Roche Diabetes Care 816 Hand Held Blood Glucose Meter User Manual manual pt 1
Roche Diagnostics Operations, Inc. Hand Held Blood Glucose Meter manual pt 1
Contents
- 1. manual pt 1
- 2. manual pt 2
manual pt 1
Roche USA – 52297 V6/1 – 07167776001 – Black Roche USA – 52297 V6/2 – 07167776001 – Cyan Roche USA – 52297 V6/3 – 07167776001 – Magenta User’s Manual Roche USA – 52297 V6/4 – 07167776001 – Yellow ACCU‑CHEK® Aviva Insight Diabetes Manager 52297_07167776001.indb 1 10/20/14 11:17 AM 52297_07167776001.indb 2 10/20/14 11:17 AM Contents Important Safety Information Startup 35 1.1 1.2 1.3 The ACCU‑CHEK Aviva Insight System Special Information for Caregivers Before You Start Testing Understanding Your Diabetes Manager 11 3.1 3.2 3.3 3.4 3.5 Before You Get Started Charging the Battery Setup Wizard Completing the Setup Wizard Important Information 35 36 41 43 50 2.1 2.2 About This User’s Manual The ACCU‑CHEK Aviva Insight Diabetes Manager at a Glance Home Screen Turning the Meter On or Off and Power Management Navigation Quick Notes Screen Using the Test Strips Summary of Features 11 2.3 2.4 2.5 2.6 2.7 2.8 12 16 21 24 29 30 33 Control Testing 57 4.1 4.2 4.3 4.4 When to Perform a Control Test About the Control Solutions Performing a Control Test Out‑of‑Range Control Results 57 58 59 63 Testing Your Blood Glucose 67 5.1 5.2 5.3 5.4 5.5 5.6 Performing a Blood Glucose Test Adding Information to a Blood Glucose Result Delivering a Bolus Without Bolus Advice Understanding Blood Glucose Results Unusual Blood Glucose Results Symptoms of Low or High Blood Glucose 67 73 76 79 83 85 52297_07167776001.indb 1 10/20/14 11:17 AM 6 Bolus Advice 87 Changing Meter Settings 139 6.1 6.2 6.3 Overview Before Using Bolus Advice Delivering a Bolus Using Bolus Advice 87 88 91 Changing Bolus Advice Settings 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 Overview 101 Setting Up Bolus Advice 103 Bolus Advice: Time Block Settings 109 Bolus Advice: Adding a Time Block 113 Bolus Advice: Deleting Time Blocks 119 Bolus Advice: Resetting All Time Blocks 128 Health Event Percentages 134 Advice Options: Meal Rise, Snack Size, Acting Time, Offset Time 136 Turning Off Bolus Advice 138 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 Overview Date, Time, and Time Format Mode Settings: Sound, Vibration Mode Settings: Signal Suspension Home Screen Default Touchscreen: Tone, Vibration Brightness Background Color Language Time Block Settings Adding a Time Block Deleting Time Blocks Resetting All Time Blocks Warning Limits: Hypo, Hyper Insulin Increment Max Bolus Amount Carbohydrate Unit 139 141 142 144 146 147 148 149 150 151 154 159 168 173 175 176 178 7.9 101 II 52297_07167776001.indb 2 10/20/14 11:17 AM 9 Meter Reminders 9.1 9.2 9.3 9.5 9.6 9.7 9.8 9.9 Overview 179 Blood Glucose Test Reminder: After Meal 182 Blood Glucose Test Reminder: After High Blood Glucose Result 184 Blood Glucose Test Reminder: After Low Blood Glucose Result 186 Doctor Visit Reminder 188 Lab Test Reminder 190 Customized Reminder 192 Alarm Clock Reminder 195 Medication Reminder 199 10 Communication 203 10.1 10.2 10.3 Overview Connecting the Meter to a PC using a USB Cable Changing USB Cable Connection Settings 203 204 207 11 Travel Settings 209 11.1 11.2 11.3 Overview Turning On Flight Mode Turning Off Flight Mode 209 210 211 9.4 179 12 My Data 213 12.1 12.2 12.3 12.4 12.5 12.6 12.7 Overview The Logbook The Trend Graph The Standard Week The Standard Day Target Data The bG Averages Table 213 214 229 237 244 250 255 13 Cleaning and Disinfecting the Meter and Lancing Device 261 13.1 13.2 13.3 Overview Cleaning and Disinfecting the Meter Cleaning and Disinfecting the Lancing Device 261 263 267 14 Care and Maintenance 271 14.1 14.2 14.3 14.4 14.5 14.6 Overview Charging the Battery Power‑Saving Tips Changing the Battery Touchscreen Calibration Meter Function Test 271 271 272 273 276 278 III 52297_07167776001.indb 3 10/20/14 11:17 AM 15 Troubleshooting 281 Appendix A: Bolus Advice Overview 331 15.1 15.2 Overview Troubleshooting the Meter 281 282 Appendix B: Bolus Advice Calculations 343 16 Technical Information 299 Glossary 349 299 299 304 Index 357 16.1 16.2 16.3 16.4 Product Limitations Specifications Product Safety Information Discarding the Meter, Test Strips, Lancing Devices, Lancets, and Batteries 16.5 List of Icons 16.6 Warranty and Limited License 16.7 Additional Supplies 16.8 Information for Healthcare Professionals 16.9 Meter Information 16.10 Error Log 16.11 Radio Frequency (RF) Signal 16.12 Meter Range Limits and Defaults 305 307 316 320 320 321 322 324 326 IV 52297_07167776001.indb 4 10/20/14 11:17 AM 1 Important Safety Information 1.1 The ACCU‑CHEK Aviva Insight System Please read this user’s manual carefully before you use your ACCU‑CHEK Aviva Insight Diabetes Manager (hereafter referred to as the meter). To use it correctly and dependably, you need to understand the meter’s operation, screen displays, and all individual features. The ACCU‑CHEK Aviva Insight meter is indicated as an aid in the treatment of insulin requiring diabetes. The ACCU‑CHEK Aviva Insight system consists of the ACCU‑CHEK Aviva Insight meter, ACCU‑CHEK Aviva Plus test strips, ACCU‑CHEK Aviva control solutions, and ACCU‑CHEK Bolus Advisor. The ACCU‑CHEK Aviva Insight meter is intended to facilitate the optimization of glycemic control in patients who are trained in multiple daily insulin injection therapy and are under the supervision of healthcare professionals experienced in managing insulin treated patients. 52297_07167776001.indb 1 10/20/14 11:17 AM The ACCU‑CHEK Aviva Insight blood glucose monitoring system is intended to be used for the quantitative measurement of glucose in fresh capillary whole blood samples drawn from the ingertips. The ACCU‑CHEK Aviva Insight blood glucose monitoring system is intended for self‑testing outside the body (in vitro diagnostic use) by people with diabetes. The ACCU‑CHEK Aviva Insight blood glucose monitoring system is intended to be used by a single person and should not be shared. The ACCU‑CHEK Aviva Insight blood glucose monitoring system should not be used for the diagnosis or screening of diabetes or for neonatal use. Alternative site testing should NOT be used with the ACCU‑CHEK Aviva Insight blood glucose monitoring system. The ACCU‑CHEK Aviva Insight system is intended for prescription home use only. The ACCU‑CHEK Aviva Insight meter is also indicated for the calculation of an insulin dose or carbohydrate intake based on user‑entered data. The ACCU‑CHEK Bolus Advisor, as a component of ACCU‑CHEK Aviva Insight meter, is intended for use in providing insulin dose recommendations in response to blood glucose, health events, and carbohydrate input. The ACCU‑CHEK Bolus Advisor is intended to provide direction for insulin adjustment within the scope of a pre‑planned treatment program from a healthcare professional. Before its use, a physician or healthcare professional must prescribe the ACCU‑CHEK Aviva Insight system and provide the patient‑speciic target blood glucose, insulin‑to‑ carbohydrate ratio, and insulin sensitivity parameters to be programmed into the ACCU‑CHEK Bolus Advisor. Once programmed, a patient must consult with his/her physician or healthcare professional before making any changes to these ACCU‑CHEK Bolus Advisor settings. 52297_07167776001.indb 2 10/20/14 11:17 AM 1 The ACCU‑CHEK Aviva Insight system includes: j ACCU‑CHEK Aviva Insight Diabetes Manager with rechargeable battery and code chip j USB cable w WARNING Choking hazard. Small parts. Keep away from children under the age of 3 years. j Power adapter with plug j ACCU‑CHEK Aviva Plus test strips* j ACCU‑CHEK Aviva control solutions* j ACCU‑CHEK FastClix lancing device* NOTE The term “blood glucose” is used when referring to “blood sugar.” Sample data displays are shown throughout the manual. Your data will difer. j ACCU‑CHEK FastClix lancet drums* *Some items may not be included in the kit. They are a separate purchase. 52297_07167776001.indb 3 10/20/14 11:17 AM Need Help? For questions, contact the ACCU‑CHEK Customer Care Service Center toll free at 1‑800‑688‑4578. We offer assistance in many languages. You can also visit http:\\www.ACCU‑CHEK.com for diabetes management tools and product demonstrations. Please complete the warranty card and mail it, so you receive the best customer service possible and product update news. 52297_07167776001.indb 4 10/20/14 11:17 AM 1 About Testing Yourself or Others w WARNING DO NOT CHANGE YOUR THERAPY BASED ON A TEST RESULT THAT DOES NOT MATCH HOW YOU FEEL OR IF YOU BELIEVE THAT YOUR TEST RESULT COULD BE INCORRECT. It is always a good idea to have a back‑up testing method available. Failure to test could cause a delay in therapy decisions and lead to a serious medical condition. Examples of back‑up testing methods include a back‑up meter or testing by a laboratory. Ask your healthcare professional or pharmacist about other possible back‑up methods. If your blood glucose result does not match how you feel and you have followed the instructions in this user’s manual, follow your healthcare professional’s instructions, or contact your healthcare professional. During normal testing, any blood glucose meter or lancing device may come in contact with blood. All parts of the kit are considered biohazardous and can potentially transmit infectious diseases from bloodborne pathogens, even after you have performed cleaning and disinfecting.1,2 52297_07167776001.indb 5 10/20/14 11:17 AM w WARNING The meter and lancing device should never be used by more than one person. Do not share the meter and lancing device with anyone, including family members, due to the risk of infection from bloodborne pathogens.1,2 Cleaning and disinfecting the meter and lancing device destroys most, but not necessarily all, bloodborne pathogens.3 If the meter is being operated by a second person who is providing testing assistance to the user, the meter and lancing device should be cleaned and disinfected prior to use by the second person. Disinfect the meter and lancing device before allowing anyone else to handle them. Do not allow anyone else to test with the meter or lancing device. It is important to keep the meter and lancing device clean and disinfected. For instructions on how to clean and disinfect the meter and lancing device, see the chapter Cleaning and Disinfecting the Meter and Lancing Device in this manual. Wash hands thoroughly before and after handling the meter, lancing device, or test strips. FDA Public Health Notiication: “Use of Fingerstick Devices on More than One Person Poses Risk for Transmitting Bloodborne Pathogens: Initial Communication, (2010). Update 11/29/2010” http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm224025.htm. Accessed March 20, 2012. CDC Clinical Reminder: “Use of Fingerstick Devices on More than One Person Poses Risk for Transmitting Bloodborne Pathogens, (2010).” http://www.cdc.gov/ injectionsafety/Fingerstick‑DevicesBGM.html. Accessed March 20, 2012 Healthcare Infection Control Practices Advisory Committee (HICPAC), William A. Rutala, Ph.D., M.P.H., and David J. Weber, M.D., M.P.H. Centers for Disease Control and Prevention, 2008. “Guideline for Disinfection and Sterilization in Healthcare Facilities. Atlanta.” 52297_07167776001.indb 6 10/20/14 11:17 AM 1 NOTE Perform a control test when you open a new test strip box or if you think that a test result is incorrect. Performing a control test lets you know that the meter and test strips are working properly. Refer to the test strip and control solution package inserts for additional health‑related information. This user’s manual shows sample screens. The screens in this manual may look slightly diferent from the screens on the meter. If you have any questions about the meter screens, contact the ACCU‑CHEK Customer Care Service Center toll free at 1‑800‑688‑4578. Blood glucose is sometimes shortened to bG, but it means the same thing. 52297_07167776001.indb 7 10/20/14 11:17 AM 1.2 Special Information for Caregivers j Do not use the meter system to measure blood glucose in people who are experiencing cardiovascular collapse (severe shock) or decreased peripheral blood flow. j Consult your healthcare professional to determine if it is appropriate for your child to be taught how to use the meter system or any other medical products. j Some people with diabetes do not experience symptoms of low blood glucose (hypoglycemia). Others, such as children or people who are unconscious or have certain disabilities, may not be able to communicate their symptoms to caregivers. For these reasons, do not change any therapy without first talking to a healthcare professional. j Not for use on critically ill patients, patients in shock, dehydrated patients, or hyperosmolar patients. 52297_07167776001.indb 8 10/20/14 11:17 AM 1 1.3 Before You Start Testing w WARNING Carefully read and follow the instructions in this manual and package inserts for the test strips and control solutions. Not following the instructions may lead to a wrong result or improper treatment, causing you health problems. Inspect the test strip container before using the test strips for the irst time. If you see any damage to the container cap or if anything prevents the cap from closing properly, do not use the test strips. Contact ACCU‑CHEK Customer Care Service Center at 1‑800‑688‑4578. Damaged test strips can cause inaccurate results, which could lead to improper therapy. The meter, test strips, and control solution are only for use outside the body (in vitro). Do not eat the test strips. Do not swallow or inject the control solution or use the control solution for any purpose other than testing the ACCU‑CHEK Aviva Insight system. 52297_07167776001.indb 9 10/20/14 11:17 AM NOTE The Setup Wizard activates every time you turn the meter on until you complete the process. Check the time and date on the meter before you begin testing. Adjust the time and date if necessary. 10 52297_07167776001.indb 10 10/20/14 11:17 AM 2 Understanding Your Diabetes Manager 2.1 About This User’s Manual To help you fully benefit from your ACCU‑CHEK Aviva Insight Diabetes Manager, the functions and features of this product are assigned as Basic and Optional. j Basic functions are essential for the intended purpose of this product and it is highly recommended to learn how to use them before you start using this product. j Optional functions help you get the maximum benefit from this product. Together with your healthcare professional you can choose to learn about and use these features at your own discretion and your own pace. This user’s manual includes the following for the safe and convenient use of the meter: w WARNING A Warning is safety information that requires your careful attention and informs you about risks to your health. Neglecting this information may lead to life‑threatening situations. NOTE A Note contains important information relating to the efficient and smooth operation of the meter. 11 52297_07167776001.indb 11 10/20/14 11:17 AM 2.2 The ACCU‑CHEK Aviva Insight Diabetes Manager at a Glance 12 52297_07167776001.indb 12 10/20/14 11:17 AM 2 Power Button Turns the meter on or of. See the Turning the Meter On or Of and Power Management section in this chapter. Lanyard Attachment Point Location for attaching a lanyard. Micro USB Connector Plug the small end of the USB cable to this connector to recharge the battery or to communicate with a PC. Memory Expansion Port Holds a memory card (included) which contains software for the meter. Do not remove the memory card. Roche will not replace a removed memory card. Touchscreen Display Touchscreen with a color display for navigating through meter menus and for viewing information. Volume Buttons Changes the volume of a message, for example a Reminder. To mute the sound, press the Volume Down button until the sound is completely of. Test Strip Slot Location for inserting the test strip for blood glucose testing and control testing. 13 52297_07167776001.indb 13 10/20/14 11:17 AM 9 Code Chip The meter is provided with a black code chip. Do not remove the code chip. If the code chip is missing, contact ACCU‑CHEK Customer Care Service Center at 1‑800‑688‑4578. Battery Door Only remove the battery door to replace the battery. See the Changing the Battery section in the Care and Maintenance chapter in this user’s manual. NOTE The meter is already coded and comes with a pre‑inserted black code chip. You never need to change this code chip even if you use test strips from boxes that contain another code chip. 14 52297_07167776001.indb 14 10/20/14 11:17 AM 2 Test Strip Metallic End ‑ Insert this end into the meter. Yellow Window ‑ Touch blood drop or control solution here. Test Strip Container (for example) Control Solution Bottle (for example) 15 52297_07167776001.indb 15 10/20/14 11:17 AM 2.3 Home Screen Home screen refers to the screen that is displayed when the meter is powered on. Home screen can be either the Main Menu or Status screen. To change the Home screen default, see the Home Screen Default section in the Changing Meter Settings chapter in this user’s manual. 16 52297_07167776001.indb 16 10/20/14 11:17 AM 2 2.3.1 Main Menu Screen Title Bar Displays meter information. See the following table. Scroll Bar Appears when there is more information than its on the screen. Menu Selections Go to Status Screen See the Status Screen section in this chapter. Go to Quick Notes Screen See the Quick Notes Screen section in this chapter. 17 52297_07167776001.indb 17 10/20/14 11:17 AM The Title Bar shows the time of day and date. In addition, the following icons may be displayed. Icon Name Description Sound / Vibrate Displayed when both sound and vibrate are turned on. Sound Displayed when only sound is turned on. Vibrate Displayed when only vibrate is turned on. Flight Mode Displayed when flight mode is turned on. Battery Displays the current battery charge condition. Temperature Displayed when the meter’s temperature is outside of the allowable temperature for performing a blood glucose test. 18 52297_07167776001.indb 18 10/20/14 11:17 AM 2 2.3.2 Status Screen The Status screen displays information for the most recent valid blood glucose test. Title Bar Displays meter information. Blood glucose result with color status bar Last blood glucose test date and time Additional information See the next page. Go to Main Menu See the Main Menu Screen section in this chapter. Go to Quick Notes Go to Meter Menu See the Quick Notes Screen section in this chapter. 19 52297_07167776001.indb 19 10/20/14 11:17 AM Additional Information The following shows possible additional information and is stored in the electronic logbook with the blood glucose test: j Meal time icon with description (for example, Before Meal) j Carbohydrates icon with the carbohydrate amount (for example, 60 g), or the carbohydrates accepted icon or carbohydrates not accepted icon may be displayed. j Health event icon with description (for example, Exercise 1) j Type of bolus icon with the total bolus insulin amount (for example, Pen/Syringe Bolus 5.00 U) j Basal insulin icon with the basal insulin value (for example, 5.0 U) j Note icon with note text (for example, Meeting) 20 52297_07167776001.indb 20 10/20/14 11:17 AM 2 2.4 Turning the Meter On or Of and Power Management Power Button Turn meter on Press and release the power button. Turn meter off Press and release the power button. Reset the meter Press and hold the power button for at least 5 seconds until the meter screen goes blank. Release the power button. NOTE Reset the meter if the display freezes or does not respond. 21 52297_07167776001.indb 21 10/20/14 11:17 AM Power Management When the meter is on and the touchscreen is not touched, the meter automatically dims the brightness of the display after 15 seconds and completely powers off after 2 minutes, unless you are performing either a blood glucose test or a control test. To conserve battery power, turn the meter off when you are finished rather than utilizing the automatic power off feature. For more on conserving battery power, see the Power‑Saving Tips section in the Care and Maintenance chapter in this user’s manual. The meter has a rechargeable battery. The battery icon on the Main Menu and the Status screens shows the battery power level or the charging status. The following table shows the different states of battery power level: Full Charge Partial Charge Low Charge Power level icon Charging status icon Battery charging screen 22 52297_07167776001.indb 22 10/20/14 11:17 AM 2 When the battery power level is low, the meter displays a message to recharge. Allowing the battery to fully drain reduces the ability of the battery to hold its charge. It is suggested to recharge the battery on a regular basis, for example, once every day. Keeping the meter plugged in to charge does not harm the battery. Included with the meter is a USB cable and a power adapter to be used for recharging the battery. See the Charging the Battery section in the Startup chapter in this user’s manual. The rechargeable battery has a limited number of charge cycles. If you notice that the meter must be charged more often than it did when it was new, you may need to change the battery. See the Changing the Battery section in the Care and Maintenance chapter in this user’s manual. 23 52297_07167776001.indb 23 10/20/14 11:17 AM 2.5 Navigation The meter has a full color display utilizing touchscreen technology. Making a Selection Scrolling the Screen Press a selection until it is highlighted in blue, then release. To help you know when a selection is made, set up the touchscreen to emit a tone, vibrate, or do both. See the Touchscreen: Tone, Vibration section in the Changing Meter Settings chapter in this user’s manual. Press and hold your inger anywhere in the middle of the screen and then move your inger up or down to scroll the screen. 24 52297_07167776001.indb 24 10/20/14 11:17 AM 2 Setting a Value Choosing from a List Select the value to be changed (Hour is selected). Select an item on the list. The radio button on the left side of the screen indicates the choice (Before Meal is chosen). Press and release + to increase, or press and release ‑ to decrease. Press and hold + or ‑ to change the value quickly. 25 52297_07167776001.indb 25 10/20/14 11:17 AM Message Screens When a message screen appears, the selection choice (for example, No, Yes, and OK) is shaded and is inactive for 3 seconds. This prevents accidental conirmation of the message before you read it. The > symbol on the right side of the screen indicates the selection displays another screen. 26 52297_07167776001.indb 26 10/20/14 11:17 AM 2 Navigation Selections OK Cancel Save Back The screen displayed requires your acknowledgement (for example, confirmation to deliver a bolus). Next Proceed to the next screen without saving settings or data. Next is used when there are multiple steps or screens (for example, startup screens for setting up the meter). The settings or data remain available when Back is used and are saved once Done is selected. Done Save settings or data. Done usually occurs at the end of a series of screens (for example, Setup Wizard screens for setting up the meter). Do not save or leave an activity without completing the action (for example, do not deliver a bolus). Save settings or data. Return to the previous screen without saving any settings or data. 27 52297_07167776001.indb 27 10/20/14 11:17 AM Keyboard Return to the previous screen without saving Save and return to the previous screen Backspace to erase Change between a keyboard with letters and a keyboard with numbers, punctuation, and characters Change between lower case letters and capital letters Change between a keyboard with letters and a keyboard with additional selections Insert a space 28 52297_07167776001.indb 28 10/20/14 11:17 AM 2 2.6 Quick Notes Screen An event (for example, Snack) may have an impact upon your blood glucose results or collected data. The Quick Notes feature is a convenient way to record events as they occur and are useful during data analysis. A Quick Notes record is not linked to a blood glucose result, nor does it inluence the data used in calculating bolus advice. Choose up to 4 events. Scroll the screen for more choices. Select Save to store a Quick Notes record into the logbook with the current date / time stamp. You are able to change the event choices for a saved Quick Notes record by selecting it in the Logbook. You are also able to type a note to save with a Quick Notes record. See The Logbook section in the My Data chapter in this user’s manual. 29 52297_07167776001.indb 29 10/20/14 11:17 AM 2.7 Using the Test Strips j Use only ACCU‑CHEK Aviva Plus test strips. j Use the test strip immediately after removing it from the test strip container. j Do not apply blood or control solution to the test strip before inserting it into the meter. If you applied blood or control solution before inserting the test strip into the meter, retest with a new test strip. If a result appears before applying blood or control solution, do not act on that result. j Close the test strip container tightly immediately after removing a test strip. Moisture can damage the test strips and produce incorrect results. j Store the unused test strips in their original container with the cap tightly closed. 30 52297_07167776001.indb 30 10/20/14 11:17 AM 2 j Discard the test strips if they are past the Use By date printed on the test strip container. If the Use By date is missing or cannot be read, do not use the test strips. Contact the ACCU‑CHEK Customer Care Service Center at 1‑800‑688‑4578. j Refer to the test strip package insert for test strip storage and system operating conditions. j Do not remove test strips from the test strip container and put them into another container, such as a plastic bag, pocket, purse, wallet, etc. j Do not reuse test strips. Once control solution or blood has been applied to a test strip, discard it. If a retest is necessary, use a new test strip. j Perform a control test every time you open a new test strip box. 31 52297_07167776001.indb 31 10/20/14 11:17 AM w WARNING To prevent inaccurate results: DO NOT expose test strips to heat, moisture, or humidity. Temperatures outside the required range, as well as moisture and humidity, can damage the test strips and lead to inaccurate results. DO NOT bend, cut, or alter the test strips. DO NOT get dirt, food, or other material on the test strip. NOTE The meter is already coded and comes with a pre‑inserted black code chip. You never need to change this code chip even if you use test strips from boxes that contain another code chip. 32 52297_07167776001.indb 32 10/20/14 11:17 AM 2 2.8 Summary of Features j The Status screen gives you quick access to information about your most recent blood glucose test. j Bolus advice is optional and it calculates an insulin bolus for you that is customized for the time of day and your changing situations. j Daily time blocks allow you to divide a day into different time periods and can be adjusted to fit your lifestyle. j Data management: • Electronic logbook containing the record of each blood glucose result, including meal time, carbohydrates, health events, bolus, basal, and notes. • View, modify, or add information to the logbook. • View data (for example, blood glucose test averages) in a graph or table format for a speciied time period (for example, the last 30 days). • Transfer data between devices, such as the meter and a computer. 33 52297_07167776001.indb 33 10/20/14 11:17 AM j Reminders: • Alarm clock reminders for when to test throughout the day. • Reminders for testing after a high blood glucose result, after a low blood glucose result, or after a meal. • Appointments with your healthcare professional or for a laboratory test. • Unique tones for diferent reminders. j Health events can be selected to indicate how you are feeling or what you are doing that might affect your blood glucose level. You have the option of setting a percentage for each health event which adjusts the bolus advice recommendation if you set up bolus advice. j Hypo (low) and hyper (high) blood glucose limits that best fit your needs. Whenever a blood glucose result is above or below this range, the meter displays a warning. j Full color visual display utilizing touchscreen technology. 34 52297_07167776001.indb 34 10/20/14 11:17 AM 3 Startup 3.1 Before You Get Started Before you can use the meter, it must be prepared as follows: Remove and discard the tab from the back of the meter. Continue to the next section, Charging the Battery. 35 52297_07167776001.indb 35 10/20/14 11:17 AM 3.2 Charging the Battery Charge the battery with the USB cable by utilizing either a power outlet or a computer. The preferred method is to use a power outlet since this is faster and takes about 3.5 hours to charge a fully drained battery. Charging the meter from a computer takes much longer. NOTE Allowing the battery to fully drain reduces the ability of the battery to hold its charge. It is suggested to recharge the battery on a regular basis, for example once every day. Keeping the meter plugged in to charge does not harm the battery. A blood glucose test cannot be performed while the meter is plugged in. 36 52297_07167776001.indb 36 10/20/14 11:17 AM 3 Charging the Battery Using a Power Outlet Clear Plastic Cover To assemble the power adapter, remove the clear plastic cover by pressing the center of the release button. Slide the clear plastic cover of in the direction of the arrow. Slide on the pronged plug where the clear plastic cover was located until it firmly clicks into place. Do not try to force the pronged plug. It only goes on one way. Release Button If the power adapter is already assembled, proceed to Step 4. Plug the large end of the USB cable into the power adapter. 37 52297_07167776001.indb 37 10/20/14 11:17 AM 4 Plug the small end of the USB cable into the meter. Plug the power adapter into a power outlet. When the battery icon is shown as fully charged you can unplug the meter. When the connection is successful, the meter displays the battery charging screen for 3 seconds. The next screen (either the Main Menu or Status screen) displays the battery icon in charging mode. 38 52297_07167776001.indb 38 10/20/14 11:17 AM 3 Charging the Battery Using a Computer Plug the small end of the USB cable into the meter. Plug the large end of the USB cable into an available USB port on the PC. Choose Charge only. As an option, choose Set as default to keep this screen from appearing each time you connect the USB cable to a PC. Select OK. NOTE The Connection Options screen does not appear if Set as default was chosen previously. To remove the default, go to the Main Menu and select Communication > Settings. Choose Prompt upon USB connect. Select Save. 39 52297_07167776001.indb 39 10/20/14 11:17 AM NOTE NOTE The PC must be turned on and not in sleep or standby mode to charge the battery. The computer is not charging the battery if the meter does not display the battery charging screen or the battery charging icon, or if the Information screen Recharge meter soon is displayed. Charge the battery using a power outlet. When the connection is successful, the meter displays the battery charging screen for 3 seconds. When the battery icon is shown as fully charged you can unplug the meter. The next screen (either the Main Menu or Status screen) displays the battery icon in charging mode. 40 52297_07167776001.indb 40 10/20/14 11:17 AM 3 3.3 Setup Wizard The irst time you turn the meter on, the Setup Wizard is activated. You must complete the Setup Wizard before performing a blood glucose test for the irst time. The Setup Wizard assists you in selecting settings for: j Meter language w WARNING It is important to discuss your individual settings for warning limits, time blocks, bolus advice, and bG test reminders with your healthcare professional. j Time and date j Units (carbohydrate) j Warning limits for hypo (low) and hyper (high) blood glucose levels j Time blocks j Bolus advice (optional) j bG test reminders (optional) 41 52297_07167776001.indb 41 10/20/14 11:17 AM NOTE The Setup Wizard activates every time you turn the meter on until you complete the process. If you turn the meter of during the Setup Wizard, you must reconirm all of the settings in order to complete the Setup Wizard. To return to a previous screen in the Setup Wizard, select Back. If you choose not to set up bolus advice and bG test reminders as part of the Setup Wizard, these features can be set up later. For information on how to set up these features after completion of the Setup Wizard, see the Setting Up Bolus Advice section in the Changing Bolus Advice Settings chapter and the Meter Reminders chapter in this user’s manual. The default settings in the meter and the settings illustrated in this user’s manual are for example only. 42 52297_07167776001.indb 42 10/20/14 11:17 AM 3 3.4 Completing the Setup Wizard Refer to the Important Information section of this user’s manual for detailed explanations of the various settings in the Setup Wizard. Power Button Starting with the meter turned off, press the power button to turn on the meter. The meter vibrates, beeps, and displays this splash screen for a short period of time (this screen appears each time the meter is turned on). 43 52297_07167776001.indb 43 10/20/14 11:17 AM 3 Choose the desired language from the list. Select Next. Choose Manual. Select Next. Select 12 hr or 24 hr to set the time format, if necessary. Set the date and time. Select Next. 44 52297_07167776001.indb 44 10/20/14 11:17 AM 3 10 Choose the appropriate carbohydrate unit. Select Next. Set the Hyper (upper) and Hypo (lower) warning limits. Select Next. Choose the appropriate insulin increment. Select Next. Set the maximum amount for any single bolus. Select Next. 45 52297_07167776001.indb 45 10/20/14 11:17 AM 11 12 13 NOTE If you choose not to receive bolus advice, the Setup Wizard skips Step 14. Choose Yes to receive bolus advice. Choose No to not receive bolus advice. Select Next. Set the start time and end time for the first time block. Select Next. Set the target range. Select Next. 46 52297_07167776001.indb 46 10/20/14 11:17 AM 3 14 15 Set the Carbohydrate ratio and Insulin sensitivity. Select Next. Select OK. 47 52297_07167776001.indb 47 10/20/14 11:17 AM 16 Select any additional time block to edit the End time, Upper value, and Lower value. Select Next when you are finished editing the time blocks. NOTE If bolus advice is on, you can also set the carbohydrate ratio and insulin sensitivity for each time block. To reset all edited time blocks to their default values, select Cancel and then Yes. This restarts the meter setup process. If you chose not to receive bolus advice, Done appears instead of Next on the screen. Select Done to complete the Setup Wizard. 17 Set the percentage for any desired health events. Scroll to view additional options. Select Next. 48 52297_07167776001.indb 48 10/20/14 11:17 AM 3 18 NOTE Set the Meal rise, Snack size, Acting time, and Offset time. Select Done to complete the Setup Wizard. Consult your healthcare professional and read the next section Important Information for help with the settings in the Setup Wizard. For additional assistance with the bolus advice settings, read the Bolus Advice chapter of this user’s manual. 49 52297_07167776001.indb 49 10/20/14 11:17 AM 3.5 Important Information 3.5.1 Carbohydrate Unit You have a choice among diferent carbohydrate units in the meter that best it your needs. The following carbohydrate units are available: Abbreviation Unit of Measurement Gram Equivalent g* Grams 1 gram KE Kohlenhydrateinheit (Carbohydrate Unit) 10 grams BE Bread Equivalent 12 grams CC Carbohydrate Choice 15 grams * Standard unit of measure in the U.S. 50 52297_07167776001.indb 50 10/20/14 11:17 AM 3 3.5.2 Warning Limits 3.5.3 Insulin Increment You can select hyper (high) and hypo (low) blood glucose warning limits that best fit your needs. Insulin increment is the amount in units (U) by which your insulin dose is adjusted when programming a bolus or when entering a manual Logbook entry. Whenever a blood glucose result is above the hyper warning limit or below the hypo warning limit, the meter displays a warning. j Set the hyper warning limit greater than the target range of all time blocks. j Set the hypo warning limit less than the target range of all time blocks. The meter rounds off the insulin amount to be delivered, which the meter calculates if bolus advice is set up, or when you manually enter the bolus and basal insulin data into the logbook. The insulin increment can be set to 0.5 or 1 U. 3.5.4 Max Bolus Max bolus serves as a safety measure against unintended large boluses. It is a meter setting that specifies a maximum bolus insulin amount. A bolus that is larger than the max bolus amount requires an additional confirmation. Max bolus can be set to a maximum of 25 U in increments of 1 U or 0.5 U (per the insulin increment value). 51 52297_07167776001.indb 51 10/20/14 11:17 AM 3.5.5 Time Blocks Setting time blocks to fit your own schedule helps you and your healthcare professional see how patterns in your blood glucose levels may be affected by your daily activities and lifestyle. You can set a different blood glucose target range for each time block. The target range for each time block must be within the hypo and hyper warning limits. Time blocks combine to cover a 24‑hour time period. When the default time blocks are set up, the settings are applied to all of the other time blocks. If bolus advice is set up, you must also set the carbohydrate ratio and insulin sensitivity for the default time block. You can set a different carbohydrate ratio and insulin sensitivity for each time block. The meter comes with 4 default time blocks. You may set up to 8 time blocks. You can change the time period for any of the default time blocks. To complete the Setup Wizard, you must complete and save the default settings for the time blocks. Each time block must be at least 15 minutes long and can only be set in 15‑minute increments. When you set the end time for a time block, the meter automatically sets this end time as the start time for the next time block. Talk to your healthcare professional about setting up time blocks. 52 52297_07167776001.indb 52 10/20/14 11:17 AM 3 3.5.6 Bolus Advice The bolus advice feature calculates a bolus for you that is customized to the time of day and your changing situations. This function is activated only if you set up bolus advice on your meter. Bolus advice provided by the meter is intended solely as advice. Carbohydrate Ratio The carbohydrate ratio is the amount of insulin necessary to account for a certain amount of carbohydrates. Talk with your healthcare professional to determine the appropriate carbohydrate ratio for you. For more detailed information on bolus advice, see the Bolus Advice chapter in this user’s manual. 53 52297_07167776001.indb 53 10/20/14 11:17 AM Insulin Sensitivity The insulin sensitivity is the amount of insulin necessary to lower your blood glucose by a certain amount. Health events available on the meter are: Talk with your healthcare professional to determine the appropriate insulin sensitivity settings for you. j Exercise 2 Health Events j Illness Health events can be selected to indicate how you are feeling or what you are doing that might affect your blood glucose level. You have the option of setting a percentage for each health event which adjusts the bolus advice recommendation if you set up bolus advice. j Premenstrual j Exercise 1 j Stress j Customized (1 ‑ 3) A positive percentage increases the bolus amount and a negative percentage (‑) decreases the bolus amount. Talk with your healthcare professional to determine the appropriate percentage for each health event for you. 54 52297_07167776001.indb 54 10/20/14 11:17 AM 3 Advice Options Snack Size Meal rise, snack size, acting time, and offset time are advice options. Below are detailed descriptions of each of these settings. The snack size defines a threshold of carbohydrates above which a meal rise is triggered. Meal Rise Acting Time During or after meals, an increase in blood glucose level is considered normal within a certain range, even though a bolus has been delivered. The period of time from the start of bolus until your blood glucose level is expected to return to the target level. Enter the maximum increase in your blood glucose level that is to be tolerated after a meal without an additional correction bolus. You can adjust the length of the acting time to fit your individual needs within a specified time interval (1 ½ hours to 8 hours). If you are unsure of your insulin acting time, check with your healthcare professional. The total acting time includes the offset time. Offset Time The expected amount of time before the insulin begins to lower blood glucose levels in the body. 55 52297_07167776001.indb 55 10/20/14 11:17 AM 56 52297_07167776001.indb 56 10/20/14 11:17 AM 4 Control Testing 4.1 When to Perform a Control Test Performing a control test lets you know the meter and test strips are working properly. You should perform a control test when: j you open a new test strip box. j you left the test strip container open. j you think the test strips are damaged. j you want to check the meter and test strips. j the test strips were stored in extreme temperatures, humidity, or both. j you dropped the meter. j your test result does not match how you feel. j you want to check if you are performing the test correctly. 57 52297_07167776001.indb 57 10/20/14 11:17 AM 4.2 About the Control Solutions j Use only ACCU‑CHEK Aviva control solutions. j Close the control solution bottle tightly after use. j Write the date you open the control solution bottle on the bottle label. The control solution must be discarded 3 months from the date the control solution bottle was opened (discard date) or on the Use By date on the bottle label, whichever comes first. j Do not use control solution that is past the Use By or discard date. j Refer to the control solution package insert for control solution storage conditions. j The meter automatically recognizes the difference between the control solution and blood. j The control results are not displayed in memory. j The control solution can stain fabric. Remove stains by washing with soap and water. j Control solution is available for purchase. To order the control solution, talk to your pharmacist or visit accu‑chek.com to order online. 58 52297_07167776001.indb 58 10/20/14 11:17 AM 4 4.3 Performing a Control Test You need the meter, a test strip, and control solution Level 1, Level 2, or both. The control level is printed on the bottle label. Check the Use By date on the test strip container. Do not use test strips past the Use By date. Insert the test strip into the meter in the direction of the arrow. The meter turns on. NOTE Be careful not to put any luids into the test strip slot. If a test strip error occurs, remove and discard the test strip and repeat the test with a new test strip. Do not apply the control solution to the test strip before you insert it into the meter. When a test strip is in the meter the buttons and touchscreen selections are inactive, including the power button. The buttons become active when you remove the test strip or when the test is complete. Another way to start a control test is from the Main Menu. Select Meter > bG Test and insert a test strip into the meter. 59 52297_07167776001.indb 59 10/20/14 11:17 AM This screen only applies when the meter has a white code chip. If the meter has a black code chip, do not match the code to the container; continue to the next step. The Apply Drop screen appears. The test strip is ready for testing. Select the control solution to test. You will enter the level later in the test. Put the meter on a flat surface, such as a table. 60 52297_07167776001.indb 60 10/20/14 11:17 AM 4 Remove the bottle cap. Wipe the tip of the bottle with a tissue. Squeeze the bottle until a tiny drop forms at the tip. Touch the drop to the front edge of the yellow window of the test strip. Do not put control solution on top of the test strip. The Analyzing screen appears when there is enough control solution in the test strip. Wipe the tip of the bottle with a tissue. Cap the bottle tightly. 61 52297_07167776001.indb 61 10/20/14 11:17 AM 9 NOTE 10 11 Within range means that the meter and test strips are working properly. Out of range, LO, or HI means that the control result is outside of the acceptable range; see the Out‑of‑Range Control Results section in this chapter. Select OK. Remove and discard the used test strip. If you choose No Entry and select Done, the Control result screen shown in Step 10 is not displayed. Go to Step 11. The control result appears on the display. Choose the control solution level and select Done. 62 52297_07167776001.indb 62 10/20/14 11:17 AM 4 4.4 Out‑of‑Range Control Results w WARNING The control range applies only to a control result. It only indicates that the test strips and meter are working properly. Do not use a control result to interpret blood glucose results. If the control result is out of range, do not use the meter until you solve the problem. Check this list in the following table to help solve the problem. 63 52297_07167776001.indb 63 10/20/14 11:17 AM Troubleshooting Checks Actions 1. Are either the test strips or control solutions expired? Discard the test strips or control solutions if either is past the Use By date. If the control solution was opened more than 3 months ago, discard it. Repeat the control test with an unexpired test strip and an unexpired control solution. 2. Did you wipe the tip of the control solution bottle before use? Wipe the tip of the bottle with a tissue. Repeat the control test with a new test strip and a fresh drop of control solution. 3. Were the caps on the test strip container and the control solution bottle always closed tightly? Replace the test strips or control solutions if you think either was uncapped for some time. Repeat the control test. 64 52297_07167776001.indb 64 10/20/14 11:17 AM 4 Troubleshooting Checks Actions 4. Was the test strip used immediately after it was removed from the test strip container? Repeat the control test with a new test strip and a fresh drop of control solution. 5. Were the test strips and control solutions stored in a cool, dry place? Repeat the control test with a properly stored test strip and control solution. 6. Did you follow the directions? Read the Control Testing chapter and repeat the control test. 7. Did you choose the correct control solution level, either 1 or 2, when you performed the control test? If you chose the wrong control solution level, you can still compare the control result to the range printed on the test strip container. 8. Are you still unsure of the problem? Contact the ACCU‑CHEK Customer Care Service Center at 1‑800‑688‑4578. 65 52297_07167776001.indb 65 10/20/14 11:17 AM 66 52297_07167776001.indb 66 10/20/14 11:17 AM 5 Testing Your Blood Glucose 5.1 Performing a Blood Glucose Test Refer to the Important Safety Information chapter at the beginning of this manual. w WARNING NOTE Do not change your treatment because of one blood glucose test result. You need the meter, a test strip, a lancing device, and a lancet. NEVER ignore symptoms of high or low blood glucose. Before you perform your irst blood glucose test, set up the meter correctly and perform a control test. A blood glucose test cannot be performed while the meter is plugged in. Blood glucose is sometimes shortened to bG, but it means the same thing. 67 52297_07167776001.indb 67 10/20/14 11:17 AM 1 Wash and dry your hands. Prepare the lancing device. Always use a new lancet with each test. Check the Use By date on the test strip container. Do not use test strips past the Use By date. Insert the test strip into the meter in the direction of the arrow. The meter turns on. 68 52297_07167776001.indb 68 10/20/14 11:17 AM 5 NOTE Be careful not to put any luids into the test strip slot. If a test strip error occurs, remove and discard the test strip. Repeat the test with a new test strip. Do not apply a blood drop to the test strip before you insert it into the meter. When a test strip is in the meter, the buttons and touchscreen selections are inactive, including the power button. The buttons become active when you remove the test strip or when the test is complete. Other ways to start a blood glucose test: • From the Main Menu, select Meter > bG Test or select Bolus > bG Test. Insert a test strip into the meter. • When a bG test reminder notiication is displayed, insert a test strip into the meter. This screen only applies when the meter has a white code chip. If the meter has a black code chip, do not match the code to the container; continue to the next step. 69 52297_07167776001.indb 69 10/20/14 11:17 AM 4 The Apply Drop screen appears. The test strip is ready for testing. Perform a fingerstick with the lancing device. Gently squeeze your finger to assist the flow of blood. This helps you get a blood drop. Touch the blood drop to the front edge of the yellow window of the test strip. Do not put blood on top of the test strip. 70 52297_07167776001.indb 70 10/20/14 11:17 AM 5 w WARNING NOTE The meter is designed to display blood glucose results from 10 to 600 mg/dL. If a result below 10 mg/dL or over 600 mg/dL appears on the display, call ACCU‑CHEK Customer Care Service Center at 1‑800‑688‑4578. The Analyzing screen appears when there is enough blood in the test strip. The result appears on the display. For information about blood glucose results, see the Understanding Blood Glucose Results and Unusual Blood Glucose Results sections in this chapter. The blood glucose result must be used within 10 minutes for bolus advice. 71 52297_07167776001.indb 71 10/20/14 11:18 AM 8 In approximately 3 seconds the Detailed bG Result screen appears. Remove and discard the used test strip. Perform one of the following: j Complete the blood glucose test without adding information or delivering a bolus: Select Done. j If bolus advice is enabled: Go to the Delivering a Bolus Using Bolus Advice section in the Bolus Advice Administering Boluses chapter in this user’s manual. j If bolus advice is not enabled: • Add information to be saved with the blood glucose result: Continue to the next section Adding Information to a Blood Glucose Result. A bolus can be delivered after adding the information. • Deliver a bolus without adding information: Select Bolus and go to the Delivering a Bolus Without Bolus Advice section in this chapter. 72 52297_07167776001.indb 72 10/20/14 11:18 AM 5 5.2 Adding Information to a Blood Glucose Result Adding information to the entry fields provides you with a record of the circumstances surrounding your blood glucose result. This information is helpful later for determining patterns in your blood glucose levels. The steps in this section only apply if the bolus advice feature is not being used. If bolus advice is enabled, go to the Delivering a Bolus Using Bolus Advice section in the Bolus Advice chapter in this user’s manual. To add an entry, select it and refer to the instructions on the following pages. 73 52297_07167776001.indb 73 10/20/14 11:18 AM Screens for Adding Entries for Detailed bG Result Meal Time Carbohydrates Health Events Basal Insulin Choose the meal time. Select Save. Set the amount of carbohydrates consumed. Select Save. Choose up to 4 health events. Select Save. Set the basal insulin amount. Select Save. 74 52297_07167776001.indb 74 10/20/14 11:18 AM 5 Note Type a note (up to 60 characters) to save with this record. Select . Perform one of the following: j Save the entries and proceed with bolus delivery: Select Bolus and continue to Delivering a Bolus Without Bolus Advice. j Save the entries and do not proceed with bolus delivery: Select Done. 75 52297_07167776001.indb 75 10/20/14 11:18 AM 5.3 Delivering a Bolus Without Bolus Advice Correction Bolus bG Result No bG Test is displayed if there is no current bG result. Insulin to return an out‑of‑target blood glucose result to a target value. Carbohydrate Bolus Carbohydrate Amount No Entry is displayed if no amount is entered. Insulin to account for the food you eat. NOTE When the Bolus screen first appears there are no bolus amounts. The bolus amounts are entered by you. Total Bolus Sum of the Correction Bolus and Carbohydrate Bolus amounts. 76 52297_07167776001.indb 76 10/20/14 11:18 AM 5 Enter the bolus amounts, as necessary. To input a bolus amount, select the entry field for Correction Bolus, Carbohydrate Bolus, or Total Bolus and set the amount. NOTE If you set either the Correction Bolus or Carbohydrate Bolus irst: The Total Bolus is disabled and cannot be adjusted; however, the Total Bolus updates accordingly. If you set the Total Bolus irst: The Correction Bolus and Carbohydrate Bolus are disabled and cannot be adjusted; however, the Correction Bolus updates accordingly. If a Carbohydrate Bolus is entered and no Carbohydrate Amount has been entered (Carbs displays No Entry), you should consider entering an amount for carbohydrates. Select Back to enter an amount. An amount is not required, but the more complete the data the more accurate any future bolus advice recommendations are when using bolus advice. 77 52297_07167776001.indb 77 10/20/14 11:18 AM 2 Select Next. Review the bolus amount. Select Back to adjust or select OK to record the bolus. Deliver the bolus using your pen or syringe. 78 52297_07167776001.indb 78 10/20/14 11:18 AM 5 5.4 Understanding Blood Glucose Results The status bar indicates how the blood glucose result compares to the target blood glucose range for the current time block. NOTE Treat low or high blood glucose as recommended by your healthcare professional. Status Bar 79 52297_07167776001.indb 79 10/20/14 11:18 AM Status Bar Descriptions The following are status bar descriptions with sample displays: Green indicates the result is within the target range for the current time block. Blue indicates the result is above the target range for the current time block. The result is not above the hyper warning limit. Blue with Hyper indicates the result is above the hyper warning limit. 80 52297_07167776001.indb 80 10/20/14 11:18 AM 5 Yellow indicates the result is below the target range for the current time block. The blood glucose result is not below the hypo warning limit. Red with Hypo indicates the result is below the hypo warning limit. 81 52297_07167776001.indb 81 10/20/14 11:18 AM LO or HI Display The blood glucose result may be below the measuring range of the meter. If you are experiencing any of the common symptoms of low blood glucose, contact your healthcare professional immediately. Treat low blood glucose as recommended by your healthcare professional. The blood glucose result may be above the measuring range of the meter. If you are experiencing any of the common symptoms of high blood glucose, contact your healthcare professional immediately. Treat high blood glucose as recommended by your healthcare professional. 82 52297_07167776001.indb 82 10/20/14 11:18 AM 5 5.5 Unusual Blood Glucose Results If your blood glucose result does not match the way you feel, follow these steps: Troubleshooting Checks Actions 1. Are the test strips expired? Discard the test strips if they are past the use by date. Repeat the blood glucose test with an unexpired test strip. 2. Has the cap on the test strip container always been closed tightly? Replace the test strips if you think the test strip container was uncapped for some time. Repeat the blood glucose test. 3. Was the test strip used immediately after it was removed from the test strip container? Repeat the blood glucose test with a new test strip. 4. Were the test strips stored in a cool, dry place? Repeat the blood glucose test with a properly stored test strip. 83 52297_07167776001.indb 83 10/20/14 11:18 AM Troubleshooting Checks Actions 5. Did you follow the directions? Read the Performing a Blood Glucose Test section in this chapter and repeat the blood glucose test. Contact ACCU‑CHEK Customer Care Service Center at 1‑800‑688‑4578 if you still have problems. 6. Are the meter and test strips working properly? Perform a control test. See the Performing a Control Test section in the Control Testing chapter in this user’s manual. 7. Are you still unsure of the problem? Contact ACCU‑CHEK Customer Care Service Center at 1‑800‑688‑4578. 84 52297_07167776001.indb 84 10/20/14 11:18 AM 5 5.6 Symptoms of Low or High Blood Glucose Being aware of the symptoms of low or high blood glucose can help you understand your test results and decide what to do if they seem unusual. Symptoms of low blood glucose (hypoglycemia) may include, but are not limited to: anxiety, shakiness, sweating, headache, increased hunger, dizziness, pale skin color, sudden change in mood or irritability, fatigue, difficulty concentrating, clumsiness, palpitations, and / or confusion. w WARNING If you are experiencing any of these symptoms, test your blood glucose. If your blood glucose result is displayed as hypo, LO, hyper, or HI, contact your healthcare professional immediately. Symptoms of high blood glucose (hyperglycemia) may include, but are not limited to: increased thirst, frequent urination, blurred vision, drowsiness, and / or unexplained weight loss. 85 52297_07167776001.indb 85 10/20/14 11:18 AM Comparing Your Meter Result to a Lab Result A common question is how the blood glucose results on your meter compare to the lab results. Your blood glucose can change quickly, especially after eating, taking medication, or physical activity. If you test yourself in the morning and then go to the healthcare professional’s office for a blood glucose test, your results will probably not match, even if you are fasting. This is typically not a problem with your meter, it just means that time has elapsed and your blood glucose has changed. If you want to compare your meter result to the lab result, you must be fasting. Take your meter to the healthcare professional’s office, and test yourself by fingerstick within five minutes of having blood drawn from your arm by a healthcare professional. Keep in mind that the lab uses different technology than the meter, and that blood glucose meter for self testing generally read somewhat lower than the lab result. j If you are fasting and you do a fingerstick test within 5 minutes of having your blood drawn, here are the general guidelines to compare your meter to the lab result: If your blood glucose is below 75 mg/dL, your results generally should fall within ±15 mg/dL of the lab result. j If your blood glucose is equal to or over 75 mg/dL, your results generally should fall within ±20 % of the lab result. 86 52297_07167776001.indb 86 10/20/14 11:18 AM 6 Bolus Advice 6.1 Overview Important information regarding the use of bolus advice is presented in Overview and Before Using Bolus Advice in this chapter. j Definitions of the bolus advice settings are in the Important Information section in the Startup chapter in this user’s manual. j Bolus advice is intended exclusively for use by well‑trained individuals who carry out their own insulin therapy with multiple daily injections (MDI) and who are using bolus and basal insulin separately. It is recommended you discuss your bolus advice settings with your healthcare professional prior to setting up this feature. j After it is set up, bolus advice may be turned off. See the Turning Off Bolus Advice section in the Changing Bolus Advice Settings chapter in this user’s manual. j Bolus advice is only available if it is set up in the initial meter startup (see the Startup chapter in this user’s manual) or through Settings on the Main Menu (see the Setting Up Bolus Advice section in the Changing Bolus Advice Settings chapter in this user’s manual). j Bolus advice calculates insulin doses for you based on many diferent pieces of information, such as: • The values you entered in the setup of bolus advice • Your current blood glucose result • The amount of carbohydrates you estimated for a meal • Your current health event status • Bolus and / or meal history 87 52297_07167776001.indb 87 10/20/14 11:18 AM 6.2 Before Using Bolus Advice 6.2.1 Intended Users For safe use, you need to understand certain information in order to use bolus advice. Working closely with your healthcare professional, you must be very familiar with your diabetes therapy. Bolus advice calculates recommended boluses for you. This can help you determine the amount of insulin you currently require. You provide the information on which the bolus advice recommendations are based. Bolus advice is not able to judge your current situation independent of your own estimation. It cannot correct possible input errors. This is particularly true for the carbohydrate amount entered. Warnings are displayed for entries that exceed possible limits. You are prompted to check these entries and make corrections, if necessary. No warning message is displayed if the data is possible (within the acceptable ranges) but incorrect. Therefore, it is important to carefully review all of your entries. w WARNING Always compare the recommendation with how you actually feel and adjust the recommended bolus, if necessary. Always carry out the actions entered into bolus advice in a timely fashion. Eat the carbohydrate amount you entered and administer the insulin amount you conirmed. Bolus advice should not be used if you are using an intermediate‑acting insulin like Neutral Protamine Hagedorn (NPH) insulin or any other intermediate‑acting insulin. Remember, long‑acting insulin should not be used as a meal or correction bolus. 88 52297_07167776001.indb 88 10/20/14 11:18 AM 6 6.2.2 Information not taken into account when bolus advice is used j It is possible that the values entered when setting up bolus advice do not match how you actually feel. In this case, you can increase or decrease the recommended bolus amount to your needs. j Bolus amounts and meals that were consumed but not entered into the meter cannot be reflected in the calculation. j If you delivered a bolus without using bolus advice, you can enter the bolus information into the electronic logbook. It is important that you enter bolus and carbohydrate information into the logbook in order to obtain accurate bolus advice recommendations. See The Logbook section in the My Data chapter in this user’s manual. 6.2.3 Warning messages After performing a blood glucose test, warning messages about your blood glucose result may be displayed. Please take careful note of these messages. j If your blood glucose result is too low, you are prompted to eat a certain amount of fast acting carbohydrates. A bolus will not be recommended in this situation. Treat your low blood glucose as recommended by your healthcare professional. j If your blood glucose result is high and above the hyper warning limit, you are prompted to consider checking bG, ketones, and insulin until your blood glucose is below the hyper warning limit. j The basal insulin doses you record do not influence the bolus advice. 89 52297_07167776001.indb 89 10/20/14 11:18 AM 6.2.4 Summary j If your blood glucose result is outside the meter’s measurement range, the meter displays a message of either LO or HI. No bolus advice will be recommended for a LO or HI result. Retest your blood glucose and contact your healthcare professional if you need more assistance. j See the Troubleshooting chapter in this user’s manual for more information regarding blood glucose warning messages. j It is recommended you set up bolus advice with your healthcare professional. j Carefully check all of your entries. j Make sure meals and boluses are recorded in the meter for accurate bolus advice recommendations. j Take note of all warning messages, especially those regarding low or high blood glucose results. Immediate action may be necessary. j Always compare the recommendation with how you actually feel and adjust the bolus, if necessary. j Always carry out the actions entered in bolus advice in a timely fashion. 90 52297_07167776001.indb 90 10/20/14 11:18 AM 6 6.3 Delivering a Bolus Using Bolus Advice NOTE Bolus advice is only available if it has been set up, which is indicated by this icon for the Bolus selection on the Main Menu and on other screens: . If bolus advice has not been set up or it has been turned of, this icon is displayed: . See the Setting Up Bolus Advice section in the Changing Bolus Advice Settings chapter in this user’s manual for instructions on how to set up bolus advice. Blood glucose is sometimes shortened to bG, but it means the same thing. or Perform a blood glucose test. See the Testing Your Blood Glucose chapter in this user’s manual. Select Bolus on the Main Menu. 91 52297_07167776001.indb 91 10/20/14 11:18 AM 2 or To add or adjust an entry, select it and refer to the instructions on the following pages. When the entries are complete, choose one of the following: j Select Bolus to proceed with bolus advice (go to Step 3). j Select Done to save the entries and not proceed with bolus advice. 92 52297_07167776001.indb 92 10/20/14 11:18 AM 6 NOTE The Detailed bG Result screen is displayed if a bG test was performed in Step 1. The Bolus Input screen is displayed if Bolus was selected on the Main Menu in Step 1. The bG Result, Carbohydrates, and Health Events entries are used in the calculation of the bolus advice recommendation. All of the entries are saved as a record. On the Bolus Input screen, if the bG Test text is displayed instead of bG Result, there is no current blood glucose result that can be used for bolus advice. Continue with bolus advice with one of the following: • Perform a blood glucose test by selecting bG Test. See the Testing Your Blood Glucose chapter in this user’s manual. After testing your blood glucose, return to this step. • Do not perform a blood glucose test, but add entries as described in Step 2. If a Carbohydrates amount is entered and you proceed with selecting Bolus, a Carbohydrate Bolus is recommended. Proceed to Step 3. 93 52297_07167776001.indb 93 10/20/14 11:18 AM NOTE The latest blood glucose result can only be used for bolus advice within 10 minutes after the test. At 2 minutes, a countdown timer appears on the top of the screen displaying the remaining time. Once the 10 minutes have elapsed, it is not possible to proceed with bolus advice and the selection on the screen is deactivated. When the countdown timer has elapsed, continue with one of the following: • Begin again with bolus advice: Remove all entries and select Done. Return to Step 1 in this chapter. • Do not use bolus advice, but save the record: Complete all entries and select Done. If the displayed blood glucose result is below your hypo warning limit (indicated by the Below hypo warning limit Warning after your blood glucose test), it is not possible to proceed to obtain a bolus advice recommendation. The Bolus selection on the Bolus Input screen is deactivated. Select Done. 94 52297_07167776001.indb 94 10/20/14 11:18 AM 6 Screens for Adding or Adjusting Entries for Bolus Advice Meal Time Carbohydrates Health Events Basal Insulin Choose an applicable meal time. Select Save. Set the amount of carbohydrates consumed. Select Save. Choose up to 4 health events. Select Save. Set the basal insulin amount. Select Save. 95 52297_07167776001.indb 95 10/20/14 11:18 AM Note Set a single, summarized health event percentage to cover the impact of the chosen health events. Select Save. Type a note (up to 60 characters) to save with this record. Select . If multiple health events have been chosen, this screen is displayed; otherwise proceed to the next step. 96 52297_07167776001.indb 96 10/20/14 11:18 AM 6 Icon Indicates if bolus advice is enabled or disabled. bG Result Current bG result. No bG Test is displayed if there is no current blood glucose result. Active Insulin A calculated value representing the efective amount of insulin currently in the body that is working to lower blood glucose. This amount does not include any insulin that is working to account for carbohydrate intake. It also does not include basal insulin. Carbohydrate Amount No Entry is displayed if no amount is entered. Health Event Percentage Percentage based upon 1 to 4 chosen health events. No Entry is displayed if no health event is chosen. 97 52297_07167776001.indb 97 10/20/14 11:18 AM 6 Countdown Timer Only displayed if less than 2 minutes are remaining to use the bG result for bolus advice. Correction Bolus Insulin to return an out‑of‑target blood glucose to a target value. The amount displayed has been adjusted by the Health Event Percentage. Carbohydrate Bolus Insulin to account for the food you eat. The amount displayed has been adjusted by the Health Event Percentage. Total Bolus Sum of items 7 and 8. 98 52297_07167776001.indb 98 10/20/14 11:18 AM 6 Review the bolus amounts (see the next page for more information). To adjust a bolus amount, select it and set the amount. Select Next to proceed with bolus delivery. NOTE If a Carbohydrate Bolus (callout 8) is entered and no Carbohydrate Amount has been entered (Carbs displays No Entry), you should consider entering an amount for carbohydrates. Select Back to enter an amount. An amount is not required, but the more complete the data the more accurate any future bolus advice recommendations are when using bolus advice. If you adjust either the Correction Bolus or Carbohydrate Bolus irst: The ability to edit the Total Bolus is disabled; however, the Total Bolus updates accordingly. If you adjust the Total Bolus irst: The ability to edit the Correction Bolus and Carbohydrate Bolus is disabled. • If Total Bolus is increased: The Correction Bolus is increased accordingly. • If Total Bolus is decreased: The Carbohydrate Bolus is decreased accordingly; once the Carbohydrate Bolus becomes 0, then the Correction Bolus is decreased accordingly. 99 52297_07167776001.indb 99 10/20/14 11:18 AM 5 Review the bolus amount. Select Back to adjust or select OK to record the bolus. Deliver the bolus using your pen or syringe. 100 52297_07167776001.indb 100 10/20/14 11:18 AM 7 Changing Bolus Advice Settings 7.1 Overview You can make changes to bolus advice to adjust for your individual therapy requirements: w WARNING Bolus advice settings It is strongly recommended that you discuss possible updates to your bolus advice settings with your healthcare professional prior to making changes. j Set up bolus advice j Health event percentages j Advice options: meal rise, snack size, acting time, and offset time j Turn off bolus advice Time blocks j Start times, end times, target ranges, carbohydrate ratio, and insulin sensitivity for time blocks j Add or delete a time block j Reset all time blocks 101 52297_07167776001.indb 101 10/20/14 11:18 AM NOTE When editing a setting, any unsaved changes are discarded if the meter turns of or if a test strip is inserted into the meter. If bolus advice is turned of, see the Changing Meter Settings chapter in this user’s manual to change the time blocks and other meter settings. 102 52297_07167776001.indb 102 10/20/14 11:18 AM 7 7.2 Setting Up Bolus Advice w WARNING The bolus advice feature should not be used if you are using an intermediate‑acting insulin like Neutral Protamine Hagedorn (NPH) insulin or any other intermediate‑acting insulin. Review the following in this user’s manual: j Overview section in the Bolus Advice chapter j Before Using Bolus Advice section in the Bolus Advice chapter j Important Information section in the Startup chapter It is strongly recommended that you discuss bolus advice with your healthcare professional prior to setting up bolus advice. Before setting up bolus advice, have the following information available: Bolus advice provides recommendations for the amount of insulin to be delivered for food intake and to correct blood glucose levels. Proceed with this section if you did not set up bolus advice when you completed the Setup Wizard (see the Startup chapter in this user’s manual) or if you have turned off bolus advice. j The number of time blocks with start and end times j The blood glucose target range, carbohydrate ratio, and insulin sensitivity for each time block j The percentage for each health event j The meal rise, snack size, acting time, and offset time 103 52297_07167776001.indb 103 10/20/14 11:18 AM NOTE After bolus advice is set up the settings can be changed, or bolus advice can be turned off. If bolus advice is turned off, the settings are discarded. 104 52297_07167776001.indb 104 10/20/14 11:18 AM 7 Main Menu > Settings > Bolus Advice From the Main Menu, select Settings. Select Bolus Advice. Select Yes. Set the default Carbohydrate ratio and Insulin sensitivity. Select Next. 105 52297_07167776001.indb 105 10/20/14 11:18 AM 5 NOTE Select OK. Select a time block to edit and continue to Step 7, or if you do not need to make any changes, select Next and go to Step 11. The End time of a time block is the same as the Start time of its following time block. Only an End time can be changed, which changes the Start time of the following time block. Changing the End time of the last time block does not change the Start time of the irst time block, but it creates a new time block. See the Bolus Advice: Adding a Time Block section in this chapter. To change the Start time of the irst time block, the time blocks must be reset. See the Bolus Advice: Resetting All Time Blocks section in this chapter. If the End time of a time block is decreased until it is the same as its Start time, the time block is deleted. See the Bolus Advice: Deleting Time Blocks section in this chapter. 106 52297_07167776001.indb 106 10/20/14 11:18 AM 7 10 Set the End time. Select Next. Set the Upper value and Lower value. Select Next. Set the Carbohydrate ratio and Insulin sensitivity. Select Done. Edit any other time block (reference Step 6). Once all time blocks are complete, select Next and continue to Step 11. 107 52297_07167776001.indb 107 10/20/14 11:18 AM 11 12 13 Set the percentages for health events. Scroll the screen to see more health events. Select Next. Set the Meal rise, Snack size, Acting time, and Offset time. Select Next. Select OK. 108 52297_07167776001.indb 108 10/20/14 11:18 AM 7 7.3 Bolus Advice: Time Block Settings This section is for changing the settings for individual time blocks if bolus advice has been set up. These time block settings include: Main Menu > Settings > Bolus Advice > Time Blocks From the Main Menu, select Settings. Select Bolus Advice. j Start time j End time j Target range j Carbohydrate ratio j Insulin sensitivity w WARNING It is strongly recommended that you discuss possible updates to your bolus advice settings with your healthcare professional prior to making changes. 109 52297_07167776001.indb 109 10/20/14 11:18 AM 3 Select Time Blocks. Select a time block to edit. 110 52297_07167776001.indb 110 10/20/14 11:18 AM 7 NOTE The End time of a time block is the same as the Start time of its following time block. Only an End time can be changed, which changes the Start time of the following time block. Changing the End time of the last time block does not change the Start time of the irst time block, but it creates a new time block. See the Bolus Advice: Adding a Time Block section in this chapter. To change the Start time of the irst time block, the time blocks must be reset. See the Bolus Advice: Resetting All Time Blocks section in this chapter. If the End time of a time block is decreased until it is the same as its Start time, the time block is deleted. See the Bolus Advice: Deleting Time Blocks section in this chapter. Set the End time. Select Next. 111 52297_07167776001.indb 111 10/20/14 11:18 AM 6 Set the Upper value and Lower value. Select Next. Set the Carbohydrate ratio and Insulin sensitivity. Select Done. Edit any other time block (reference Step 4). Once all time blocks are complete, select Done and continue to Step 9. Select Save. 112 52297_07167776001.indb 112 10/20/14 11:18 AM 7 7.4 Bolus Advice: Adding a Time Block This section is for adding a time block if bolus advice has been set up. Before adding a time block, have the following information available: To add a time block, decrease the last time block’s end time. After the time block is created, it may be necessary to change the end time and other information for each time block until all of the time blocks are set up the way you want them. j The number of time blocks you need with the start and end times for each j The blood glucose target range, carbohydrate ratio, and insulin sensitivity for each time block w WARNING It is strongly recommended that you discuss possible updates to your bolus advice settings with your healthcare professional prior to making changes. 113 52297_07167776001.indb 113 10/20/14 11:18 AM Main Menu > Settings > Bolus Advice > Time Blocks From the Main Menu, select Settings. Select Bolus Advice. Select Time Blocks. Select the last time block. 114 52297_07167776001.indb 114 10/20/14 11:18 AM 7 Decrease the End time. NOTE Decrease the End time for the last time block by any amount in order to create a new time block. This creates a time block by splitting the last time block into 2 time blocks. Do not decrease the End time until it equals the Start time because the meter deletes the time block when you select Next. Once the new time block is created, you can change the End time for all appropriate time blocks. For this example, a time block is added with a Start time of 9:30 pm and an End time of 11:00 pm. Select Next. 115 52297_07167776001.indb 115 10/20/14 11:18 AM 7 Set the Upper value and Lower value for the new time block. Select Next. Set the Carbohydrate ratio and Insulin sensitivity for the new time block. Select Done. IIt may be necessary to change the end times and settings of other time blocks. Select a time block to edit and continue to Step 10, or if you do not need to make any changes, select Done and go to Step 14. 116 52297_07167776001.indb 116 10/20/14 11:18 AM 7 NOTE The End time of a time block is the same as the Start time of its following time block. Only an End time can be changed, which changes the Start time of the following time block. To change the Start time of the irst time block, the time blocks must be reset. See the Bolus Advice: Resetting All Time Blocks section in this chapter. If the End time of a time block is decreased until it is the same as its Start time, the time block is deleted. See the Bolus Advice: Deleting Time Blocks section in this chapter. 10 11 Set the End time. Select Next. Set the Upper value and Lower value. Select Next. 117 52297_07167776001.indb 117 10/20/14 11:18 AM 12 13 14 Set the Carbohydrate ratio and Insulin sensitivity. Select Done. Edit any other time block (reference Step 9). Once all time blocks are complete, select Done and continue to Step 14. Select Save. 118 52297_07167776001.indb 118 10/20/14 11:18 AM 7 7.5 Bolus Advice: Deleting Time Blocks This section is for deleting time blocks if bolus advice has been set up. There are 2 different methods for deleting time blocks. The first method deletes one or more time blocks by combining time blocks. The alternative method deletes a single time block. After time blocks are deleted, it may be necessary to change the end times and other information for the remaining time blocks until all of the time blocks are set up the way you want them. Before deleting time blocks, have the following information available: j The number of time blocks you need with the start and end times for each j The blood glucose target range, carbohydrate ratio, and insulin sensitivity for each time block w WARNING It is strongly recommended that you discuss possible updates to your bolus advice settings with your healthcare professional prior to making changes. 119 52297_07167776001.indb 119 10/20/14 11:18 AM 7.5.1 Bolus Advice: Deleting One or More Time Blocks This method of deleting one or more time blocks is accomplished by combining time blocks. Main Menu > Settings > Bolus Advice > Time Blocks From the Main Menu, select Settings. Select Bolus Advice. Select Time Blocks. Select the first time block that is to be combined. 120 52297_07167776001.indb 120 10/20/14 11:18 AM 7 NOTE For this example, the last 3 time blocks are combined into one time block. The target range, carbohydrate ratio, and insulin sensitivity values in this irst time block selected are used in the resulting time block. Increase the End time until it equals the End time of the last time block to be deleted. Select Next. Select Yes. 121 52297_07167776001.indb 121 10/20/14 11:18 AM 7 NOTE It may be necessary to change the end times and other information for the remaining time blocks. Select a time block to edit and continue to Step 8, or if you do not need to make any changes, select Done and go to Step 12. The End time of a time block is the same as the Start time of its following time block. Only an End time can be changed, which changes the Start time of the following time block. Changing the End time of the last time block does not change the Start time of the irst time block, but it creates a new time block. See the Bolus Advice: Adding a Time Block section in this chapter. To change the Start time of the irst time block, the time blocks must be reset. See the Bolus Advice: Resetting All Time Blocks section in this chapter. Set the End time. Select Next. 122 52297_07167776001.indb 122 10/20/14 11:18 AM 7 10 11 12 Set the Upper value and Lower value. Select Next. Set the Carbohydrate ratio and Insulin sensitivity. Select Done. Edit any other time block (reference Step 7). Once all time blocks are complete, select Done and continue to Step 12. Select Save. 123 52297_07167776001.indb 123 10/20/14 11:18 AM 7.5.2 Bolus Advice: Deleting a Single Time Block To delete a time block, decrease the time block’s end time until it equals its start time. Main Menu > Settings > Bolus Advice > Time Blocks From the Main Menu, select Settings. Select Bolus Advice. Select Time Blocks. 124 52297_07167776001.indb 124 10/20/14 11:18 AM 7 Select the time block to delete. Decrease the End time until it equals the Start time. Select Next. Select Yes. 125 52297_07167776001.indb 125 10/20/14 11:18 AM 7 It may be necessary to change the end times and other information for the remaining time blocks. Select a time block to edit and continue to Step 8, or if you do not need to make any changes, select Done and go to Step 12. NOTE The End time of a time block is the same as the Start time of its following time block. Only an End time can be changed, which changes the Start time of the following time block. Changing the End time of the last time block does not change the Start time of the irst time block, but it creates a new time block. See the Bolus Advice: Adding a Time Block section in this chapter. To change the Start time of the irst time block, the time blocks must be reset. See the Bolus Advice: Resetting All Time Blocks section in this chapter. Set the End time. Select Next. 126 52297_07167776001.indb 126 10/20/14 11:18 AM 7 10 11 12 Set the Upper value and Lower value. Select Next. Set the Carbohydrate ratio and Insulin sensitivity. Select Done. Edit any other time block (reference Step 7). Once all time blocks are complete, select Done and continue to Step 12. Select Save. 127 52297_07167776001.indb 127 10/20/14 11:18 AM 7.6 Bolus Advice: Resetting All Time Blocks This section is for resetting and re‑entering the settings for all of the time blocks if bolus advice has been set up. One reason for resetting the time blocks is to change the start time of the first time block. Before you reset the time blocks, have the following information available: w WARNING It is strongly recommended that you discuss possible updates to your bolus advice settings with your healthcare professional prior to making changes. j The number of time blocks you need with start and end times for each j The blood glucose target range, carbohydrate ratio, and insulin sensitivity for each time block The health event percentages and the advice options (meal rise, snack size, acting time, and offset time) are not reset. 128 52297_07167776001.indb 128 10/20/14 11:18 AM 7 Main Menu > Settings > Bolus Advice > Time Blocks From the Main Menu, select Settings. Select Bolus Advice. Select Time Blocks. Select Reset. 129 52297_07167776001.indb 129 10/20/14 11:18 AM 5 Select Yes. Set the Start time and End time for the first time block. Select Next. Set the default Upper value and Lower value. Select Next. Set the default Carbohydrate ratio and Insulin sensitivity. Select Next. 130 52297_07167776001.indb 130 10/20/14 11:18 AM 7 Select OK. 10 Select a time block to edit and continue to Step 11, or if you do not need to make any changes, select Done and go to Step 15. NOTE The End time of a time block is the same as the Start time of its following time block. Only an End time can be changed, which changes the Start time of the following time block. Changing the End time of the last time block does not change the Start time of the irst time block, but it creates a new time block. See the Bolus Advice: Adding a Time Block section in this chapter. If the End time of a time block is decreased until it is the same as its Start time, the time block is deleted. See the Bolus Advice: Deleting Time Blocks section in this chapter. 131 52297_07167776001.indb 131 10/20/14 11:18 AM 11 12 13 Set the End time. Select Next. Set the Upper value and Lower value. Select Next. Set the Carbohydrate ratio and Insulin sensitivity. Select Done. 132 52297_07167776001.indb 132 10/20/14 11:18 AM 7 14 15 Edit any other time block (reference Step 10). Once all time blocks are complete, select Done and continue to Step 15. Select Save. 133 52297_07167776001.indb 133 10/20/14 11:18 AM 7.7 Health Event Percentages This section is for changing Health Event percentages if bolus advice has been set up. Main Menu > Settings > Bolus Advice > Health Events From the Main Menu, select Settings. Select Bolus Advice. w WARNING It is strongly recommended that you discuss possible updates to your bolus advice settings with your healthcare professional prior to making changes. 134 52297_07167776001.indb 134 10/20/14 11:18 AM 7 Select Health Events. Set the percentages for health events. Scroll the screen to see more health events. Select Save. Select Save. 135 52297_07167776001.indb 135 10/20/14 11:18 AM 7.8 Advice Options: Meal Rise, Snack Size, Acting Time, Offset Time This section is for changing the values for meal rise, snack size, acting time, and offset time if bolus advice has been set up. Main Menu > Settings > Bolus Advice > Advice Options From the Main Menu, select Settings. Select Bolus Advice. w WARNING It is strongly recommended that you discuss possible updates to your bolus advice settings with your healthcare professional prior to making changes. 136 52297_07167776001.indb 136 10/20/14 11:18 AM 7 Select Advice Options. Set the Meal rise, Snack size, Acting time, and Offset time. Select Save. Select Save. 137 52297_07167776001.indb 137 10/20/14 11:18 AM 7.9 Turning Off Bolus Advice Once turned off, bolus advice must be set up to be used again. Main Menu > Settings > Bolus Advice > Bolus Advice Settings From the Main Menu, select Settings. Select Bolus Advice. Select Off. Select Save. All bolus advice settings are deleted if you continue. Select Yes to turn off bolus advice. 138 52297_07167776001.indb 138 10/20/14 11:18 AM 8 Changing Meter Settings 8.1 Overview You can make the following changes to the meter to adjust it to your individual therapy requirements and personal preferences. Consult with your healthcare professional to ensure the appropriate settings are selected. Time blocks j Start times, end times, and target ranges for time blocks j Add or delete a time block Device settings j Reset all time blocks j Date and time Therapy settings j Mode settings: sound, vibration, and signal suspension j Warning limits: Hyper and Hypo j Home screen default j Insulin increment j Touchscreen: tone and vibration j Max bolus amount j Display brightness j Carbohydrate unit j Background color j Language 139 52297_07167776001.indb 139 10/20/14 11:18 AM NOTE When editing a setting, any unsaved changes are discarded if the meter turns of or if a test strip is inserted into the meter. If bolus advice is turned on, see the Changing Bolus Advice Settings chapter in this user’s manual to change the time blocks, health events, and advice options (meal rise, snack size, acting time, and ofset time). 140 52297_07167776001.indb 140 10/20/14 11:18 AM 8 8.2 Date, Time, and Time Format Main Menu > Settings > Date and Time From the Main Menu, select Settings. Select Date and Time. Date and Time: Select and set the appropriate fields. Time Format: Choose 12 hr or 24 hr. Select Save. 141 52297_07167776001.indb 141 10/20/14 11:18 AM 8.3 Mode Settings: Sound, Vibration You can choose whether you want the meter to sound, vibrate, or do both at the same time as an event occurs (such as a Warning). You can adjust the sound volume. Main Menu > Settings > Mode Settings From the Main Menu, select Settings. Select Mode Settings. 142 52297_07167776001.indb 142 10/20/14 11:18 AM 8 Choose a mode. Choose the desired mode setting. Set the volume, if applicable. Select Save. Select Save. 143 52297_07167776001.indb 143 10/20/14 11:18 AM 8.4 Mode Settings: Signal Suspension You can suspend the signals for Warnings for a specified period of time. However, since Error and Maintenance messages require your immediate attention, you cannot suspend these event signals. Also, the Reminders you programmed will not be suspended. Main Menu > Settings > Mode Settings > Signal Suspension From the Main Menu, select Settings. Select Mode Settings. A signal suspension can be set to occur once or it can be set to repeat at the same time every day. NOTE Warnings that occur during the signal suspension period are displayed when the meter turns on, or when the signal suspension period ends. 144 52297_07167776001.indb 144 10/20/14 11:18 AM 8 Select Signal Suspension. Select On: Set the Start time and End time. Continue to Step 5. If On is selected, scroll the screen and choose either Once or Repeat. Select Save. Select Save. Select Off: Select Save. Go to Step 6. 145 52297_07167776001.indb 145 10/20/14 11:18 AM 8.5 Home Screen Default The Home screen is the screen displayed when the meter is powered on or after you complete a meter function, like delivering a bolus or changing a setting. You can choose either the Main Menu or Status screen to be the Home screen. Main Menu > Settings > Meter Settings > Home Screen From the Main Menu, select Settings. Scroll the screen and select Meter Settings. Select Home Screen. Choose a screen. Select Save. 146 52297_07167776001.indb 146 10/20/14 11:18 AM 8 8.6 Touchscreen: Tone, Vibration You can choose whether you want the meter to emit a tone, vibrate, do both at the same time, or do neither when you make a selection on the touchscreen. Main Menu > Settings > Meter Settings > Touchscreen From the Main Menu, select Settings. Scroll the screen and select Meter Settings. Select Touchscreen. Choose the desired touchscreen setting. Select Save. 147 52297_07167776001.indb 147 10/20/14 11:18 AM 8.7 Brightness You can adjust the brightness level of the meter display for different lighting conditions. Main Menu > Settings > Meter Settings > Brightness From the Main Menu, select Settings. Scroll the screen and select Meter Settings. Select Brightness. Set the brightness level. Select Save. 148 52297_07167776001.indb 148 10/20/14 11:18 AM 8 8.8 Background Color You can choose the background color of the meter display to be either dark or light. Main Menu > Settings > Meter Settings > Background Color From the Main Menu, select Settings. Scroll the screen and select Meter Settings. Select Background Color. Choose the desired background color. Select Save. 149 52297_07167776001.indb 149 10/20/14 11:18 AM 8.9 Language You can select a language for the screen text from a predefined list. Main Menu > Settings > Language From the Main Menu, select Settings. Scroll the screen and select Language. Choose the desired language. Select Save. 150 52297_07167776001.indb 150 10/20/14 11:18 AM
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