Insulin Pump

Q: How small is the MiniMed Paradigm^® Insulin Pump?
A: The MiniMed Paradigm^® 522 Insulin Pump is about the size of a cell phone, measuring just 5.1 x 7.6 x 2 centimetres. The 722 model is about 1.5 cm longer than the 522 Insulin Pump: Exact dimensions are 5.1 x 9.1 x 2 centimetres.

Q: How light is the MiniMed Paradigm^® Insulin Pump?
A: A MiniMed Paradigm^® 522 Insulin Pump with a full reservoir weighs just 100 grams. The MiniMed Paradigm^® 722 Insulin Pump with a full reservoir is just 108 grams.

Q: What is the MiniMed Paradigm^® Insulin Pump's reservoir size?
A: The MiniMed Paradigm^® 522 reservoir has a maximum capacity of 176 units, which meets the needs of most people who use up to 50 units of insulin daily. The MiniMed Paradigm^® 722 Insulin Pump offers the benefit of a small-sized insulin pump while offering a larger reservoir size. The MiniMed Paradigm^® 722 Insulin Pump can hold up to 300 units of insulin; it can also use either of the two MiniMed Paradigm^® reservoirs - the 1.76 ml (MMT-326A) or the 3.0 ml (MMT-332A) reservoir.

Q: What is the difference between the MiniMed Paradigm^® 522 and 722 Insulin Pumps?
A: MiniMed Paradigm^® 522 and 722 Insulin Pumps have the same features and capabilities. The only difference between the two insulin pumps is the reservoir size each can hold. The MiniMed Paradigm^® 722 Insulin Pump can accommodate either a 3 ml reservoir (MMT-332A), which holds 300 units of insulin, or a 1.76 ml reservoir (MMT-326A), which holds 176 units of insulin. The MiniMed Paradigm^® 522 Insulin Pump can accommodate just the 1.76 ml reservoir.

Q: How do I determine which MiniMed Paradigm^® Insulin Pump is right for me?
A: We have designed the MiniMed Paradigm^® 722 Insulin Pump for patients who use more insulin or anticipate using more (specifically, more than 50 units daily). The MiniMed Paradigm^® 722 Insulin Pump can hold up to 300 units of insulin. It can use either of the two MiniMed Paradigm^® reservoirs - the 1.76 ml (MMT-326A) or the 3.0 ml reservoir (MMT-332A). If you are anticipating life changes (such as pregnancy or adolescence), or are currently using more than 50 units of insulin daily, you may want to consider the MiniMed Paradigm^® 722 model for its larger reservoir capacity and the flexibility to upsize or downsize your reservoir.

The MiniMed Paradigm^® 522 model is ideal for people who require less than 50 units of insulin per day. It can accommodate our 1.76 ml reservoir (up to 176 units of insulin), and is the best choice for people who want the maximum discretion offered by the smaller, lightweight design of the Paradigm^® 522 Insulin Pump.

Please note: Discuss this decision with your healthcare professional since it relates to your insulin use.

Q: What is the programming unit for basal rates on the MiniMed Paradigm^® Insulin Pump?
A: The MiniMed Paradigm^® Insulin Pump can be programmed in 0.05 unit basal increments.

Q: What infusion sets are available for MiniMed Paradigm^® Insulin Pumps?
A: Medtronic offers a wide variety of infusion sets for use with the MiniMd Paradigm^® Insulin Pump. Every MiniMed Paradigm^® infusion set can be used with a Serter^TM auto-insertion device for easy, fast, reliable, and virtually painless insertion.

MiniMed Paradigm^® Infusion Sets

Quick-setTM infusion set (10/box)
MMT-396	43" tubing with 9 mm cannula
MMT-397	23" tubing with 9 mm cannula
MMT-398	43" tubing with 6 mm cannula
MMT-399	23" tubing with 6 mm cannula
SilhouetteTM infusion set (10/box)
MMT-377	17 mm cannula, 43" full set (10 complete sets)
MMT-379	17 mm cannula, 43" combo set (10 sites/5 tubing sets)
MMT-378	17 mm cannula, 23" full set (10 complete sets)
MMT-380	17 mm cannula, 23" combo set (10 sites/5 tubing sets)
MMT-381	13 mm cannula, 23" full set (10 complete sets)
MMT-382	13 mm cannula, 43" full set (10 complete sets)
Sof-Set Ultimate QRTM infusion set (12/box)
MMT-317	42" Quick ReleaseTM soft plastic cannula set
MMT-318	24" Quick Release soft plastic cannula set
Sof-Set Micro QR® infusion set (12/box)
MMT-324	42" Quick Release soft plastic cannula set (6mm catheter)
MMT-325	24" Quick Release soft plastic cannula set (6mm catheter)

Q: When I order a MiniMed Paradigm^® REAL-Time System, which infusion set will I receive?
A: You will initially receive samples so you and your trainer can define the best infusion set to suit your needs.

Q: How do I decide which set is right for me?
A: Information on each type of infusion set is available here

Q: Can I use sets from other manufacturers with the MiniMed Paradigm^® Insulin Pump?
A: It is important to understand that we do not test reservoirs and infusion sets from other manufacturers. As a result, we cannot, and do not, guarantee or warrant the performance of reservoirs and infusions sets not designed by us, and your warranty may not cover damage or malfunction caused by another reservoir or infusion set.

Q: Can I swim or bathe while wearing a MiniMed Paradigm^® Insulin Pump?
A: The insulin pump is water resistant, which means that it is designed to withstand accidental dunks or splashes.  However, you should temporarily disconnect your MiniMed Paradigm^® Insulin Pump while bathing or if you plan to be in the water. Talk with your healthcare professional to establish a plan for diabetes management while you are disconnected if you plan to remove it regularly for swimming or other activities.
The Truth About Watertight

Q: How much continuous glucose monitoring (CGM) system data can the insulin pump store?
A: The insulin pump stores the last 90 days of CGM system data, which can be downloaded for historical analysis.

For additional Insulin Pump Tips:
Helpful Tips

MiniLink^TM REAL-Time Transmitter

Q: What is the transmitter?
A: The MiniLink^TM REAL-Time Transmitter attaches to your body separately from your infusion set and connects to the glucose sensor. Using radio frequency, the transmitter sends glucose data from the glucose sensor to the insulin pump which displays a reading every five minutes.

Q: What type of batteries does the transmitter use?
A: The MiniLink^TM REAL-Time Transmitter has a self-contained battery, which cannot be changed, but can be recharged using the battery-powered MiniLink^TM charger.

Q: What is the warranty for the MiniLink^TM REAL-Time Transmitter and charger?
A: Each has a 6-month warranty and a 6-month extended service program available outside the warranty period*.

* The following are requirements for the extended service program: 1. confirmation with the 24 hour helpline of non-function, 2. purchase of a box of 10 sensors, 3. completion of Transmitter Replacement Form.  Once the transmitter is out of the extended service period, a new transmitter can be purchased at a cost of $350 with a new warranty and extended service.

Q: How will I know when the MiniLink^TM REAL-Time Transmitter battery is getting low?
A: When the MiniLink^TM REAL-Time Transmitter reaches a low battery condition, it will notify the insulin pump. The insulin pump then displays a "LOW TRANSMTR" notification. From the first "LOW TRANSMTR" notification of a low battery, you have about five days of continuous use before the battery is completely depleted. You will then receive a "BAD TRANSMTR" notice which means the transmitter battery has been used up.

Q: What is the operating range between the MiniLink^TM REAL-Time Transmitter and the insulin pump?
A: The MiniLink^TM REAL-Time Transmitter and the insulin pump must be within six feet (approximately two metres) of each other for wireless transmission to occur.

Q: What happens when the MiniLink^TM REAL-Time Transmitter and insulin pump move out of range?
A: If the MiniLink^TM REAL-Time Transmitter and insulin pump are too far apart (about six feet or two metres), an alert will sound and either a "WEAK SIGNAL" or "LOST SENSOR" message will appear on the screen.
The MiniMed Paradigm^® REAL-Time System allows the user to set the period of time the insulin pump will wait before alerting you of a failed reception of continuous glucose monitoring (CGM) data from the transmitter to the insulin pump. The delay can be set for anywhere from 5 minutes to 40 minutes. The default setting is 30 minutes.

Q: How much data does the MiniLink^TM REAL-Time Transmitter store? If I move outside of the six foot (two metres) transmission range - will I lose my data?
A: When the MiniLink^TM REAL-Time Transmitter is separated from the insulin pump for more than six feet (approximately 2 metres), the transmission is considered "out of range." The transmitter holds 40 minutes worth of memory, so even though your system is "out of range," continuous glucose monitoring (CGM) data can be re-populated in the insulin pump.
If your system is out-of-range for longer than 40 minutes, when reviewing historical reports you would notice "data gap" where information is missing during this period of time.

Q: Can I swim, shower, or bathe with the MiniLink^TM Transmitter?
A: Yes, the transmitter is waterproof, so you can swim, shower, or bathe with the transmitter and glucose sensor connected. The transmitter with the glucose sensor connected can be worn to a depth of eight feet (2.4 metres) for 30 minutes. However, we do not recommend immersing the MiniLink^TM in very hot water (like a jacuzzi).  

To participate in water activities, you can easily disconnect from your insulin pump. As long as the transmitter is within 6 feet (approximately 2 metres) of the insulin pump, continuous glucose monitoring (CGM) data will be displayed on the insulin pump's screen.

Glucose Sensors

Q: What is a glucose sensor?
A: The glucose sensor is a tiny electrode worn for up to three days. Following a 2-hour initialization period, the glucose sensor measures glucose levels in the interstitial fluid, which is where cells get oxygen and nutrients, including glucose. The glucose sensor is easily inserted into the skin (subcutaneous tissue) by patients, caregivers, or healthcare providers using the Sen-serter^TM automatic insertion device. Like many types of infusion sets, a needle is used to introduce the glucose sensor, but the needle is then removed leaving a tiny flexible electrode just under the skin. The glucose sensor is then connected to the transmitter so the readings from the glucose sensor can be transmitted to and displayed on your insulin pump.

Q: Does the glucose sensor infuse insulin?
A: The glucose sensor measures glucose levels in your body's interstitial fluid (fluid between the cells). It does not infuse insulin, nor does the measurement automatically cause the insulin pump to infuse a certain amount of insulin. Insulin is administered through a traditional infusion set that should be inserted at least 2 inches away from the glucose sensor site. The Bolus Wizard^TM calculator will help you decide on insulin doses during the day, after you enter a glucose reading from a confirmatory fingerstick measurement.

Q: In what temperature range should I store my glucose sensors?
A: Glucose sensors are shipped in a protective foam container containing chilled gel packs designed to protect glucose sensors from temperature changes during shipment.

• Glucose sensors can be stored at temperatures ranging from 2° to 27° Celsius without the need for refrigeration or cooling.
• For any temperature greater than 27° Celsius, glucose sensors must be stored in a cooled environment (such as in an ice chest or refrigerator).
• For any temperature lower than 2° Celsius, glucose sensors must be stored in a warmer environment (you will want to avoid freezing conditions).
• As a general reminder, glucose sensors should not be frozen, or placed in direct sunlight, extreme temperatures or high humidity.
• Of course, you can continue to store your glucose sensors in a refrigerator if you choose.

Q: How long do glucose sensors last? Do they expire?
A: Glucose sensors have a six-month expiration date from the time they are manufactured. An expiration date will appear on the outside of the glucose sensor box and on each individual glucose sensor package.

Q: Where are the preferred body locations for wearing a glucose sensor?
A: Placement of the glucose sensor may be affected by clothing, comfort, individual preference or experience. In the case of people using insulin, users may want to avoid recent infusion sites. While many people choose the abdominal stomach area, an alternative location is on the upper buttocks. This location is less likely to be bumped or affected by clothing at the waistline.

Differences Between Blood Glucose Metre and Continuous Glucose Monitoring (CGM) Readings

Q: Why can't I use a sensor glucose reading to adjust insulin levels?
A: Patients and clinicians have a lot of experience with blood glucose meters. However, they do not have nearly as much experience with REAL-Time Continuous Glucose Monitoring (CGM). The diabetes community is just beginning to learn about this new technology.

It is important that you continue to use your meter to confirm sensor glucose readings before treatment. Take a fingerstick measurement before adjusting your insulin levels, as well as for calibrating the CGM system.

An important benefit of using a CGM system is REAL-Time readings and trend graphs. They allow you to be proactive so you can avoid severe highs and lows, and take action much earlier. With this information, you will be able to confidently make changes to your daily glucose management.

Q: Do I enter the fingerstick reading or the CGM reading into the Bolus Wizard calculator?
A: You should enter the fingerstick reading into the Bolus Wizard calculator.

Q: The CGM readings do not match my meter readings. Should I be concerned about this?
A: No, the important thing about REAL-Time CGM systems is the trend information as opposed to the actual numbers. If you are comparing numbers, you may want to consider that even though meters have been the standard for diabetes care, their readings vary. For example, it is unlikely that two consecutive meter readings from the same blood sample will match. The odds are worse if you compare readings from two different meters. Perfectly matched readings - whether they come from meters or CGM systems, are unlikely to happen.

If your sensor glucose reading differs greatly from your meter readings, your glucose may be changing rapidly. It could be that you have recently eaten something. In about an hour, you will probably find that your glucose sensor and meter readings are more closely aligned.

The advantages of REAL-Time CGM are the trend graphs. The trend graphs allow you to see when glucose is trending up or trending down and how fast it is moving. All of these things help you by providing timely information.

REAL-Time Alarms

Q: What are the high and low glucose alert thresholds that I can set?
A: High alert thresholds can be set as high as 22 mmol/L and the minimum low alert threshold can be set as low as 2.2 mmol/L. High and low threshold ranges can be customized by the user.
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Q: Is there anything I can do to reduce the number of alarms I get?
A: Yes, you can reduce the number of alarms you get by adjusting your user settings.
For example, you can change your high and low alert thresholds to levels that are appropriate for you. In addition, you can disable the "high glucose" alarm when you know you are going high. Another option is to adjust the time duration of the "snooze alarm" so that you receive fewer reminders. Other alarms can be avoided by taking action before they occur, such as doing your calibration on a regular schedule and keeping your transmitter within 6 feet (2 metres) of the insulin pump so that synchronization is not lost.
You will still get alarms, but it is important to realize that each alarm serves a meaningful purpose. You need to pay attention to the number and type of alarms you receive so that you can fine tune your settings and optimize your response.
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Q: How loud are the alarms, will they wake me up while I sleep?
A: The alarm is loud enough to wake most persons to take action. The system emits alarms of more than 50 decibels at 1 metre.

Q: What is a CAL ERROR and what should I do when I get one?
A: A CAL ERROR happens when a meter reading vastly differs from a CGM reading. There are three main reasons this can happen:

1. If you have an inaccurate meter reading, or a long delay between taking your fingerstick and entering your meter value into the CGM system, or if you use more than one blood glucose meter to calibrate
2. If you calibrated when your glucose is changing rapidly - such as after a meal
3. If there is something wrong with the sensor

If you get a CAL-ERROR, you should wait at least 15 minutes (or longer if you are in a circumstance of rapidly changing glucose values) before calibrating with a new meter reading. This will rule out whether the first meter value was accurate or not. If your glucose was changing rapidly, waiting a while allows your glucose to stabilize so that doesn't cause another error.

If the new meter reading is still very different from the CGM reading, the sensor may need to be replaced. In this case, the system will display a second CAL-ERROR message, followed by a "SENSOR END" message, and you will need to replace the sensor.

Q: I wear a Paradigm^® System and I sometimes get a WEAK SIGNAL or LOST SENSOR message. What does this mean?
A: In order to receive signals, your transmitter and insulin pump must be within 6 feet (2 metres) of each other. If they are outside of this range, you may lose your signal. Sometimes if you are too close to certain devices, such as cell phones, cordless phones, wireless networks, televisions and radios – they can interfere with your transmitter signal. If your signal is completely lost for about 45 minutes you will receive the LOST SENSOR message.

Calibration

Q: Does the MiniMed Paradigm^® REAL-Time System replace fingerstick measurements?
A: No. You still need to use your blood glucose meter to confirm a continuous glucose monitoring (CGM) reading and to calibrate the CGM system.

Q: Why do I have to calibrate?
A: Calibration is like buying a watch and setting the time for the first time. Glucose sensors are similar in nature. To initialize a glucose sensor, you need to enter a meter reading to give the system a starting point. And, just as a watch needs to be adjusted occasionally, so does a glucose sensor. You need to enter at least two meter readings a day - once every 12 hours. This aligns the glucose sensor with the meter so that continuous glucose monitoring (CGM) readings are representative of your blood glucose level.

Q: How often do I have to calibrate the system?
A: The MiniMed Paradigm^® REAL-Time System must be calibrated a minimum of twice a day (once every 12 hours). This is done by entering a fingerstick value into the insulin pump. However for best results, the system should be calibrated 3 to 4 times per day, with the calibrations spread throughout the day at periods when glucose is not changing rapidly.

Q: If I calibrate more often, will the glucose sensor be more accurate?
A: Not necessarily. The best practice is to calibrate 3 to 4 times per day. You need to spread your calibrations throughout the day.

Q: When should I calibrate?
A: It is best to calibrate when your blood sugar is not changing rapidly. It is recommended that you calibrate on a routine schedule, for instance when you first wake up, before a meal, or before your bedtime snack. Try to find a time during the day when your blood sugar is stable. Make sure you do not calibrate when your blood sugar is changing rapidly, like within the first hour after a meal.