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  5. Advanced Owner's Booklet

Accu-Chek Aviva Advanced Owner's Booklet

Manual is about: for Self-Testing Only

Summary of Aviva

  • Page 1

    Aviva combo 00048009695/c-0709 blood glucose meter advanced owner’s booklet ©2009 roche diagnostics. All rights reserved. Roche diagnostics gmbh sandhofer strasse 116 68305 mannheim, germany www.Accu-chek.Com accu-chek, accu-chek aviva, accu-chek aviva combo, accu-chek spirit combo, and accu-chek mu...

  • Page 2

    Last update: 2009-07 45676_adv.Indb 2 11/3/09 4:45:05 pm.

  • Page 3: Contents

    1 contents introduction 5 1 bolus advice 7 1.1 overview 8 1.2 before using bolus advice 10 1.3 calculating and delivering a bolus using bolus advice 13 2 administering a bolus 25 2.1 overview 26 2.2 choosing your bolus type 27 2.3 delivering a bolus 29 2.4 updating the diary with bolus information 3...

  • Page 4: Combo Pump

    2 3 using the accu-chek aviva combo meter with the accu-chek spirit combo pump 33 3.1 overview 34 3.2 the system at a glance 35 3.3 controlling the pump with the meter 38 3.4 managing pump errors and warnings with the meter 53 4 communication between the accu-chek aviva combo meter and accu-chek spi...

  • Page 5: Appendices

    3 appendices 81 appendix a: bolus advice 81 appendix b: bolus advice calculations 100 appendix c: explanation of symbols 104 index 105 45676_adv.Indb 3 11/3/09 4:45:05 pm.

  • Page 6

    4 45676_adv.Indb 4 11/3/09 4:45:05 pm.

  • Page 7: Introduction

    5 your new meter includes three booklets: • getting started guide: use this booklet to set up the meter. • standard owner’s booklet: use this booklet for instructions on how to operate the standard features of the meter. • advanced owner’s booklet: use this booklet for instructions on how to operate...

  • Page 8

    6 45676_adv.Indb 6 11/3/09 4:45:05 pm.

  • Page 9: Bolus Advice

    1 7 1 bolus advice 1.1 overview 8 1.2 before using bolus advice 10 1.3 calculating and delivering a bolus using bolus advice 13 45676_adv.Indb 7 11/3/09 4:45:05 pm.

  • Page 10: 1.1 Overview

    8 1.1 overview important information regarding the use of bolus advice is presented in this chapter. Read it carefully and completely before you begin using bolus advice. • it is recommended you discuss your bolus advice settings with your healthcare professional prior to setting up this feature. • ...

  • Page 11

    1 9 i notes: • this booklet shows sample screens. The screens in this booklet may look slightly different from the screens on your accu-chek aviva combo meter. If you have any questions about the meter screens, contact roche. • blood glucose and bg are interchangeable and mean the same thing. 45676_...

  • Page 12

    10 1.2 before using bolus advice intended users as with any specialized feature, you need to understand certain information in order to use bolus advice. You must be completely familiar with your diabetes therapy and be able to judge your current situation as well as possible. Bolus advice calculate...

  • Page 13

    1 11 safety information regarding bolus advice w warnings: • it is very important you follow the safety information in this chapter. • always compare your result with the way you actually feel and adjust the recommended bolus, if necessary. • always carry out the actions entered into bolus advice in...

  • Page 14

    12 warning messages about your blood glucose result after performing a blood glucose test, warning messages about your blood glucose result may be displayed. Please take careful note of these messages. If your blood glucose result is too low, you are prompted to eat a certain amount of fast acting c...

  • Page 15: Bg Test Result

    1 13 5.8 mmol/l 19 g exercise 1 bolus type confirm cancel 2 u --- u bolus advice 0.0 u 2.1 u -0.1 u standard 1.3 calculating and delivering a bolus using bolus advice bg test result active insulin carb entry health event entry bolus type recommended bolus amount 45676_adv.Indb 13 11/3/09 4:45:06 pm.

  • Page 16: To Deliver A Bolus

    14 to deliver a bolus main menu > bolus advice 1. J from the main menu, select bolus advice and press = . 2. J if you have not completed a recent blood glucose test (this is indicated when “bg test” is displayed near the top of the meter screen rather than an actual bg value), it is recommended you ...

  • Page 17

    1 15 to enter a health event: j select the health entry field and press = . J select a health event and press = . To adjust the bolus amount: j select the bolus entry field and press = . J set the bolus insulin amount and press = . To deliver a … j standard bolus: step 3 j multiwave bolus: step 6 j ...

  • Page 18

    16 5. Pump delivering standard bolus stop bolus ok deliver bolus 2 u pump exit back bolus cancelled to snooze w8 ! Delivery completed menu deliver bolus j select ok and display the main menu. Bolus delivery continues until it is complete. J to stop bolus delivery, select stop bolus. The pump screen ...

  • Page 19

    1 17 6. 7. Deliver bolus? Multiwave bolus back deliver confirm bolus 2 u duration 0.5 u hh mm 4:00 immediate to deliver a multiwave bolus j select the type entry field and press = . J select multiwave and press = . To confirm the entries, select confirm. J to change the immediate bolus, select immed...

  • Page 20

    18 pump exit back bolus cancelled to snooze w8 ! Multiwave bolus delivery continuing menu deliver bolus immediate delivery completed j to stop bolus delivery, select stop bolus. The pump screen bolus cancelled appears. If no buttons are pressed, when the bolus delivery is complete the immediate deli...

  • Page 21: 10.

    1 19 9. To deliver an extended bolus j select the type entry field and press = . J select extended and press = . To confirm the entries, select confirm. 10. 11. Deliver bolus? Extended bolus back deliver confirm bolus 2 u duration 4:00 hh mm extended bolus delivery continuing menu deliver bolus j to...

  • Page 22: 12.

    20 12. To deliver a bolus manually on the pump j select the type entry field and press = . J select manual pump and press = . To confirm the entries, select confirm. 13. Manual pump bolus back ok confirm bolus 2 u set bolus on pump the bolus amount is displayed on the meter screen j manually program...

  • Page 23: 15.

    1 21 15. Pen/syringe bolus back ok confirm bolus 2 u inject insulin the bolus amount is displayed on the meter screen. J inject the recommended bolus using an insulin pen or syringe or, if necessary, select back and return to the bolus advice screen to adjust the bolus. J select ok to go to the main...

  • Page 24

    22 w warnings: • bolus advice provided by the meter is solely advice. Contact your healthcare professional prior to changing your diabetes therapy. • it is important to make the correct selection for the carbohydrate ratio and insulin sensitivity. If you select the wrong ratio (the basis for all cal...

  • Page 25

    1 23 i notes: • bolus advice can also be accessed after you perform a bg test (see the standard owner’s booklet). When the detailed bg result screen is displayed, press . . This is not available if your bg result is below your hypo warning limit (red colour bar is displayed). • for additional inform...

  • Page 26

    24 45676_adv.Indb 24 11/3/09 4:45:10 pm.

  • Page 27: Administering A Bolus

    25 2 2 administering a bolus 2.1 overview 26 2.2 choosing your bolus type 27 2.3 delivering a bolus 29 2.4 updating the diary with bolus information 31 45676_adv.Indb 25 11/3/09 4:45:10 pm.

  • Page 28: 2.1 Overview

    26 2.1 overview there are several methods to deliver a bolus. The pump makes it possible to deliver more precise amounts of insulin than can be injected using an insulin pen or syringe. 45676_adv.Indb 26 11/3/09 4:45:10 pm.

  • Page 29: 2.2 Choosing Your Bolus Type

    27 2 2.2 choosing your bolus type there are several types of bolus delivery available. The bolus types include: • standard a bolus that delivers an immediate food or correction bolus. When standard is selected, the bolus is delivered by the pump. This option is available only when bluetooth ® wirele...

  • Page 30

    28 • extended a bolus delivered over a period of time. It can be helpful during long meals, dinners, or receptions, or when you have meals that are digested slowly. The extended bolus may also be appropriate for people who have gastroparesis (delayed digestion). This option is available only when bl...

  • Page 31: 2.3 Delivering A Bolus

    29 2 2.3 delivering a bolus w warnings: • incorrect meter settings may cause inappropriate insulin delivery. • the meter must be configured with your personal settings prior to administering a bolus. If you are not sure about your personal settings, talk to your healthcare professional. • work with ...

  • Page 32

    30 i note: you can cancel a bolus (including an extended bolus) that is being delivered by the pump directly on the pump or remotely on the meter (through the pump menu on the meter). Delivering a bolus using bolus advice for instructions on how to deliver a bolus using bolus advice, see chapter 1, ...

  • Page 33

    31 2 2.4 updating the diary with bolus information when the pump is synchronized with the meter, bolus information from the pump is imported into the meter. For any manual pump bolus record in the meter database with a time stamp that is older than 10 minutes and is not confirmed by the pump, the me...

  • Page 34

    32 45676_adv.Indb 32 11/3/09 4:45:10 pm.

  • Page 35

    33 3 3 using the accu-chek aviva combo meter with the accu-chek spirit combo pump 3.1 overview 34 3.2 the system at a glance 35 3.3 controlling the pump with the meter 38 3.4 managing pump errors and warnings with the meter 53 45676_adv.Indb 33 11/3/09 4:45:10 pm.

  • Page 36: 3.1 Overview

    34 the accu-chek aviva combo meter can be used to remotely control the accu-chek spirit combo insulin pump using bluetooth wireless technology. Before using the meter to control the pump, it is important to understand how to operate the pump using the meter. If you experience any communication probl...

  • Page 37: 3.2 The System At A Glance

    35 3 in the meter’s pump menu, the meter buttons have different functions. The buttons function as button (key) presses on the pump. 3.2 the system at a glance the pump sends screens to the meter. The meter sends button presses to the pump. D f 45676_adv.Indb 35 11/3/09 4:45:12 pm.

  • Page 38: Meter Button

    36 meter button pump key function x a j move forward in an information screen j increase a setting j program a quick bolus j cancel a quick bolus j turn off the stop-warning z s j move backward in an information screen j decrease a setting j program a quick bolus j cancel a quick bolus j turn off th...

  • Page 39: Meter Button

    37 3 meter button pump key function . D and a j exits menus, function screens, and information screens without saving your changes j move to the previous screen , none j return to the main menu 45676_adv.Indb 37 11/3/09 4:45:12 pm.

  • Page 40

    38 when bluetooth wireless technology is turned on, the pump main screen appears on the meter when you are in the pump menu. The meter is able to control the following pump functions: • standard bolus • extended bolus • multiwave bolus • temporary basal rate • my data • basal rate selection • basal ...

  • Page 41

    39 3 the following pump functions cannot be remotely controlled using the meter: • changing the insulin cartridge • priming the infusion set • rewinding the piston rod • data transfer (to a computer) • bluetooth wireless technology menu • display orientation and contrast 45676_adv.Indb 39 11/3/09 4:...

  • Page 42

    40 i notes: • you can administer a bolus manually on the pump (without using the meter). When the meter and bluetooth wireless technology are both turned on, the pump automatically transfers bolus information to the meter. If bolus advice is used, it is important you enter carbohydrate information i...

  • Page 43: Pump Screen

    41 3 pump exit back 10:02 1 1.00 u/h pump screen corresponding meter buttons return to main menu pump screens on the meter bluetooth wireless technology icon back pump double button press ( d and a ) 45676_adv.Indb 41 11/3/09 4:45:13 pm.

  • Page 44

    42 in remote control mode, the bluetooth wireless technology icon appears on the meter screen and on the pump screen. To control the pump using the meter, you must be in the pump menu. From the pump menu, use the corresponding meter buttons to scroll through the pump menus and submenus (the same as ...

  • Page 45

    43 3 delivering a bolus – standard bolus to program a standard bolus remotely 1. J from the main menu, select pump and press = . 2. J repeatedly press and release until the standard bolus screen appears. 3. Pump exit back standard bolus j press > to select the standard bolus menu. Bolus advice pump ...

  • Page 46

    44 5. Pump exit back bolus amount 2.5 u j when the correct bolus amount is displayed, press > to confirm the bolus amount. 6. Pump exit back bolus amount 2.5 u b b b b b b b o o o o o o o l l l l l u u u u u s s s s s j the standard bolus icon blinks for five seconds (bolus delivery start delay). Th...

  • Page 47: Time

    45 3 time cancelling the bolus result when programming a standard bolus (the bolus amount blinks on the screen) j if you do not press any meter buttons for approximately 20 seconds, the meter returns to the pump run screen. J exit the bolus amount screen and return to the standard bolus screen by pr...

  • Page 48: Time

    46 time cancelling the bolus result during bolus delivery (meter is counting down the bolus amount) j press and hold x or z for three seconds until the meter beeps. The meter displays the pump warning w8: bolus cancelled. Press > twice to confirm and mute the warning. You can view the actual bolus a...

  • Page 49

    47 3 programming a temporary basal rate (tbr) 1. J from the main menu, select pump and press = . 2. 3. J press > to select the temporary basal rate (tbr) menu. Bolus advice pump my data settings bg test 10:02 2 feb 08 j repeatedly press and release until the temporary basal rate (tbr) screen appears...

  • Page 50

    48 5. Pump exit back tbr duration 03:00 120% the pump screen tbr duration appears. J press x or z to set the duration time. J press > to save the changes. 6. The pump run screen with the tbr appears. The new tbr is activated. The meter beeps when the activation occurs. Pump exit back 120 % 0.600u/h ...

  • Page 51

    49 3 i notes: • if a tbr is not currently active, the tbr percentage is set to 100 %. • when a tbr is active, it remains in effect even if the basal rate profile is changed. • a tbr can only be programmed when the pump is in run mode. • when a tbr is active, the pump beeps and vibrates every hour. T...

  • Page 52: Situation

    50 situation cancelling the temporary basal rate result when programming a tbr j if you do not press any meter buttons for approximately 20 seconds, the meter returns to the pump run screen. J return to the temporary basal rate (tbr) screen by pressing . Or by pressing and x simultaneously. J set th...

  • Page 53: Changing A Basal Profile

    51 3 changing a basal profile 1. J from the main menu, select pump and press = . 2. 3. Bolus advice pump my data settings bg test 10:02 2 feb 08 pump exit back basal rate selection j press > to select the basal rate selection menu. J repeatedly press and release until the basal rate selection screen...

  • Page 54

    52 4. Pump exit back select profile 1 42.00 u j press x or z to select the basal rate profile. The basal rate profile number and the basal rate total amount appear. J when the correct basal rate profile appears, press > to select it. For more information, see the pump user guide. 45676_adv.Indb 52 1...

  • Page 55

    53 3 3.4 managing pump errors and warnings with the meter if the meter is off when a pump error, warning, or reminder occurs and you turn on the meter, after communication to the pump is established: • the meter goes directly to the pump screen. • pump errors, warnings, and reminders appear on the m...

  • Page 56: Cartridge Low Warning

    54 cartridge low warning pump exit back cartridge low to snooze 1 w ! J when the contents of the insulin cartridge on the pump have dropped to 20 units of insulin, the pump warning w1: cartridge low appears. When the warning appears on the meter pump screen, press > twice to snooze and to confirm th...

  • Page 57

    55 4 4 communication between the accu-chek aviva combo meter and accu-chek spirit combo pump 4.1 overview 56 4.2 turning bluetooth ® wireless technology on/off 57 4.3 using the system while traveling 60 4.4 pairing the accu-chek aviva combo meter with the accu-chek spirit combo pump 61 4.5 cancellin...

  • Page 58: 4.1 Overview

    56 the meter and pump use bluetooth wireless technology to communicate. If you are experiencing communication problems between the meter and pump, it is recommended you go directly to the pump and operate the pump manually. For more information on troubleshooting communication between the meter and ...

  • Page 59: 4.2  Turning

    57 4 4.2 turning bluetooth ® wireless technology on/off you may turn bluetooth wireless technology on or off at any time using the meter. Bluetooth wireless technology icon communication states icon communication state bluetooth wireless technology is on. The meter and pump are communicating. Blueto...

  • Page 60: Bluetooth

    58 turning pump communication ( bluetooth wireless technology) on or off main menu > settings > meter > bluetooth 1. J from the main menu, select settings and press = . 2. J select meter and press = . 3. Key lock warning limits back meter language units bluetooth pair with pump j select bluetooth an...

  • Page 61

    59 4 4. Press and hold backlight button until bluetooth icon changes meter name: meter12345678 back bluetooth j press and hold * until the bluetooth icon changes. For instructions on how to turn on or turn off bluetooth wireless technology on the pump, see the pump user guide. I notes: • you cannot ...

  • Page 62

    60 4.3 using the system while traveling when traveling on an aircraft, you must ensure bluetooth wireless technology is turned off on the meter and on the pump prior to closure of the aircraft door. Electromagnetic emissions from the meter or pump could interfere with the electronics systems of the ...

  • Page 63: Accu-Chek Spirit Combo Pump

    61 4 4.4 pairing the accu-chek aviva combo meter with the accu-chek spirit combo pump when obtained as a kit, the meter and pump are paired. If the meter and pump are not paired, see the instructions below. Pairing the meter and pump 2. Pump: j ensure bluetooth wireless technology is turned on. If t...

  • Page 64

    62 3. Pump: j if the paired device none screen appears, proceed to step 6. Pump: j if the paired device screen appears, press d and proceed to the next step. Or 4. Pump: j to delete the device so the pump can be paired with another meter, press f . 45676_adv.Indb 62 11/3/09 4:45:19 pm.

  • Page 65

    63 4 5. 6. Pump: j press f to confirm deletion of the paired device. Pump: j press d . 7. Meter: j ensure the meter is turned off. J press and hold * and then press + . 45676_adv.Indb 63 11/3/09 4:45:19 pm.

  • Page 66: 10.

    64 9. Pump: j press f to initiate the pairing process. 8. J proceed to the next step for instructions on how to place the pump in pairing mode. J to not continue with setting up pairing, press + . Ensure pump is in pairing mode through bluetooth menu on pump waiting . . . Meter12345678 pair with pum...

  • Page 67: 11.

    65 4 11. 12. Pump: j the add device pairing screen appears followed by the add device enter pin code screen. Meter: the pair with pump screen appears enter the pin shown on the pump display: j press = . J set the first number and press = . Repeat until all of the numbers have been entered. Enter pin...

  • Page 68: 13.

    66 13. When the correct pin is confirmed, the pairing completed for … screen appears on the meter and then the device paired screen appears on the pump. J press + to turn off the meter. Once the meter has turned off, the pairing process is complete. You may turn on the meter and begin using it. Pair...

  • Page 69

    67 4 4.5 cancelling the pairing of the meter and pump prompt if the meter and pump are not paired, the meter prompts you to complete the pairing process each time you turn on the meter unless you cancel the pairing process. 45676_adv.Indb 67 11/3/09 4:45:21 pm.

  • Page 70

    68 1. Pairing setup has not been completed setup next cancel j turn on the meter. The pairing setup has not been completed screen appears. J select cancel to cancel the pairing process prompt. Proceed to step 2. J select next to begin the pairing process. Go to the section, “pairing the accu-chek av...

  • Page 71

    69 4 i notes: • a blood glucose test cannot be performed during the pairing process. • the meter and pump remain paired when the batteries are removed and replaced. • only one meter can be paired with one pump at a time. • if the meter is paired with a pump, and you pair the meter with another pump,...

  • Page 72

    70 45676_adv.Indb 70 11/3/09 4:45:22 pm.

  • Page 73: Troubleshooting

    71 5 5 troubleshooting 5.1 overview 72 5.2 troubleshooting communication between the meter and pump 73 45676_adv.Indb 71 11/3/09 4:45:22 pm.

  • Page 74: 5.1 Overview

    72 for most communication problems between the meter and pump, the meter displays a message with a short description of the symptom and, along with it, a proposed solution. This chapter goes into more detail by describing the symptom, the possible cause, and the possible solution. If the possible so...

  • Page 75: Pump

    73 5 5.2 troubleshooting communication between the meter and pump display shows possible cause(s) possible solution(s) bluetooth icon fl ashing j communication ended due to a button press on the pump. J meter and pump are outside communication range. J check the pump and continue operation of the pu...

  • Page 76: Display Shows

    74 display shows possible cause(s) possible solution(s) bolus delivery unavailable j the meter cannot communicate with the pump. J retry or set to manual pump. J ensure the meter and pump have bluetooth wireless technology turned on. J ensure the meter and pump are within communication range. J if t...

  • Page 77: Display Shows

    75 5 display shows possible cause(s) possible solution(s) communication lost j pump is out of range of the meter. J review or cancel the bolus on the pump. J ensure the meter and pump have bluetooth wireless technology turned on. J ensure the meter and pump are within communication range. J if the l...

  • Page 78: Display Shows

    76 display shows possible cause(s) possible solution(s) connection lost j the connection was lost between the meter and the pump during the pairing process. Therefore, the attempt to pair your meter and pump was unsuccessful. J restart the pairing process. See chapter 4, “communication between the a...

  • Page 79: Display Shows

    77 5 display shows possible cause(s) possible solution(s) infrequent pump communication j at least two weeks have passed since the meter and pump have communicated. J it is important to use bluetooth wireless technology communication between the meter and pump regularly if you utilize bolus advice. ...

  • Page 80: Display Shows

    78 display shows possible cause(s) possible solution(s) meter and pump not paired j meter and pump have not been paired. You cannot use the pump functions without pairing the meter and the pump. J you must pair the meter and pump to use these features. J for instructions on how to pair the meter and...

  • Page 81: Display Shows

    79 5 display shows possible cause(s) possible solution(s) pump not available j the pump is out of the communication range of the meter. J ensure the meter and pump have bluetooth wireless technology turned on. J ensure the meter and pump are within communication range. J i f the low battery icon is ...

  • Page 82

    80 w warning: if you are experiencing communication problems between your meter and pump, it is recommended you operate the pump manually and not use the meter to remotely control the pump. I note: for additional information on errors and warnings, see the standard owner’s booklet. 45676_adv.Indb 80...

  • Page 83: Appendices

    81 appendices appendix a: bolus advice bolus advice is only available if you have set up bolus advice on the accu-chek aviva combo meter. For instructions on how to set up bolus advice, see the standard owner’s booklet. Along with the basic blood glucose and carbohydrate values, there are several me...

  • Page 84: Bolus Advice Meter Settings

    82 bolus advice meter settings this section contains an overview of the information that must be entered into the meter for accurate bolus advice recommendations. Carbohydrate units • bolus advice recommendations are based on the units of carbohydrates selected. • the right choice of carb units is i...

  • Page 85

    83 warning limits • you can select hyper (high) and hypo (low) blood glucose limits that best fit your needs. • whenever a blood glucose test result is above the hyper warning limit or below the hypo warning limit, the meter displays a warning. • set the hyper warning limit greater than the target r...

  • Page 86

    84 target range • the range of your blood glucose results considered acceptable. • the meter automatically calculates the target blood glucose level as the average between the upper and lower blood glucose target limits. • talk with your healthcare professional to determine the appropriate target ra...

  • Page 87: Time Block

    85 insulin sensitivity • for the current time block, the insulin sensitivity (correction factor) is the amount of insulin necessary to lower your blood glucose by a certain amount. • talk with your healthcare professional to determine the appropriate insulin sensitivity settings. Your meter comes wi...

  • Page 88: Time Block

    86 talk to your healthcare professional about setting up time blocks to help you manage your diabetes. Here is a suggested pattern: time block start time end time 1. Night time midnight the time you normally wake up 2. Breakfast the time you normally wake up 1½ hours before you normally eat lunch 3....

  • Page 89

    87 setting up time blocks: important information • time blocks cover a 24-hour time period (from midnight to midnight). • you can change the time period for any of the preset time blocks. • when setting up bolus advice, you must complete and save the settings in at least one time block. • each time ...

  • Page 90

    88 health events available on the meter are: • exercise 1 • exercise 2 • stress • illness • premenstrual • fasting bolus advice options meal rise, snack size, acting time, and offset time are bolus advice options. Below are detailed descriptions of each of these settings. Meal rise • during or after...

  • Page 91

    89 snack size • the snack size is the amount of carbohydrates that is not to be counted as a regular meal with the expected meal rise. Acting time • the period of time from the start of the meal rise or the delivery of a correction bolus until your blood glucose level returns to the target level. • ...

  • Page 92: Bolus Calculation

    90 bolus calculation the bolus recommended by the bolus advice feature of the meter consists of two components: a recommendation for a meal bolus that covers your food intake and a recommendation for a correction bolus to adjust your blood glucose level if it is not within the target range. The corr...

  • Page 93

    91 correction bolus if your current blood glucose level is not within your target range, a correction bolus is recommended. Blood glucose limits discuss your blood glucose limits with your healthcare professional. Hyper warning bg result upper target limit target lower target limit hypo warning 4567...

  • Page 94

    92 the calculation for the recommended correction bolus depends on your current blood glucose result, your insulin sensitivity for the current time block, and whether you are planning to eat. Example bolus advice calculations blood glucose level without food intake (no carbs) prior to a meal above u...

  • Page 95: Other Boluses

    93 other boluses subsequent meal boluses if you are planning to eat several meals or snacks in a short period of time, you should administer a meal bolus for each meal. The calculation is always the same as a meal bolus. Correction bolus after a meal after a meal, it is normal to allow for a rise of...

  • Page 96

    94 the dotted line shows how your blood glucose level might change after a meal bolus. Bolus advice tolerates an increase in your blood glucose level within the meal rise range (green) without calculating an extra correction bolus. When you enter a carbohydrate amount that is greater than the snack ...

  • Page 97

    95 subsequent correction boluses the difference between your current blood glucose level and your target blood glucose level is called delta bg. A correction bolus administered according to the previous conditions covers this difference for a certain period of time. As the correction bolus starts to...

  • Page 98

    96 examples of bolus advice recommendations the following graphs provide differing examples of how bolus advice considers different factors when calculations are made. The currently allowed blood glucose value considers the following factors: • target range mean value • meal rise • correction bolus ...

  • Page 99

    97 after a correction bolus the above diagram shows an example of the effect of this rule. The first correction bolus at 12:00 remains active during the acting time (the width of the blue area). If the blood glucose value at 14:00 falls below the currently allowed blood glucose value (top of the blu...

  • Page 100

    98 when a blood glucose test result is greater than the currently allowed blood glucose value, a bolus is calculated (light blue) that only considers the difference between the current blood glucose value (orange dots) and the currently allowed blood glucose value (the top of the blue area). Bg leve...

  • Page 101

    99 subsequent meals if you eat several meals in a row, the meal rise is restarted for each new meal bolus. Bg level hyper hypo acting time target range time target value offset time current bg values currently allowed bg value: meal rise bolus bolus not required meal rise meal 45676_adv.Indb 99 11/3...

  • Page 102

    100 appendix b: bolus advice calculations the mathematical basis for bolus calculations the following is a list of the most important formulas and the calculation principles on which bolus advice is based. It is difficult to calculate accurately a bolus yourself using these formulas when the acting ...

  • Page 103

    101 meal bolus the following formula is used to calculate the bolus for meals: meal bolus = carbohydrate intake × insulin carbohydrates from carbohydrate ratio currently allowed blood glucose value the target range average value used in the calculation of the correction bolus, as shown below, change...

  • Page 104

    102 correction bolus generally, a correction bolus is only calculated if the current blood glucose value is above the hypo bg warning limit and outside the target range. If the current blood glucose value is above the target range, the currently allowed blood glucose value must also be exceeded. Onl...

  • Page 105

    103 correction bolus with carbohydrate intake whenever carbohydrates have been entered, the related meal bolus is always offset against any (even negative) correction bolus. When a meal is eaten, the correction bolus is also calculated for blood glucose results that fall within the target range if: ...

  • Page 106

    104 appendix c: explanation of symbols you may encounter the following symbols on the packaging, on the type plate, and in the instructions for the meter, shown here with their meaning. J consult the instructions for use. W j warning (refer to accompanying documents). Please refer to safety-related ...

  • Page 107: Index

    105 index a acting time, 89 active insulin, 89 aircraft. See bluetooth wireless technology, using while traveling b basal profile, changing, 51–52 bluetooth wireless technology, communication states, 57 turning on or off, 58–59 using while traveling, 60 bolus advice, intended users, 10 meter screen ...

  • Page 108

    106 c carbohydrate units, 82 carb ratio, 84 carbs amount, 14 communication, meter and pump, overview, 34 , 56 troubleshooting, 73–80 correction bolus, 93–95 d deliver a bolus. See bolus, delivery using bolus advice diary, updating bolus information, 31 e errors, pump, 53–54 extended bolus, delivery ...

  • Page 109

    107 o offset time, 89 p pairing, delete device, 62 pairing meter with pump, 61–66 pairing prompt, cancelling, 67–69 pen bolus, description, 28 pin, enter into meter, 65 pump control using meter, 38–40 pump screens on meter, features, 41–42 s safety information, bolus advice, 10–12 bolus delivery, 22...

  • Page 110

    108 u upper blood glucose target limit, 84 w warning limits, 83 warnings, pump, 53–54 45676_adv.Indb 108 11/3/09 4:45:26 pm.