DURING TRAINING CONTINUOUS GLUCOSE MONITORING MINIMED 630G SYSTEM

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1 DURING TRAINING CONTINUOUS GLUCOSE MONITORING MINIMED 630G SYSTEM

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3 TABLE OF CONTENTS DURING TRAINING CONTINUOUS GLUCOSE MONITORING MINIMED 630G SYSTEM Welcome... Section 1: Getting Started... Section : Keys to Success Sensor Glucose (SG) Blood Glucose (BG)... 3 Trends... 6 Personalized Alerts... 8 Sensor Insertion - Thumbprint Sensor Taping Calibration Section 3: Sensor Display...0 Section 4: Sensor Alerts and Suspend... 1 Sensor Alerts... 1 Suspend on Low... Section 5: CareLink Personal Software... 4 Keys to Success Review... 5 Additional Topics... 6 Quick Reference Guides Connecting the Pump and Transmitter... 9 Enlite Sensor and One-press Serter Calibration Sensor Alerts SmartGuard Technology: Suspend on Low CareLink Personal Software

4 GETTING STARTED Welcome We are happy you are at your training today. Your trainer will work with you to learn how to use your Continuous Glucose Monitor (CGM). Together, you will enter your CGM settings and learn information to help ensure your success using CGM. Section 1: Getting Started Why is starting CGM so exciting? CGM fills in the gaps between fingerstick tests taken with your meter, and allows you to see what your glucose values are when you are not testing. Not only will you see your glucose value, but you will also get insight into the speed and direction your glucose is moving. Glucose Values 100 mg/dl 85 mg/dl 85 mg/dl 75 mg/dl 70 mg/dl 1:00 AM 8:00 AM 4:00 PM Time

5 SENSOR GLUCOSE AND BLOOD GLUCOSE Section : Keys to Success The next several pages will cover the important topics and concepts that are very helpful to understand when using CGM. Key to Success: Sensor Glucose (SG) Blood Glucose (BG) SENSOR GLUCOSE BLOOD GLUCOSE The sensor and your blood glucose meter measure glucose in two different places: The glucose sensor measures glucose in the interstitial fluid Your meter measures glucose in the blood. Because glucose moves between these two places, your blood glucose meter readings (BG) and sensor glucose readings (SG) will be similar, but will rarely match. This difference is normal and should be expected. You can expect to see a larger difference between your BG meter reading and the sensor glucose reading when glucose levels are rising or falling quickly. This often occurs: After meals or taking insulin During and after exercise When arrows appear on your pump screen SG BG 3

6 SENSOR GLUCOSE AND BLOOD GLUCOSE Understanding SG & BG Think of SG and BG like a roller coaster. BG is in the front car, SG is in the back car. When glucose levels are stable, SG and BG values will be similar but rarely exactly the same. When climbing up the track, or rising, the BG value is greater than the SG that follows behind it. But when moving down the track, or falling, the BG in front is now less than the SG value. LIFE WITH CGM Donna gets a high SG alert on her pump after eating breakfast. She checks her glucose value with her meter. It is also high but there is a difference between her BG and SG. She remembers that this is okay and that it is normal for there to be a larger difference between SG and BG after meals. 4

7 SENSOR GLUCOSE AND BLOOD GLUCOSE! Do not make therapy treatment decisions based on sensor glucose values because sensor glucose and blood glucose values may differ. If your sensor glucose reading is low or high, or if you feel symptoms of low or high glucose, confirm your sensor glucose with your BG meter prior to making therapy decisions to avoid severe low or high glucose conditions. Write either SG or BG next to each statement below. SG Sensor Glucose BG Blood Glucose glucose readings measured with your meter glucose readings measured using CGM measured in interstitial fluid often a lower reading when glucose is moving down quickly Ashley knows it is okay to see a difference between sensor glucose and blood glucose readings. When confirming a sensor glucose with a blood glucose, what might Ashley see as sensor and blood glucose readings? (circle the best answer) A sensor glucose 80 and blood glucose 70 B sensor glucose 15 and blood glucose 35 C sensor glucose 65 and blood glucose 80 D all of the above Why will your sensor glucose be different from your blood glucose? (circle the best answer) A sensor glucose levels generally follow behind blood glucose B sensor glucose is measured in the interstitial fluid and blood glucose is measured in the blood C glucose moves continuously between blood and interstitial fluid D all of the above 5

8 TRENDS Key to Success: Trends When using CGM, you will want to focus on sensor glucose trends. Trends give insight into the speed and direction your glucose has been changing. This allows you to: focus less on the individual sensor glucose numbers. focus more on how quickly your glucose may be rising or falling. TRENDS The sensor graph and trend arrows show you this information. Example of Sensor Information on the Home Screen Trend Arrows Sensor Glucose Graph Sensor Glucose Reading When looking at the sensor information above, you see the current SG reading is 100 mg/dl. But also notice: the sensor graph: shows sensor glucose is trending downward two arrows above the number: tells you glucose has been dropping This gives you important insight that you didn t get from the number itself. I ll focus less on the number and more on the direction and speed that glucose is changing or or or = = = SG has been changing SG has been rising or falling about 0-40 mg/dl over the last 0 minutes (1- mg/dl per minute) SG has been changing quickly SG has been rising or falling about mg/dl over the last 0 minutes (-3 mg/dl per minute) SG has been changing very quickly SG has been rising or falling more than 60 mg/dl over the last 0 minutes (more than 3 mg/dl per minute) If you see no arrows above the sensor glucose value, your sensor glucose is not rising or falling quickly. 6

9 TRENDS LIFE WITH CGM Using Trend Arrows Steven sees a sensor glucose value of 110 mg/dl and $$$ trend arrows. This means his sensor glucose has dropped approximately 60 mg/dl or more in the last 0 minutes. He tests with his meter to confirm his glucose level and decides to eat some carbohydrate to help avoid hypoglycemia. Chris looks down at his sensor display at work. What should he do if his sensor displays the following: A give a correction bolus B confirm with a blood glucose reading using his BG meter C eat a snack Paula sometimes forgets to bolus before eating. Which trend arrow(s) might she see next to her sensor glucose reading as a result of forgetting to bolus? A ## B $$ C ### D both A and C are possibilities 7

10 PERSONALIZED ALERTS Key To Success: Personalized Alerts Your CGM alert and suspend settings are most beneficial if they are personalized for your needs. Your healthcare professional will work with you to determine your initial settings and help with adjustments that need to be made after you start using CGM. PERSONALIZED ALERTS If you are receiving too many alerts, have your healthcare professional help adjust the settings so you are alerted only when you find it is helpful. High Settings Here you can see the alerts that can be set: 400 mg/dl High Limit Sensor Glucose Readings Alert on High Alert before High Rise Alert ( High Snooze) My settings may need to be adjusted after I start using CGM. 40 mg/dl Time periods: Different time periods can be used when setting high alerts. For example, you may want to use different high alerts during the day than you do at night. High Limit: This is the high sensor glucose value that you set. You can be alerted when you are approaching and/or when you reach or rise above it. You can have a different high limit for each time period that you set. 8

11 PERSONALIZED ALERTS Alert options: once the time period and high limit are decided, you set the alerts that will be used during that time: Alert before high Time before high Alert on high Your SG is approaching your high limit. The number of minutes before reaching the high limit that you will receive the Alert before high. Your SG has reached or risen above your high limit. Rise Alert Snooze Your SG is rising rapidly. The amount of time before being re-alerted if the high alert condition is still occurring. LIFE WITH CGM Alert on high Sarah has been working hard to keep her glucose levels under control. Her healthcare professional has set her high limit at 5 mg/dl and is having her use the Alert on high. If her SG reaches or rises above this limit, she will receive an alert and will test her BG. She can take insulin if needed to help her glucose levels return to her target range. Low Settings Here you can see the alerts and suspend option that can be set: 400 mg/dl ( Low Snooze) Alert before Low Suspend on Low Alert on Low Sensor Glucose Readings 40 mg/dl 9

12 PERSONALIZED ALERTS Time periods: Like the high settings, different time periods can be used when setting low alerts. For example, you may want to use different settings while you are at work or school than you do when at home. Low Limit: This is the low sensor glucose value that you set. You can be alerted when you are approaching and/or when you reach or fall below it. It is also the point that insulin would be suspended if the Suspend on low feature is being used. You can have a different low limit for each time period that you set. Low Alerts and Suspend options: these are chosen for each time period, Alert before low Your SG is approaching your low limit. You will be notified when your SG is predicted to reach your low limit in 30 minutes. Suspend on low Your pump will temporarily stop delivering insulin if your SG has reached or fallen below your low limit. This keeps additional insulin from being delivered. Alert on low Your SG has reached your low limit. If you use Suspend on low, this alert will automatically be set to On. Low snooze The amount of time before being re-alerted if the low alert or suspend condition is still occurring. More information on addressing these alerts and a Suspend on low event is covered in Section 4. I will test my BG with my meter before making any treatment decisions. 10

13 PERSONALIZED ALERTS My High Limit during the day is set at: mg/dl. My Low Limit during the night is set at: mg/dl. Place a T by each statement that is True. Rise Alert means you have reached your high limit Alert before low means your SG is approaching your low limit Suspend on low will stop insulin delivery Alert on low means your SG has reached your low limit I should confirm my SG with my meter BG before making any treatment decisions. A True B False If you are receiving too many alerts you may need to: A change your low and high snooze settings to give your glucose more time to recover B adjust the alert settings so they occur only when you need to take action C just turn off all of the alerts D both A and B 11

14 SENSOR INSERTION - THUMBPRINT Key to Success: Sensor Insertion - Thumbprint You are now ready to insert your sensor. Before you begin, gather the supplies needed: THUMBPRINT Enlite System Components C A A B One-press Serter Enlite Sensor & Pedestal A Sensor B Pedestal C Adhesive Tape Sensor Overtape A Pre-cut Hole Guardian Link Transmitter Drawings throughout this document are only generic representations of the system components. Connect Your Pump and Guardian Link Before using the sensor for the first time, you will need to wirelessly connect the pump and transmitter so that they can communicate with each other. This allows the sensor information to be displayed on the pump screen. For help connecting your Insulin Pump and Guardian Link, see the Quick Reference Guide on page 9. Check the resource that you will use to help with your Enlite sensor insertion: Quick Reference Guide: see page 31 mylearning video: my.medtronicdiabetes.com/mylearning Medtronic Diabetes website: 1

15 SENSOR INSERTION - THUMBPRINT Select Your Site Your sensor can be inserted in the abdomen and should be at least: inches from your navel 1 inch from your insulin pump infusion site 1 inch from any manual insulin injection site Avoid inserting the sensor in areas where: clothing rubs or is tight against your body your body bends or there is a lot of motion you have scar tissue Insertion Important Points We will first review some important things to remember while you are inserting the sensor: About the serter: I ll rotate my site when I put a new sensor in. There is a small bump on each green button. Have your fingers on these bumps when inserting the sensor. When loading and removing the sensor: Be sure the sensor is on a hard and even surface like a table or desk. Be sure your thumb is on the thumbprint and not the green buttons. Place the serter gently onto the sensor/pedestal to ensure it loads properly. Keep your thumb on the thumbprint when removing the serter. 13

16 SENSOR INSERTION - THUMBPRINT When inserting the sensor: Hold the serter gently against your skin. Light to the touch Place your fingers on the bumps on the green buttons. Then press and RELEASE both buttons at the same time. Continue to hold serter against body to allow the adhesive time to stick to the skin. Slowly pull the serter away from the skin making sure the buttons are not pressed. When removing the sensor needle: Place fingers on the front and back of the sensor as shown (not on the sensor arms). Hold the needle on the ridges at the top of the needle housing when removing it. Review Key to Success: Taping before inserting the sensor. 14

17 SENSOR TAPING Key to Success: Sensor Taping Once the sensor is inserted, it is very important that you use the Enlite sensor overtape to ensure the sensor stays in place. After sensor is inserted and the needle is removed: SENSOR TAPING Correct tape placement Attach the overtape to both the rounded part of the sensor and the skin in front of the sensor. When tape is placed onto the skin, press the adhesive against the skin to help ensure that it sticks securely. When connecting the Guardian Link transmitter to your sensor: Avoid pulling the adhesive tab too tightly when placing it over the transmitter. You are now ready to insert and tape the sensor. For step by step instructions for inserting the Enlite sensor, see the Quick Reference Guide for the Enlite Sensor and One-press Serter on page 31 of this book. 15

18 SENSOR INSERTION Which of the following are important when loading the sensor into the serter? A the sensor should be on a hard and even surface B my thumb should be on the thumbprint and not the green buttons C I should place the serter gently onto the sensor/pedestal D all of the above are important Which of the following is important when pressing the green buttons to insert the sensor? A my fingers should be on the bump toward the bottom of the green buttons B I need to push the buttons very hard to get the sensor to insert C I can have my fingers anywhere on the buttons My fingers should be on the ridges of the needle house when I remove the sensor. A True B False A second button press is required before removing the serter from the body. A True B False Which of the following steps are in the correct order? Circle the correct answer. A 1. Insert the sensor. Connect the transmitter 3. Tape the sensor B 1. Insert the sensor. Tape the sensor 3. Connect the transmitter 16

19 CALIBRATION Key to Success: Calibration Calibration is essential for optimal CGM performance. To calibrate, you must use a fingerstick blood sample to test your BG on your meter and then enter that value into your pump.* CHECKPOINT CALIBRATION Complete this calibration schedule so you know when to calibrate: Day 1 The time you inserted your sensor: AM / PM 1st Calibration due hours later: AM / PM nd Calibration due within 6 hours: by AM / PM Days - 6 Before Breakfast: Before Lunch: Before Dinner: Before Bed: Calibration Checklist: Wash hands before checking your BG Calibrate with the BG value right away Calibrate: before meals before taking insulin before bedtime When I get a Calibrate Now alert: C = Clear the Alert A = Accurate BG (enter right away) L = Look for arrows (if arrows, don t calibrate) Aim for 3 to 4 but no more calibrations each day If you see arrows, wait to calibrate LIFE WITH CGM Calibrate before bed Pam does not want to be woken during the night by a Calibrate now alert so she tests her BG and calibrates her sensor before she goes to bed. 17

20 CALIBRATION There are several different ways that you can enter a BG reading to calibrate the sensor. When it is time to calibrate, choose the one that works best for you. OPTION 1 When you check your BG with the CONTOUR NEXT LINK.4 Meter: Select Calibrate Sensor once the BG appears on the pump screen. OPTION If giving a bolus using the Bolus Wizard calculator: This screen will appear after you select Deliver Bolus. Select Yes. OPTION 3 If option 1 or does not apply, you may calibrate through the Home screen graph: Highlight sensor graph and hold select. Enter BG and select Calibrate. Once you have entered a calibration BG, the Home screen will show you that the system is calibrating. You will start seeing updated sensor glucose readings in about minutes. For calibration tips, see the Calibration Quick Reference Guide on page

21 CALIBRATION What might happen if a calibration is required and it is not entered into your pump? A SG readings will not display B I will continue to get the SG data on my pump C I may not get important alerts/alarms such as Suspend on low D Both A and C Place a T by each statement that is true. I should calibrate 3-4 times each day for best sensor performance If I don t calibrate, I will still get alarms and alerts It is best to calibrate after meals When I do a fingerstick for a calibration, I should wait at least 15 minutes before entering it into the pump I should always wash my hands before a fingerstick calibration If I notice a large difference between my SG and BG. I can retest my BG and calibrate again if needed Decide if the times below are good times to calibrate. Circle Yes or No. After a meal? After a bolus? After exercise? Arrows on screen? Yes No Yes No Yes No Yes No 3-4 times/day? Before bed? SG is stable? More than 4 times/day? Yes No Yes No Yes No Yes No 19

22 SENSOR DISPLAY Section 3: Sensor Display Once the sensor has started giving you sensor glucose readings, the Home screen will display them similar to what you see here: High Limit 3-hour Sensor Glucose Graph Low Limit Additional Sensor Icons Trend Arrows Most recent Sensor Glucose (SG) Reading SmartGuard Suspend by Sensor Icon Bolus Marker In addition to the pump icons, you will see additional sensor icons on the Status Bar when using CGM. Connection icon: shows radio frequency (RF) communication between the pump and sensor. Calibration icon: represents the time left until next calibration is due. The icon empties as time decreases. A down arrow means calibration is needed. Sensor Life icon: represents the number of days before sensor needs to be changed. Additional icons: appear when the sensor is in warm up, pump and transmitter are out of range, system cannot be calibrated, or calibration or sensor age are unknown. SmartGuard Suspend by Sensor Icon During any time segment when Suspend on low is set to on, you will see the Suspend by sensor icon on the Home screen: Suspend on low is on and ready. If insulin delivery is suspended, the icon will flash while insulin delivery is stopped Suspend on low is on but is unavailable. This can be due to a recent suspend or when no SG values are available. 0

23 SENSOR ALERTS AND SUSPEND Section 4: Sensor Alerts and Suspend Receiving alerts is a part of wearing CGM. When an alert is received, the pump screen will let you know why the alert is occurring. You will want to take these steps when you receive an alert or an alarm. Read message on pump screen and take any action necessary Press Press on desired option Sensor Alerts Alert before low alert message: Sensor expired alert message: For a list of the most common sensor alerts, see the Sensor Alerts Quick Reference Guide on page 35. 1

24 SENSOR ALERTS AND SUSPEND Suspend on Low When Suspend on low is turned on, your pump will temporarily stop delivering insulin if your sensor glucose has reached or fallen below your low limit. This keeps additional insulin from being delivered. When Suspend on low occurs, the screen you see to the right appears on your pump screen and all insulin delivery is stopped immediately. Here is a general overview of this alarm: SUSPEND ON LOW OCCURS Insulin Delivery is Stopped The Suspend on low alarm screen appears. If you are alert and able to respond: If you are not able to respond and do not clear the alarm: Press and to clear the alarm. After minutes the pump will begin to siren and will continue to siren. Insulin will stay suspended for hours unless you choose to resume insulin delivery. The Medical device screen will appear. Insulin will stay suspended for hours (unless you choose to resume it). The pump will continue to siren until you clear the alarm. For more information about Suspend on low, see the Quick Reference Guide on page 37.

25 SENSOR ALERTS AND SUSPEND After the Suspend on low message is cleared the Home screen will display: Suspended on low at the bottom of the screen a shaded area to represent the time when insulin has been suspended a flashing SmartGuard icon Resuming Insulin Delivery There are two ways in which basal insulin delivery will be resumed following a Suspend on low event. Automatic Resume: When Suspend on low occurs, basal insulin delivery will automatically be resumed after hours. You will always receive a Basal delivery resumed alert when this occurs. Manual Resume: You have the option to manually resume insulin delivery at any time. Follow these steps to restart basal insulin delivery: 1. Select Suspended on low.. Press to Resume Basal. 3. Press and select Yes.! Do not use the Suspend on low feature to prevent or treat low glucose. The Suspend on low feature is designed to suspend insulin delivery when you are unable to respond to the Suspend on low alarm. Always confirm your sensor glucose using your BG meter, and follow the instructions of your healthcare professional. Using Suspend on low to prevent or treat low glucose may result in prolonged hypoglycemia. 3

26 CARELINK PERSONAL SOFTWARE Section 5: CareLink Personal Software CareLink software is another key to CGM success. You may already be familiar with CareLink Personal software. It allows you to upload information from your insulin pump, CGM device, and blood glucose meter through a free, web-based program. CareLink software makes it easier to uncover trends and patterns and assess overall glucose control. CARELINK Lets you upload your pump, sensor and meter information Displays information on reports Helps you see patterns and trends You and your healthcare professional can make changes to your pump and CGM settings You may have registered onto CareLink Personal software when you started pump therapy. If you have not, you will want to do so since it will provide very helpful information for you and your healthcare professional. There is additional helpful information in your Book 3, After Training. For help setting up your account, see the CareLink Personal Software Quick Reference Guide on page 39. 4

27 KEYS TO SUCCESS REVIEW Keys to Success Review CHECKPOINT 5

28 ADDITIONAL TOPICS Additional Topics There will be questions that arise as you start using CGM. More information and answers to some of the most commonly asked questions on the following topics can be found in Book 3, After Training. The First Few Days: reviews the most important things to remember the first few days using CGM. Frequently Asked Questions: answers questions often asked on the following topics: Calibration Sensor and Blood Glucose Sensor Glucose Data Sensor Alerts and Suspend Sensor Position and Taping CareLink Personal Software Charging the Guardian Link Transmitter Guardian Link Transmitter Care X-ray, MRI or CT Scan Traveling by Air Help and Supply Ordering: provides resources that are available when you need help and the different options you have for ordering your CGM supplies. Congratulations on your new journey in your diabetes management. Please be sure to see your After Training guide for help with common questions that arise. We hope you find the information CGM provides beneficial. Always remember, we are here to help if you need it. 6

29 QUICK REFERENCE GUIDES Quick Reference Guides This section contains handouts that you can refer to during or after training. The Quick Reference Guides can be used when performing the most common tasks using CGM. These topics include: Connecting the Pump and Transmitter Enlite Sensor and One-press Serter Calibration Sensor Alerts SmartGuard Technology: Suspend on Low CareLink Personal Software Feel free to tear these Quick Reference Guides out and keep them in a place where they are easily accessible. If you need more assistance after reviewing the Quick Reference Guides, you can also: Call the 4-Hour HelpLine at Go to and click Support Contact your StartRight SM team member Contact your trainer 7

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31 !! CONNECTING THE PUMP AND TRANSMITTER MINIMED 630G INSULIN PUMP & GUARDIAN LINK TRANSMITTER Before using the sensor for the first time, you will need to wirelessly connect the pump and transmitter so that they can communicate with each other. CONNECTING YOUR PUMP AND TRANSMITTER 1. Attach the transmitter to the charger and make sure it is fully charged. Charger Transmitter 7. Once device is found, confirm that the serial number (SN) shown on the pump is the serial number on the back of your transmitter. Then select Confirm. If you receive the No devices found message, place the transmitter back onto the charger. Then remove the transmitter from the charger and immediately select Retry on the pump.. From the Menu, select Utilities and then Device Options. 3. Select Connect Device. 8. Connection is now complete. CHARGING THE GUARDIAN LINK TRANSMITTER 4. Select Auto Connect. 5. Read the message that appears. Press and select Continue. You will need to charge the transmitter after each sensor use. A fully charged transmitter can be used for a maximum of six days without recharging. It can take up to an hour to fully recharge. When the transmitter is charging, a green light will flash on the charger. This green light will turn off when the transmitter is completely charged. CLEANING THE GUARDIAN LINK TRANSMITTER 1. Wash your hands thoroughly and attach the tester to the transmitter. 6. Make sure the transmitter is on the charger before proceeding. Now start the search process on both devices: a. Remove the transmitter from the charger. If green light on transmitter does not flash, reconnect to charger until fully charged. b. Immediately select Search on the pump.. Dampen a clean cloth with mild liquid soap and warm water. Wipe the outside of the transmitter. 3. Rinse the transmitter under warm tap water. 4. Using an antibacterial hand-sanitizer on a clean, dry cloth, wipe the transmitter s surface. Do NOT get any hand-sanitizer inside the tester opening or transmitter connector. 5. Disconnect the tester from the transmitter. 6. Place the transmitter on a clean, dry cloth and air dry for -3 minutes. The charger and tester are watertight only when they are connected to each other. 9

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33 ENLITE SENSOR AND ONE-PRESS SERTER QUICK REFERENCE GUIDE INSERTING A NEW SENSOR 5a. Place serter on body. Hold serter steadily against your cleaned insertion site, without pushing serter too deeply into skin. Note: Failing to hold serter securely flat against body may allow serter to spring back after pressing buttons and result in improper insertion of sensor. Wash your hands and clean insertion site with alcohol. 1. Open sensor package. Pull corner of paper covering to open sensor package. 5b. Insert sensor. Press and release bump on both buttons at same time. a. Hold sensor by plastic pedestal. Remove sensor with attached pedestal by holding pedestal only. Place sensor/ pedestal on a clean, flat surface (such as a table). b. Tuck adhesive tab. Make sure that sensor s adhesive tab is tucked under sensor connector and snaps. X Correct Incorrect 3. L oad sensor into serter. Grip serter exactly as shown with thumb on serter thumb print. Do not hold green buttons. Push serter down onto pedestal until base of serter sits flat on table. Incorrect Fingers NOT holding green buttons 4. Detach serter from pedestal. To detach serter from pedestal, grip serter as shown, with thumb on thumb print on serter. With other hand, place two fingers on pedestal arms and slowly pull serter straight up. Note: Make sure that pedestal is firmly on table before pulling serter away. Warning: Do not detach pedestal from serter in midair as this may damage sensor. 5c. Hold serter against body. Continue holding serter against body to allow adhesive time to stick to skin. 5d. Remove serter from body. Slowly pull serter away from skin, making sure buttons are not pressed. 6. Remove needle housing. Gently hold base of sensor against skin with one hand. With other hand, hold the needle housing at the top and slowly pull straight out, away from the sensor. Dispose of needle housing in a sharps container. X Correct 7a. Remove adhesive pad liner. Hold sensor in place and gently remove liner from under adhesive pad. 7b. Press entire adhesive pad to skin. Firmly press adhesive against skin and smooth entire adhesive pad so it sticks to skin. NOTE: Enlite adhesive is pressure-sensitive. Continue applying pressure to ensure sensor remains inserted in skin for whole 6 days of wear. 8a. Untuck adhesive tab. Untuck adhesive tab from under sensor connector. 8b. Straighten adhesive tab. Straighten adhesive tab so it lies flat against your skin, but do not remove adhesive liner yet. 31

34 ENLITE SENSOR AND ONE-PRESS SERTER QUICK REFERENCE GUIDE TAPING THE SENSOR 1. Remove liner marked 1 from overtape. Do not remove two smaller liners marked from sides of overtape.. Important: Attach overtape to both sensor and skin next to sensor. Tape is over both sensor and skin 3. Stretch remaining part of overtape around sensor connector so that overtape sticks to curved adhesive pad and does not block sensor connector and snaps. Continue to press overtape to your skin to help ensure that it sticks securely. 4. Remove two liners marked from the sides of the overtape and press adhesive against the skin. 5. This image is an example of overtape applied correctly. Sensor connector and snaps are not covered and appear in opening of overtape. CONNECTING THE TRANSMITTER 1. With one hand, hold sensor in place. With other hand, connect transmitter to sensor.. You will hear a faint click indicating that two components are connected. Check for a green light to flash on transmitter. 3. Remove liner on adhesive tab. Connector and snaps in hole of tape STARTING THE SENSOR 1. Once Sensor connected message appears, press. This typically takes less than a minute, but may take up to 10 minutes.. Select Start New Sensor. 3. Sensor warm-up started message will appear. Press and then to clear. Warm up... will appear on the Home screen until sensor is ready for first calibration. CALIBRATING 1. Select Snooze.. Pump will display this screen. 3. Test your BG and use it to calibrate sensor. 4. Fold adhesive tab over and onto transmitter. Important: Be careful not to pull adhesive tab too tightly or it may cause transmitter to pull from sensor connector. 5. Press adhesive onto transmitter Once calibration BG is entered, this screen will display. You will begin receiving sensor glucose readings in 5-15 minutes. For additional help in Calibrating See the Getting Started with Continuous Glucose Monitoring page 7.

35 CALIBRATION QUICK REFERENCE GUIDE WHEN TO CALIBRATE THE DAY YOU START YOUR SENSOR: ~ hours after sensor is started Again within 6 hours and before bed EACH DAY AFTER: 3-4 TIMES PER DAY When you wake up or Before Meal 1 Before Meal Before Meal 3 Before Bed Skip calibration if you see or 3 up or down arrows on your pump screen WAYS TO CALIBRATE OPTION 1 Using the CONTOUR NEXT LINK.4 Meter OPTION Using the Bolus Wizard Calculator OPTION 3 Using the Home Screen Graph Select Calibrate Sensor after BG is sent from meter. Select Yes to calibrate sensor after bolus is delivered. Highlight sensor graph, press and hold select. Enter BG and select Calibrate. CALIBRATION TIPS Wash your hands before checking your BG with your meter. Don t wait. Use the BG value to calibrate right away. Before is best. Typically the best times to calibrate are before meals, before taking insulin, and before bedtime when your glucose is most likely to be stable. Avoid calibrating when you see trend arrows above the sensor glucose reading. Be sure to wait at least 15 minutes between calibrations. Calibrate before bed to avoid being woken up by a Calibrate now alert while sleeping. Sensor accuracy may be improved with 3-4 but no more calibrations each day. Calibrate your sensor regularly to ensure that you continue to receive sensor glucose data. If you notice a large difference between your BG and SG readings: Wash your hands and do another BG test. Check the sensor site to be sure the over tape is holding the sensor in place. If it is not, you will need to remove and insert a new sensor. 33

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37 SENSOR ALERTS QUICK REFERENCE GUIDE SENSOR ALERTS This table shows some of the most common alerts that you may receive when using CGM. Remember: To clear an alert, press and then press on the desired option. Alert Reason Steps to take Alert on high Sensor glucose value is equal to or higher than the high limit that you set. Alert on low Sensor glucose value is equal to or lower than the low limit that you set. Alert before high Sensor glucose reading is expected to reach the high glucose limit in the length of time you set for the Time before high. Do not treat your glucose based on SG. Confirm it using your BG meter. Treat if necessary based on instructions from your healthcare professional and continue to monitor. Alert before low Sensor glucose reading is expected to reach the low glucose limit within 30 minutes. Rise Alert Sensor glucose reading is increasing at a rate that is equal to or faster than the Rate Limit that you set. 35

38 SENSOR ALERTS QUICK REFERENCE GUIDE SENSOR ALERTS This table shows some of the most common alerts that you may receive when using CGM. Alert Reason Steps to take Calibrate now A calibration is needed in order to receive sensor glucose readings. Enter BG value into your pump to calibrate. Lost sensor signal Calibration not accepted BG not received Communication between pump and transmitter has been lost for 30 minutes during or after warm-up. The BG meter value could not be used to calibrate; it was too different from the SG value. The transmitter was unable to receive the calibration BG reading from the pump. Check that the sensor is still inserted in the skin and the transmitter and sensor are still connected. Move your pump closer to your transmitter. It can take up to 15 minutes for your pump and transmitter to start communicating. Wash your hands and repeat the BG test. Use this value to calibrate again. Move your pump closer to your transmitter and select OK. The pump will try sending the BG again. Sensor expired Sensor has reached it s maximum usage of 6 full days. Remove the sensor and follow the instructions for inserting and starting a new sensor. Change sensor You have received two Calibration not accepted alerts in a row. Remove the sensor and follow the instructions for inserting and starting a new sensor. Cannot find sensor signal The pump has not received a signal from the transmitter. Disconnect and reconnect your transmitter and sensor and select OK. For a complete list of Alerts and Alarms, refer to the MiniMed 630G System User Guide. 36

39 SMARTGUARD TECHNOLOGY: SUSPEND ON LOW QUICK REFERENCE GUIDE Suspend on Low occurs when your SG reading has reached or fallen below your programmed Low Limit. When Suspend on low occurs, all insulin delivery is immediately stopped. SUSPEND ON LOW OCCURS The Suspend on low alarm screen appears. Insulin delivery has been stopped. If you are alert and able to respond: If you are not able to respond and do not clear the alarm: Press and to clear the alarm. After minutes the pump will begin to siren and will continue to siren. Insulin will stay suspended for hours unless you choose to resume insulin delivery. The Medical device screen will appear. Home screen displays: Suspended on low Shaded area on graph Flashing SmartGuard icon Insulin will stay suspended for hours (unless you choose to resume it). The pump will continue to siren until you clear the alarm. 37

40 SMARTGUARD TECHNOLOGY: SUSPEND ON LOW QUICK REFERENCE GUIDE RESUMING BASAL DELIVERY Automatic Resume Manual Resume Basal insulin delivery will automatically be resumed after the hour maximum suspend time. You will always receive a Basal delivery resumed alert when this occurs. You can choose to resume basal insulin delivery anytime during a Suspend on low event. From the Home screen, select Suspended on low, select Resume basal, and Yes to confirm. SUSPEND UNAVAILABLE After a Suspend on low occurs and insulin is resumed, there will be a period of time when the pump will not suspend again, even if you are below your low limit. If you clear the alarm within hours: insulin will stay suspended for a maximum of hours unless you manually resume insulin delivery. basal insulin will then resume and will not suspend again for the duration of time determined by your Low Snooze setting. after this time has passed, insulin will then be suspended again if sensor glucose is at or below the low limit. If you do not clear the alarm: insulin delivery will remain suspended for hours. basal insulin will then resume automatically and will not suspend again for 4 hours regardless of your sensor glucose value. If you clear the alarm during the 4 hour period, the time before insulin can be suspended again will be reduced to the duration of your Low Snooze setting. TIPS WHEN USING SUSPEND ON LOW Do not miss calibrations. Suspend on low requires that CGM is working. Calibrate before going to bed. Address the lost sensor signal alert. Suspend on low will not be activated if the pump and Guardian Link are not communicating. Check the battery. Change the pump battery when you receive a low battery alert to avoid depleting the battery during a Suspend on low. Suspend on low is not intended to be used to treat or prevent low blood glucose. Confirm your blood glucose using your BG meter. Then treat your confirmed low blood glucose using the Rule or as directed by your healthcare professional. 38

41 CARELINK PERSONAL SOFTWARE QUICK REFERENCE GUIDE WHAT IS CARELINK PERSONAL SOFTWARE? Carelink Personal software allows you to collect information from your insulin pump, continuous glucose monitoring (CGM) device, and blood glucose meter to evaluate your glucose control through a free, secure, web-based software. These reports can be used during office visits to discuss therapy changes with your healthcare professional. You can also monitor your progress to improved glucose management. WHAT DO I NEED TO START? All it takes to get started is an easy upload using the CONTOUR NEXT LINK blood glucose meter or the CareLink USB provided with your Medtronic pump or CGM. SIGN UP IS EASY Before using for the first time, you need to set up a user account and password. Go to: TO CREATE AN ACCOUNT, START AT THE WELCOME SCREEN AND FOLLOW THESE EASY STEPS: Please consult the Getting Started Guide available on the CareLink Personal software homepage for more information on sign up or by accessing CareLink-Getting-Started-Guide 1 From the Welcome screen, click the Sign Up Now button and select language. After you accept the terms of agreement, you ll be asked to create a username and password. The password can be any combination of letters or numbers from 8 to 3 characters long and include one uppercase letter, one number, and one special character. Passwords are case-sensitive. 3 Enter your personal information in all the required fields. You will be asked to follow through the recaptcha feature of enrollment on the bottom of the screen. Check the box and click Submit. Once you have registered, you can log in from the Welcome screen using your new username and password. BROWSER SETUP BEFORE UPLOAD: For Windows 7, 8, 8.1, and 10, you will need Administrator Rights. Windows 7 1 Be sure all open windows in Internet Explorer are closed. Open your Start Menu and click on All Programs RIGHT-CLICK on your Internet Explorer icon and select Run as Administrator. Click Allow in the User Account Control window. Windows 8 or Windows From the Start screen, click the Desktop tile and make sure you are viewing the desktop. RIGHT-CLICK on Internet Explorer icon from the task bar, RIGHT-CLICK again on Internet Explorer in the menu that appears. Select Run as administrator. Click Allow in the User Account Control window. Windows 10 1 From your Start menu on your desktop, Go to All Apps, then Windows Accessories. RIGHT-CLICK on Internet Explorer in the menu list. Select Run as Administrator. Click Allow or Yes in the User Account Control window. 39

42 CARELINK PERSONAL SOFTWARE QUICK REFERENCE GUIDE UPLOADING DATA FROM YOUR DEVICE 1 Go to carelink, enter your user name and password, and click on Sign In. DO NOT CONNECT your CONTOUR NEXT LINK or CareLink USB to the computer until prompted. Click on Upload Data from My Device. Allow the Java Plug-in to load. 3 Choose device and select MiniMed Insulin Pump and click Next. The Check Pump Status... screen will appear, then click Next. 4 Select your pump type. For MiniMed 630G pump, select MiniMed 600 series. For MiniMed 530G pumps and older, select Paradigm series pumps. 5 Enter your pump s serial number as instructed on the Identify the pump screen. 6 Depending on which pump type you selected from Step 4, you will receive either screen. Choose the correct USB linking device you are using. Most commonly, it will be your CONTOUR NEXT LINK meter. Click Next to continue. STILL HAVE QUESTIONS? Please call our 4-Hour HelpLine at , option 1. 7 CONNECT your USB linking device to your computer. The Verify Connections screen will appear to confirm communication between your devices and inform you when setup is complete. Click Finish to continue. NOTE: MiniMed 630G pump users, you will be prompted by the pump to Connect Device. Select Yes on your pump to allow connection A progress window will then be displayed. The amount of time it takes to upload your data will depend on how much data needs to be uploaded. When the upload completes successfully, you are now able to view your reports. For a list of supported operating systems please see: carelink-personal Please visit for detailed product and important safety information.

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44 18000 Devonshire Street Northridge, CA 9135 USA Toll-free: (4-hour technical support for physicians and medical professionals) Ascensia, the Ascensia Diabetes Care logo and Contour are trademarks and/or registered trademarks of Ascensia Diabetes Care. PP-CNL-.4-US-0043 Bolus Wizard, CareLink, Guardian, Enlite, MiniMed are registered trademarks, SmartGuard is a trademark, and StartRight is a service mark of Medtronic MiniMed, Inc. M96887A001_B 950M Medtronic MiniMed, Inc. All Rights Reserved.