The MiniMed Paradigm™ Veo™ System A step-by-step guide www.medtronic-diabetes.com.
Your HCPs Contact Details Staying in touch with your Healthcare Professionals (HCPs) Your Endocrinologist: Phone number: Email: Your Diabetes Educator: Your Diabetes Centre: Address: Phone number: Email: Medtronic Diabetes Customer Service: 1800 668 670 Medtronic Diabetes 24 Hour Helpline: 1800 777 808 www.medtronic-diabetes.com.au www.medtronic-diabetes.co.
INTRODUCING THE PARADIGM™ VEO™ SYSTEM Contents Introducing the Paradigm™ Veo™ System • Paradigm Veo System Overview • Menu & Menu Options • Operation Mode and Key Alarms 4 6 8 10 Infusion Set and Reservoir 12 • • • • • Medtronic Paradigm Reservoirs and Infusion Sets Inserting the Infusion Set and Filling the Reservoir Fill the Infusion Set Tubing Insertion of the Medtronic Quick-Set™ Infusion Set Insertion of the Medtronic Silhouette™ Infusion Set Basal and Bolus • • • • • Setting the B
INTRODUCING THE PARADIGM™ VEO™ INSULIN PUMP Introducing the Paradigm™ Veo™ Insulin Pump The key elements in managing your diabetes with insulin pump therapy RESERVOIR VOLUME BATTERY STATUS BATTERY COMPARTMENT EASY BOLUS/ scroll up BACKLIGHT/ scroll down RESERVOIR compartment express Bolus ESCAPE to prior screen RESERVOIR TRANSFER GUARD 4 4 MINILINK™ TRANSMITTER & SENSOR ACT confirm information or menu selection PARADIGM CONNECTOR infusion set Refer to Chapter 3 in the MiniMed Paradigm™ Veo™ User
Getting Started Getting Started Thank you for choosing Medtronic Diabetes as a partner in managing your diabetes. Whether you are just starting pump therapy or upgrading from a previous model, this step-by-step guide is designed to help you understand the basic operation of the MiniMed Paradigm Veo System. It is intended to be used in conjunction with the guidance of a healthcare professional. Please consult your healthcare professional before making any therapy adjustments.
GET TING STARTED The Paradigm Veo Insulin Pump A patient-friendly insulin pump With the Paradigm Veo pump: • You only need to press a few buttons to make appropriate selections and adjustments • Simple on-screen instructions help with the infusion set and reservoir changes • An easily-accessible backlight illuminates the pump’s screen in the dark • Large, clear text makes all on-screen information easy to read • Inserting the infusion set is straightforward and virtually painless In this section, we’ll ex
Getting Started GET TING STARTED Breakdown of the Buttons Simple buttons for simple use The buttons on the Paradigm Veo insulin pump are designed to make it simple and effective to manage your Paradigm Veo pump. EXPRESS Bolus to set a Bolus RETURN to prior screen aCT to confirm information or menu selection SCROLL UP SCROLL DOWN NOTE: The Paradigm Veo insulin pump ACT buttons will be referred to throughout the brochure using the icons shown to the right.
GET TING STARTED Menus and Menu Options MAIN MENU Bolus Suspend Sensor Capture Event Basal Reservoir + Set Utilities Navigation Press the ACT button from the MAIN MENU to get to the sub-menus. button from a submenu Press the screen to return to the MAIN MENU. Scroll bar (appears on the right of the screen when more screen text is available) Press to scroll down to view additional screen text. Press to scroll back up. Note: All screens are samples only.
Getting Started Status Screens CAPTURE EVENT Getting Started 6 Enter BG Insulin marker Meal marker Exercise marker Other History BG Units Carb Units Basal MENU Set/Edit Temp Basal Set Duration Cancel Temp Basal7 Select Patterns8 Basal Review Basal Setup Set/Edit Basal Set Basal Rate 1 Max Basal Rate Patterns Off On Temp Basal Type Insulin Rate Percent of Basal RESERVOIR + SET Reservoir Setup Fill Tubing9 Fill Cannula History 6.
GET TING STARTED Operational Modes The 3 Operational Modes Normal Mode The pump operates normally. Press to view the status screen so you can review the reason for the empty circle. Special Mode Indicates special circumstances: low battery, low reservoir, temporary basal, etc. Attention Mode Administration of insulin is s†opped. Press ACT to view alarm type to take action.
THE SCREEN INDICATES THE REASON FOR THE ALARM and ACT clear the alarm. Press Getting Started Key Alarms Empty Reservoir CHANGE THE RESERVOIR immediately. Weak Battery REPLACE THE AAA BATTERY immediately. No Delivery BLOCKAGE DETECTED: insulin delivery stopped. Check blood glucose and ketone levels. Failed Batt Test CHECK SETTINGS BATTERY VOLTAGE INADEQUATE Install a new battery. Bolus Stopped CHECK Bolus HISTORY Reprogram Bolus with the amount of insulin not delivered.
GET TING CONNECTED Infusion Set and Reservoir A Unique Connection Medtronic has developed a range of infusion sets and reservoirs designed for your Paradigm Veo insulin pump. They have one key element in common: Use it right and use it in good health. Change your infusion set every 2 to 3 days. • The Medtronic Paradigm Connection – a unique interface between your Medtronic Paradigm infusion set and reservoir.
Infusion Set & Reservoir Getting Connected Understanding Infusion Set and Reservoir The Paradigm™ Veo™ insulin pump shown in pink. For this section, you will need: • Reservoir • Infusion Set • Serter (optional) • Insulin www.medtronic-diabetes.co.
GET TING CONNECTED Medtronic Paradigm Reservoirs Simplicity and Security Transfer Guard snaps onto insulin vial OR PEN CARTRIDGE for secure and stable reservoir filling Needle incorporated into Transfer Guard to help prevent injury Pre-assembled and Ready to Use for fast, efficient reservoir filling Silicone Membrane seals the reservoir when the TransferGuard is removed to help prevent leakage Rounded Shape helps eliminate air bubbles to promote consistent insulin delivery Ergonomic design makes it eas
GET TING CONNECTED Medtronic Paradigm Infusion Sets Medtronic Quick-set infusion set Is the Quick-set right for you? • Soft cannula set • 90 degree insertion angle • Medtronic Quick-serter™ insertion device for consistent insertion depth • At-site tubing disconnection • Cannula length: 6 or 9 mm Due to its versatile design and straight 90 degree insertion angle, you may like the Quick-set if you are of average to heavier build.
GET TING CONNECTED Inserting the Infusion Set Insert the Infusion Set • Wash hands thoroughly before any handling • Prepare materials: insulin, reservoir, infusion set, and pump Prior to filling the reservoir, it is recommended that the insulin should be at room temperature. Refer to instructions for use for the cannula: Medtronic Quick-Set or Silhouette infusion sets. 5 4 1 2 3 Remember to rotate and cleanse insertion sites.
GET TING CONNECTED Step 1 Step 5 CLEAN the insulin cartridge (or vial) stopper with an alcohol wipe. REMOVE any air bubbles from the reservoir by gently tapping the side and then slowly pushing plunger up a little. 1 1.8 ml Step 6 INSERT the needle of the blue Transfer Guard into the cartridge (or vial). REMOVE the Transfer Guard from the reservoir (1/4 turn) and connect the reservoir to the infusion set. 1.8 ml 1 1.8 ml 1 1.
GET TING CONNECTED Fill the Infusion Set Tubing Step 1 Step 7 ACT ACT Step 2 ACT Fill until drops are seen at the end of the infusion set tubing. , then ACT Step 3 Step 9 ACT ACT Step 4 Step 10 ACT Step 5 Insert set (see instructions for inserting infusion sets). ACT Step 11 Insert the reservoir (with set connected) into the pump compartment and lock it (1/4 turn). ACT Using the arrows, ADJUST the volume needed to fill the cannula.
GET TING CONNECTED Insertion of the Medtronic Quick-Set Infusion Set Infusion Set & Reservoir Please refer to page 16 of this manual before you start Step 1 Step 3 INSERT the Quick-Set into the insertion device (Quick-Serter). LOAD the Quick-Serter by pulling back on the plunger. Step 2 Step 4 REMOVE the protective films from the adhesive. REMOVE the needle protector (blue cone) by unscrewing it.
(Insertion of the Medtronic Quick-Set Infusion Set, continued) Step 5 Step 8 POSITION the Quick-Serter at the desired site. REMOVE the Quick-Serter while supporting the tubing with your other hand. Step 6 Step 9 SQUEEZE the 2 white triggers to begin insertion. Carefully WITHDRAW the introducer needle. Step 7 Step 10 PRESS the plunger with your index finger to release the introducer needle. Fold the needle before placing it in a sharps container. 90° Recommended Cannula Fill: 0.3 U for 6 mm 0.
GET TING CONNECTED Insertion of the Medtronic Silhouette Infusion Set Infusion Set & Reservoir Please refer to page 16 of this manual before you start Step 1 Step 3 OPEN the mouth of the Sil-Serter inserter. REMOVE the needle protector. REMOVE first half of the protective film from the adhesive. Step 4 Step 2 LOAD the Sil-Serter. PLACE the Silhouette set in the Sil-Serter and release the mouth.
(Insertion of the Medtronic Silhouette Infusion Set, continued) Step 5 Step 8 PLACE the feet of the Sil-Serter on the insertion site and position at an approximately 30 degree angle. WITHDRAW the introducer needle by squeezing on the sides before pulling. Step 6 Step 9 INSERT the Silhouette set by pressing the white button. REMOVE the other half of protective film from the part before the adhesive. ADHERE the back part of the adhesive to the skin.
GET TING FREEDOM Basal and Bolus Understanding Basal and Bolus. 5U 4U 0.60 U/h 00:00 Basal rates The Paradigm Veo pump allows you to give a Bolus, or dose of insulin on demand when you eat. You can also increase or decrease your meal Bolus based on the foods you choose to eat. A Bolus may also be used to lower an elevated BG. This is called a correction Bolus. Infusion Set & Reservoir 7U 1.
Getting Freedom Understanding Basal and Bolus For this section, you will need: • Starting hourly Basal rate • Sensitivity factor • Insulin to carb ratio (or exchange) • Blood glucose targets • Active insulin time 24 The Paradigm™ Veo™ pump shown in blue, with 'Bubbles' SKIN.
ge t ting freedom Setting the Basal Rate Step 1 Select Basal SETUP from the Basal menu and press ACT . Step 2 Select SET/EDIT Basal from the “Basal SETUP” menu and press ACT . Step 3 Set Basal RATE 1 using ACT . and press Note: U/H is units of insulin per hour. Step 4 To set Basal RATE 2, enter the start time and the second rate. If starting with one Basal rate, simply press ACT to get back to the Basal rate review menu. Step 5 Remember to check the 24-hour total.
ge t ting freedom Basal Review To check your Basal rates and times: Step 1 To check your Basal rates & times choose “Basal REVIEW” from the Basal menu and press ACT . Step 2 Use to scroll up and down and view your set Basal rates & times.
ge t ting freedom Medtronic Bolus Wizard Calculator The Medtronic Bolus Wizard calculator performs the calculations needed to manage your insulin dosing and reduce the potential for hypoglycaemia, by calculating the: • Correction Boluses when glucose is out of target range. • Meal Boluses, if you are able to calculate your carbohydrates. Before using the Bolus Wizard, you must determine the following settings with your diabetes care team: • Insulin-carbohydrate ratio (Carb Ratio).
ge t ting freedom Programming the Bolus Wizard Calculator The following is a step-by-step guide to the Bolus Wizard calculator. Follow the instructions using the screens as a guide. Step 1 From the MAIN menu choose “Bolus” and press ACT . Step 2 From the Bolus menu choose “Bolus SETUP” and press ACT . Step 3 From the Bolus SETUP menu choose “Bolus WIZARD SETUP” and press ACT . Step 4 From the Bolus WIZARD SETUP menu choose “EDIT SETTINGS” and press ACT .
ge t ting freedom Using the Bolus Wizard Calculator • Perform a Correction Bolus: enter only blood glucose • Perform a Meal Bolus: enter only the amount of carbohydrates • Combine both (meal + correction Bolus): enter both blood glucose and carb amounts Example: blood glucose of 7.1 mmol/L and carbohydrates = 40 g Step 1 Press ACT 3 times to access the Bolus Wizard™. Step 2 Use to enter BLOOD GLUCOSE mmol/L and press ACT . Step 3 Use to enter MEAL CARBOHYDRATES and press ACT .
ge t ting freedom Setting the Missed Bolus Reminder Missed Bolus Reminder feature: When Turned On: is used as a reminder to eat or deliver a Bolus within a given period of time. If you do not deliver a Bolus within the Missed Bolus Reminder time period, the MISSED Bolus alert will , ACT to clear this alert. be displayed. Press Add, delete, and review Bolus reminders: You have to turn on the Missed Bolus Reminder option to add, delete, and review the programmed reminders.
ge t ting freedom Step 3 After this time is set, the End Time flashes. Set the End Time, then press ACT . Select Delete Reminder on the MISSED Bolus REMINDER screen and press ACT . Step 2 In the DELETE REMINDER screen, highlight the Bolus reminder that you want to delete and press ACT . Review a Reminder Step 1 You can set up to four Missed Bolus Reminders. Select Review Reminders on the MISSED Bolus REMINDER screen and press ACT . Step 2 Review your Missed Bolus reminders.
ge t ting freedom Temporary Basal Rate Setting a Temporary Basal Rate To adjust the Basal rate as needed for different everyday activities: unexpected physical activity, sports, illness, etc. Only the time duration and then the temporary rate need to be adjusted. This will take effect immediately! You can also set your Temp Basal Rate as a percentage of your current Basal rate. Step 1 Select Basal SETUP from the Basal menu and press ACT . Step 2 Set the DURATION using . Step 3 Press ACT .
ge t ting freedom Express Bolus Setting the Express Bolus Step 1 Click on Bolus times. and press ACT three Step 2 Use arrows to adjust Bolus rate, then press ACT . Step 3 Basal & Bolus The pump delivers a Bolus immediately. Cancelling a Bolus (Temporary stop) Step 1 WARNING: The Bolus and Basal flow have been stopped. The pump is not administering any insulin while suspended. Step 2 RESUME will restart Basal rate only All remaining Bolus is cancelled following suspend.
GET TING CONTROL Continuous Glucose Monitoring (CGM) Continuous Glucose Monitoring provides better insights of low and high glucose levels and gives you more control of your diabetes with: • Continuous Glucose Readings provide continuous visibility of your current glucose level 24 hours a day. • Trend Graphs covering 3, 6, 12, and 24 hours give you a clearer picture of your glucose levels over time, allowing you to identify personal patterns.
CGM Getting Control Understanding the benefits of Continuous Glucose Monitoring For this section, you will need: • Medtronic MiniLink Transmitter • Sensor • Medtronic Sen-Serter™ Insertion Device • Paradigm Veo Insulin Pump www.medtronic-diabetes.co.uk/cgm The Paradigm™ Veo™ insulin pump shown in black.
GET TING CONTROL Insertion of Sensor Wash your hands thoroughly before starting. You will need the following: • a sensor at room temperature • the Medtronic Sen-Serter insertion device • tape or a bandage (e.g. IV 3000® dressing) Select a site for insertion and choose a site free of lumps, bumps, bruises, tattoos, etc. Remember to alternate sites. Clean the insertion site with alcohol wipes. Insert the sensor at 45/60 degrees using the Sen-Serter (on taut skin).
GET TING CONTROL Inserting the Sensor Step 4 Step 7 PLACE the sensor in the Sen-serter (the black rings should no longer be visible). REMOVE the needle guard. SLIDE the Sen-serter backward along the skin, while keeping the sensor in place. Step 2 Step 5 Step 8 LOAD the Sen-serter by pressing the sensor backwards into the Sen-serter until you hear a CLICK. PLACE the Sen-serter onto taut skin. REMOVE the introducer needle carefully, keeping it at an angle.
GET TING CONTROL Starting a Sensor 1. Sensor Start 2. Sensor Initialisation Once the sensor is inserted under the skin: 2 hours later the METER BG NOW alarm should , then: ACT sound; CLEAR the alarm: • WAIT 5-15 minutes; this is the time required for the sensor to be wetted with interstitial fluid. • REMOVE the MiniLink transmitter from its charger: it will flash green. Wait 1 minute. • CONNECT the MiniLink transmitter to the sensor; the MiniLink will flash green again = ok.
GET TING CONTROL Key CGM Alarms Alarms Enter blood glucose for sensor calibration Press then ACT to clear the alarm. > Main Menu > Sensor > Enter BG to enter blood > Enter BG > Use glucose and validate with ACT No communication to pump from sensor Connect pump and sensor > Sensor > Link to Sensor > Find lost sensor Capillary blood glucose and sensor level are incompatible Wait 30 minutes before checking blood glucose again. Enter the new blood glucose value.
GET TING CONTROL Trend Graphs This section allows you to review trends of your glucose levels. • 3, 6, 12, and 24-hour graphs. 3 - hour graph From the home screen, press once to access the 3 hour graph. To see variations in your glucose levels over 5 only to navigate the minutes press graph itself. To access 6, 12, and 24-hour graphs, once in the 3 hour graph, use the button when the cursor is at the far-right of the screen.
GET TING CONTROL Understand the Trend Graphs All graphs show High and Low Glucose Limits lines, a continuous Sensor Glucose (SG) measurement line, a data section, and the cursor (flashing vertical line). Sensor glucose line. Indicates that your glucose has risen above 17.2 mmol/L. Data section shows the selected time, the type of graphs (or “History” if you have scrolled to the left on the graphs), and the sensor glucose measurement (or alert). High Glucose Limit Line at 10.
GET TING CONTROL Alerts Allows you to set your customisable alerts. Turning glucose alerts on: Glucose alerts will sound if your glucose level reaches or goes beyond the target you set. To turn the alert feature on: Make sure that the EDIT SETTINGS screen is open. Step 1 From the MAIN menu choose “SENSOR” and press ACT . Step 2 From the SENSOR menu choose ”EDIT SETTINGS” and press ACT . Step 3 From the EDIT SETTINGS menu choose “GLUCOSE ALERTS: OFF” and press ACT .
GET TING CONTROL Glucose Limits Allows you to set the high and low Glucose Limits. Step 1 From the SENSOR menu choose “EDIT SETTINGS” and press ACT . Step 2 From the EDIT SETTINGS menu choose “GLUCOSE LIMITS” and press ACT . Step 3 To select your LOW GLUCOSE LIMIT use to set a value between 2.2 and 22 mmol/L and press ACT . Step 4 Next select your HIGH GLUCOSE LIMIT to set a higher value between using 2.2 and 22 mmol/L and press ACT . The first pair of Glucose Limits is now set.
GET TING CONTROL Predictive Alerts The Predictive Alerts calculate when you may reach your Low or High Glucose Limits, then send you an alert before you reach those limits. A Predictive alert tells you that if your sensor glucose measurements keep falling or rising at the current rate, you may reach your Glucose Limit in the number of minutes you select. This is known as the time sensitivity. To set up the Predictive alerts: Step 1 Select PREDICT ALERT in the "EDIT SETTINGS" screen, then press ACT .
GET TING CONTROL Rate of Change Alerts Fall Rate: sensor glucose values falling at or faster than your pre-defined rate. Rise Rate: sensor glucose values rising at or faster than your predefined rate. To set up the Rate of Change alerts: Step 1 Select RATE ALERTS in the "EDIT SETTINGS" screen then press ACT . Step 2 Select the Fall Rate Limit, then press ACT . Step 3 Step 4 Select the Rise Rate Limit, then press ACT .
GET TING CONTROL Low Glucose Suspend Purpose Settings • The Low Glucose Suspend (LGS) is a feature designed to help reduce the risk of severe hypoglycaemia. If the feature is turned on, it automatically alarms and halts insulin infusion when glucose levels reach a pre-determined threshold. • Without patient intervention, after a two-hour suspension, the pump resumes Basal insulin delivery.
GET TING CONTROL The Paradigm Veo insulin pump and CGM functionalities aim at helping people reduce glucose variability Low Glucose Suspend in focus * Insulin infusion resumed 7.8 Target zone 3.
OPTIONAL EXTRAS Medtronic CareLink® Therapy Management Software: for you and your Healthcare Professional Bringing it all together Medtronic CareLink® therapy management software gives you an overall picture of how your glucose levels are behaving. The software combines data from the glucose sensor, glucose transmitter, glucose meters, and Paradigm Veo insulin pump to create the only truly integrated diabetes management system.
OPTIONAL EXTRAS Personalise Your Pump Pumps with SKINS Make it Yours Paradigm Veo SKINS Blue Goo Paradigm Veo SKINS Lightning Bolt Paradigm Veo SKINS Green Aura Paradigm Veo SKINS White Daisies Paradigm Veo SKINS Pink Feathers Paradigm Veo SKINS Jelly Beans All colors and SKINS are subject to availability. 49 Optional Extras Paradigm Veo SKINS- Available in many different SKINS and 5 different colours. To order, please visit the Medtronic Diabetes Online Shop at http://www.medtronic-diabetes.
MINIMED PARADIGM™ VEO™ SYSTEM Notes 50
Safety Information Insulin Pump Therapy and MiniMed Insulin Infusion Pumps Patients should always discuss the benefits and potential risks with a clinician. Please review the product’s technical manual prior to use for detailed instructions and disclosure. Indications for use The insulin pump is indicated for the continuous delivery of insulin, at set and variable rates, for the management of diabetes mellitus in persons requiring insulin.
