- Treating Low Blood Glucose
- Glucagon — The Insulin "Antidote"
- Hypoglycemia Unawareness
- Treating High Blood Glucose
- How to Check for Ketones
- Preventing Diabetic Ketoacidosis (DKA)
- Guidelines for When You Are Sick
- X-Rays, CT Scans or MRI
- Computers, Cell Phones or Airport Detectors
- Temporary Disconnection Guidelines
Treating Low Blood Glucose
While low blood glucose (BG) levels cannot be completely avoided on insulin pump therapy, most people find that they occur less often and are less severe than with insulin injections. In fact, clinical studies show that BG lows can be reduced by as much as 50% when using insulin pump therapy.
Low BGs occur when there is too much insulin in the body. The excess insulin moves most of the glucose from your bloodstream and interstitial fluid into your cells. Your cells use the glucose and then there is not enough glucose left in the bloodstream and interstitial fluids to provide the energy your body needs to function well or for your brain to think clearly.
Common causes of low BGs on an insulin pump are:
- Having the basal rate set too high for your background insulin
- Taking more insulin than needed for food or to correct a high BG
- Exercising without setting a lower temporary basal rate
- Drinking alcoholic beverages without eating carbohydrate containing foods
A low BG should be treated as soon as it is noticed. Treating mild lows promptly prevents more serious lows from occurring.
| Protocol for Treating a Low BG: 15-15 Rule | |
|---|---|
| If Your BG Drops Below 70 mg/dL: | |
| 1. | Eat 15 grams of carbohydrate |
| 2. | Recheck your BG in 15 minutes |
| 3. | If your BG is still below 70 mg/dL, repeat steps 1 and 2 every 15 minutes until your BG returns to your target range |
| NOTE: If BG is less than 50 mg/dL, start treatment with 20 to 25 grams of carbohydrate. | |
| Did You Know? |
|---|
| Over-treating lows is a common mistake that is made by many people. Often, a person wants to continue eating or drinking until they feel better. Keep in mind, it takes 10 to 15 minutes for carbohydrates to move from the digestive tract into the bloodstream and raise glucose levels. If you are not careful, you will eat more than 15 grams in 15 minutes! Over-treating a low BG results in having a very high BG later. This low-high "yo-yo" effect is very hard on your body. |
Glucagon — The Insulin "Antidote"
Severe lows rarely occur when using insulin pump therapy. However, it is recommended that everyone who takes insulin (whether by injection or an insulin pump) should keep a glucagon emergency kit on hand. Glucagon can be given by injection to help raise glucose levels if you are not able to eat or drink, or you are unconscious. Glucagon raises glucose levels by signaling the liver to release stored glucose.
Your family and friends should know where you keep your glucagon emergency kit and know how to use it! Don't forget to inform new roommates or new spouses. Also, be sure to check the expiration date on your glucagon every year.
You Need Glucagon If:
- You are unconscious and your glucose level is either unknown or below 60 mg/dL
- You are conscious and in a hypoglycemic episode but unable or unwilling to ingest food to treat the reaction
How Is Glucagon Supplied?
Glucagon Emergency Kits are available through pharmacies with a prescription from your doctor. The kit contains 2 items: a syringe filled with diluting fluid, and a vial with powdered glucagon. Since the glucagon is not stable after it is mixed, it must be mixed just before use.
The cost of glucagon should be covered under your insurance policy. You will need to replace it once a year. If you have 80% coverage, the cost to you will probably be less that $6.
Who Should Teach My Family to Give Glucagon?
Your healthcare provider or pharmacist can teach your family members and caregivers when and how to give glucagon. They should be told "Don't worry, you can't injure or hurt anyone by giving this medicine." One suggestion is to take a 3 x 5 card and have the person write the steps down in their own handwriting.
Hypoglycemia Unawareness
Life in the modern world is full of distractions, and unfortunately these can sometimes cause the symptoms of impending hypoglycemia to go unnoticed. The noisy children, demanding boss, and a host of daily concerns can cause us to "tune out" what our bodies are trying to tell us.
More dangerous is a phenomenon that can affect people who have had diabetes for a long time or who have experienced multiple bouts of hypoglycemia. Known as "hypoglycemia unawareness," this is a syndrome in which the normal warning signs of hypoglycemia fail to appear. When the body fails to provide the physiological warning signs that a hypoglycemic episode is about to happen (for example: the pounding heartbeat, the dizziness, the sweaty palms, etc.) there is even less time to take corrective action, such as ingesting carbohydrates.
If you have lost your early warning systems for hypoglycemia, you may want to talk to your healthcare team about using a Personal CGM device. Personal CGM devices monitor the trends your glucose levels take and can alert you to a potential hypoglycemic episode before it occurs.
Treating High Blood Glucose
Hyperglycemia or high blood glucose (BG) means there is too much glucose in the blood. This occurs when there is too little insulin available in the body. A major goal of managing diabetes is to avoid high BGs as much as possible and to properly treat a high as soon as it is noticed because:
- Exposure to high glucose levels over time can cause diabetes related complications (such as eye, kidney, and nerve ending damage).
- Under certain circumstances, high BGs that occur because of inadequate insulin can develop into a serious complication known as diabetic ketoacidosis (DKA).
Causes of Hyperglycemia
Glucose levels can rise too high for many reasons:
- Food can cause BG levels to rise too high if you do not take enough insulin to cover your food (especially if carbohydrate grams are not counted correctly, or if a food bolus is missed)
- Illness or Infection (such as cold, flu, or stomach virus) can cause BG levels to run higher than usual. Using a temporary basal rate to cover increased basal insulin needs can help keep BG levels in better control during an illness.
- Stress (emotional or physical) can cause your BG level to run high.
- Medications (prescription and over-the-counter) can affect your BG. Consult with your healthcare provider to determine if your medication could be affecting your BG control.
- Weak Insulin can cause high BGs. Insulin can lose its strength if it is exposed to extreme heat or cold, if it has expired or if it has been used too long (not changing the insulin reservoir)
- Not receiving insulin because an infusion set has become kinked, dislodged or is leaking. Although this rarely occurs, it can happen. Always check to see if this could be the cause of an unexplained high BG, especially if your BG level is not decreasing in response to a correction bolus
You should never ignore a high BG reading when using insulin pump therapy.
Most hyperglycemia occurs when there is some insulin in the body, but not enough to keep glucose levels within your target range. These high BG levels can usually be corrected by delivering a correction bolus.
| Protocol for Treating A High BG Lower than 250 mg/dL | |
|---|---|
| 1. | Enter the BG reading into your insulin pump. |
| 2. | Allow the Bolus Wizard® feature to calculate the amount of correction insulin you need. |
| 3. | Allow the insulin pump to deliver the correction bolus. |
| 4. | Recheck your BG in an hour to make sure your BG is coming down. |
If your BG is higher than 250 mg/dL, you should check for ketones and follow the protocol for treating BGs higher than 250 mg/dL.
Protocol for Treating A BG Higher than 250 mg/dL
CHECK for KETONES
| If KETONES are NEGATIVE | |
|---|---|
| 1. | Take a correction bolus of insulin (you can use your insulin pump). |
| 2. | Re-check your BG in one hour. If your BG has started to decrease, continue to monitor your BG until it is normal. |
| 3. | If your BG has not started to decrease 1 hour after the first correction dose, take a correction dose of insulin (using a syringe). Change your infusion set, reservoir and insulin. Continue to check your BG until normal. |
| If KETONES are POSITIVE | |
|---|---|
| 1. | Take a correction dose of insulin using a syringe. |
| 2. | Change your infusion site, infusion set, reservoir and insulin. |
| 3. | Follow the "Not Responding to a correction Bolus? Try These…" to see if there is a problem with your insulin pump or infusion set. |
| 4. | Check your BG every 1 to 2 hours, continue to take insulin (as needed) using a syringe until glucose levels are normal. |
| 5. | Drink plenty of water or non-carbohydrate fluids. |
| 6. | If your BG continues to rise or if you have moderate to high ketones, nausea, vomiting or difficulty breathing notify your healthcare provider or go to the nearest emergency room. |
| Following this protocol will help you prevent complications and DKA. | |
| Did You Know? |
|---|
| Positive ketones indicate that you do not have enough insulin in your body, and that you are using fat for energy. |
How to Check for Ketones
Checking for urine ketones is easy and inexpensive. All you need are ketone strips (purchased from pharmacy) and a sample of your urine.
Dip the end of the ketone strip into the urine sample and read the results according to the instructions found on the ketone strip bottle.
Ketones can also be tested with a drop of blood. Ask your healthcare provider which method is best for you.
| Important |
|---|
| Notify your healthcare provider if: ketones are moderate to high, if you have nausea or vomiting or if you have difficulty breathing. |
Preventing Diabetic Ketoacidosis (DKA)
DKA is caused from a lack of insulin. When the body does not receive any insulin or receives inadequate amounts of insulin over a period of time, glucose levels rise and the body is forced to burn fat for energy. When fat is used as the main source of energy, ketones (a waste product of fat) are produced in large amounts and accumulate in the blood. If your body does not receive insulin, DKA can develop. The length of time it takes and how high the glucose levels rise varies, but DKA can occur within a few hours.
Although DKA rarely occurs when using an insulin pump, it is serious and can be life-threatening if not handled correctly. Checking your blood glucose (BG) regularly (4 to 6 times each day), testing more frequently when you are ill, and recognizing and responding appropriately to high glucose levels will almost always prevent DKA.
The good news is DKA does not occur without significant warning signs and can almost always be avoided if you pay attention and take action when warning signs appear.
Warning Signs/Symptoms of DKA
- High BG
- Ketones (in blood and urine)
- Nausea, vomiting and abdominal pain (cramps)
- Confusion
- Lethargy (tired, sluggish or weak)
- Difficulty breathing
- Unconsciousness
| Important |
|---|
| The warning signs of DKA are similar to the symptoms experienced with flu or a stomach virus (nausea, vomiting, stomach pain). Therefore, anytime you have nausea or vomiting, you should monitor your BG closely and check for ketones regularly. The signs and symptoms of DKA will always include high BGs and ketones. Testing for ketones will tell you if DKA may be developing and if you need to take corrective action to prevent it. |
Keep in mind that your insulin pump uses rapid acting insulin.
- If your insulin infusion is interrupted, you can expect to see a fast rise in your glucose levels (usually within a couple of hours)
- Insulin infusion should not be interrupted or suspended for more than about an hour without checking your blood glucose
Guidelines for When You Are Sick
Illness and infections typically cause glucose levels to run high. Because illness causes glucose levels to increase and because the risk of developing DKA is higher when you are sick, you should check your blood glucose (BG) and monitor for ketones frequently.
The importance of checking your BG and monitoring for ketones frequently when you are ill cannot be over emphasized.
Sick Day Guidelines
- Check BG every 2 hours
- Check urine for ketones each time you urinate
- Drink plenty of clear/non-carbohydrate fluids to prevent dehydration
Notify your healthcare provider if you have moderate or high ketones, nausea, vomiting or if your glucose levels remain high.
Keep a few supplies on hand in case you become sick. Recommended items include:
- Sugar-free liquids, such as diet drinks, boullion, and chicken broth, can be used to replace lost fluids and prevent dehydration
- Fluids that contain sugar, such as regular soda, popsicles, and jello, can be used to replace needed calories if you are not able to eat
- Extra glucose meter strips
- Ketone strips
- Medications (sugar-free) for cough, congestion, nausea or vomiting, and fever
X-Rays, CT Scans or MRI
If you are going to have an X-ray, CT scan, MRI or other type of exposure to radiation, take off your insulin pump, transmitter, sensor, meter and remote control and remove them from the area. Your infusion set can be left in your body without concern.
If your insulin pump is inadvertently exposed to a strong magnetic field like an MRI, discontinue use and contact our 24-Hour HelpLine at 1-866-948-6633, select option 1 for further assistance.
Computers, Cell Phones or Airport Detectors
Your insulin pump and Personal CGM device are designed to withstand common electromagnetic interference, including airport security systems. Be sure to carry the Airport Card provided with your insulin pump when you are traveling. (the card states "I am wearing a required medical device prescribed by my physician" and has some space to provide some personal details about you and your insulin pump).
The OneTouch® UltraLink™ Meter, the MiniLink® REAL-Time Transmitter and the Paradigm Link® Blood Glucose Monitor send information to the insulin pump using radio frequency. If other devices that use radio frequency are in use, such as cell phones, cordless phones or wireless networks, they may prevent communication between the insulin pump and the meter. This interference will not cause incorrect data to be transmitted and will not cause any harm to your insulin pump or meter. If it occurs, moving away from or turning off these other devices may allow communication to resume.
Temporary Disconnection Guidelines
Whether it's for a day at the beach or because you want to take a "pump holiday" – returning temporarily to injections will be easier if you establish a plan beforehand.
Discuss with your healthcare provider your specific plan using the chart below as a guideline. Note: This chart assumes that you will use rapid-acting insulin (Humalog® or NovoLog® or Apidra®), and will be taking it by injection.
| Time off Insulin Pump and Necessary Adjustments |
|---|
| Up to 1 hour |
|
| Up to 4 hours |
|
| Overnight |
|
| Up to 24 hours (or longer) |
|
| More than one day |
|
If you have questions about diabetes management while disconnected from your insulin pump, please contact your healthcare provider.
Humalog is a registered trademark of Eli Lilly and Company. NovoLog is a registered trademark of Novo Nordisk A/S. Apidra is a registered trademark of Aventis Pharmaceuticals Inc.
- Wearing an Insulin Pump
- Sleeping with a Medtronic Device
- Intimacy
- Water Activities
- Adjusting Insulin Pump Therapy for Exercise
- Aviation License
Wearing an Insulin Pump
There are many ways to wear an insulin pump. Because the insulin pump is a small hand-held device, about the size of a cell phone, it is easy to conceal completely. You decide where you want to wear it: in a pocket, tucked into a bra or garter belt, or placed in a case that can be worn on a belt. Some people prefer to have their insulin pump visible so access to programming is easy. This can be done with a simple belt clip available with the insulin pump, similar to belt clips used with cell phones.
Check out our online store for some accessory options.
Sleeping with a Medtronic Device
Insulin Pump
With up to 42 inches of infusion set tubing, there are many options available. Some insulin pump wearers place their insulin pump next to them on the bed, while others leave it on a bedside table. Many wearers place the insulin pump under their pillow so they always know where it is. Others put it in a pocket of their pajamas. Check out Unique Accessories to see some options with boxers and nightshirts with small pockets built in. Kangaroo Pump Pockets is another web site you may want to explore.
MiniLink™ Transmitter
At less than 1/4 of an ounce and about the size of a quarter, you will probably not notice wearing the transmitter as you sleep. The only thing to keep in mind is what part of your body do you lie on as you sleep? You won’t want to lie on the transmitter while you sleep as it may interrupt the RF signals being sent to your insulin pump.
Intimacy
Initially, most insulin pump users are concerned about this, but they find that it's not much of an issue as long as it's discussed openly with their partner. Many people prefer to disconnect from the insulin pump and tubing before intimate contact by using the Quick Release™. With a simple twist, the insulin pump and tubing can be detached so that insulin pump therapy is not a part of intimate moments. Or, if you and your partner are comfortable with the insulin pump, just leave it in place. You may want to use 42" tubing length to allow you to place the insulin pump well out of reach. Many insulin pumps have spent an intimate evening nestled in a garter belt. In short, you can do anything with an insulin pump that you can do with injections and, perhaps more importantly, just about anything you would choose to do if you didn't have diabetes!
Water Activities
While the insulin pump is water resistant, which means that it is designed to survive only an accidental dunk or splash, it is a fairly sensitive instrument and should be protected from being immersed in water.
There are several easy ways to handle your insulin pump when bathing, showering, or swimming. Medtronic Diabetes makes several products that simplify this and other every day issues. Many insulin pump wearers like to use the Medtronic Diabetes Quick Release™ (QR®) so that they can easily disconnect from the insulin pump and tubing – leaving only the infusion site in place. Or the insulin pump can be placed in the Shower–Pak™, a specially designed plastic bag that can be hung around the neck or on a faucet handle during the shower. You can even just set the insulin pump on the floor during a bath, letting the tubing drape over the side of the tub.
The MiniLink™ REAL–Time Transmitter when connected with a glucose sensor is waterproof. You can swim, shower or bathe with the transmitter and glucose sensor connected. The transmitter with the glucose sensor connected can be worn for a depth of eight feet (2.4 meters) for 30 minutes. However we do not recommend immersing the transmitter and glucose sensor in very hot water (like a Jacuzzi or hot tub).
There should be no problems due to rain, splashing, or the accidental submersion in water. To participate in water activities, you can easily disconnect from your insulin pump. If the MiniLink transmitter and insulin pump are out-of-range (separated by more than 6 feet) for longer than 40 minutes, only the last 40 minutes will be re-populated. When reviewing historical reports, you would notice a "data gap" with missing information during this period of time.
Talk with your healthcare provider to establish a plan for diabetes management while you are disconnected from your insulin pump if you plan to remove it regularly for swimming or other activity. Click here for some temporary disconnection guidelines you can discuss with your healthcare provider.
Adjusting Insulin Pump Therapy for Exercise
Different activities will cause different effects on glucose levels, during or after the activity. It will take some trial and error to achieve a balance with your particular activities.
Your insulin pump has two features that enable you to make immediate and flexible basal insulin adjustments to compensate for the effect exercise has on glucose levels:
- Temporary Basal Rates (pp 105-112) are used to increase or decrease the basal rate in half-hour increments from 30 minutes to 24 hours.
- Patterns (pp 102-105) can be used to modify the basal rates on exercise days, once you know what basal rate works best with your activities.
You will need to work with your healthcare team to determine the basal rates and features on your insulin pump that will work for your exercise regimen.
CareLink™ Personal
Uploading your device data into CareLink™ Personal is a great way to work with your healthcare team to achieve your individual treatment and exercise goals. This powerful and free tool let you see the effect of meals, insulin dosage and lifestyle on your glucose levels.
Try the tutorial, or sign-on to CareLink Personal today.
Disconnecting for Exercise
For some activities, you may choose to disconnect from your insulin pump. If you use Personal Continuous Glucose Monitoring (CGM), know that if the MiniLink™ transmitter and insulin pump are too far apart (about six feet or two meters), an alert will sound and either a "WEAK SIGNAL" or "LOST SENSOR" message will appear on the screen. Simply, clear any alert and the transmitter and insulin pump will re-synch.
Your system allows you to set the period of time your insulin pump will wait before alerting you of a failed reception of CGM data from the transmitter to the insulin pump. The delay can be set for anytime including and between 5 minutes to 40 minutes. The default setting is 30 minutes.
The MiniLink™ transmitter holds 40 minutes worth of memory, so even though your system is "out of range," CGM data can be re-populated in the insulin pump when the transmitter and insulin pump are back in range. If your system is out-of-range for longer than 40 minutes, be aware when you upload your device data to CareLink™ Personal that there will be a "data gap" with missing information during this period of time.
Aviation License
The Federal Aviation Association (FAA) has established a policy that permits the special issuance medical certification of insulin treated applicants for third class medical certification. In general, the third class medical certification is reserved for students, recreational and private pilots. Click on this link to learn more.
- Food
- Calculating Carbohydrates for Recipes
- Carbohydrate Food Lists Online
- Free Daily Journal
- Unexplained Rise in Early Morning Glucose Levels
- High Carbohydrate Meals — like Pasta and Pizza
Food
It’s not "you are what you eat", but rather "your glucose levels are what you eat." With an insulin pump you have the tools to allow yourself the freedom to indulge once in a while. Knowing how to carb count and how to use your Bolus Wizard® feature appropriately will help you manage your glucose levels.
- For assistance with your carb counting skills, check out the local events in your area and register for a carb counting class today.
- For a refresher on how to use your Bolus Wizard feature, sign on to Pump School Online to review the section on using your Bolus Wizard feature.
If you use a Personal Continuous Glucose Monitoring (CGM) device, you have a tool in your hands that will allow you to see in how specific foods affect your glucose levels in real-time. With the aid of Personal CGM and a confirmatory fingerstick, you can make timely insulin adjustments as needed.
Calculating Carbohydrates for Recipes
Insulin-Pumpers.org has a great article written by Mary Jean Renstrom on how to deal with recipes that don’t provide the nutritional information. When you want to cook your family favorites, check out this link to figure out the carbohydrate content of any food you eat.
Carbohydrate Food Lists Online
- Calorie King — The CalorieKing.com Food Database holds the nutritional information for over 50,000 American generic and brand name foods (including over 260 fast-food chains).
- USDA National Nutrient Database — Look up the nutrient and carb content of almost every possible foodstuff on this U.S. government web site.
- Nutrition Data — One of the most authoritative and useful sources of nutritional analysis on the Web.
- Fast Food Facts — Your source for the most up-to-date nutritional information on your favorite fast food.
- Glycemic Index — Not all carbohydrate foods are created equal, in fact they behave quite differently in our bodies. The glycemic index or GI describes this difference by ranking carbohydrates according to their effect on our blood glucose levels.
Free Daily Journal
Consider uploading your device data into CareLink™ Personal Software. This free tool lets you see the effect of meals, insulin dosage and lifestyle on your glucose levels. It is a great way to work with your healthcare provider to achieve your individual treatment goals. Try the tutorial, or sign-on to CareLink Personal today.
Select the "Logbook" tab to add details to your uploaded data as needed. To review your daily journal, select the "Reports" tab and choose the "Logbook Diary" or "Daily Summary" report after you have uploaded your device data.
If you prefer using a printed version, click here This document requires Adobe Reader to view or print. (103KB Adobe PDF)
Unexplained Rise in Early Morning Glucose Levels
Don’t despair. The unexplained rise in glucose levels happening every morning means you may have a condition called "Dawn Phenomenon." This phenomenon occurs in more than 80 percent of adults with type 1 diabetes1.
It may even be why your healthcare provider prescribed your insulin pump and/or Personal CGM in the first place.
How A Personal CGM System Can Help
After wearing your Personal CGM System for at least 24 hours, upload the data into CareLink™ Personal. Select and view the "Sensor Daily Overview" report. This report can place up to seven days worth of data on one 24-hour time plot. This really helps you see spikes during a particular time period.
Look at the early morning hours. Is there a consistent upward spike around 5:00 AM? If not 5:00 AM, is there one earlier or later in the morning?
If you see a spike, you can work with your healthcare team to change your basal rate prior to the spike so that you can smooth out your overnight glucose control.
How Your Insulin Pump Can Help
If you don’t use a Personal CGM System, you can still follow your overnight glucose levels using your blood glucose (BG) meter and an alarm clock. You will have to wake yourself up a couple times during the night to check your BG using your meter.
Ask your healthcare team for some guidance but generally, you will have to take a fingerstick around midnight, 3:00 AM and 7:00 AM. Make sure your glucose level is greater than 100 mg/dL before going to sleep. Rather than remember to write down all of those readings, you can upload data from your blood glucose meter2 into CareLink™ Personal along with your insulin pump so that you have all your information in one place.
Review your findings with your healthcare provider to pinpoint when you are experiencing dawn phenomenon. Your insulin pump can handle multiple basal rates across time periods customized to your needs. To match the increase in glucose levels caused by the dawn phenomenon, you can program your insulin pump to deliver a higher basal rate amount 2-3 hours before the dawn phenomenon starts, to just before it ends.
Your healthcare provider will want to verify any changes to your basal rates by re-evaluating overnight BGs over the next two to three nights.
1 Perriello G, et al. Diabetologia 34:21–28, 1991.
2 Compare your choice of blood glucose meter with the list here to ensure it is compatible with CareLink™ Personal.
High Carbohydrate Meals — like Pasta and Pizza
The variable bolus features on your insulin pump are designed to better match insulin action to insulin need during periods of extended eating or to compensate for delayed digestion (gastroparesis).
The Square Wave® Bolus allows you to select an amount and duration (from 30 min to 8 hrs) over which time a bolus is to be delivered.
The Dual Wave® Bolus simply combines a Square Wave® Bolus with a Normal bolus and delivers them at the same time.
Use Variable Boluses For
- Prolonged Meals Banquets
- Formal Dinners
- Feasts
- Extended Snacking
- Receptions
- Spectator Sporting Events
- High Fat Meals (e.g., pizza)
- Gastroparesis (delayed digestion)
Bolus Types
| Matching Insulin Action With Carbohydrate Digestion: | |
|---|---|
 |
For prolonged meals, the insulin action of a standard bolus is too quick to adequately compensate for the carbohydrate digestion. Glucose levels go high after meal. |
 |
For gastroparesis (slow digestion), insulin action peaks before carbohydrate (CHO) digestion occurs. Glucose levels run high after meal. |
 |
Using a Square Wave® Bolus, insulin action matches the carbohydrate digestion of prolonged meals or gastroparesis. Insulin levels remain in target range after meals. |
Using The Variable Bolus
Refer to your Insulin Pump User’s Guide for specific instructions on programming the Square Wave and Dual Wave boluses.
Electronic copies of the MiniMed Paradigm REAL–Time System can be located by clicking here. For all other insulin pump models, click here.
- Medtronic Diabetes Support Outside the United States
- Travel Loaner Program
- Storing Glucose Sensors
- Airport Security
- Airport Detectors
- Using My Insulin Pump or Personal CGM On An Airplane
- Temporary Disconnection Guidelines
- Daylight Saving Time
Medtronic Diabetes Support Outside the United States
Before you travel abroad, make certain you have the direct number to Medtronic Diabetes (1.818.576.5555) because the toll-free number (1.800.646.4633) will not work outside the U.S. This phone number is printed on the back of most insulin pump models.
Medtronic Diabetes is a global company with offices worldwide. If you're planning an international trip, please print out our list of World Sales Offices and keep it handy while you travel. In most cases, we can help you source extra insulin pump supplies or Personal CGM supplies should something unexpected happen and you require additional supplies. We can also assist you in locating an endocrinologist internationally.
Travel Loaner Program
Medtronic Diabetes offers a Travel Loaner program for our U.S.-based customers. This program allows you to take a back-up insulin pump with you when you travel outside the U.S. or are taking a cruise. Since international mail services can have delays due to going through customs, and can require customs fees, this program allows you to be prepared when you travel abroad and the unexpected happens.
There is a US $50 fee to cover the shipping and handling costs. Please contact us at least two weeks prior to your trip so we can ensure on-time delivery of your Travel Loaner insulin pump. The program only includes insulin pumps, and does not include blood glucose meters or Personal CGM devices. You will need to turn in your Travel Loaner insulin pump when you return.
To request your Travel Loaner, please complete the easy online form. Enjoy your trip!
Storing Glucose Sensors
Glucose sensors can be stored at temperatures ranging from 36° to 80° Fahrenheit (2° to 27°Celsius) without the need for refrigeration or cooling.- For any temperature greater than 80° Fahrenheit (27°Celsius), glucose sensors must be stored in a cooled environment (such as in an ice chest or refrigerator).
- For any temperature lower than 36° Fahrenheit (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 humidity.
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.
Airport Security
Taking an insulin pump through airport security is quite common. That's because hundreds of thousands of people use insulin pumps—and many travel regularly. Airport tips are enclosed below and apply to travel within the 50 United States. It is subject to change, however, so please also check with the Transportation Safety Administration (TSA). International passengers should consult their individual air carriers for applicable international regulations:
Tips: Insulin Pumps and Security
- Notify security screeners that you have diabetes, that you are wearing an insulin pump and are carrying supplies with you.
- There is no need to remove your insulin pump: Metal detectors will not harm your insulin pump, and insulin pumps often will not trigger metal detectors. Request that they visually inspect the insulin pump rather than removing it from your body. Do not send your insulin pump through the x-ray equipment.
- You should be offered a private screening if a pat down requires the removal or lifting of clothing to display your insulin pump. You may request a private area for your personal search at any time during the screening process.
Tips: Syringes, Supplies and Security
- Doctors' letters are no longer sufficient proof of medical necessity when you are carrying syringes. In order to board with syringes and other insulin delivery devices, you must produce an insulin vial with a professional, pharmaceutical, pre-printed label that clearly identifies the medication. No exceptions will be made. If the prescription is located on the outside of the box that the insulin comes in, you should carry that as well.
- Never store insulin in checked luggage, because it may be exposed to extreme (often freezing) temperatures, which can change its effectiveness.
- Carry your glucagon in its original, pharmaceutically labeled container or box.
- Boarding with lancets will be allowed as long as the lancets are capped and they are carried along with a glucose meter with the manufacturer's name embossed on the meter.
Should you encounter difficulty when trying to pass through airport security, ask to speak with the TSA ground security commissioner or the international equivalent. In addition, the American Diabetes Association (ADA) asks that you contact them at 1.703.549.1500 ext. 1768 if you encounter problems, so that they may be kept informed of airline protocols and security measures.
Tips: General Practices
- Always carry all medications (especially insulin and glucose tablets), snacks and supplies in your carry-on luggage. This can be critical if your luggage is lost, your flight is delayed or if you are otherwise separated from your checked luggage for an extended period.
- Test your glucose more often. Glucose levels can change due to stress, illness or changes in activity or eating while traveling.
- Wear or carry a medical ID indicating you have diabetes.
- Make sure you get up and walk the aisles during long flights to help encourage good circulation, and drink water to avoid dehydration.
Tips: What to Pack — Diabetes and Insulin Pump Supplies
Always pack at least double the amount of supplies you think you'll need.- Extra insulin and an extra prescription in case your luggage gets lost or if your insulin becomes denatured.
- Insulin pump supplies and batteries. Not all Medtronic Diabetes supplies are available in other countries.
- Insulin pump manual and logbook with basal rates.
- Syringes for injections and dosing instructions from your doctor.
- Blood-glucose meter, test strips and lancets.
- Ketone strips.
- Glucagon Emergency Kit® (your travel companions should carry the kit, and know when and how to use it).
- Carbohydrate for low glucose treatment and at least one day's supply of food, for example, nutrition bars, which are easy to carry.
- Medication for diarrhea and nausea.
Airport Detectors
Your insulin pump and Personal CGM device are designed to withstand common electromagnetic interference, including airport security systems. Be sure to carry the Airport Card provided with your insulin pump when you are traveling. (the card states "I am wearing a required medical device prescribed by my physician" and has some space to provide some personal details about you and your insulin pump).
The OneTouch® UltraLink™ Meter, the MiniLink™ REAL-Time Transmitter and the Paradigm Link® Blood Glucose Monitor send information to the insulin pump using radio frequency. If other devices that use radio frequency are in use, such as cell phones, cordless phones or wireless networks, they may prevent communication between the insulin pump and the meter. This interference will not cause incorrect data to be transmitted and will not cause any harm to your insulin pump or meter. If it occurs, moving away from or turning off these other devices may allow communication to resume.
Using My Insulin Pump or Personal CGM On An Airplane
International standards and U.S. Federal Communications Commission (FCC) regulations require that devices using radio frequency capabilities should not be used on an aircraft.
As a result, you must:- Disconnect the transmitter from the glucose sensor while traveling on an airplane; however, you can continue using the insulin pump. It is not sufficient to simply turn off the continuous glucose monitoring (CGM) feature off on the insulin pump because the transmitter will continue to transmit RF signals and must be physically disconnected from the glucose sensor to stop. There is no need to remove the glucose sensor from your skin.
- When on an airplane, you may manually test your glucose levels using a standard meter. As a reminder, when uploading device data into CareLink™ Personal, you will notice "data gap" where information is missing during this period of time.
Temporary Disconnection Guidelines
Whether it's for a day at the beach or because you want to take a "pump holiday" – returning temporarily to injections will be easier if you establish a plan beforehand.
Discuss with your healthcare provider your specific plan using the chart below as a guideline. Note: This chart assumes that you will use rapid-acting insulin (Humalog® or NovoLog® or Apidra®), and will be taking it by injection.
| Time off Insulin Pump and Necessary Adjustments |
|---|
| Up to 1 hour |
|
| Up to 4 hours |
|
| Overnight |
|
| Up to 24 hours (or longer) |
|
| More than one day |
|
If you have questions about diabetes management while disconnected from your insulin pump, please contact your healthcare provider.
Humalog is a registered trademark of Eli Lily and Company. NovoLog is a registered trademark of Novo Nordisk A/S. Apidra is a registered trademark of Aventis Pharamceuticals Inc.
Daylight Saving Time
Most of the United States makes a Spring time change or Daylight Saving Time (DST) at 2:00 a.m. on the second Sunday in March. Daylight Saving Time ends in the United States in the Fall at 2:00 a.m. on the first Sunday in November.
Your device will not automatically "spring forward or fall back" the time for Daylight Saving / Standard Time!
Quick Tip: Update your device when you change your clocks. Changing the time is simple and easy. Just click on your device model below to get time change instructions:
- MiniMed Paradigm® 522/722
- MiniMed Paradigm 515/715
- MiniMed Paradigm 512/712
- MiniMed Paradigm 511
- MiniMed 508
- MiniMed 507C
- MiniMed 507
- MiniMed 506
The above documents require Adobe Reader to view or print.
Also, please remember to synchronize the clocks on your computer, insulin pump, and blood glucose meter so as to maintain the accuracy of time for data when using CareLink™ Personal Software or Solutions® Software to upload your insulin pump's data.
For assistance setting the time on your Windows computer, see microsoft.com.
For assistance setting the time on your blood glucose meter, check with the manufacturer.
- Reordering Supplies
- Product Support
- Support Resources for Kids With Diabetes and Their Parents
- Support Resources for Adults With Diabetes
- Advocacy Groups
- Donating Insulin Pumps and Supplies
Reordering Supplies
Once you experience the ease and benefits of your insulin pump, you won’t want to go a day without it. Since most orders are processed through insurance, this can take some time – usually around 14 days (Medicare and Medicaid have additional requirements, which may extend the time it takes to process your supply order). Your supply reorder options are:
- mySupplyConnection™ – This is an automated ordering process that mails your supplies to you on a regular schedule. In addition to your personal supply needs, the process is based on what your insurance allows. Keep in mind that some insurance plans do not allow automatic reordering or place limits on when reordering can take place.
- Supply Reorder Card – This reminder comes in the mail around the time you need to reorder supplies. By simply checking the acceptance box, signing the pre-paid postage card and dropping it into the mail, your supplies will be shipped to you, and your insurance company will be billed directly. It’s that easy.
- Online Store – Create a myAccount and order online for convenient, free home delivery.
- Call Live Agent – Speak live with a representative in our Supply Order Sales Department by calling 1-866-948-6633 and selecting option 2, Monday through Friday, 6:00 AM to 4:00 PM Pacific Time.
Product Support
In the event that you have a question about one of your Medtronic devices or suspect something is wrong with your insulin pump or MiniLink® transmitter, you should call Medtronic Diabetes’ 24-Hour HelpLine: 1-866-948-6633, select option 1.
If we are unable to resolve the problem by troubleshooting over the phone, we will instruct you on how to return your product. In its place, a replacement product will be sent out to you based on your warranty status.
The MiniMed Paradigm® Insulin Pump is very reliable and sturdy. Over the years, we have diligently implemented quality improvements in an effort to ensure that our insulin pumps are dependable. With more than 25 years of product innovation, and more than 200,000 people on Medtronic Diabetes insulin pumps, we are committed to creating safe, reliable products – and being there when you need us. 24 hours a day, every single day of the year.
Support Resources for Kids With Diabetes and Their Parents
- Children with Diabetes – An informative site with lots of diabetes info pertaining to children. Contains a very good listing of Web resources.
- ADA – The section for "Parents and Kids" provides all kinds of great stuff to help you stay in control of your diabetes. A very useful resource site.
- JDRF Kids Site – Lots of cool info!
- Pump Girls – A singing, pumping phenomenon! These teens have a CD and a message: "kids with diabetes take charge of your life!"
- Children Have Rights In School – The goal of this organization is to make changes in local and national legislation regarding the needs and rights of schoolchildren who have diabetes.
- My Child Has Diabetes – Online support for parenting a child with diabetes.
- World's Youngest Known Pumper at 10 Days Old – A brief article with photo of our youngest known insulin pumper.
Support Resources for Adults With Diabetes
- Insulin Pumper’s Home Page – The only web site focused on insulin pumps. A community of over 20,000 pumpers. You can chat in a number of different rooms
- Take Control of Your Diabetes – TCOYD’s Vision is to enable all people with diabetes and their loved ones to have full access to proper education and therapy.
- NIDDK – The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) conducts and supports basic and clinical research.
- dLife – A website (and TV show) dedicated to diabetes lifestyle and diabetes community
- Diabetes Health – This website supports the print magazine by the same name. Diabetes patients, caregivers and researchers worldwide recognize Diabetes Health magazine as the essential resource for living long and well with diabetes.
- On-Line Diabetes Resources – David Mendosa’s excellent compilation of diabetes resources. Review this site for its chat rooms as well as listings of updated industry news on diabetes.
- DiabetesFriends Network – This is a free social network for people with diabetes or people with an interest in diabetes.
- IDEA 2000 – This is an international group of people with insulin dependent diabetes committed to leading healthy and adventurous lives.
- Fit4D – This organization provides an innovative coaching program that pairs a team of diabetes experts with you to address the unique healthcare, fitness and nutritional needs a person with diabetes has with regards to exercise.
- Diabetes Exercise & Sports Association (DESA) – The goal of this organization is to enhance the quality of life for people with diabetes though exercise and physical fitness.
- American Association of Clinical Endocrinologists (AACE) — Mostly info for its professional membership, with much on diabetes.
Advocacy Groups
- American Diabetes Association (ADA) – This is ADA central, a must visit and explore.
- Juvenile Diabetes Foundation (JDF) – Good info on the disease and funding activity for a cure.
- Canadian Diabetes Association – The Canadian Diabetes Association works in communities across Canada to promote the health of Canadians and eliminate diabetes.
- International Diabetes Federation (IDF) – is a global alliance of over 200 diabetes associations in more than 160 countries, who have come together to enhance the lives of people with diabetes everywhere.
Donating Insulin Pumps and Supplies
- The Charles Ray III Diabetes Association provides medical devices and supplies to those unable to afford the cost