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2.3 Delivering a Bolus

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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 your healthcare professional to determine the timing, amount, and type of bolus you need to

deliver.

• If an intended bolus is unintentionally stopped, it is recommended you administer the remaining bolus

manually with the pump or remotely with the meter. You may also administer the bolus through bolus
advice by entering the remaining bolus amount and then administering it. Check the meter diary or the
pump diary to determine how much insulin has already been delivered. If the bolus was delivered and
stopped using the meter, when the next pump synchronization occurs the amount of insulin delivered is
updated in the meter diary.

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Содержание Aviva

Страница 1: ...COMBO ACCU CHEK SPIRIT COMBO and ACCU CHEK MULTICLIX are trademarks of Roche The Bluetooth word mark and logos are registered trademarks owned by Bluetooth SIG Inc and any use of such marks by Roche i...

Страница 2: ...LAST UPDATE 2009 07 45676_adv indb 2 11 3 09 4 45 05 PM...

Страница 3: ...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...

Страница 4: ...e Accu Chek Aviva Combo Meter and Accu Chek Spirit Combo Pump 55 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 A...

Страница 5: ...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...

Страница 6: ...4 45676_adv indb 4 11 3 09 4 45 05 PM...

Страница 7: ...Started Guide the Standard Owner s Booklet and the Advanced Owner s Booklet carefully before you use your new meter To use it correctly and dependably you need to understand its operation screen displ...

Страница 8: ...6 45676_adv indb 6 11 3 09 4 45 05 PM...

Страница 9: ...1 7 1Bolus 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...

Страница 10: ...ilable if you have set up bolus advice on your meter For instructions on how to set up bolus advice see the Standard Owner s Booklet Bolus advice may make delivering a bolus more precise and reduce er...

Страница 11: ...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...

Страница 12: ...are based Bolus advice is not able to judge your current situation independently of your own estimation It cannot correct possible input errors This is particularly true for the carbohydrate amount en...

Страница 13: ...atch the way your body actually feels In this case you can increase or reduce the bolus insulin dose to adjust it to your needs Bolus insulin doses and meals taken before bolus advice is used for the...

Страница 14: ...by your healthcare professional Summary It is recommended you set up bolus advice with your healthcare professional Carefully check all of your entries Make sure all recent meals and insulin doses are...

Страница 15: ...irm 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 Bo...

Страница 16: ...a blood glucose test Select bG Test and press See the Standard Owner s Booklet for information on how to perform a blood glucose test When the detailed bG Result screen appears select Bolus To Enter...

Страница 17: ...ed Bolus Step 9 j Bolus manually on the Pump Step 12 j Bolus using an Insulin Pen or Syringe Step 14 3 4 Deliver Bolus Standard Bolus Back Deliver Confirm Bolus 2 U To Deliver a Standard Bolus j Selec...

Страница 18: ...nd display the Main Menu Bolus delivery continues until it is complete j To stop bolus delivery select Stop Bolus The Pump screen BOLUS CANCELLED appears If no buttons are pressed when the bolus deliv...

Страница 19: ...To confirm the entries select Confirm j To change the immediate bolus select Immediate entry field and press j Set the bolus amount and press j To change the duration select Duration entry field and...

Страница 20: ...LUS CANCELLED appears If no buttons are pressed when the bolus delivery is complete the Immediate Delivery Completed screen appears j Select Menu to go to the Main Menu 8 Pump Delivering Multiwave Bol...

Страница 21: ...onfirm Bolus 2 U Duration 4 00 HH MM Extended Bolus Delivery Continuing Menu Deliver Bolus j To adjust the duration select the Duration entry field and press j Set the length of duration and press j T...

Страница 22: ...2 U Set Bolus on Pump The bolus amount is displayed on the meter screen j Manually program the pump and deliver the bolus or if necessary select Back and return to the Bolus Advice screen to adjust t...

Страница 23: ...ing 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 Menu 14 To Deliver a Bolus Using an Insulin Pen or Syr...

Страница 24: ...re the bolus information in the diary is correct prior to starting a new bolus advice calculation For information on how to view and edit diary data see the Standard Owner s Booklet Accuracy of bolus...

Страница 25: ...reen is displayed press This is not available if your bG result is below your hypo warning limit red colour bar is displayed For additional information about different bolus types see Chapter 2 Admini...

Страница 26: ...24 45676_adv indb 24 11 3 09 4 45 10 PM...

Страница 27: ...25 2 2Administering 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...

Страница 28: ...rview 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...

Страница 29: ...ess technology is turned on and the meter and pump are communicating Multiwave A bolus designed to better simulate the body s insulin delivery It combines an immediate bolus delivery followed by an Ex...

Страница 30: ...pe is available when using bolus advice It can be used at anytime but is intended for times when the meter and pump are not communicating You must manually program the pump to deliver the bolus For in...

Страница 31: ...to deliver If an intended bolus is unintentionally stopped it is recommended you administer the remaining bolus manually with the pump or remotely with the meter You may also administer the bolus thr...

Страница 32: ...uctions of your healthcare professional when delivering a bolus using an insulin pen or a syringe Delivering a Bolus Using the Accu Chek Aviva Combo Meter and the Accu Chek Spirit Combo Pump You can r...

Страница 33: ...ibility of having a bolus on the meter that was not delivered on the pump If you used the bolus advice feature and delivered a bolus manually on the pump it is important you update the information in...

Страница 34: ...32 45676_adv indb 32 11 3 09 4 45 10 PM...

Страница 35: ...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...

Страница 36: ...it is important to understand how to operate the pump using the meter If you experience any communication problems between the pump and meter it is recommended that you go directly to the pump and op...

Страница 37: ...er 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...

Страница 38: ...backward in an information screen j Decrease a setting j Program a Quick Bolus j Cancel a Quick Bolus j Turn off the STOP Warning d j Cycles through menus functions and information screens f j Selects...

Страница 39: ...utton 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 0...

Страница 40: ...wave Bolus Temporary Basal Rate My Data Basal Rate Selection Basal Rate Programming 1 5 all individual Reminder Settings Time and Date Settings Pump Settings Therapy Settings Menu Settings Stop Your P...

Страница 41: ...otely 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...

Страница 42: ...tion into the meter for boluses delivered manually on the pump so that accurate bolus advice calculations are made In the Pump Menu the meter beeps and or vibrates similarly to the pump When the meter...

Страница 43: ...ack 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...

Страница 44: ...ding meter buttons to scroll through the pump menus and submenus the same as you would on the pump Instructions for how to deliver a standard bolus how to program a temporary basal rate TBR and how to...

Страница 45: ...u 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 My Data Set...

Страница 46: ...S S S S S j The Standard Bolus icon blinks for five seconds bolus delivery start delay The meter beeps three times and vibrates once then the pump begins to deliver the bolus amount A countdown of the...

Страница 47: ...r by pressing and x simultaneously j Set the bolus amount to 0 0 units Press to exit the BOLUS AMOUNT screen A bolus is not delivered During the bolus delivery start delay Standard bolus icon is blink...

Страница 48: ...ning W8 BOLUS CANCELLED Press twice to confirm and mute the warning You can view the actual bolus amount that was delivered prior to the bolus cancellation by viewing the pump bolus history Bolus deli...

Страница 49: ...ress 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 Pump Exit Ba...

Страница 50: ...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 10 02 02 59 1 4 Pump Exit Back TBR PERCENTAGE 120 02...

Страница 51: ...e pump is in RUN mode When a TBR is active the pump beeps and vibrates every hour The meter beeps and vibrates if the meter is in the pump mode in a Pump screen For more information about programming...

Страница 52: ...The pump continues to deliver the normal basal rate During the delivery of the TBR j Press The meter beeps and returns to the Pump Run screen j You can put the pump in Stop mode The TBR delivery is ca...

Страница 53: ...s 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...

Страница 54: ...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...

Страница 55: ...nder 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 meter screen You can mu...

Страница 56: ...is empty Cartridge Empty Error Pump Exit Back STOP CARTRIDGE EMPTY TO SNOOZE 1 E j When the insulin cartridge is empty the pump error E1 CARTRIDGE EMPTY appears You must change the cartridge immediate...

Страница 57: ...p 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 Ca...

Страница 58: ...ing 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 mete...

Страница 59: ...Wireless Technology Icon Communication States Icon Communication State Bluetooth wireless technology is on The meter and pump are communicating Bluetooth wireless technology is off The meter and pump...

Страница 60: ...t 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 and press Bolus Advice Pump My Data Settings bG Test 10...

Страница 61: ...pump If you change the pump time and date the meter time and date will automatically synchronize to match the pump If the meter and pump are out of communication range the connection between the meter...

Страница 62: ...u 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 e...

Страница 63: ...f 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 turned off press a to turn on j Press d 1 Pump j...

Страница 64: ...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...

Страница 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...

Страница 66: ...de j To not continue with setting up pairing press Ensure Pump is in pairing mode through Bluetooth menu on Pump Waiting METER12345678 Pair with Pump 10 Pump j If NO DEVICE FOUND screen appears see th...

Страница 67: ...own on the Pump Display j Press j Set the first number and press Repeat until all of the numbers have been entered Enter PIN shown on Pump display Pair with Pump 1 Cancel Pair with Pump Enter PIN show...

Страница 68: ...en 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 Pairing complet...

Страница 69: ...ng 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_a...

Страница 70: ...k Spirit Combo Pump 2 Cancelling the Pairing Process will prevent you from communicating with the Pump Setup Yes No Cancel Pairing j Select Yes to cancel the pairing process j Select No to return to t...

Страница 71: ...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 the meter is unpaired from the first pump If the meter is paired with a pum...

Страница 72: ...70 45676_adv indb 70 11 3 09 4 45 22 PM...

Страница 73: ...71 5 5Troubleshooting 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...

Страница 74: ...fix the problem contact Roche For information about troubleshooting the standard meter features see the Standard Owner s Booklet w WARNING Never make treatment decisions based on a warning or error m...

Страница 75: ...j Ensure the pump has Bluetooth wireless technology turned on j Ensure the pump is within communication range Bolus Advice Bolus Advice data deleted j Bolus advice data integrity cannot be confirmed...

Страница 76: ...y turned on j Ensure the meter and pump are within communication range j If the low battery icon is displayed on the meter the meter cannot communicate with the pump Replace the batteries j The pump i...

Страница 77: ...Communication Warning j Communication of bolus data from the pump was not successful Therefore pump data are not available and the bolus data may not be accurate j Communication of bolus data from th...

Страница 78: ...he Accu Chek Aviva Combo Meter and Accu Chek Spirit Combo Pump j Ensure the meter and pump have Bluetooth wireless technology turned on j If the low battery icon is displayed on the meter the meter ca...

Страница 79: ...he meter and pump regularly if you utilize bolus advice 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 low...

Страница 80: ...pump to use these features j For instructions on how to pair the meter and pump see Chapter 4 Communication Between the Accu Chek Aviva Combo Meter and Accu Chek Spirit Combo Pump Pairing Failed j Th...

Страница 81: ...tion range j I f the low battery icon is displayed on the meter the meter cannot communicate with the pump Replace the batteries Time Mismatch j The time or date on the meter is more than five minutes...

Страница 82: ...ms 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 Stand...

Страница 83: ...tings required to optimize the bolus advice feature so the recommendations match your insulin needs to the greatest possible extent You must set up bolus advice correctly Bolus advice is not available...

Страница 84: ...s selected The right choice of carb units is important for bolus advice recommendations to be accurate Carbohydrate units must be selected whether or not you set up bolus advice The following carbohyd...

Страница 85: ...mit Time Blocks Time blocks allow you to select settings to take into account the fact that your insulin requirement varies throughout the day Using the same values and factors for the day would not n...

Страница 86: ...Blood glucose results within the lower target limit and the upper target limit are considered within the target range Lower Blood Glucose Target Limit The lower limit of the blood glucose target range...

Страница 87: ...o lower your blood glucose by a certain amount Talk with your healthcare professional to determine the appropriate insulin sensitivity settings Your meter comes with the following preset time blocks T...

Страница 88: ...ght The time you normally wake up 2 Breakfast The time you normally wake up 1 hours before you normally eat lunch 3 Lunch 1 hours before you normally eat lunch 1 hours before you normally eat dinner 4...

Страница 89: ...within the hypo and hyper warning limits When a time block is edited for the first time the settings target range carb ratio and insulin sensitivity are applied to all of the other time blocks Health...

Страница 90: ...ailed descriptions of each of these settings Meal Rise During or after meals an increase in blood glucose levels is considered normal within a certain range even though a meal bolus has been delivered...

Страница 91: ...it your individual needs within a specified time interval 1 hours to 8 hours Offset Time Offset time takes into account the expected delay for the blood glucose level to actually fall during the actin...

Страница 92: ...f it is not within the target range The correction bolus can be positive if your current blood glucose level is above your target range or negative if it is below your target range Meal Bolus A meal b...

Страница 93: ...thin 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 Lowe...

Страница 94: ...s Between Upper and Lower Target Limit No correction bolus is necessary bG Target bG x Insulin Sensitivity Meal Bolus A correction bolus can be negative Between Lower Target Limit and Hypo Warning No...

Страница 95: ...administered the correct meal bolus The allowed blood glucose level rise is called meal rise After a certain period of time offset time the meal rise decreases from its maximum until your blood glucos...

Страница 96: ...er a carbohydrate amount that is greater than the snack size the meal rise setting is added to the blood glucose target value The shape of the meal rise the width of the green area is determined by th...

Страница 97: ...er the Offset Time At the end of the Acting Time your blood glucose level should return to the target limit You receive a recommendation for another correction bolus only if your current blood glucose...

Страница 98: ...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...

Страница 99: ...the blue area If the blood glucose value at 14 00 falls below the currently allowed blood glucose value top of the blue area another correction bolus is not calculated bG Level Hyper Hypo Acting Time...

Страница 100: ...lus 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 Level Hype...

Страница 101: ...e 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 requi...

Страница 102: ...blood glucose result falls below the hypo warning limit It is based on the other values defined for the current time block and the result is calculated as a carbohydrate intake recommendation Carbohyd...

Страница 103: ...the definition for the time blocks Consequently the currently allowed blood glucose value is calculated as follows Blood Glucose Range Covered by Correction Bolus currently acting correction boluses a...

Страница 104: ...ter than 0 trigger a corresponding acting time Correction Bolus Current bG Currently Allowed bG Insulin bG from insulin sensitivity The blood glucose correction portion depends on the following requir...

Страница 105: ...all within the target range if The current blood glucose result falls below the target range average value or The current blood glucose result is above the currently allowed blood glucose value Since...

Страница 106: ...er to safety related notes in the owner s booklets accompanying this instrument c j Caution refer to accompanying documents Please refer to safety related notes in the owner s booklets accompanying th...

Страница 107: ...meter screen features 13 overview 8 9 bolus advice calculations carbohydrate suggestion 100 correction bolus 102 correction bolus with carbohydrate intake 103 currently allowed blood glucose value 101...

Страница 108: ...tion 31 E errors pump 53 54 extended bolus delivery using bolus advice 19 description 28 H health events 15 87 88 I insulin sensitivity 85 L lower blood glucose target limit 84 M manual bolus insulin...

Страница 109: ...elivery 22 23 29 snack size 89 standard bolus cancel programmed meter delivery 45 46 delivery using bolus advice 15 16 description 27 program delivery through meter 43 44 symbols explanation 104 synch...

Страница 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...

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