Getting Started - Amazon S3 Started... · 2019-06-24 · Getting Started with Continuous Glucose Monitoring ... See Getting Started with CGM, pages 5-16 on Personalize Alerts and

Learning Guide

Getting Startedwith Continuous Glucose Monitoringfor the MiniMed® 530G with Enlite®

CGM Foundations

2

We recommend that you record your CGM settings on this form to refer to when necessary.

Continuous Glucose Monitoring Learning Guide

1: 12:00AM _________ - _________ mg/dL

2: ________ _________ - _________ mg/dL

3: ________ _________ - _________ mg/dL

4: ________ _________ - _________ mg/dL

High Repeat:

________ minutes o hour o

Low Repeat:

________ minutes o hour o

Predictive Alerts:

Low: OFF o ON o ________ minutes

High: OFF o ON o ________ minutes

Rate of Change Alerts:

Fall Rate: OFF o ON o ________ mg/dL/min

Rise Rate: OFF o ON o ________ mg/dL/min

Glucose Limits: Threshold Suspend:

OFF o ON o ________ mg/dL

Calibration Repeat:

________ minutes

Calibration Reminder:

________ minutes o hour o

Transmitter ID:

_______________

Weak Signal:

________ minutes

MiniMed® 530G with Enlite® - Continuous Glucose Monitoring Settings Form

3

Glucose readings that are measured with your fingerstick test are called

___________________ glucose.

Glucose readings that are measured by your CGM are called

___________________ glucose.

You should expect that your sensor glucose will be different from your blood glucose as:

a. Sensor glucose generally follows behind blood glucose b. Sensor glucose is measured in the interstitial fluid and blood glucose is measured in the blood c. Glucose moves continuously between blood and interstitial fluid d. All of the above

You will see a greater difference between your sensor and blood glucose readings:

a. When glucose is changing quickly such as after exercise b. After eating or taking a bolus of insulin c. Both a and b

CGM Start

SENSOR GLUCOSE ≠ BLOOD GLUCOSE See Getting Started with CGM, page 3 on SG ≠ BG

You should always rely on which glucose reading before treating a high or low glucose?

a. Sensor glucose b. Blood glucose c. Both a and b

Comparing Sensor Glucose and Blood Glucose...

Jennifer knows it is okay to see a difference between sensor glucose and blood glucose readings. When confirming a sensor glucose with a blood glucose what might Jennifer see as sensor and blood glucose readings?

a. Sensor 80 and blood glucose 70 b. Sensor 215 and blood glucose 235 c. Sensor 65 and blood glucose 80 d. All of the above

3

2x

?CHECKPOINT

SENSOR GLUCOSE ≠ BLOOD GLUCOSE

4

When using CGM it is important to focus on the trends rather than individual sensor glucose numbers. Trends tell you:

a. If your glucose has been rising, falling, or has been stable for minutes or hours b. The speed at which your glucose has been changing c. Both a and b

The example CGM screen tells you which of the following:

a. The sensor glucose will continue to change quickly b. The sensor glucose has been changing quickly c. The sensor glucose is becoming stable

See Getting Started with CGM, page 4 on TrendsTRENDS

CGM Start

108

1:33P

PM

Matt glances at his CGM display while at work. What should he do first if his CGM display shows the following? a. Give a correction bolus b. Confirm with a blood glucose reading using his BG meter c. Eat a snack

Responding to trends...

Noticing trend arrows...

Margaret sometimes forgets to bolus before eating. Which trend arrow(s) might she see next to her sensor glucose reading as a result of forgetting to bolus? a. b. c. Either a or b

3

2x

?CHECKPOINT

TRENDS

235

1:30P

PM

5

Personalizing alerts means:

a. Programming only those settings that are necessary and helpful for you b. Adjusting your alert settings as you become more familiar with using CGM c. Both a and b

If you are receiving too many alerts you may need to:

a. Change your Low and High Repeat settings to give your glucose time to recover b. Change the settings that are alerting often so that they are less restrictive c. Both a and b d. Do nothing

See Getting Started with CGM, pages 5-16 on Personalize Alerts and Quick Reference page on CGM Alarm and AlertsPERSONALIZE ALERTS

CGM Start

250

70

High Predictive

High Glucose Limit

Fall Rate

Low Predictive

Threshold Suspend

Sensor Glucose

Personalize Alerts

CGM Alert Setting

Low Repeat High Repeat

Rise Rate

Low Glucose Limit

3

2x

?CHECKPOINT

PERSONALIZE ALERTS

6

One night, while Anna is sleeping her pump begins to siren with a Threshold Suspend alarm.

Anna wakes up several hours later with her pump alarming and her basal insulin delivering.

What happened while Anna was sleeping? a. Insulin delivery stopped for 4 hours, then restarted for 4 hours b. Insulin delivery stopped for 2 hours, then restarted for 4 hours

Sleeping during a Threshold Suspend...

The next afternoon, while Anna is watching TV with her family, she receives another Threshold Suspend alarm.

Why should Anna clear the alarm AND select either Suspend or Restart Basal?

a. Because her pump will siren again in a few minutes when she may not want it tob. Because her pump will stop working

Clearing the Threshold Suspend alarm and making a selection...

See Getting Started with CGM, pages 13 – 14 and Quick Reference page on Threshold Suspend

CGM Start

THRESHOLD SUSPEND

7

See Getting Started with CGM, pages 13 – 14 and Quick Reference page on Threshold Suspend

The next night, John goes to bed early. His last calibration was at lunch time.

What is needed in order for Threshold Suspend to alarm?a. His sensor glucose needs to be at or below his Suspend Thresholdb. He needs to calibrate his sensorc. His sensor and transmitter need to be communicating with his pump d. All of the above

For Threshold Suspend to work...

While John is at work, his pump begins to siren with a Threshold Suspend alarm.

What should John do next?a. Clear the alarm and do nothing elseb. Clear the alarm, check blood glucose with his meter, treat the low as needed, and restart basalc. Do nothing because his blood glucose will recover on its own

Responding to the Threshold Suspend alarm...

CGM Start

THRESHOLD SUSPEND

8

Write the steps that each picture is showing for inserting the Enlite sensor.

DOUBLE BUT TON PRESS

CGM Start

See Getting Started with CGM, pages 17-19 and Quick Reference page on Using the Enlite Sensor

3

2x

?CHECKPOINT

DOUBLE BUTTON PRESS

____________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

____________________________________________________________________

____________________________________________________________________

9

There are several places to go for helpful instructions on how to insert your Enlite sensor. Which one will you use?

o Getting Started with CGM, pages 17-19

o Quick Reference page in the back of Getting Started with CGM

o myLearning video: my.medtronicdiabetes.com/mylearning

o Medtronic Diabetes website: www.medtronicdiabetes.com

DOUBLE BUT TON PRESS

CGM Start

It is very important that you use the Enlite sensor overtape to keep your sensor under your skin. Which picture(s) below show the sensor overtape applied correctly? Circle the correct picture(s).

TAPING

See Getting Started with CGM, pages 17-19 and Quick Reference page on Using the Enlite Sensor

See Getting Started with CGM, pages 20 - 21 on Taping

3

2x

?CHECKPOINT

TAPING

IMPORTANT: All Enlite tapes and adhesives stick best when you apply pressure for several seconds after putting them on your skin. Doing so helps the Enlite sensor stay fully inserted.

Count for 5 seconds or more while you apply pressure on the tape to ensure enough time for it to stick to your skin.

a.

c.

b.

d.

10

CGM Start

Which of the following steps are in the correct order? Circle the correct answer.

You can also review how to properly tape the Enlite sensor by using these resources:

o Getting Started with CGM, page 20-21

o Quick Reference page in the back of Getting Started with CGM

o myLearning video: my.medtronicdiabetes.com/mylearning

o Medtronic Diabetes website: www.medtronicdiabetes.com

1. Insert the sensor2. Connect the transmitter3. Tape the sensor

In 6 days you will receive a “Sensor End” alert telling you that your Enlite sensor has reached the end of its life. Remove the sensor and insert a new one.

TAPING

1. Insert the sensor2. Tape the sensor3. Connect the transmitter

1. Connect the transmitter2. Insert the sensor3. Tape the sensor

See Getting Started with CGM, pages 20 -21 on Taping

11

CGM Start

What might happen if a calibration is required and it is not entered into your pump?

a. Sensor glucose readings will not continue to display b. You may not receive important glucose alerts/alarms such as Low Limit or Threshold Suspend c. Both a and b

If you notice a large difference between your sensor and blood glucose readings what actions should you take?

a. Wash your hands b. Do another BG fingerstick and calibrate again if needed c. Check that the sensor has not pulled out of your skin d. All of the above

In order for your CGM to work, calibrations are needed:

a. At least once every 12 hours (after the first day) b. Every day and at times that are convenient for you such as before bed c. 3-4 times a day for best sensor performance d. All of the above

CALIBRATION See Getting Started with CGM, pages 25-26 for guidelines on Calibrating

Enlite sensor inserted: ______________ AM/PM

I will calibrate:

2 hours after sensor inserted: ______________ AM/PM

Within the next 6 hours: ______________ AM/PM

At bedtime: ______________ AM/PM

I will calibrate:

When I wake up: ______________ AM/PM

Again within 12 hours: ______________ AM/PM

At bedtime: ______________ AM/PM

Calibration Schedule

Day 1

Day 2 to Day 6

3

2x

?CHECKPOINT

CALIBRATION

12

CGM Start

CareLink software helps you to understand the

effects of ________________, _________________, and

______________ on your glucose levels.

What are three benefits of using CareLink?

1. _____________________________________________________________________________ 2. _____________________________________________________________________________ 3. _____________________________________________________________________________

Follow these steps to get started on CareLink:

1. Go to www.medtronicdiabetes.com and click on CareLink 2. Click the Sign Up Now button 3. Read and accept the terms of agreement 4. Create a User Name, Password, and enter your contact information 5. Once you submit, you will be able to log in from the Welcome screen 6. Click the Upload button and follow the steps provided on the screen 7. Click on Reports to view your uploaded information

You can learn more about setting up your account, uploading your pump and looking at reports by:

• Going to www.medtronicdiabetes.com/carelink • Taking the CareLink class on myLearning at my.medtronicdiabetes.com/mylearning • Seeing Getting Started with CareLink Personal Software

My CareLink Username:

_________________________________

and Password:

_________________________________

CARELINK® See Getting Started with CGM, pages 28-29 on CareLink

3

2x

?CHECKPOINT

CARELINK

13

See Getting Started with CareLink CARELINK REPORTS

CGM Follow-up

14

Look carefully at this example Daily Summary report – the sections on Glucose, Insulin Delivery, and Carbohydrates and Exercise.

During the overnight period was the sensor glucose mostly above or below target?_______________

To determine if this is the same pattern that is seen on most overnights, which CareLink report would

you review? __________________________________

To treat the sensor glucose levels during the overnight period which action was taken?

a. Boluses were delivered

b. Temporary basal was programmed

c. No action was taken

d. I don’t know what happened

What events might have caused the sensor glucose to fall and trigger a Threshold Suspend

alarm at 5 pm?

_______________________________________________________________________________________

_______________________________________________________________________________________

Insulin delivery was automatically suspended for two hours (5pm – 7 pm) and then basal insulin was

restarted automatically. Should the Threshold Suspend have occurred again afterwards? Why or why

not?

_______________________________________________________________________________________

_______________________________________________________________________________________

See Getting Started with CareLink CARELINK REPORTS

CGM Follow-up

15

See Getting Started with CareLink CARELINK REPORTS

CGM Follow-up

16

Now, look at another example Daily Summary report.

What might have caused the sensor glucose to rise steadily starting at 11 am?

_______________________________________________________________________________________

At about 7:40 pm a Threshold Suspend alarm began to siren. Did insulin delivery remain suspended or

was it restarted? _________________________________________________________________________

What event(s) might have caused the sensor glucose to fall and then trigger the Threshold Suspend

alarm?

_______________________________________________________________________________________

_______________________________________________________________________________________

How many total Threshold Suspend alarms were received? ______________________________________

CARELINK REPORTS

CGM Follow-up

See Getting Started with CareLink

17

Starting continuous glucose monitoring is exciting, but it can also sometimes feel like a lot to learn.

If you need answers, there are several places you can go:

• This Learning Guide shows you where to go for more information and help on the topics we covered.

• To find additional information on many topics go to www.medtronicdiabetes.com/support

• For classes to review information and help you learn more go to my.medtronicdiabetes.com/mylearning

• The 24-hour HelpLine is there for you 24 hours a day, 365 days a year to help with any technical questions: 1-800-646-4633

Ordering Supplies

It is important that you do not run out of CGM supplies. There are several ways to order. Choose the way that will work best for you.

o mySupplyConnection™ Automatic Reorder Program Call 1.800.646.4633, Option 2 to have your supplies automatically sent to you on a regular basis.

o Supply Reorder Card This card is mailed to you. Simply follow the instructions on the card and return to us by mail.

o Online Store Create an account at my.medtronicdiabetes.com and order online. If you have already gone onto myLearning, you will use that username and password. o myMedtronic Connect This app lets you order supplies right from your phone. Go to iTunes to download for your iPhone, iPad or iPod Touch. o Automated Phone System Place an order 24 hours a day, 7 days a week by calling 1.800.646.4633, Option 2.

o Live Representative Call the Supply Order Team at 1.800.646.4633, Option 2, Monday through Friday, from 8:00 AM to 6:00 PM Central Standard Time.

RESOURCES

3

2x

?CHECKPOINT

RESOURCES

CGM Start

18

CGM Start

Let’s review. . .

3

2x

?CHECKPOINT

9501

487-

012

2013

0903

©M

edtr

onic

Min

iMed

, Inc

. 201

3. A

ll rig

hts

rese

rved

.

Medtronic, Inc. | Diabetes18000 Devonshire StreetNorthridge, CA 91325USA1-800-646-4633www.medtronicdiabetes.com