Roche Accu-Chek Aviva User's Guide

Aviva Combo00048009695/C-0709BLOOD GLUCOSE METERAdvanced Owner’s Booklet©2009 Roche Diagnostics. All rights reserved. Roche Diagnostics GmbH Sandhofer

81.1 OverviewImportant information regarding the use of bolus advice is presented in this chapter. Read it carefully and completely before you begin u

98When a blood glucose test result is greater than the currently allowed blood glucose value, a bolus is calculated (light blue) that only considers t

99 Subsequent MealsIf you eat several meals in a row, the meal rise is restarted for each new meal bolus.bG LevelHyperHypoActing TimeTarget RangeTimeT

100Appendix B: Bolus Advice CalculationsThe Mathematical Basis for Bolus CalculationsThe following is a list of the most important formulas and the ca

101Meal BolusThe following formula is used to calculate the bolus for meals:Meal Bolus = Carbohydrate Intake ×InsulinCarbohydratesfrom carbohydrate ra

102Correction BolusGenerally, a correction bolus is only calculated if the current blood glucose value is above the hypo bG warning limit and outside

103Correction Bolus With Carbohydrate IntakeWhenever carbohydrates have been entered, the related meal bolus is always offset against any (even negati

104Appendix C: Explanation of SymbolsYou may encounter the following symbols on the packaging, on the type plate, and in the instructions for the mete

105IndexAacting time, 89active insulin, 89aircraft. See Bluetooth wireless technology, using while travelingBbasal prole, changing, 51–52Bluetooth

106Ccarbohydrate units, 82carb ratio, 84carbs amount, 14communication, meter and pump,overview, 34, 56troubleshooting, 73–80correction bolus, 93

107Ooffset time, 89Ppairing, delete device, 62pairing meter with pump, 61–66pairing prompt, cancelling, 67–69pen bolus, description, 28PIN, enter

19i NOTES: • This booklet shows sample screens. The screens in this booklet may look slightly different from the screens on your Accu-Chek Aviva Comb

108Uupper blood glucose target limit, 84Wwarning limits, 83warnings, pump, 53–5445676_adv.indb 108 11/3/09 4:45:26 PM

101.2 Before Using Bolus AdviceIntended UsersAs with any specialized feature, you need to understand certain information in order to use bolus advice.

111Safety Information Regarding Bolus Advicew WARNINGS: • It is very important you follow the safety information in this chapter.• Always compare yo

12Warning messages about your blood glucose resultAfter performing a blood glucose test, warning messages about your blood glucose result may be displ

1135.8 mmol/L19 gExercise 1BolusTypeConfirmCancel2 U--- UBolus Advice0.0 U2.1 U-0.1 UStandard1.3 Calculating and Delivering a Bolus Using Bolus Advic

14To Deliver a BolusMain Menu > Bolus Advice1.j From the Main Menu, select Bolus Advice and press =.2.j If you have not completed a recent blood

115To Enter a Health Event:j Select the Health entry eld and press =. j Select a Health Event and press =.To Adjust the Bolus Amount:j Select the

165.Pump DeliveringStandard BolusStop BolusOKDeliver Bolus2 UPumpExit BackBOLUS CANCELLEDTO SNOOZEW8!Delivery CompletedMenuDeliver Bolusj Select OK a

1176. 7.Deliver Bolus?Multiwave BolusBack DeliverConfirm Bolus2 UDuration0.5 UHH MM4:00ImmediateTo Deliver a Multiwave Bolus j Select the Type entry

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18PumpExit BackBOLUS CANCELLEDTO SNOOZEW8!Multiwave Bolus DeliveryContinuingMenuDeliver BolusImmediate DeliveryCompletedj To stop bolus delivery, sel

1199.To Deliver an Extended Bolus j Select the Type entry eld and press =. j Select Extended and press =.To conrm the entries, select Conrm.10. 11

2012.To Deliver a Bolus Manually on the Pumpj Select the Type entry eld and press =. j Select Manual Pump and press =.To conrm the entries, selec

12115. Pen/SyringeBolusBackOKConfirm Bolus2 UInject InsulinThe bolus amount is displayed on the meter screen.j Inject the recommended bolus using an

22w WARNINGS: • Bolus advice provided by the meter is solely advice. Contact your healthcare professional prior to changing your diabetes therapy.•

123i NOTES: • Bolus advice can also be accessed after you perform a bG Test (see the Standard Owner’s Booklet). When the detailed bG Result screen is

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2522 Administering a Bolus2.1 Overview 262.2 Choosing Your Bolus Type 272.3 Delivering a Bolus 292.4 Updating the Diary with Bolus Information 314

262.1 OverviewThere are several methods to deliver a bolus. The pump makes it possible to deliver more precise amounts of insulin than can be injected

2722.2 Choosing Your Bolus TypeThere are several types of bolus delivery available. The bolus types include:• StandardA bolus that delivers an immedia

1ContentsIntroduction 51 Bolus Advice 71.1 Overview 81.2 Before Using Bolus Advice 101.3 Calculating and Delivering a Bolus Using Bolus Advice

28• ExtendedA bolus delivered over a period of time. It can be helpful during long meals, dinners, or receptions, or when you have meals that are dige

2922.3 Delivering a Bolusw WARNINGS: • Incorrect meter settings may cause inappropriate insulin delivery. • The meter must be configured with your pe

30i NOTE: You can cancel a bolus (including an extended bolus) that is being delivered by the pump directly on the pump or remotely on the meter (thro

3122.4 Updating the Diary with Bolus InformationWhen the pump is synchronized with the meter, bolus information from the pump is imported into the me

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3333 Using the Accu-Chek Aviva Combo Meter with the Accu-Chek Spirit Combo Pump3.1 Overview 343.2 The System at a Glance 353.3 Controlling the Pump

34The Accu-Chek Aviva Combo Meter can be used to remotely control the Accu-Chek Spirit Combo Insulin Pump using Bluetooth wireless technology. Before

353In the meter’s Pump Menu, the meter buttons have different functions. The buttons function as button (key) presses on the pump.3.2 The System at a

36Meter Button Pump Key Functionx aj Move forward in an information screenj Increase a settingj Program a Quick Bolusj Cancel a Quick Bolusj Turn off

373Meter Button Pump Key Function.d and aj Exits menus, function screens, and information screens without saving your changesj Move to the previous

23 Using the Accu-Chek Aviva Combo Meter with the Accu-Chek Spirit Combo Pump 333.1 Overview 343.2 The System at a Glance 353.3 Controlling the Pu

38When Bluetooth wireless technology is turned on, the pump main screen appears on the meter when you are in the Pump Menu.The meter is able to contro

393The following pump functions cannot be remotely controlled using the meter:• Changing the insulin cartridge• Priming the infusion set• Rewinding th

40i NOTES: • You can administer a bolus manually on the pump (without using the meter). When the meter and Bluetooth wireless technology are both tur

413PumpExit Back 10:0211.00U/hPump ScreenCorresponding Meter ButtonsReturn to Main MenuPump Screens on the MeterBluetooth Wireless Technology IconBac

42In remote control mode, the Bluetooth wireless technology icon appears on the meter screen and on the pump screen.To control the pump using the mete

433Delivering a Bolus – Standard BolusTo Program a Standard Bolus Remotely1.j From the Main Menu, select Pump and press =.2.j Repeatedly press and r

445.PumpExit BackBOLUS AMOUNT2.5Uj When the correct bolus amount is displayed, press > to conrm the bolus amount.6.PumpExit BackBOLUS AMOUNT2.5UB

453Time Cancelling the Bolus ResultWhen programming a Standard bolus (the bolus amount blinks on the screen)j If you do not press any meter buttons f

46Time Cancelling the Bolus ResultDuring bolus delivery (meter is counting down the bolus amount)j Press and hold x or z for three seconds until the

473Programming a Temporary Basal Rate (TBR)1.j From the Main Menu, select Pump and press =.2. 3.j Press > to select the Temporary Basal Rate (TBR

3Appendices 81Appendix A: Bolus Advice 81Appendix B: Bolus Advice Calculations 100Appendix C: Explanation of Symbols 104Index 10545676_adv.indb

485.PumpExit Back TBR DURATION03:00120%The Pump screen TBR DURATION appears.j Press x or z to set the duration time.j Press > to save the change

493i NOTES: • If a TBR is not currently active, the TBR percentage is set to 100 %.• When a TBR is active, it remains in effect even if the basal rat

50Situation Cancelling the Temporary Basal Rate ResultWhen programming a TBRj If you do not press any meter buttons for approximately 20 seconds, the

513Changing a Basal Profile1.j From the Main Menu, select Pump and press =.2. 3.Bolus AdvicePumpMy DataSettingsbG Te st10:022 Feb 08PumpExit BackBASA

524.PumpExit BackSELECT PROFILE142.00 U j Press x or z to select the basal rate prole. The basal rate prole number and the basal rate total amount

5333.4 Managing Pump Errors and Warnings with the MeterIf the meter is off when a pump error, warning, or reminder occurs and you turn on the meter,

54Cartridge Low WarningPumpExit BackCARTRIDGE LOWTO SNOOZE1W!j When the contents of the insulin cartridge on the pump have dropped to 20 units of ins

5544 Communication between the Accu-Chek Aviva Combo Meter and Accu-Chek Spirit Combo Pump4.1 Overview 564.2 Turning Bluetooth® Wireless Technology O

56The meter and pump use Bluetooth wireless technology to communicate. If you are experiencing communication problems between the meter and pump, it i

5744.2 Turning Bluetooth® Wireless Technology On/OffYou may turn Bluetooth wireless technology on or off at any time using the meter. Bluetooth Wirel

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58Turning Pump Communication (Bluetooth Wireless Technology) On or OffMain Menu > Settings > Meter > Bluetooth1.j From the Main Menu, select

5944.Press and hold backlight buttonuntil Bluetooth icon changesMeter Name: METER12345678BackBluetoothj Press and hold * until the Bluetooth icon cha

604.3 Using the System While TravelingWhen traveling on an aircraft, you must ensure Bluetooth wireless technology is turned off on the meter and on t

6144.4 Pairing the Accu-Chek Aviva Combo Meter with the Accu-Chek Spirit Combo PumpWhen obtained as a kit, the meter and pump are paired. If the met

623.Pump:j If the PAIRED DEVICE NONE screen appears, proceed to Step 6.Pump:j If the PAIRED DEVICE screen appears, press d and proceed to the next s

6345. 6.Pump:j Press f to conrm deletion of the paired device.Pump:j Press d.7.Meter:j Ensure the meter is turned off.j Press and hold * and then

649.Pump:j Press f to initiate the pairing process.8.j Proceed to the next step for instructions on how to place the pump in pairing mode.j To not

65411. 12.Pump:j The ADD DEVICE PAIRING screen appears followed by the ADD DEVICE ENTER PIN CODE screen.Meter:The Pair with Pump screen appearsEnter

6613.When the correct PIN is conrmed, the Pairing Completed for … screen appears on the meter and then the DEVICE PAIRED screen appears on the pump.j

6744.5 Cancelling the Pairing of the Meter and Pump PromptIf the meter and pump are not paired, the meter prompts you to complete the pairing process

5Your new meter includes three booklets:• Getting Started Guide: Use this booklet to set up the meter.• Standard Owner’s Booklet: Use this booklet

681.Pairing setup has notbeen completedSetupNextCancelj Turn on the meter. The Pairing setup has not been completed screen appears.j Select Cancel t

694i NOTES: • A blood glucose test cannot be performed during the pairing process.• The meter and pump remain paired when the batteries are removed an

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7155 Troubleshooting5.1 Overview 725.2 Troubleshooting Communication Between the Meter and Pump 7345676_adv.indb 71 11/3/09 4:45:22 PM

72For most communication problems between the meter and pump, the meter displays a message with a short description of the symptom and, along with it,

735 5.2 Troubleshooting Communication Between the Meter and PumpDisplay Shows Possible Cause(s) Possible Solution(s)Bluetooth icon  ashingj Communi

74Display Shows Possible Cause(s) Possible Solution(s)Bolus Delivery Unavailable j The meter cannot communicate with the pump.j Retry or set to Manu

755Display Shows Possible Cause(s) Possible Solution(s)Communication Lostj Pump is out of range of the meter.j Review or cancel the bolus on the pum

76Display Shows Possible Cause(s) Possible Solution(s)Connection Lostj The connection was lost between the meter and the pump during the pairing proc

775Display Shows Possible Cause(s) Possible Solution(s)Infrequent Pump Communicationj At least two weeks have passed since the meter and pump have c

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78Display Shows Possible Cause(s) Possible Solution(s)Meter and Pump Not Pairedj Meter and pump have not been paired. You cannot use the pump functio

795Display Shows Possible Cause(s) Possible Solution(s)Pump Not Availablej The pump is out of the communication range of the meter.j Ensure the mete

80w WARNING: If you are experiencing communication problems between your meter and pump, it is recommended you operate the pump manually and not use t

81AppendicesAppendix A: Bolus AdviceBolus advice is only available if you have set up bolus advice on the Accu-Chek Aviva Combo Meter. For instruction

82Bolus Advice Meter SettingsThis section contains an overview of the information that must be entered into the meter for accurate bolus advice recomm

83Warning Limits• You can select hyper (high) and hypo (low) blood glucose limits that best fit your needs. • Whenever a blood glucose test result is

84Target Range• The range of your blood glucose results considered acceptable.• The meter automatically calculates the target blood glucose level as

85Insulin Sensitivity• For the current time block, the insulin sensitivity (correction factor) is the amount of insulin necessary to lower your blood

86Talk to your healthcare professional about setting up time blocks to help you manage your diabetes. Here is a suggested pattern:Time Block Start Tim

87Setting Up Time Blocks: Important Information• Time blocks cover a 24-hour time period (from midnight to midnight).• You can change the time period

171 Bolus Advice1.1 Overview 81.2 Before Using Bolus Advice 101.3 Calculating and Delivering a Bolus Using Bolus Advice 1345676_adv.indb 7 11/3/0

88Health events available on the meter are:• Exercise 1• Exercise 2• Stress• Illness• Premenstrual• FastingBolus Advice OptionsMeal rise, snack size,

89Snack Size• The snack size is the amount of carbohydrates that is not to be counted as a regular meal with the expected meal rise.Acting Time• The

90Bolus CalculationThe bolus recommended by the bolus advice feature of the meter consists of two components: a recommendation for a meal bolus that c

91Correction BolusIf your current blood glucose level is not within your target range, a correction bolus is recommended.Blood Glucose LimitsDiscuss y

92The calculation for the recommended correction bolus depends on your current blood glucose result, your insulin sensitivity for the current time blo

93Other BolusesSubsequent Meal BolusesIf you are planning to eat several meals or snacks in a short period of time, you should administer a meal bolus

94The dotted line shows how your blood glucose level might change after a meal bolus. Bolus advice tolerates an increase in your blood glucose level w

95Subsequent Correction BolusesThe difference between your current blood glucose level and your target blood glucose level is called Delta bG. A corre

96Examples of Bolus Advice RecommendationsThe following graphs provide differing examples of how bolus advice considers different factors when calcula

97After a Correction BolusThe above diagram shows an example of the effect of this rule. The first correction bolus at 12:00 remains active during the