Roche Diagnostics Diabetes Care GW Accu-Chek Solo micropump User Manual Part 3

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Date Submitted	2018-03-07 00:00:00
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Performing a Blood Glucose Test
Inserting the test strip
Check the use by date that is
indicated on the test strip
container next to the e
symbol.
Use only test strips that are
not past the use by date.
Insert the test strip into the
test strip slot of the diabetes
manager in the direction of the
arrow. The device turns on
automatically and the LED at
the test strip slot lights up. If
the tone for blood glucose
tests is turned on, a signal is
issued.
Note
When the diabetes manager
prompts you to apply a drop,
you have approximately
2 minutes to apply blood to
the test strip. If you do not
apply any blood during this
time, the diabetes manager
turns itself off.
The Apply drop display
appears. The test strip is
ready for testing.
Put the diabetes manager
aside.
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Testing Your Blood Glucose
jj Do not allow any liquid to enter the test strip slot of the
diabetes manager.
jj Remove the test strip in case of a test strip error, and repeat
the blood glucose test using a new test strip.
jj Only apply blood to the test strip when the test strip is in the
test strip slot and Apply drop is displayed.
jj When a test strip is in the diabetes manager, the touchscreen
and the buttons, including the power button, are deactivated.
The buttons are activated again when you remove the test strip
or the test is complete.
jj Other ways to start a blood glucose test: In the Main menu, tap
the Test menu. If you want to perform a test in a dark
environment, this procedure is beneficial because the light at
the test strip slot is turned on.
Obtaining blood
Use your finger pricker to prick
the side of a fingertip.
Encourage a blood drop to
form by gently massaging the
finger in the direction of the
fingertip.
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Performing a Blood Glucose Test
Applying blood
Displaying the test result
Touch the blood drop to the
front yellow edge of the test
strip.
Do not put blood on top of the
test strip.
The blood glucose test starts
when enough blood has been
drawn up by the test strip.
The test result is displayed and
saved.
Note
For information on blood
glucose results, see the
section Causes of Implausible
Test Results in this chapter.
jj The blood glucose result
can be used for bolus
advice for a period of 15
minutes.
If the tone for blood glucose
tests is turned on, a signal is
issued.
Tap OK.
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Testing Your Blood Glucose
10
After approximately 3 seconds the Test result in detail display
appears.
Note
jj You can subsequently
change the added
information in the My data
menu.
jj If bolus advice has been
calculated based on
information you added
about health events and
carbohydrates, you cannot
change this information
anymore.
11
Remove the used test strip and
dispose of it according to local
regulations.
If you want to add information (Time of test, Carbohydrates,
Health events, Note) to the test result, follow the instructions in
the following section.
If you want to complete the blood glucose test without adding any
information or delivering a bolus, tap Done.
If you want to deliver a bolus, tap Bolus.
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Adding Information
5.3 Adding Information
Entering the time of test
You can save additional information for a test result to describe
certain events in connection with this test result or particular
characteristics of the test result.
You can assign exactly one
time of test to each blood
glucose test. This information
may be helpful later on for
determining patterns in your
blood glucose level.
If you are using the bolus advice feature, see also the information
in Chapter 7 Bolus Advice.
w WARNING
Incorrect entries for carbohydrate amounts or health events
may lead to incorrect bolus advice.
Tap Time of test.
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Testing Your Blood Glucose
Entering carbohydrates
If you test your blood glucose
in connection with a meal, it is
advisable to save the
carbohydrate amount you
consumed.
Tap Carbohydrates.
Use or to set the amount
of carbohydrates consumed.
If you are using bolus advice,
the entered carbohydrate
amount is used to calculate
the insulin amounts you need.
Tap the desired Time of test
(for example, After meal).
Tap Save.
Tap Save.
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Adding Information
Setting health events
If you have set up bolus advice and select a health event, bolus
advice will be adjusted by the percentage you specified.
Tap Health events.
Choose from 1 to a maximum
of 4 health events. Tap the
appropriate health events.
If you have selected more than one health event in the Health
events display, you will have to enter an overall percentage for
the selected health events in the next step.
Discuss health event adjustments with your healthcare
professional, who will help you to determine the suitable
percentage for the adjustment.
Tap Save.
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Testing Your Blood Glucose
Entering a note
10
11
12
In the Test result in detail
menu, tap Add Note.
You can enter a note (up to
280 characters) to save with
this entry.
Tap Done if you do not want to
deliver a bolus at this time.
If you want to deliver a bolus,
tap Bolus. For more
information, see the chapters
Delivering a Bolus and Setting
Up and Using Bolus Advice.
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Adding Information
Injection mode (without micropump): Entering basal insulin
Injection mode allows you to
save the amounts of basal
insulin you injected in the
diabetes manager. This is done
most easily when you test your
blood glucose. Note that the
basal insulin you specify does
not have any influence on
bolus advice calculation.
13
14
15
If the diabetes manager is not
connected to the micropump
(injection mode): Tap Basal
insulin.
Use and to set the
desired amount of basal
insulin.
If you want to save all entries
without delivering a bolus, tap
Done.
Tap Save.
If you want to save all entries
and deliver a bolus, tap Bolus.
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Testing Your Blood Glucose
5.4 Evaluating Test Results
Blood glucose results reflect the current status of the blood
glucose level. Test results are influenced by different factors,
including type of diet, medication taken, state of health, stress
and physical activity.
Certain substances can interfere with the blood glucose result.
This can lead to falsely elevated or lowered test results. For more
information, see the test strip package insert.
Note
jj Do not change your therapy based on single blood glucose
results.
jj If the test result is below or above the blood glucose range
that you defined with your healthcare professional, consult
your healthcare professional.
jj If the test result does not match how you feel, for example,
if it is unexpectedly low, eat fast acting carbohydrates.
Afterwards, perform a control test with the Accu-Chek Aviva
control solutions. Then repeat the blood glucose test. If the
new test result still does not match how you feel, consult
your healthcare professional.
jj If your blood glucose level is very high without any
apparent cause, check the micropump system for
occlusions or leaks. Repeat the blood glucose test. If in
doubt, replace the reservoir and the infusion assembly.
jj If test results repeatedly do not match how you feel, check
the items in the following section Causes of Implausible
Test Results.
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Evaluating Test Results
5.4.1 Colour Coding of Test Results
Green
Blue
Green dot:
The blood glucose result is
within the target range for the
current time block.
Blue dot:
The blood glucose result is
above the target range for the
current time block.
On the Test result in detail display, a coloured dot appears to the
right of the test result. The colour of the dot depends on how high
the test result is in relation to the defined blood glucose target
range for the current time block.
Overview of meaning of colours:
Colour of dot
Blood glucose result is
above the hyper warning limit. It is strongly
Blue, Hyper recommended that you test for ketones and
test your blood glucose frequently.
Blue
above your target range, but below your
hyper warning limit.
Green
within your target range.
Yellow
below your target range, but above your
hypo warning limit.
Red, Hypo
below your hypo warning limit. It is strongly
recommended that you eat a sufficient
amount of fast acting carbohydrates
immediately.
The blood glucose result does
not exceed the hyper warning
limit.
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Testing Your Blood Glucose
Blue with Hyper
Yellow
Red
Blue dot with the supplement
Hyper:
The blood glucose result
exceeds the hyper warning
limit.
Yellow dot:
The blood glucose result is
below the target range for the
current time block.
Red dot with the supplement Hypo:
The blood glucose result falls below the hypo warning limit.
jj Eat fast acting carbohydrates, such as juice or dextrose, and, if
required, also slow carbohydrates, such as a cereal bar or
bread.
jj Test your blood glucose again within the next half hour.
jj If hypoglycaemia persists, test your blood glucose and consult
your healthcare professional.
The diabetes manager displays
a warning. Check blood
glucose, ketones and insulin
delivery.
The blood glucose result does
not fall below the hypo
warning limit.
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Evaluating Test Results
5.4.2 LO Display
LO display
Treat a very low blood glucose level as instructed by your
healthcare professional. The LO display can also appear for
technical reasons.
w WARNING
The LO display may indicate a very low blood glucose value
(possibly severe hypoglycaemia).
Being aware of the symptoms of low blood glucose can help you
to better understand your test results and decide what to do.
Symptoms of low blood glucose (hypoglycaemia) may include:
jj Anxiety, shakiness
jj Sweating, headache
jj Increased hunger, dizziness
jj Pale skin colour, fatigue
jj Sudden change in mood or irritability
jj Difficulty concentrating, clumsiness
jj Palpitations and/or confusion
The blood glucose result is below the measuring range of the
diabetes manager (less than 1.1 mmol/L). If you are experiencing
a symptom of low blood glucose, proceed as follows:
jj Eat fast acting carbohydrates, such as juice or dextrose, and, if
required, also slow carbohydrates, such as a cereal bar or
bread.
jj Test your blood glucose again immediately and then again
within the next half hour.
jj If hypoglycaemia persists, test your blood glucose and consult
your healthcare professional.
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Testing Your Blood Glucose
5.4.3 HI Display
HI display
w WARNING
Repeat the blood glucose test. If the repeated test also results in
a HI display, proceed as instructed by your healthcare
professional. Being aware of the symptoms of high blood glucose
can help you to better understand your test results and decide
what to do.
Symptoms of high blood glucose (hyperglycaemia) may include:
jj Increased thirst
jj Frequent urination
jj Blurred vision
jj Drowsiness
jj Abdominal pain/cramps
jj Nausea
jj Dizziness
The HI display may indicate
a very high blood glucose
value (possibly severe
hyperglycaemia). Proceed
as instructed by your
healthcare professional
straight away and repeat
the blood glucose test.
The blood glucose result is
above the measuring range of
the diabetes manager. If you
are experiencing any of the
common symptoms of high
blood glucose, contact your
healthcare professional.
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Evaluating Test Results
5.4.4 Causes of Implausible Test Results
Troubleshooting checks
If the diabetes manager repeatedly displays implausible test
results or error messages, check the items listed below. Answer
the questions in the following table.
Did you perform the blood glucose test as instructed in the
User’s Manual?
If you cannot answer the questions in the table with yes, correct
the respective item and repeat the test.
If you have observed all these items and are still experiencing
implausible test results or error messages, contact your Customer
Support and Service Centre.
Did you wash your hands with warm water and soap and dry
them thoroughly?
Did you only apply blood after Apply drop appeared on the
screen?
Did you apply the blood drop immediately after it formed?
Are the test strips still valid (see the label on the test strip
container next to the e symbol)?
Did you perform the test within the correct temperature range?
Did you observe the storage conditions for the diabetes
manager and the test strips?
Did you observe the sources of error mentioned in the test strip
package insert?
Was the cap on the test strip container always closed tightly?
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Testing Your Blood Glucose
Troubleshooting checks
Did you use the test strip immediately after removing it from
the test strip container?
If you are not sure whether the diabetes manager is working
properly, perform a control test. For more information, see the
section Control Testing in the chapter Care and Maintenance of
this User’s Manual.
Are the diabetes manager and test strips working properly?
w WARNING
Implausible test results and error messages may also be
caused by the diabetes manager having fallen off of
something. If this is the case, contact your Customer
Support and Service Centre.
Note
Check at regular intervals whether the micropump system
has visible or tangible signs of damage. This applies
especially if the system components fell off of something
or were exposed to particular mechanical stress.
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6
Delivering a Bolus
A bolus represents the required insulin amount to be delivered in
addition to the basal rate, in order to cover the intake of food and
correct an elevated blood glucose level. The bolus type and bolus
amount are determined by your healthcare team’s guidelines,
your blood glucose level, your eating behaviour, your state of
health as well as the type and duration of physical activity.
6.1 Manual Bolus Delivery
A prerequisite for insulin therapy is that you received qualified
training and are able to understand and apply the basic principles
of bolus calculation according to the specifications of your
healthcare team.
The entries required to program a manual bolus without using
the bolus advice feature are made on the Bolus input display.
You can deliver a bolus manually or by means of the bolus advice
feature. This chapter explains manual bolus delivery with
different bolus types. Moreover, it describes the options to cancel
bolus delivery.
When you enter the total amount for a manual bolus, this insulin
amount is always added to the correction part of a bolus. A
correction part is always delivered as a standard bolus or as an
immediate delivery part of a multiwave bolus.
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Delivering a Bolus
6.2 Bolus Input Display
Blood glucose result
The current test result is displayed.
If no current test result exists, --- is displayed.
Active insulin
If bolus advice is activated, the amount of
active insulin that is to be considered is
displayed. If there is no active insulin, --- is
displayed.
This display element is only visible if the bolus
advice feature is activated.
Carbohydrate amount
The carbohydrate amount entered after
performing a blood glucose test is displayed.
If no carbohydrate amount was entered, --- is
displayed.
104
Total amount
In this entry field, you can enter the total
amount for the bolus.
The total amount is the sum of correction
bolus and meal bolus.
man_07866364001_A_en.indb 104
Correction bolus
Tap this entry field to enter the insulin
amount needed to bring a blood glucose
value outside the target range back into the
target range.
Meal bolus
Tap this entry field to enter the insulin
amount to compensate for the food intake.
Bolus type
Tap this element to select one of the
following bolus types: standard bolus,
extended bolus, multiwave bolus, quick
bolus, pen/syringe.
28.07.2017 12:16:31
Bolus Types
Note the following for bolus input:
jj When the Bolus input display appears for the first time, there is
no bolus amount specified. You must enter the bolus amount.
jj If you first set the correction bolus or the meal bolus, the total
bolus amount is deactivated and cannot be adjusted. The value,
however, is updated accordingly.
jj Take the following into account when you enter the total
amount:
• The entry fields for correction bolus and meal bolus are
deactivated.
• If you increase the total amount, the value for the correction
bolus is increased accordingly.
• If you reduce the total amount, the value for the meal bolus
is reduced, if one exists. Once the meal bolus reaches “0”,
the correction bolus is reduced accordingly.
6.3 Bolus Types
You can choose from the following bolus types on the Bolus input
display:
jj Standard bolus
jj Extended bolus
jj Multiwave bolus
In addition, you can choose a quick bolus, a customised bolus and
a bolus with pen or syringe.
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Delivering a Bolus
Symbol
Name
Description
Standard bolus
The standard bolus delivers the programmed insulin dose all at once. Use this bolus for foods that
contain fast acting carbohydrates, such as cake or bread.
Use the standard bolus if you want to correct an elevated blood glucose level.
Extended bolus
The extended bolus does not deliver the bolus insulin all at once, but over a longer period of time.
Use the extended bolus for meals that are digested slowly, for example, foods with complex
carbohydrates or foods that are high in fat and protein. An extended bolus can also be helpful for
meals that extend over a longer period of time (for example, a buffet).
Multiwave bolus
A multiwave bolus combines a standard bolus with an extended bolus. A part of the bolus amount is
delivered immediately, whereas the other part is delivered over a specified period of time.
Use this bolus for meals that contain both fast and slowly digestible carbohydrates, proteins and
fats. You can also use this bolus for meals with several courses. If you are planning to eat slowly
digestible carbohydrates but have an elevated blood glucose level before the meal, you can use this
bolus type as well. In this case, you program the immediate part of the bolus to correct the blood
glucose level and the extended part for the carbohydrates.
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Programming a Bolus
6.4 Programming a Bolus
You can program a bolus in
different ways. Start with one
of the following three options:
or
Test result > Bolus
or
Status screen > Bolus
Main menu > Bolus
Option 1:
Option 2:
Option 3:
After testing your blood
glucose: On the Test result in
detail display, tap Bolus.
On the Status screen, tap New
bolus or the
symbol.
In the Main menu, tap the
Bolus menu.
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Delivering a Bolus
Tap Manual bolus.
Tap the entry fields that are
appropriate to your situation to
enter the correction bolus,
meal bolus or total amount.
Use and to set the
desired amount for the meal
bolus.
Use and to set the
desired amount for the
correction bolus.
Tap Save.
Tap Save.
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Programming a Bolus
6.4.1 Standard Bolus
The Standard bolus type is set
as the default in the factory
settings.
To confirm this step and
deliver the standard bolus,
press the insulin button lit up
below the
in green
diabetes manager screen.
Tap Bolus.
When the diabetes manager is
ready to deliver basal or bolus
insulin, the insulin button
below the screen lights up
green.
The Deliver insulin display with
the green frame always
appears when you deliver a
bolus using the diabetes
manager.
Check the displayed total
amount before pressing the
insulin button.
The micropump delivers the
standard bolus. The Status
screen is displayed with the
current bolus information.
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Delivering a Bolus
6.4.2 Extended Bolus
The duration of bolus delivery
can be programmed in
15-minute increments for a
period of up to 24 hours.
Delivery begins immediately
after you confirm the bolus.
Throughout bolus delivery, the
Status screen shows the
remaining time and remaining
amount of the extended bolus.
The extended bolus must not
be used to correct blood
glucose values. Therefore, you
cannot select this bolus type if
the bolus you programmed
contains correction insulin.
Tap Type.
Tap Extended bolus.
Tap Duration.
Then tap Save.
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Programming a Bolus
Use and to set the hours
and minutes for the extended
bolus duration.
Tap Save.
Note
The duration you set for the
extended bolus will be used
as the default setting when
the extended bolus is
delivered the next time.
Tap Bolus.
To confirm this step and
deliver the standard bolus,
press the insulin button lit up
below the
in green
diabetes manager screen.
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Delivering a Bolus
When the diabetes manager is
ready to deliver basal or bolus
insulin, the insulin button
below the screen lights up
green.
The Deliver insulin display with
the green frame always
appears when you deliver a
bolus using the diabetes
manager.
Check the displayed Total
amount and the duration
before pressing the insulin
button.
Note
You can add a standard bolus
to an ongoing extended bolus
and one additional extended
bolus or a multiwave bolus.
The micropump delivers the
extended bolus. The Status
screen is displayed with the
current bolus information.
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Programming a Bolus
6.4.3 Multiwave Bolus
The duration of the extended
bolus delivery can be
programmed in 15-minute
increments for a period of up
to 24 hours. Delivery begins
immediately after you confirm
the bolus.
You can add an extended bolus
to an ongoing multiwave bolus.
As soon as the immediate part
of a multiwave bolus was
delivered, you can add a
standard bolus or another
multiwave bolus.
Tap Type.
Tap Multiwave bolus.
Note
Start with the entries for the
correction insulin and the
meal bolus.
If you enter the total amount
first, you cannot make any
entries for the correction
bolus and the meal bolus.
The entry fields will be
deactivated (greyed out).
Then tap Save.
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Delivering a Bolus
Tap Immediate amount to
enter the bolus part that is to
be delivered immediately.
Use and to set the
Immediate amount.
Tap Delayed amount to enter
the bolus part that is to be
delivered in a delayed fashion.
Use and to set the
Delayed amount.
The Immediate amount must
not be less than the part set
for the correction insulin.
The Delayed amount must not
be greater than the part set for
the meal bolus.
Tap Save.
Tap Save.
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Programming a Bolus
Tap Duration.
Use and to set the
duration of the delayed part.
Note
The duration you set for the
extended bolus will be used
as the default setting when
the multiwave bolus is
delivered the next time.
Tap Bolus.
Tap Save.
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Delivering a Bolus
10
To confirm this step and
deliver the multiwave bolus,
press the insulin button lit up
below the
in green
diabetes manager screen.
When the diabetes manager is
ready to deliver basal or bolus
insulin, the insulin button
below the screen lights up
green.
The Deliver insulin display with
the green frame always
appears when you deliver a
bolus using the diabetes
manager.
Check the displayed Total
amount, Immediate amount,
Delayed amount and the
duration before pressing the
insulin button.
11
The micropump delivers the
multiwave bolus. The Status
screen is displayed with the
current bolus information.
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Quick Bolus
6.5 Quick Bolus
A quick bolus is a bolus that can be programmed and delivered
using the quick bolus buttons on the micropump.
As with the standard bolus, the quick bolus delivers the
programmed insulin dose all at once. The quick bolus is suitable
for meals that contain mainly carbohydrates that can be digested
rapidly as well as for the correction of an elevated blood glucose
level.
A quick bolus allows a bolus to be discreetly delivered if the
diabetes manager is not available or cannot communicate with
the micropump. This is the case, for example, when flight mode is
turned on. The bolus amount can only be programmed in defined
increments.
w WARNING
jj Make sure that you know and use the set quick bolus
increment. If you use a different quick bolus increment to
the one you intended, an incorrect insulin dose will be
delivered.
jj Note that a quick bolus is always considered to be a
correction bolus.
Note
Fill in the increment you set for the quick bolus on the flap
card of the perforated cover page.
The basic setting for the quick bolus increment is 0.2 units. Thus,
you can set the bolus amount to 0.2 units, 0.4 units, 0.6 units and
so on. If necessary, you can change the quick bolus increment to
0.2, 0.5, 1.0 or 2.0 units. See the chapter Changing Settings.
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Delivering a Bolus
6.5.1 Programming a Quick Bolus
Tap Type.
Tap Quick bolus.
Tap Bolus.
Check the total amount and
follow the instructions given
in the information.
Then tap Save.
Tap OK.
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Quick Bolus
6.5.2 Delivering a Quick Bolus
Note
If you made entries for the
quick bolus on the Bolus
input display, they must be
confirmed by the micropump
within a period of 15
minutes. Otherwise, these
entries may not be assigned
correctly. As a result, the
entries that cannot be
synchronised by the
micropump system will be
discarded.
Example
With a quick bolus increment
of 0.5 units, you must press
the quick bolus buttons 5
times to deliver an insulin
amount of 2.5 U.
3s
Press and hold both quick
bolus buttons for
approximately 3 seconds until
you hear a sequence of
signals.
Simultaneously press both
quick bolus buttons repeatedly
until the desired insulin
amount is set. The micropump
issues a signal every time the
buttons are successfully
pressed.
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Delivering a Bolus
Note
jj If you have not pressed the
quick bolus buttons for
approximately 3 seconds,
the entry phase ends and
the micropump provides
acoustic feedback. A signal
is issued for each
programmed quick bolus
increment.
jj If you do not confirm the
acoustic feedback in
Step 4 by pressing the
quick bolus buttons, no
bolus will be delivered and
a sequence of signals for
cancelling the bolus will be
issued.
Check whether the acoustic
feedback corresponds to the
desired insulin amount.
If the acoustic feedback
corresponds to the bolus
amount you require, press the
quick bolus buttons to confirm
insulin delivery until you hear
a sequence of signals.
Note
Enter the insulin and
carbohydrate amounts
associated with the quick
bolus in the logbook. Be sure
to assign correction and
mealtime boluses correctly.
Otherwise, subsequent data
entries in the logbook as well
as future bolus advice
calculations might not be
correct.
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Delivering the Bolus with a Pen or Syringe
6.6 Delivering the Bolus with a Pen or Syringe
If you want to deliver a bolus with a pen or syringe, you can
document the insulin amounts delivered on the Bolus input
display.
Select one of the 3 options for
bolus delivery that are
mentioned in the section
Standard Bolus. Perform the
appropriate steps until the
Bolus input menu is displayed.
Tap the Pen/syringe bolus
type.
The boluses that you deliver with a pen or syringe are saved in
the diabetes manager database. The entered insulin amounts are
evaluated for future bolus advice calculations. This improves the
result of further bolus advice calculations.
Tap Type.
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Delivering a Bolus
Tap the desired entry field.
Use and to set the
insulin amount you want to
deliver using a pen or syringe.
Tap Bolus.
If the total amount to be
delivered is correct, tap OK.
If you tap Total amount, the
entered insulin amount is
added to the correction bolus.
Tap Save.
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Cancelling a Bolus
6.7 Cancelling a Bolus
Example
To cancel an ongoing bolus, press the button on the Status
screen or in the Main menu.
If this is not possible, remove the micropump from the
infusion assembly.
6.7.1 Cancelling Bolus Programming
Inject the insulin units with a
pen or syringe.
Standard, extended and multiwave bolus
button to go back to the
While programming, press the
previous step and enter a new value.
Quick bolus
If you do not confirm the quick bolus by pressing both quick bolus
buttons within 5 seconds of the acoustic feedback for the insulin
amount, programming of the quick bolus will be cancelled
automatically.
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Delivering a Bolus
6.7.2 Cancelling a Bolus During Delivery
If you have the diabetes manager at hand: Press the button
during bolus delivery to cancel the bolus. Bolus delivery is
cancelled and the diabetes manager displays warning W38
Bolus cancelled.
Cancelling all boluses
On the Status screen or in the
Main menu, tap .
If you want to cancel all
ongoing boluses at the same
time, tap Cancel all boluses.
If you do not have the diabetes manager at hand: Remove the
micropump from the infusion assembly for as long as the bolus is
being delivered. Then place the micropump back onto the infusion
assembly.
6.7.3 Cancelling a Bolus Using the Cancel bolus Menu
In the Main menu and on the Status screen, you can cancel a
bolus by tapping .
In the Bolus menu, you can tap the Cancel bolus item. Here you
can cancel one bolus or all ongoing boluses.
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Cancelling a Bolus
Cancelling single boluses
Note
The display in Step 2 only
appears if more than one
bolus is programmed.
If you want to cancel all
boluses now, tap Yes.
Tap the bolus you want to
cancel.
Tap Yes if you want to cancel
the bolus now.
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Delivering a Bolus
6.8 Delaying Bolus Delivery
In some situations (for example, if you have gastroparesis) it may
be helpful to only start a bolus after you have started eating. You
can use the delivery lag time setting to specify an interval
between programming a bolus and the actual start of bolus
delivery.
Discuss using the delivery lag time setting with your healthcare
team.
Setting the delivery lag time
Select one of the 3 options for
bolus delivery that are
mentioned in the section
Standard Bolus. Perform the
appropriate steps until the
Bolus input menu is displayed.
Tap the required bolus type,
for example, Standard bolus.
If you want to use the delivery lag time, you must activate this
feature in the Bolus settings menu first (see chapter Settings).
Note
If a bolus contains correction insulin, it is not possible to enter
a delivery lag time. Correction insulin must always be
delivered immediately.
Tap Type.
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Delaying Bolus Delivery
Tap Bolus.
Tap Delivery lag time.
Use and to set the
Delivery lag time.
Tap Bolus.
Tap Save.
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Delivering a Bolus
To confirm this step and
deliver the standard bolus,
press the insulin button lit up
below the
in green
diabetes manager screen.
The Status screen is displayed
with the current bolus
information and the set
delivery lag time.
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7
Bolus Advice
The bolus advice feature aims to bring your blood glucose level
back into the target range defined for you, by delivering an insulin
amount that was calculated in advance. The bolus advice feature
of the diabetes manager consists of two components: First, a
recommendation for a correction bolus to adjust your blood
glucose level if it is not within the target range. Secondly, a
recommendation for a meal bolus that covers your food intake.
However, the bolus advice feature only makes a recommendation
if you set up (configured) bolus advice beforehand.
7.1 Overview
If your blood glucose value is below the hypo warning limit, no
bolus advice is issued. Instead, you receive a recommendation to
consume a certain carbohydrate amount to bring your blood
glucose level back to within the target range.
Advantages of bolus advice:
jj Bolus advice is calculated based on the current blood glucose
value, your carbohydrate intake and other factors.
jj Insulin from a previous bolus that is still acting and difficult to
be estimated manually, is taken into account automatically.
jj Therapy schemes can be adhered to more consistently.
jj Blood glucose values can be kept within the target range for a
longer time period more easily.
The bolus advice feature of the diabetes manager consists of two
components: First, a recommendation for a correction bolus to
adjust your blood glucose level if it is not within the target range.
Secondly, a recommendation for a meal bolus that covers the
carbohydrates contained in your meals.
The recommendation for the correction bolus is positive if your
current blood glucose level is above your target range. If, at the
same time, a meal bolus is recommended, a negative correction
bolus lowers the total insulin amount of bolus advice.
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Bolus Advice
Note the following:
jj The micropump system is not able to judge your current
situation independently of your own assessment.
jj Insulin that was not delivered via the micropump system can
only be taken into account if you specify this in the diabetes
manager.
jj Bolus advice cannot correct any input errors. This is particularly
true for the carbohydrate amount entered.
jj Warnings are displayed for entries that exceed possible limit
values.
jj 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.
Terminology for setting bolus advice
Carbohydrate ratio
The carbohydrate ratio defines the insulin amount necessary to
compensate for a certain amount of ingested carbohydrates.
Insulin sensitivity
The insulin sensitivity defines the insulin amount required to
lower your blood glucose level by a certain value.
Target range
The target range describes which blood glucose values are
considered acceptable when fasting or before a meal. The target
range is specified by the lower and upper BG thresholds.
Meal rise
During or after meals, an increase in the blood glucose level is
considered normal within a certain range, even if a bolus was
delivered. Enter the maximum increase in your blood glucose
level that is to be tolerated without an additional correction bolus.
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Snack size
The snack size defines a carbohydrate threshold; when this is
exceeded, a meal rise should be taken into account. Thus, the
snack size indicates which carbohydrate amounts should not be
considered as regular meals with an expected and tolerated meal
rise.
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Overview
Acting time
The acting time is the period of time from the start of bolus
delivery until the blood glucose level is expected to return to the
target level.
You can specify the duration of the acting time according to your
needs. The total acting time includes the offset time.
Note
jj Discuss intended changes to your bolus advice options with
your healthcare professional in advance.
jj After bolus advice is set up, you can change the options or
turn off bolus advice, if required.
jj If you turn off bolus advice, all bolus advice options will be
deleted.
Offset time
The offset time is the period of time after which the insulin is
expected to start lowering the blood glucose level in the body.
Time blocks
Time blocks allow you to divide the day into different time periods
according to your individual lifestyle.
Time blocks help you and your healthcare professional to
recognise more easily how your blood glucose level is affected by
your daily activities and lifestyle.
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Bolus Advice
7.2 Setting Up Bolus Advice
Tap Bolus advice.
Tap Yes.
Main menu > Settings > Bolus settings
After you turn on bolus advice, you set up the time blocks first. All
time blocks add up to a time period of 24 hours. The diabetes
manager factory settings contain 5 default time blocks. You can
set up a maximum of 8 time blocks.
The bolus advice feature uses the time blocks that you have
already set while executing the setup wizard. If required, you can
change the time block settings.
w WARNING
Discuss intended changes to your bolus advice options with
your healthcare professional in advance.
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Setting Up Bolus Advice
Defining a time block
The display for defining the
first time block appears.
Use and to set the Start
time for the first time block.
Use and to set the End
time for the first time block.
The changed start and end
times for the first time block
are displayed.
Tap Start time.
The minutes can be set in
15-minute increments.
The minutes can be set in
15-minute increments.
Tap Save.
Tap Save.
If you want to keep the start
and end times, tap Done.
The
Tap Done.
button is deactivated.
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Bolus Advice
Setting the target range
Tap Upper limit value.
Use and
limit value.
If you do not want to modify
the limit values for the target
range, tap Next.
Tap Save.
to set the Upper
Use and
limit value.
to set the Lower
The limit values currently set
for the target range are
displayed.
Tap Save.
Tap Next.
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Setting Up Bolus Advice
Defining the default settings
To define the default settings,
tap the adjustment fields for
the Carbohydrate ratio.
Then tap the adjustment fields
for the Insulin sensitivity.
Carbohydrate ratio
Note
The Done button on the
Default settings display
remains deactivated (grey)
until the entries for
Carbohydrate ratio and
Insulin sensitivity are
complete.
Example
Carbohydrate ratio:
1.00 U : 10 g
Use and to set the
insulin units for the
Carbohydrate ratio.
Use and to set the
carbohydrate amount for the
Carbohydrate ratio.
Tap Save.
Tap Save.
In this example, one insulin
unit compensates for 10 g
of carbohydrates.
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Bolus Advice
Insulin sensitivity
Example
Use and to set the
insulin units for the Insulin
sensitivity.
Use and to set the blood
glucose value for the Insulin
sensitivity.
Tap Done.
Tap Save.
Tap Save.
Insulin sensitivity:
1.00 U : 2.2 mmol/L
In this example, one insulin
unit lowers the blood glucose
value by 2.2 mmol/L.
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Setting Up Bolus Advice
Changing the time block settings
Note
You can change the start
time for the first time block
only.
Changes to the Target range,
Carbohydrate ratio and
Insulin sensitivity can be
made for each time block.
The default settings for
carbohydrate ratio and insulin
sensitivity are copied to all
time blocks.
You can change the settings
for each time block separately.
Tap the time block you want to
change.
Tap End time.
If you do not want to change
the copied settings for the
other time blocks, tap Done.
Continue with the section
Setting health events.
Tap OK.
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Bolus Advice
Set the End time for the
selected time block.
Tap Next.
Set the upper and lower limit
values.
Tap Done when you have
completed the desired settings
for all time blocks.
Tap Save.
Tap Next.
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Setting Up Bolus Advice
Setting health events
Health events or your activities have an impact on your blood
glucose level. Bolus advice calculation takes health events into
account.
w WARNING
Incorrectly entered health events may lead to inappropriate
bolus advice.
Each health event adjusts bolus advice by the percentage set by
you. A positive percentage (+) increases the bolus amount and a
negative percentage (-) decreases the bolus amount.
You can choose between 5 default health events and
3 customised health events:
jj Exercise 1
jj Exercise 2
jj Stress
jj Illness
jj Premenstrual
jj Customised: Name 1-3
Example
You go for a run and create the customised health event Run
with a percentage of -20 %.
When you select the Run health event during bolus
calculation, the bolus amount is decreased by 20 %.
You can also enter health events at a later time.
The percentage for a health event must be between -50 % and
+50 %. The percentage can be changed in increments of 5 %.
Discuss changes to your bolus advice options with your
healthcare professional in advance.
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Bolus Advice
Setting a health event
Customised health event
Tap the health event for which
you want to make settings (for
example, Stress).
Enter a Percentage for the
selected health event.
The Health events are
displayed with the percentages
that were set.
Tap to enter a name (for
example, Run) for the
customised health event.
Tap Save.
Repeat Steps 1 and 2 to set
the percentage for other health
events.
If you want to set a
customised health event, tap
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Setting Up Bolus Advice
Note
You can select a maximum of
4 health events.
If you have selected more
than one health event, you
will have to enter a total
percentage for the selected
health events in the next
step.
Use and to set the
percentage for the customised
health event.
The Health events are
displayed with the percentages
that were set.
Tap Save.
Tap Done.
Discuss health event
adjustments with your
healthcare professional, who
will help you to determine the
suitable percentage for the
adjustment.
Specify a total percentage for
the health events.
Tap Save.
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Bolus Advice
Changing percentages for health events
Tap Health events.
Tap the health event for which
you want to make settings (for
example, Stress).
Enter a percentage for the
selected health event.
The Health events are
displayed with the percentages
that were set.
Tap Save.
Repeat Steps 2 and 3 to set
the percentage for other health
events.
Tap Done after setting the
health events.
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Setting Up Bolus Advice
Bolus advice options
Tap Meal rise, Snack size,
Acting time and Offset time to
adjust the respective settings.
Note
The Done button on the Bolus
advice options display
remains deactivated (grey)
until the entries for Meal rise,
Snack size, Acting time and
Offset time are complete.
Meal rise
Snack size
Use and
rise value.
Tap Save.
to set the meal
Use and
size value.
to set the snack
Tap Save.
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Bolus Advice
Acting time
Offset time
Use and to set the hours
and minutes for the acting
time.
Use and to set the hours
and minutes for the offset
time.
Tap Done to complete the
setup wizard.
All settings for calculating
bolus advice are now
complete.
Tap Save.
Tap Save.
Tap OK.
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Setting Up Bolus Advice
7.2.1 Adding a Time
Block
Adding time blocks
Tap the last time block.
Tap End time and change it to
the desired end time (for
example, from 05:30 to 03.30).
This section describes how to
add a new time block.
To add a time block, decrease
the end time of the last time
block.
After the new time block has
been created, you may have to
adjust the end time and other
information for each time
block.
Note
jj Decrease the End time of
the last time block by any
amount in order to create a
new time block. This
creates a new time block
by splitting the last time
block into 2 time blocks.
jj However, do not decrease
the End time until it equals
the Start time because this
will delete the time block.
Tap Next.
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Bolus Advice
The last time block is split into
two time blocks (for example,
second to last time block
22:00–03:30, last time block
03:30–05:30).
Set the Upper limit value and
Lower limit value for the new
time block.
Set the Carbohydrate ratio and
Insulin sensitivity for the new
time block.
It may be necessary to change
the end times and settings of
other time blocks.
Tap Next.
Tap Done.
Tap Done when you have
finished editing the time
blocks.
Tap Done.
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Setting Up Bolus Advice
7.2.2 Deleting Time
Blocks
Deleting several time blocks
Select the first time block that
is to be merged with one or
more time blocks.
Increase the end time until it
equals the end time of the last
time block to be deleted.
Tap Yes if you want to delete
the time blocks.
In this example, the three time
blocks between 08:30 and
22:00 are being merged.
Tap Next.
This section describes how to
delete one or more time
blocks.
The first method to delete one
or more time blocks is to
merge time blocks.
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Bolus Advice
Set the Upper limit value and
Lower limit value for the
merged time block.
Set the Carbohydrate ratio and
Insulin sensitivity for the
merged time block.
It may be necessary to change
the end times and settings of
the remaining time blocks.
Tap Done.
Tap Done.
Tap Done when you have
finished editing the time
blocks.
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Setting Up Bolus Advice
Deleting a single time block
The second method deletes a
single time block by
decreasing the end time of the
time block until it is the same
as its start time.
Tap the time block to be
deleted.
Decrease the end time until it
equals the start time.
Tap Yes if you want to delete
the time block.
In this example, the time block
from 11:30 to 15:30 is to be
deleted.
Tap Next.
After time blocks have been
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.
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Bolus Advice
Set the Upper limit value and
Lower limit value for the new
time block.
Set the Carbohydrate ratio and
Insulin sensitivity for the
merged time block.
It may be necessary to change
the end times and settings of
the remaining time blocks.
Tap Done.
Tap Done.
Once you have finished editing
the time blocks, tap Done.
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Setting Up Bolus Advice
7.2.3 Resetting All Time
Blocks
Tap Reset.
If you want to reset all time
blocks, tap Yes.
Set the Start time and End
time for the first time block.
This section describes how to
restore the settings for all time
blocks to the factory settings
and then re-enter them.
Changing the start time of the
first time block may be one
reason for resetting all time
blocks.
Tap Done.
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Bolus Advice
Set the default values for the
Upper limit value and Lower
limit value.
Set the default values for the
Carbohydrate ratio and Insulin
sensitivity.
Tap OK.
It may be necessary to change
the end times and settings of
the other time blocks.
Tap Done.
Tap Done.
Tap Done when you have
finished editing the time
blocks.
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Setting Up Bolus Advice
7.2.4 Changing Bolus Advice Options
This section describes how to
change the values for meal
rise, snack size, acting time
and offset time.
Tap Bolus advice options.
Tap the respective entries to
set the Meal rise, Snack size,
Acting time and Offset time.
Tap Done after making all the
settings.
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Bolus Advice
7.3 Using Bolus Advice
Delivering a recommended bolus
You can use the bolus advice feature directly after testing your
blood glucose. Note that a blood glucose result is only valid for
bolus advice within 15 minutes of the blood glucose test.
You can also call up bolus advice from the Status screen or Main
menu.
Additional information:
symbol indicates that the bolus advice feature is
jj The
turned on.
If no bolus advice is set up, bolus advice is turned off or a
symbol is displayed.
manual bolus was delivered, the
jj If you deliver a bolus straight from the micropump, the
information on the total bolus amount is taken into account for
future bolus advice. However, the total bolus amount is
considered as a correction bolus, and no meal rise is
registered. If this bolus was used for food intake, you should
edit the bolus in your logbook to assign the bolus part that was
used for the carbohydrates. This ensures that you receive as
accurate bolus advice as possible as a direct consequence
(during acting time).
jj If you provide values for Blood glucose result, Carbohydrates
and Health events to calculate bolus advice, you will obtain the
best results. All entries are saved.
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Using Bolus Advice
Starting bolus advice after a BG test
Tap the respective entries to
add information on Time of
test, Carbohydrates or Health
events.
Enter the percentage for the
total amount if you have
selected several health events.
If you have entered only one or
no health event, the Health
events display will not appear.
Tap Bolus.
Tap Save.
Tap Bolus.
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Bolus Advice
Selecting the bolus type
The bolus advice feature
calculates a suggestion and
transfers the recommended
values to the entry fields.
Tap the respective entry fields
if you want to change the
suggested values.
Changing bolus advice values
Correction bolus
Meal bolus, changed
Value has been updated
If you change the correction bolus or meal bolus first, the Total
amount cannot be changed. The value, however, is updated
accordingly (see figure).
Tap Type to select the desired
bolus type.
If you change the Total amount first, the correction bolus and
meal bolus cannot be changed.
Tap Bolus.
If you increase the Total amount, the Correction bolus is
increased accordingly. If you decrease the Total amount, the
meal bolus is decreased accordingly. Once the meal bolus
reaches “0”, the correction bolus is reduced accordingly.
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Using Bolus Advice
Confirming the bolus
Note
Not every bolus type can be
selected, depending on the
setting. You cannot select an
extended bolus, for example,
if a correction bolus is to be
delivered.
Tap Bolus.
To confirm this step and
deliver the standard bolus,
press the insulin button lit up
below the
in green
diabetes manager screen.
The Status screen is displayed
showing the current bolus
information.
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Bolus Advice
Starting bolus advice without a BG test
Tap Bolus advice.
Tap No to obtain bolus advice
without performing a blood
glucose test.
or
On the Status screen, tap New
symbol.
bolus or the
In the Main menu, tap the
Bolus menu.
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Using Bolus Advice
Note
If no valid blood glucose
result exists and you do not
want to test your blood
glucose, you can enter the
carbohydrate amount you
consumed. If you then tap
Bolus on the Bolus advice
display, a suggestion for a
meal bolus is displayed.
Entering carbohydrates
Confirming the bolus
Enter the carbohydrates
consumed.
Tap Bolus.
To confirm this step and
deliver the bolus, press the
insulin button lit up in green
below the diabetes
manager screen.
Enter a carbohydrate amount
of up to 240 g.
To set the carbohydrates using
the keyboard, tap .
Tap Save.
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Bolus Advice
7.3.1 Bolus Advice for Pen/Syringe
The bolus advice feature is also available in injection mode. Make
sure that the insulin amount saved by the micropump system is
identical to the amount you delivered.
Start bolus advice with or
without testing your blood
glucose.
Tap Pen/syringe.
Also consult the instructions for use for your insulin pen or
syringe.
Tap Type.
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Using Bolus Advice
Once you have completed your
entries, tap Bolus.
Tap OK.
The Status screen is displayed.
Deliver the insulin units you
confirmed with a pen or
syringe.
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Bolus Advice
7.4 Turning Off Bolus Advice
Tap Bolus advice.
Tap Yes if you want to turn off
bolus advice now.
Main menu > Settings > Bolus settings
This section describes how to turn off bolus advice.
Note
If you turn off bolus advice, all bolus advice options will be
restored to the factory settings. If you want to use bolus
advice again, you must set it up once again.
The bolus advice options will
be deleted!
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8
Basal Rate Profiles and Temporary Basal Rates
8.1 Basal Rate Profiles
In this chapter you will learn how you can adapt your basal
insulin supply to your life situations using different basal rate
profiles and Temporary Basal Rates (TBR).
The basal rate is a continuous delivery of insulin that covers the
meal-independent insulin requirement. The size of the basal rate
depends on your personal circumstances and the time of day.
A basal rate profile consists of a combination of basal rates that
are defined according to your personal requirements and cover
24 hours a day. If your insulin needs differ on certain weekdays,
on weekends, during illness or on holiday, you can create and
use different basal rate profiles. You can set up a maximum of 5
basal rate profiles in the diabetes manager.
Basal rate profiles are defined through basal rate segments. Each
basal rate segment needs a start time and an end time as well as
an insulin amount, which is specified in insulin units per hour
(U/h).
If you activate a Temporary Basal Rate of less than 100 % in
addition to a low basal rate, this may be less than the minimum
possible output amount of the micropump.
Note
If you activate a different basal rate profile, all ongoing insulin
deliveries (basal rate, boluses) will be cancelled.
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Basal Rate Profiles and Temporary Basal Rates
8.2 Creating and Editing a Basal Rate Profile
A basal rate profile can be
programmed, edited and
deleted in different ways. Start
by using one of the following
two options:
or
On the Status screen, tap the
area indicating the basal rate.
In the Main menu, tap the
Basal rate menu.
In the Basal rate menu, tap
Basal rate profiles.
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Creating and Editing a Basal Rate Profile
8.2.1 Programming a Basal Rate Profile
Note
jj Basal rate time blocks are not identical to or shared with the
time blocks for bolus advice.
jj You are only able to edit the end times of basal rate time
blocks. The start time of each time block is identical to the
end time of the previous time block.
jj To add a new time block, set the end time of the last time
block to the desired start time of the new time block.
jj To delete a time block, set the end time of the time block to
equal the start time of the same time block.
jj When the maximum possible number of 5 basal rate profiles
is reached, the Basal rate profiles display does not show the
symbol.
Tap to add a basal rate
profile.
Tap the item with the
symbol.
Enter the desired name (for
example, Weekend) for the
Basal rate profile. The name
may have up to 12 characters.
Confirm your entry with
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Basal Rate Profiles and Temporary Basal Rates
Tap the first time block. Set
the end time and the insulin
amount.
Use and to set the
end time for the time block (for
example, start at 07:00, end at
08:30).
Use and to set the
insulin amount for the time
block (for example, 1.50 U/h).
Repeat this process for all 24
time blocks.
Tap Save.
Tap Save.
Tap Save.
If you want to use the basal
rate profile immediately, tap
Activate.
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Creating and Editing a Basal Rate Profile
8.2.2 Activating a Basal Rate Profile
The newly programmed basal
rate profile is displayed in the
overview of the existing basal
rate profiles.
Tap the basal rate profile you
want to activate (for example,
Profile 2).
If required, scroll the screen
upwards to be able to check
all time blocks of the basal
rate profile.
To confirm this step and
activate the basal rate profile,
press the insulin button lit up
below the
in green
diabetes manager screen.
Check whether the total
amount displayed corresponds
to the total amount defined by
your healthcare professional.
The currently active basal rate
profile is indicated by the
symbol.
Once all settings are correct,
tap Activate.
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Basal Rate Profiles and Temporary Basal Rates
Note
cancels the
Tapping
activation of the selected
basal rate profile and takes
you to the previous display.
The basal rate profile that
was previously active,
remains active.
The activated basal rate profile
is displayed on the Status
screen.
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