104illustration . . . . . . . . . . . . . . . . . . . . . . . 3lock . . . . . . . . . . . . . . . . . . . . . . . . . 54,55operating temperature . . . . . . . . . . .103replacing batteries . . . . . . . . . . . . . . 98reset . . . . . . . . . . . . . . . . . . . . . . . . 56,57set up . . . . . . . . . . . . . . . . . . . . . . . . . 10specifications . . . . . . . . . . . . . . . . . . 103storage . . . . . . . . . . . . . . . . . . . . . 97,103water . . . . . . . . . . . . . . . . . . . . . 58,69,99iXL™ Diabetes Management System User Guide: Index 113
reservoir . . . . . . . . . . . . . . . . . . . . . . . . 102resources . . . . . . . . . . . . . . . . . . . . . . . 105resume insulin delivery . . . . . . . . . . . . . 45Ssafety features . . . . . . . . . . . . . . . . . . . . 67screen time-out . . . . . . . . . . . . . . . . . 54,55sensitivity factor . . . . . . . . . . . . . vii,ix,107setup wizard . . . . . . . . . . . . . . . . . . . . . . 10sharps . . . . . . . . . . . . . . . . . . . . . . . . . . 110sharps container . . . . . . . . . . . . . . . . . 110sick days . . . . . . . . . . . . . . . . . . . . . . 79,80soft key . . . . . . . . . . . . . . . . . . . . vi,3,4,110specificationspump . . . . . . . . . . . . . . . . . . . . . . . . . 103remote . . . . . . . . . . . . . . . . . . . . . . . . 103statusbutton . . . . . . . . . . . . . . . . . . . . . . . . . 3,4screen . . . . . . . . . . . . . . . . . . . . . . . . . . 6stop insulin delivery . . . . . . . . . . . . . . . 43storageinsulin . . . . . . . . . . . . . . . . . . . . . . . . 100pump . . . . . . . . . . . . . . . . . . . . 47,97,103remote . . . . . . . . . . . . . . . . . . . 58,97,103supplies . . . . . . . . . . . . . . . . . . . . . . . 100suppliesorder . . . . . . . . . . . . . . . . . . . . . . . . . 100storage . . . . . . . . . . . . . . . . . . . . . . . 100travel . . . . . . . . . . . . . . . . . . . . . . . . . . 70surgery . . . . . . . . . . . . . . . . . . . . . . . . . . 81suspend insulin delivery . . . . . . . . . . . . 43symbols . . . . . . . . . . . . . . . . . . . . . . . vi,104system options and settings . . . . . . . . 102system setup menu . . . . . . . . . . . . . . . . 50T target blood glucose range . . . . vii,ix,110temporary basal presets . . . . . . . . . . . . 22cancel active . . . . . . . . . . . . . . . . . . . 23change . . . . . . . . . . . . . . . . . . . . . . . . 24create . . . . . . . . . . . . . . . . . . . . . . . . . 22delete . . . . . . . . . . . . . . . . . . . . . . . . . 24edit . . . . . . . . . . . . . . . . . . . . . . . . . . . 24enable . . . . . . . . . . . . . . . . . . . . . . . . . 23personal presets . . . . . . . . . . . . . . . . . ixrename . . . . . . . . . . . . . . . . . . . . . . . . 24temporary basal rate . . . . . . . . . . . . . . . 24cancel active . . . . . . . . . . . . . . . . . . . 25enable . . . . . . . . . . . . . . . . . . . . . . . . 24time . . . . . . . . . . . . . . . . . . . . . . . . . . 11,50time-outbacklight . . . . . . . . . . . . . . . . . . . . 54,55screen . . . . . . . . . . . . . . . . . . . . . . 54,55travelairport security . . . . . . . . . . . . . . . . . . 70emergency supplies . . . . . . . . . . . 70,71time zones . . . . . . . . . . . . . . . . . . . . . 69U up/down controller button . . . . . . . . . . 3,4user info/support button . . . . . . . . . . . 3,4user information . . . . . . . . . . . . . . . . . . 64Vviewing window . . . . . . . . . . . . . . . . . 3,46W warranty . . . . . . . . . . . . . . . . . . . . . . . . 101watertight rating (IPX8) . . . . . . . 47,69,103wireless technology . . . . . . . . . . . . . . 2,58X x-rays . . . . . . . . . . . . . . . . . . . . . . . . . . . 81114 iXL™ Diabetes Management System User Guide: IndexIndex
iXL™ Diabetes Management System User Guide: 115

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