How to: Use the missed Bolus Reminder

How to use the missed Bolus Reminder

I was sitting in a 1:30pm meeting when my pump went “Beep beep beep”. It didn’t sound like a sensor alert. I knew my reservoir was half-full. And I was sure that I hadn’t hit any buttons out of the ordinary. I looked down at the screen and it read “MISSED BOLUS.” 

I scrolled to review my bolus history. Oops. As a matter of fact, yes, I did miss a bolus. It was a busy day, and I got wrapped up talking with a fellow coworker during lunch. My lunch bolus totally slipped my mind. I checked my blood sugar and it hadn’t gone too high yet, so I was able to bolus accordingly. Crisis averted. Phew! 

I was familiar with the “Bolus Reminder” feature, but up until recently, I never actually used it. When I went through my MiniMed 530G training, my trainer asked me why I didn’t have the feature turned on. I let her know missing boluses just wasn’t something I ever did, and in my decade-plus on a pump, I could count on one hand how many times this had occurred. I also let her know that my meal times can widely vary depending on the day, and I didn’t want my pump to alert me more than it needed to. She let me know that it’s a great safety net and there really isn’t a downside to setting it up. Once I better understood the feature, I completely agree. 

Since I turned on this feature, it’s actually alerted me a few times. Sometimes it reminds me of an actual missed bolus (like during my meeting), while other times it just reminds me that I’m likely too wrapped up in my afternoon task, and it’s been too long since I’ve eaten. I’ve found both of these use cases to be helpful! 

Here is how it works. The Missed Bolus Reminder can either be turned on or off. If you turn it on, you can set up to four different time periods throughout the day you want to receive a meal bolus reminder. If a bolus hasn’t been given by the end of the set time period duration, you’ll receive a “Missed Bolus” alert. I have two set up, one from 11:00am-1:30pm and the other from 6:00pm-9:00pm. These are the extended time periods when I typically eat lunch and dinner, so if my pump doesn’t document that I’ve bolused during these time frames, it triggers a “Missed Bolus” alert. I used to think my pump would remind me at 11:00am and 6:00pm to bolus, but that isn’t the case. It reminds me at 1:30pm and 9:00pm if I haven’t bolused. 

It can be good if you’re just busy like me, or you can set them within smaller time constraints if you need to be reminded to bolus at all of your meals. Sometimes life just happens, and it’s nice to know that this feature can be there to alert you in case you ever need it. 

Do you use this feature? Why or why not? If you’re interested, here are the steps to set up Missed Bolus reminders on the MiniMed 530G system. Check your user guide for more information. 

Add, Delete, and Review Bolus Reminders 

You have to turn on the Missed Bolus Reminder option to add, delete and review the programmed reminders.

1. Go to the MISSED BOLUS REMINDER screen.

Main > Bolus > Bolus Setup > Missed Bolus Reminder

2. Select On/Set, then press ACT.

Add 

You can set up to four Missed Bolus Reminders.

1. Select Add Reminder on the MISSED BOLUS REMINDER screen, then press ACT. 

2. The Start Time flashes. Times can be entered in 30 minute increments. Set the Start Time, then press ACT. 

3. After this time is set, the End Time flashes. Set the End Time, then press ACT.

If you enter the same Start Time and End Time, you will get one Missed Bolus Reminder in a 24 hour period. If you add a Missed Bolus Reminder with a start time earlier than the current pump time, you will not get this Missed Bolus Reminder until the next day. 

Delete

1. Select Delete Reminder on the MISSED BOLUS REMINDER screen and press ACT. 

2. In the DELETE REMINDER screen, highlight the bolus reminder that you want to delete and press ACT.

Review

1. Select Review Reminders on the MISSED BOLUS REMINDER screen and press ACT. 

2. Review your Missed Bolus reminders.

 IMPORTANT SAFETY INFORMATION

- Medtronic Diabetes insulin infusion pumps, continuous glucose monitoring systems and associated components are limited to sale by or on the order of a physician and should only be used under the direction of a healthcare professional familiar with the risks associated with the use of these systems. 

- Successful operation of the insulin infusion pumps and/or continuous glucose monitoring systems requires adequate vision and hearing to recognize alerts and alarms.

Medtronic Diabetes Insulin Infusion Pumps

- Insulin pump therapy is not recommended for individuals who are unable or unwilling to perform a minimum of four blood glucose tests per day. 

- Insulin pumps use rapid-acting insulin. If your insulin delivery is interrupted for any reason, you must be prepared to replace the missed insulin immediately. 

For more information, please visit: MedtronicDiabetes.com/isi.

 

Related Articles

About Author

Blog comments

Submitted by Cathy Brockie (not verified) on

In reply to by Commenter (not verified)

My charger for the transmitter stopped working last evening, 2/2/15; I called medtronics and was told it would take 3 days to ship; I mentioned by extreme hypoglycemic problem and asked her manager and said it would ship and arrive today, 2/3/15; I received a call and message from Medtronics later that evening stating they didn't have any chargers in stock;
What? What happened? You had stock earlier; call back with no stock? This is the 2nd item from Medtronics that wasn't available to ship. The first was a sensor; that was last week 1/25/15; now the chargers......again I have extreme lows and happens when I sleep. Last year I never had an issue with Medtronic's stock; what has happened? Have you experienced this problem? I don't have a transmitter charged to place a sensor to read. There's got to be a better way! Oh, but I did receive a package to return the failed charger
early this morning....9 a.m. NDA a return envelope....ridiculous.

l

Submitted by naomi.kingery@… on

In reply to by Cathy Brockie (not verified)

Cathy, I’m sorry to hear about this experience, and can understand how this would be frustrating. I will have a member of my team connect with you shortly to try and help. Please let me know if there’s anything else I can help you with.

Submitted by Ellen Archibald (not verified) on

In reply to by Commenter (not verified)

After reading the article, I discovered that Model 523 also has the missed bolus reminder. No one ever mentioned it to me, nor do I recall reading of it. With gastroparesis, almost all boluses must be delayed, so I've forgotten several times - just turned on the newly-discovered feature. Medtronic sent me a new 523 just a year ago, so the model is obviously current; I hope you'll contact all 523 users about it.

Submitted by naomi.kingery@… on

In reply to by Ellen Archibald (not verified)

Ellen, I’m sorry you were not previously made aware of the missed bolus feature on your insulin pump. The MiniMed Revel 523 insulin pump and MiniMed 530G system both have the missed bolus feature and you can read more about it in the user guide for your insulin pump. Please let me know if you have any questions about using this feature, and I’ll connect you with someone from my team.

Submitted by Pat Zapf (not verified) on

In reply to by naomi.kingery@…

I have also been a long time CGM/pump user and never was told about missed bolus feature. It is not a big problem for me but I recently went to 530 g class and wonder what else has been left out.

Submitted by naomi.kingery@… on

In reply to by Pat Zapf (not verified)

Pat, I’m sorry you weren’t previously aware of the missed bolus feature. We share blogs like these to bring awareness to these features but feel free to research this in your pump user guide or discuss it in more detail with your doctor. Let me know if you have any questions about the feature, and I’ll have someone from my team connect with you to help.

Submitted by Fremont Clow (not verified) on

In reply to by Commenter (not verified)

I use the missed bonus feature but sometimes receive the missed bonus alert after I have received the first missed bonus alert and have responded to it with my food bonus. Could y ou explain this and advise me on this. Thanks

Submitted by naomi.kingery@… on

In reply to by Fremont Clow (not verified)

Fremont, that’s a good question. Since I do not know the specifics of your situation, I’ll have a member of my team reach out to you to try and help.

Submitted by Rita (not verified) on

In reply to by Commenter (not verified)

Naomi,
Thanks so much for this article! I did not know about this feature but thanks to you I know have activated it and I can rest assured that I will no longer miss a bolus! Things do get hectic in our everyday lives and this is just one more thing to help us control our blood sugars. God bless you! Rita

Submitted by naomi.kingery@… on

In reply to by Rita (not verified)

Rita, you are welcome! I understand how hectic life can be and I’m glad you found this article helpful! Let me know what you think of the feature, or if you have any questions.

Hello Naomi,
This is not related to the Bolus reminder, hope you don't mind . I have often wondered why Medtronic doesn't have speaking pumps and speaking meters for Diabetics, since diabetes can and does lead to blindness. I have had diabetes since age 2-1/2 and I am now 55. I have no sight in my left eye, and a cataract in my good eye- which I am nervous about having it removed. I have spoke with a phone representative about it, but have not heard about it or read about it. Could you please point me in the right direction or have someone contact me about this issue.

Thank you

Sharon, thank you for your feedback. Please know that our current insulin pumps are not indicated for people whose vision or hearing does not allow recognition of pump and CGM signals or alarms.

Submitted by Janine (not verified) on

In reply to by naomi.kingery@…

Yes, but that was not the question. I lost my vision for months in 2010 and the pump was the WORST ~ I could not read a thing on its gray screen. Each time I call, I mention this on the recordings ...as the writer wrote, many Diabetics become blind. and your pumps do not assist us in any manner (except for a small backlight). You should have answered the question.

Submitted by Karrie Hawbaker (not verified) on

In reply to by Janine (not verified)

I'm sorry, Janine. At this time, we don't currently carry pumps for those with vision or hearing concerns. While our research and development team are consistently working on new what's next, we cannot discuss future products that have not been FDA approved. I appreciate you reaching out and thanks for the feedback.

Submitted by Wendy Connelly (not verified) on

In reply to by Commenter (not verified)

Thank you so much for the article on Bolus reminders. I never knew it existed. Now I can be safer with having this to help me in case I forget, which has happened in the past. Especially when I am in a hurry and just want to eat lunch and get on with my day. What a great help this will be. Thank you Medtronics . I really love Medtronics having had Diabetes for 50 years, the pump has made it easier to cope with the disease.

Submitted by naomi.kingery@… on

In reply to by Wendy Connelly (not verified)

Wendy, I’m happy to hear you found this article informative, and are doing well on insulin pump therapy! The insulin pump has advanced optional features that can sometimes take time to learn. Thank you for sharing your experiences with us, you’re an inspiration!

Submitted by Alana (not verified) on

In reply to by Commenter (not verified)

Thanks for this post Naomi, I'd forgotten about this feature of my pump. I'm in the process of fine tuning my basal and bolus rates due to life changes. Due to occasional lows before meals I have delayed bolusing at times. Sometimes I realize after the fact I have forgotten to bolus entirely. I'm now set up so this doesn't happen. I do wish that there was a feature that I could set different reminders for different days of the weeks.

Submitted by naomi.kingery@… on

In reply to by Alana (not verified)

Alana, I’m glad you found the article to be a good refresher. Thanks for sharing your feedback with us, I’ll be sure to pass it along to our team.

Submitted by Bryan Diemer (not verified) on

In reply to by Commenter (not verified)

Like others here, I chose for a long time not to employ this as [I believe] I have enough alarming as it is, particularly nuisance alarming from such things as Low Reservoir (we get two even though after one we know we've a low reservoir) and Meter BG (we get one every hour even though we acknowledged the first one and it might be a few hours until we can get to a meter to check against and we already have the alarm on the BG graph). But after reading this post I'll try using the missed bolus, primarily for the following:

I nearly always (97% of the time) use Normal bolus instead of a Square Wave or Dual Wave...but sometimes I do use the Square Wave. As we know, Square wave bolusing with the wizard requires one additional entry, the square wave time. Once the bolus is finished, however, the default bolus type now becomes Square Wave, not Normal. As I use a Normal bolus 97% of the time, I almost always enter my BG, my Food, and, like a robot, I press ACT three more times while listening for two beeps...assuming I've just started the bolus and I put the pump back in the case and move on. But the pump, now defaulted to Square Wave, is instead waiting for a Square Wave time, and will eventually alarm (which I won't hear as the pump is put away) and fail to deliver a bolus as it was incomplete. Sure, my robot-like entry process is flawed...but we all do such shortcuts after having programmed 40,000+ boluses over the years.

Even if I have a correct Square Wave bolus entered and it's currently timing, and if, during that active Square Wave, I correctly enter a Normal bolus and the normal bolus finishes delivery before the end of the square wave time, the pump will still [unfortunately] default to Square Wave, even though the last bolus I programmed was Normal. This has tripped me up a dozen times in the past, as I assumed the default was based on the last bolus type entered.

Possibly, Missed Bolus might help me with both of these types of self-inflicted errors. I'll continue to evaluate the number of nuisance alarms from this feature vs. valid alarming.

I do appreciate these blog posts, thank you Naomi!

Submitted by naomi.kingery@… on

In reply to by Bryan Diemer (not verified)

Bryan, I’m sorry you find some of the alarms a nuisance, and are having difficulties setting the normal bolus. I will have someone on my team connect with you about these issues to try and help you out. Glad you find these blog posts helpful!

Submitted by Mary Lou Dene (not verified) on

In reply to by Commenter (not verified)

Thank you so much for the article; like some others, I too was unaware of the missed bolus reminder, and when I read about it, I immediately set my pump for lunch and supper reminders! But how about this: I occasionally put the pump in suspense, esp. if I'm running a lot or pretty hard, and I often forget that it is in suspense. Other times I put it in suspense and forget about doing so, and when I remember a few HOURS later and check my FSBS, it's really high. How about an alarm to remind us- at least every 1/2 hour-that the pump is suspended?

Submitted by naomi.kingery@… on

In reply to by Mary Lou Dene (not verified)

Mary, I’m happy to hear you found this article helpful! I appreciate your feedback, and will be sure to pass it along to my team.

Submitted by Robert (not verified) on

In reply to by Commenter (not verified)

This is an interesting feature, but what I am in more critical need of is a "bolus entry timed out" alarm. I have had my new pump for about 6 months, and I have had at least 4 occasions where I have checked my blood sugar several hours after a meal and it is very high. I go to the pump to enter some insulin to reduce it and note that display reads "Bolus entry timed out before delivery. If bolus intended, enter values again" message is displayed. This NEVER occurred with my old pump (although there were occasions where I actually completely forgot to enter my bolus... once I told it to deliver it the bolus would be delivered). The first two times this occurred, I figured that it was because I was still getting used to the new pump... but now that I have had it for over half a year and this continues to occur I want to find out if something can be done about it.

If I tell the pump to deliver a bolus and then I forget to push the final "yes, please really deliver it" button, why doesn't the pump give me a continuous alarm - similar to what occurs for a blockage that causes the basel or a bolus to stop - until I acknowledge that the pump has decided that it will not deliver what I started to ask it to deliver? There should be an option to turn an audible alarm on if I select a bolus amount but do not deliver the insulin, starting something like 60 seconds after I do not acknowledge that the requested bolus has timed out.

If I have missed a setting somewhere in the pump that accomplishes the above, can you please let me know how to activate it? If not, can you please consider it as an update?

Thanks

Submitted by Naomi Ruperto (not verified) on

In reply to by Robert (not verified)

Hi Robert, thanks so much for the feedback. Our 24 HelpLine might have some tips for you in regard to ways to make this work. I've shared your information with my team to reach out.

Submitted by Fran Selinger (not verified) on

In reply to by Commenter (not verified)

Thank you for this post. I missed two boluses two days in a row. I received a VEO pump a few months ago and didn't know about this feature.

Submitted by Naomi Ruperto (not verified) on

In reply to by Fran Selinger (not verified)

Glad it helped, Fran!


Post a new comment

Required fields are marked *
The content of this field is kept private and will not be shown publicly.