INTR
OD
U
C
TI
ON
INTRODUCTION |
Your Personal Diabetes Manager Settings
YOUR PERSONAL DIABETES MANAGER
SETTINGS
It is always a good idea to keep a copy of your Personal Diabetes Manager settings handy in the event you have to set up another
Personal Diabetes Manager.
Your healthcare provider will provide you with your initial start rates as well as any future changes.
CAUTION: Do not attempt to start or make any changes to your Personal Diabetes Manager settings without formal instruction from your healthcare provider.
OMNIPOD DASH
™
PuMP THerAPy OrDer FOrM
Initial Pump Settings entered in PDM *indicates settings provided by HCP on page 1
Basal
Max Basal Rate*
_______ U/hr
Basal 1*
Time Segment
12:00 am - _________
_________ - _________
_________ - _________
_________ - _________
_______ U/hr
_______ U/hr
_______ U/hr
_______ U/hr
Temporary Basal Rate
On
Off
Blood Glucose (BG)
BG Goal Limits
Lower Limit ______ mg/dL
Upper Limit ______ mg/dL
BG Meter
Pair
Skip
Bolus
Bolus Calculator
On
Off
Target BG & Correct Above*
Time Segment
12:00 am - _________
_________ - _________
_________ - _________
_________ - _________
Target
_________ mg/dL
_________ mg/dL
_________ mg/dL
_________ mg/dL
Correct Above
_________ mg/dL
_________ mg/dL
_________ mg/dL
_________ mg/dL
Minimum BG for Bolus Calcs
_________ mg/dL
Insulin to Carb (IC) Ratio*
Time Segment
12:00 am - _________
_________ - _________
_________ - _________
_________ - _________
1 unit of insulin covers
_______ g
_______ g
_______ g
_______ g
Correction Factor*
Time Segment
12:00 am - _________
_________ - _________
_________ - _________
_________ - _________
1 unit of insulin decreases BG by
_______ mg/dL
_______ mg/dL
_______ mg/dL
_______ mg/dL
Reverse Correction*
On
Off
Duration of Insulin Action*
_______ hours
Maximum Bolus*
_______ units
Extended Bolus
On
Off
education reviewed:
Carb Counting
Site Selection/Rotation
Blood Glucose Testing
Suggested Bolus Calculations
Site Adhesion
Hypoglycemia – Symptoms/Treatment
Advanced Features
Temp Basal
Extended Bolus
Patient Insulin Adjustment
Basal
Bolus
Hyperglycemia – Symptoms/Treatment
Ketone Testing
Exercise
Sick Day Management
______________________
Additional Notes: ____________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________
If you have any additional questions or concerns please feel free to contact me at ______________________________________________________________________
Trainer Name____________________________________________ (Trainer signature)___________________________________________________ Date ____________
40519-USA-ENG-AW Rev A 05/18 © 2018 Insulet Corporation. Omnipod, the Omnipod logo, DASH and the DASH logo are trademarks or registered trademarks of Insulet Corporation.
All rights reserved.
Page 2 of 2
Date
_______/______/_______
Dear ______________________________________________________________
Below you will find current settings along with education topics reviewed with your patient ______________________________________.
I have instructed your patient to follow the self-management/insulin adjustment guidelines provided. Your patient has been instructed to
call Insulet Customer Care for any technical/product assistance.
Dr. Name
Patient Name
* Indicates settings provided by HCP
Be sure to check with your healthcare provider before adjusting these settings.
Содержание DASH SYSTEM PODDER
Страница 1: ...OMNIPOD DASH SYSTEM PODDER RESOURCE GUIDE Insulin Delivery That s Simple Smart and Discreet ...
Страница 2: ... 2 3 ...
Страница 29: ...OMNIPOD DASH SYSTEM INSTRUCTIONS ADDITIONAL NOTES ...
Страница 47: ...ADDITIONAL NOTES ...