MiniMed 640G Getting Started Guide Aug 2014 PDF download

let’s get started!

Table of Contents Section 1: Getting Started�� 3 Getting Started with the MiniMed® 640G Insulin Pump��3 1.1 Pump Mechanics and the Delivery of Insulin��4 1.1.1 Infusion Set�� 4 1.1.2 Reservoir�� 4 1.1.3 Pump�� 4 1.2 Pump Basics��5 1.2.1 The Front of Your Pump�� 5 1.2.2 The Bottom of Your Pump�� 5 1.2.3 The Back of Your Pump�� 5 1.2.4 Attaching the Skins�� 6 1.2.5 Inserting the Battery �� 6 1.3 Startup Wizard��7 1.4 Home Screen��8 1.4.1 Unlocking the Pump�� 9 1.4.2 Status Bar�� 9 1.4.3 Status Screens��10 1.5 Menu��11 1.5.1 Scroll Bar��11 1.5.2 Basic Menu Map��12 1.5.3 Navigation��13 1.5.4 Menu Options��14 1.6 Alerts��15 1.7 Alarms��16 1.8 Menu Options - A Closer Look��17 1.8.1 Audio Options��17 1.8.2 Display Options��17 1.9 Basal Patterns��18 1.9.1 Basal Pattern Setup – One Basal Rate��18 1.9.2 Basal Pattern Setup – Changing a Basal Rate��20 1.9.3 Basal Pattern Setup – Multiple Basal Rates��21 1.9.4 Basal Pattern Setup – Removing Basal Rates ��24 1.9.5 Select Basal Pattern��24 1.10 Bolus Wizard™ Calculator ��25 1.10.1 Using the Bolus Wizard™ Calculator��25 1.10.2 Checking Last Bolus ��30 1.11 Suspend Delivery��31 1.12 Charging the Contour® Next LINK 2.4 Meter��33

Section 2: Medtronic CareLink® Personal Software��34 2.1 Introduction to Medtronic CareLink® Personal Software��34

Section 3: Connecting the MiniMed® 640G Insulin Pump & the Contour® Next LINK 2.4 Meter�� 35 Section 4: Getting Started Using the Contour® Next LINK 2.4 Meter�� 36 4.1 Giving a Remote Bolus��36

Section 5: Changing the Reservoir and Infusion Set�� 37 5.1 Reservoir & Tubing��37

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Table of Contents

Section 6: Additional Features��40 6.1 History��40 6.1.1 Summary��40 6.1.2 Daily History��40 6.1.3 Alarm History��40 6.2 Manual Bolus��41 6.3 Insulin Settings��41 6.3.1 Max Basal��42 6.3.2 Adding New or Copying Basal Patterns��43 6.3.3 Temp Basal��44 6.4 Preset Insulin Settings��46 6.4.1 Preset Temp Setup ��46 6.4.2 Preset Bolus ��47 6.5 Max Bolus��49 6.6 Advanced Bolus��50 6.6.1 Square Wave��50 6.6.2 Dual Wave ��52 6.6.3 Bolus Increment ��54 6.7 Easy Bolus ��55 6.8 Auto Suspend��57 6.9 Bolus Speed ��58 6.10 Event Markers��59 6.11 Reminders��60 6.11.1 Personal Reminder��60 6.11.2 Bolus BG Check Reminder��60 6.11.3 Missed Meal Bolus Reminder��61 6.11.4 Low Reservoir Reminder��62 6.11.5 Set Change Reminder��63 6.11.6 Turning Reminders Off��63 6.12 Utilities��64 6.12.1 Airplane Mode ��64 6.12.2 Time & Date ��64 6.12.3 Block ��64 6.12.4 Remote Bolus ��64 6.12.5 Self Test ��64 6.12.6 Carb Unit ��65 6.12.7 Manage Settings ��65 6.12.8 Sensor Demo ��65 6.12.9 Language ��65

Section 7: Training Handouts��66 7.1 Basal Quick-Reference Guide for the MiniMed® 640G Insulin Pump��67 7.2 Bolus Wizard™ Quick-Reference Guide for the MiniMed® 640G Insulin Pump��69 7.3 Changing the MiniMed® Sure-T® Infusion Set with the MiniMed® 640G Insulin Pump��71 7.4 Changing the MiniMed® mio® Infusion Set with the MiniMed® 640G Insulin Pump��77

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Introduction I Welcome Getting Started with the MiniMed® 640G Insulin Pump Welcome! We are glad that you have chosen insulin pump therapy and are excited for you to begin using your insulin pump. Whether you’ve chosen pump therapy because of its convenience, the flexibility it provides, or to help improve your glucose control, your pump will be a valuable tool in helping to manage your diabetes. This guide provides step-by-step instructions on the basic operation and programming of your pump. Using your pump to complete each practice exercise will help you become comfortable with the basics and prepare you for your in-person training. The information is presented in an order that will build your skills and knowledge. During your in-person training, your trainer will build on this information and help ensure you are confident to begin pump therapy.

Did You Know? A complete explanation of the technical and operational aspects of your pump can be found in the MiniMed® 640G System User Guide.

Here are some quick tips to keep in mind as you work through this information:

• Be sure you are not attached to your insulin pump while you practice. • It’s okay if you make a mistake. If you press the wrong button, use the

to go back to the previous screen and try again.

• If you do not touch a button for 15 seconds, the pump screen will turn dark. Press any button and the pump screen will return.

• Avoid the Reservoir & Tubing menu option as you practice. You will review these steps during your in-person training. We hope you enjoy learning about your new insulin pump.

Did You Know? An interactive online version of this training is available at www.medtronicdiabetes.com.au

IMPORTANT Do NOT attach the insulin pump to your body or attempt to use insulin in your pump as you use this guide to practice and learn.

Attaching and using must only be done when you receive formal training with your healthcare professional or a certified product trainer.

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Section 1 I Getting Started 1.1 Pump Mechanics and the Delivery of Insulin Before we begin, let’s make sure you know how insulin is delivered when using an insulin pump. The parts that make up the pump’s delivery system are the infusion set, the reservoir, and the pump.

Infusion Set* 1 Tubing

1.1.1 Infusion Set

3

2

Insertion Site Section Cannula 5 Adhesive 6 Reservoir Compartment 4

The infusion set consists of tubing (1) that carries insulin from the pump to you. On one end of the tubing is the reservoir connector (2) that attaches to the reservoir which holds the insulin. On the other end is the insertion site section (3) that attaches to you. The insertion site section has a small insertion needle that places a tiny flexible tube called a cannula (4) into your body**. Once the infusion set is inserted, you remove the needle, leaving just the cannula behind. A small piece of adhesive (5) holds the infusion set in place.

Reservoir Connector

1

3

2 4

The reservoir is similar to a syringe and holds 2- to 3-days supply of insulin. The reservoir fits into the pump’s reservoir compartment (6). You will be replacing both the infusion set and the reservoir every 2 to 3 days.

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1.1.2 Reservoir

5

Reservoir

1.1.3 Pump 6

u

Inside the pump, at the bottom of the reservoir compartment, is a piston. The piston acts like the plunger rod on a syringe, pushing up on the bottom of the reservoir, moving insulin into the tubing, through the cannula, and into your body. The piston is controlled by a mini computer inside the pump that’s able to deliver insulin in very small doses, sometimes as small as 0.025 units. It must be rewound each time a newly filled reservoir is placed into the reservoir compartment.

Pump

*Medtronic Quick-set™ infusion set shown in illustration. **Some infusion sets do not use a cannula but have a small needle that remains inserted in the body.

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Section 1 I Getting Started 1.2 Pump Basics Before inserting the battery or pressing any buttons, let’s take a closer look at your pump.

1.2.1 The Front of Your Pump Up,

Down,

Left, and

Right

• Press to scroll up or down through a menu or list • Press to move to desired area on the screen • Press to change the value in an area Back • Press to return to a previous screen • Press and hold to return to the starting screen, called the Home screen

Menu

Up

Select • Press to select or confirm a value or menu option that is highlighted • Press when directions say ‘select’

Back

Left

Right Select

Notification Light

Menu • Press to get to the Menu Notification Light

Down

• Flashes when an Alert or an Alarm is occurring

1.2.2 The Bottom of Your Pump

US Medtronic Diabetes Helpline Telephone Number For product assistance within Australia please use the local number to call the 24-hour helpline: 1800 777 808

1.2.3 The Back of Your Pump

Pump Serial and Model Number You may need to provide these numbers if you call for assistance.

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Section 1 I Getting Started

1.2.4 Attaching the Skins You have received skins to attach to the back of the pump and the front of the belt clip. You can find these with the accessories. In addition to personalising the look of your pump, skins provide additional protection against surface scratches. Apply the skins using the instructions provided with them.

1.2.5 Inserting the Battery Your insulin pump is powered by a AA battery. A lithium, alkaline, or rechargeable AA battery can be used. The battery you place into your pump should always be new or fully charged. To insert the battery and get started, you will need: • the battery cap found with the pump • the belt clip found with the accessories • the AA battery found with the accessories

u Step 1. Place the battery

into the battery compartment with the negative (flat) end going in first.

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Step 2. Place the battery cap onto the pump. Use the edge of the belt clip to turn the cap to the right (clockwise) and tighten until the slot is horizontal to the pump. See image below.

Note: Do not undertighten or try to overtighten the battery cap. It should be aligned horizontally with the pump case as shown here.

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u

Section 1 I Getting Started 1.3 Startup Wizard Always look for the item on the screen that is highlighted in yellow. This is the item that can be selected. Use and buttons to highlight the item you want to choose and press the button to select it.

u

u Select English.

Select 12 Hour (AM/PM) or press press

The pump will power on and Startup wizard will begin.

to 24 Hour and . This example uses

12 hour.

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The minutes will be flashing. Press / to the correct minutes and press .

Select Year. Press to the correct year and press .

Wait a moment.

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The hour will be flashing. Press / to the correct hour and press .

u

Select Month. Press / to the correct month and press . Select Day. Press / to the correct day and press .

The AM/PM will be flashing. Select Next. Press / if needed and press . To scroll faster, press and hold Select Next. the or button.

Select OK.

Once you reach the correct value or item, press to select.

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Section 1 I Getting Started 1.4 Home Screen You are now on the Home screen. The Home screen will be your starting place to access all features in the pump. When you haven’t pressed any buttons for a while, the pump screen will look dark. The pump is still on. It is just saving battery power. You can simply press any button to make the screen reappear. The following information is displayed on the Home screen.

Status bar: provides a quick look at the pump’s status

Current time

BG reading: displays a BG taken in the last 12 minutes Bolus: gives you access to the bolus delivery screen and other bolus insulin options

Active insulin: displays any insulin still active from a previous bolus Basal: gives you access to basal insulin options

Keeping the screen on longer... Margaret noticed when she wasn’t pressing buttons on her pump, the screen would turn dark. This happens to save battery life. She soon learned she could simply press any button to turn the screen back on. Helpful Hint: If the pump is going into Power Save mode too quickly, the setting can be changed. You will learn how to do this on page 17.

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Section 1 I Getting Started

1.4.1 Unlocking the Pump After the Backlight has been off for a few minutes, the pump goes into Sleep mode and the pump is locked. When you begin using your pump again, you will see a screen like the one shown here when you leave the Home screen. You will need to press the arrow key that is highlighted to unlock the pump. This confirms you are reading the screen and the button presses are not accidental.

If the wrong arrow key is pressed, you will see the screen here. Select OK to return to the Home screen and try again.

You can press and hold if you wish to put the pump into Sleep mode and keep it locked when you are not using it. Doing this can also help save battery life.

1.4.2 Status Bar The Status Bar displays the following icons so you can quickly view important information. When using your pump, you will see 3 of these icons. Battery icon: Shows the level of charge your battery has. As the battery charge decreases, the icon will become less full and change to yellow and then red. Reservoir icon: Shows the approximate amount of insulin left in your reservoir. As insulin is used, the icon will become less full and change to yellow and then red. Audio icon: Shows the audio mode you are using: audio audio and vibrate

, vibrate

or

.

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Section 1 I Getting Started 1.4.3 Status Screens There will be times when you need additional status information. For example, the Status Bar icon shows you if the insulin in your reservoir is getting low, but you may need to know exactly how many units are left. This additional status information can be found in the status screens. to highlight the Status Bar and press

1)

Press

2)

If prompted, press the arrow key that appears to

3)

.

unlock the pump.

Press

to view Notifications or press

to

highlight the status screen you wish to view and press

.

Here you can see the status information that can be found when you select each menu item:

Notifications - shows the name and times of alarms, alerts, messages, and reminders that you have received over the past 24 hours.

Quick Status - provides a current summary of pump information including the last bolus you delivered, the last BG entered, and your current basal rate.

Pump - provides detailed information about your pump, including the date you last changed the reservoir, and the number of units left in it.

Settings Review - displays the settings you have programmed into your pump. Remember: You can go back to the previous screen by pressing .

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Section 1 I Getting Started 1.5 Menu Pressing the

button will take you to the Menu.

Scroll Bar

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There are 9 items listed on the Menu. Each menu item contains the features and functions that pertain to that menu item. You will find the items meant to be most quickly accessible closest to the top of the Menu.

1.5.1 Scroll Bar When a screen or menu has more than five lines of information, a scroll bar appears on the right side of the screen. Press to scroll down and view the additional items. On the following page, you will find a map of the basic menu. This shows you the options that you will find under each of the Menu items.

Note: You will not be using all of these options right away. We will focus on the ones that you will need to get started.

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Section 1 I Getting Started

1.5.2 Basic Menu Map

Suspend Delivery Audio Options History Reservoir & Tubing Press

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Insulin Settings Sensor Settings Event Markers Reminders Utilities

Home Screen

History Summary Daily History Alarm History

Suspend Delivery

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Audio Options

Reservoir & Tubing

Audio Audio & Vibrate Vibrate Volume

New Reservoir Fill Cannula

Section 1 I Getting Started

1.5.3 Navigation Press

from any screen to open the Menu.

Press

and

Press

on the desired menu item to open.

to scroll through the menu items.

The scroll bar appears on menus to indicate when additional text is available.

Press

to scroll down to view additional items.

Press

to scroll back up.

to go to previous screen. Hold

to return to the Home screen.

Reminders Personal Bolus BG Check Missed Meal Bolus Low Reservoir Set Change

Sensor Settings Sensor

Utilities Insulin Settings Bolus Wizard Setup Basal Pattern Setup Preset Temp Setup Preset Bolus Setup Dual/Square Setup Bolus Increment Max Basal/Bolus Easy Bolus Auto Suspend Bolus Speed

Event Markers BG Injections Food Exercise Other

Airplane Mode Display Options Time/Date Remote Bolus Block Self Test Carb Unit Manage Settings Sensor Demo Device Options Keypad Lock Language

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Section 1 I Getting Started

1.5.4 Menu Options Here you see a brief summary of the information found within each menu item.

• Suspend Delivery: Lets you stop insulin delivery. This is commonly used when disconnecting to swim or bathe. • Audio Options: Lets you choose audio, vibrate or both to inform you of alerts and notifications. You can also change the volume here. • History: Shows information about recent insulin delivery, actions you performed on your pump, and alerts and alarms received. You can look back to previous days when necessary. • Reservoir & Tubing: Contains steps to changing the reservoir and infusion set. • Insulin Settings: Contains all features and settings that affect or change your pump’s delivery of insulin. These settings help you to individualise the pump to meet your insulin needs. • Sensor Settings: Contains all options related to sensor use. These are set when using continuous glucose monitoring. • Event Markers: Lets you use your pump instead of a written log to record events such as taking an injection or exercising.

• Reminders: Lets you set the pump to remind you to do important routine activities such as checking BG and changing your infusion set. • Utilities: Contains various other features and settings related to pump use.

The Menu... When Lisa first started on her pump, she didn’t know if she could ever learn how to use all the features the pump had available. But, she just focused on the basics first, and then she started learning the additional features that she found helped her the most. Helpful hint: Take some time to get comfortable with basics first. Then learning the additional features will be much easier and more fun to do.

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Section 1 I Getting Started 1.6 Alerts An alert makes you aware of a situation that may need your attention. When an alert occurs, you should check to see what your pump is telling you. Examples of alerts include Low reservoir or Low battery. When an alert occurs: Notification Light: The red light on the pump will blink once followed by a pause, blink again followed by a pause. This sequence continues until the alert is cleared. The flashing pattern is shown here: Audio: Depending on your Audio Option settings, the pump emits a repeated alert tone, a continuous two-pulse vibration, or both. Display: The pump will display a notification with a yellow icon and instructions on what to do. To address and clear the alert: 1) Read the text on the screen to understand the alert and the steps that should be taken. 2) Press . 3) Press

on the desired option.

Press

If you do not respond to an alert, the audio / vibration pattern repeats every five minutes until the alert is cleared.

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Section 1 I Getting Started 1.7 Alarms When an alarm occurs, something has been detected that is preventing insulin from being delivered. You are not getting insulin. It is important that you address an alarm right away. Examples of alarms are Insulin flow blocked and Replace battery now. When an alarm occurs: Notification Light: The red light on the pump will blink twice, followed by a pause, blink twice again followed by a pause. This sequence continues until the alert is cleared. The flashing pattern is shown here: Audio: Depending on your Audio Option settings, the pump emits a repeated alert tone, a continuous three-pulse vibration, or both. Display: The pump will display a notification with a red icon and instructions on what to do. To address and clear the alarm: 1) Read the text on the screen to understand the alarm and the steps that should be taken. . 2) Press 3) Press

on the desired option.

Press

If you do not respond to an alarm, the audio / vibration pattern repeats every minute for 10 minutes. After 10 minutes, the alarm begins to siren.

IMPORTANT: It is important that you are able to address an Insulin flow blocked alarm. This alarm means that insulin is not able to get through the tubing or cannula. If this alarm occurs, check to see if your infusion set has become dislodged or if your tubing is kinked. • If you don’t detect an issue and are unable to change your reservoir and infusion set right away, you might choose to select Resume Basal. If an Insulin flow blocked alarm occurs again, follow the steps on the screen. Select Rewind and change your reservoir and infusion set. • If you detect an issue or if your reservoir has run out of insulin, follow the steps on the screen. Select Rewind to change your reservoir and infusion set.

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Section 1 I Getting Started 1.8 Menu Options - A Closer Look You are now ready to set a couple of the basic features within the Menu.

1.8.1 Audio Options You will use Audio Options to set pump to beep (Audio), beep and vibrate (Audio & Vibrate), or just vibrate (Vibrate). If you set Audio or Audio and Vibrate, you can also increase or decrease the Volume.

Let’s Practice: 1)

Press

to open the Menu.

2)

Press

to Audio Options and press

3)

Press

to the option that you prefer and press

. .

The icon shown here will display on the Status Bar on the Home screen.

If you choose Audio or Audio & Vibrate, you are able to adjust the volume. 4)

Press

to Volume and press

5)

Press

or

and press 6)

The Option you select turns On.

.

to desired volume .

Select Save.

1.8.2 Display Options Display Options allows you choose the brightness of your pump screen. This is also where you go to change the amount of time your pump stays on before it goes into Power Save mode.

Let’s Practice: 1)

Press

to open the Menu.

2)

Press

to Utilities and press

3)

Press

to Display Options and press

. .

If you want to adjust the screen brightness: 4)

Select Brightness.

5)

Press

to the setting you prefer and press

.

To adjust the backlight: 6)

Select Backlight.

7)

Press

8)

Select Save.

to the setting you prefer and press

The Auto setting automatically adjusts the screen brightness to match your current environment.

.

Note: How you adjust these settings can affect battery life. For instance, increasing the Backlight time will decrease the life of your battery.

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Section 1 I Getting Started 1.9 Basal Patterns

U/hr U/hr

Remember, your body needs insulin so glucose can be moved into your cells providing energy for your body. Insulin is needed 24 hours a day, even between meals and during the night. This is called basal insulin. The pump supplies basal insulin by delivering small amounts throughout each hour, every hour of the day and night. This allows for insulin to be increased and decreased to adjust for your body’s needs.

00:00 00:00

24:00 24:00

24 Hours Hours 24

Basal insulin amounts must be programmed into your pump. This is done by setting a basal pattern. A basal pattern consists of one or more basal rates being delivered over the course of 24 hours.

Before her pump... Lynn always had to remember to take her injection of long-acting insulin at bedtime. Taking it at the same time every night like her doctor asked her to was difficult. She is at university and some nights she would go to bed early, others she would be at the library until late studying. Now with her pump, she doesn’t have to worry about taking an injection. She is getting her basal insulin automatically 24 hours a day.

1.9.1 Basal Pattern Setup – One Basal Rate Your healthcare professional will calculate the hourly basal rate or rates are best for you to use when you start on your pump. You may simply start with a basal pattern that has only one basal rate. The pump will deliver that exact basal amount evenly over each hour, 24 hours a day. For example, if your starting basal rate is 1.0 unit, your pump would deliver one unit of insulin throughout each hour. This means you would receive a total of 24 units of basal insulin every 24 hours. To set your Basal Patterns, you will need to go to the Insulin Settings menu option and then to Basal Pattern Setup. There are two ways to access Insulin Settings: 1) From the Home screen, select Basal and press OR 2) Press and press to Insulin Settings

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to Insulin Settings

Section 1 I Getting Started

Let’s Practice: Setting a Basal Pattern with one Basal Rate Let’s set a Basal pattern with a basal rate of 0.75 U/hr from 00:00 - 24:00 1)

From the Home screen, select Basal.

2)

Press

to Insulin Settings and press

3)

Press

to Basal Pattern Setup and press

4)

Select Basal 1.

5)

Currently, the pump is delivering 0.000 U/hr. Select Options.

6)

Select Edit.

7)

Press

.

9)

Press

to 0.750 and press

10)

Select Done.

.

Verify that Basal 1 is entered correctly.

If NO changes need to be made: 12)

.

Press on the time segment. The End time will be flashing. Since you are setting only one basal rate for all 24 hours, the End time does not need to be changed.

8)

11)

.

Select Save.

This basal pattern delivers 18 U over 24 hours.

If changes need to be made: 12)

Press

.

13)

Press

press

14)

Select Save.

. Repeat Steps 8-11.

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