MiniMed Paradigm 512 with Link

Antonio,

Quoted message said:

Does anyone have a MiniMed Paradigm 512 that is using the Link feature?

Our patients are using the link to the BD meter and like it.

Quoted message said:

I would like to find out more about this. In particular, I am concerned because I was told by a
MiniMed rep that, once you check your BG and are advised of the correction and meal boluses, these
cannot be altered. You must either accept them totally, or just enter the bolus amount manually,

You can use the Bolus Wizard feature with or without input from the BD meter, if you are concerned
about that. You can set the BG manually without the direct radio data link with any meter you like.

Of course you set the carb intake yourself.

The insulin sensitivity factor can be set at any level you want, and you can use different
sensitivities for different times of day if you like. Ditto for the carb to insulin ratio, you can
pre-set it for various levels according to time of day.

We found that those patients who were getting boluses that were too high or too low either had their
carb ratio set incorrectly, or they were counting carbs wrong.

Quoted message said:

which kind of defeats the whole purpose of the Link. If your blood sugar

is

Quoted message said:

LOW, can it correct for that as well, by giving a lower bolus?

Yes, it reduces the dose for you. Plus the "Target" glucose is adjustable. Some people use a target
of 110, some use 125 for instance. It can be set in steps of 1 mg/dl anywhere between 80 and 160 .
The bolus is corrected depending on how much it differs from the target value.

If you are below 70, the wizard won't let you bolus until you are above 70.

Quoted message said:

I was also told by a MiniMed rep that the pump reminds you to check your BG 2 hours after each meal
bolus. Is this true?

There is a personal reminder alert feature. This is defaulted to off. Have to set a specific time
for it to go off.

Quoted message said:

Can it be changed to say 3 hours, or deactivated entirely. Can you set it so that it doesn't do
this at night and wake you up? How does it "remind" you?

It displays the word REMINDER on the screen. It's basically just an alarm clock, you need to set the
times of day in advance to get the reminder. This might be useful for patients that do a lot of
testing where timing is critical.

You can download the users guide at
minimed.comParadigm 512 User Guide.pdfOpen ↗

Quoted message said:

Thanks for any information and assistance.

Good luck Antonio,

William C Biggs, MD

MiniMed Paradigm 512 with Link

Group: misc.health.diabetes Date: Tue, Oct 14, 2003, 2:13am (EDT+4) From:
[email hidden] (Juan=A0Antonio) Does anyone have a MiniMed Paradigm 512 that is
using the Link feature? I would like to find out more about this. In particular, I am concerned
because I was told by a MiniMed rep that, once you check your BG and are advised of the correction
and meal boluses, these cannot be altered. You must either accept them totally, or just enter the
bolus amount manually, which kind of defeats the whole purpose of the Link. If your blood sugar is
LOW, can it correct for that as well, by giving a lower bolus? I was also told by a MiniMed rep that
the pump reminds you to check your BG 2 hours after each meal bolus. Is this true? Can it be changed
to say 3 hours, or deactivated entirely. Can you set it so that it doesn't do this at night and wake
you up? How does it "remind" you? Thanks for any information and assistance.
--
Antonio Age 37, Type 1 for 10 years On Insulin Pump

my guess is the tones are not any louder than my 511. and that ain't very loud.

as far as the 512 info page goes i think you are going to have to call them because i never saw a
break down on the options.

i can try to send it to you if you would like me to.

MiniMed and i are not on speaking terms at this point because of the water proof problem that they
now say they have.

LAWYERS hate them but got to have them.

case

the case, minus a few cans!

thanks for the link. I just started reading the pdf file. What jumps out at me immediately is the
oversimplification that MiniMed uses by incorporating "insulin sensitivity". The real fact of the
matter is insulin sensitivity varies by the time of day, plus the current bg level. For example my
i.s. is 1/38 during the day, and a paltry 1/22 during the dawn period. Also, when I get really
high, like 275 or greater, you can throw those numbers right out the window. Which is why I spent a
lot of time analyzing what happens under different circumstances and set up some reference charts
to get me in the ballpark for those times when everything's gone wacky. Like when I get too high
from a dislodged set, or eat something more naughty then I'd anticipated it was. If only it were
all so simple...

I will read more of the pdf tomorrow. just wanted to mention this before I forgot. Thanks again for
the link...

dave

William C Biggs said:

Antonio,

Quoted message said:

Does anyone have a MiniMed Paradigm 512 that is using the Link feature?

Our patients are using the link to the BD meter and like it.

Quoted message said:

I would like to find out more about this. In particular, I am concerned because I was told by a
MiniMed rep that, once you check your BG and are advised of the correction and meal boluses, these
cannot be altered. You must either accept them totally, or just enter the bolus amount manually,

You can use the Bolus Wizard feature with or without input from the BD meter, if you are
concerned about that. You can set the BG manually without the direct radio data link with any
meter you like.

Of course you set the carb intake yourself.

The insulin sensitivity factor can be set at any level you want, and you can use different
sensitivities for different times of day if you like. Ditto for the carb to insulin ratio, you can
pre-set it for various levels according to time of day.

We found that those patients who were getting boluses that were too high or too low either had
their carb ratio set incorrectly, or they were counting carbs wrong.

Quoted message said:

which kind of defeats the whole purpose of the Link. If your blood sugar

is

Quoted message said:

LOW, can it correct for that as well, by giving a lower bolus?

Yes, it reduces the dose for you. Plus the "Target" glucose is adjustable. Some people use a
target of 110, some use 125 for instance. It can be set in steps of 1 mg/dl anywhere between 80
and 160 . The bolus is corrected depending on how much it differs from the target value.

If you are below 70, the wizard won't let you bolus until you are above 70.

Quoted message said:

I was also told by a MiniMed rep that the pump reminds you to check your BG 2 hours after each
meal bolus. Is this true?

There is a personal reminder alert feature. This is defaulted to off. Have to set a specific time
for it to go off.

Quoted message said:

Can it be changed to say 3 hours, or deactivated entirely. Can you set it so that it doesn't do
this at night and wake you up? How does it "remind" you?

It displays the word REMINDER on the screen. It's basically just an alarm clock, you need to set
the times of day in advance to get the reminder. This might be useful for patients that do a lot
of testing where timing is critical.

You can download the users guide at
minimed.comParadigm 512 User Guide.pdfOpen ↗

Quoted message said:

Thanks for any information and assistance.

Good luck Antonio,

William C Biggs, MD

Thank you, Dr. Biggs for your informative reply and the link to the manual. I am going to read that
over very carefully. However, it almost sounds like the 512 with Link is not worth pursuing. Correct
me if I'm wrong, but it sounds like it is best suited for people who don't want to do all the math
that's involved with carb counting and correction calculations. First, if all the BD meter is doing
is sending a BG reading to the meter, then that's not a big deal. I could enter 2 or 3 digits
manually myself. Furthermore, if I'm sitting down at a meal and my BG tests at 70, then I don't want
to have to wait until I have eaten enough for it to come up then have to retest just so the pump
will let me bolus. That seems idiotic. My one question that's probably not covered in the manual is:
Can the target BG be set with a range, and for different times of the day? For instance, I have been
taught over the last 10 years that my BG should be between 80 and 120, but that my BG should be 140
at bedtime.

I apologize if I sound snide, but like Case, who posted later in this thread, I have issues with
MiniMed so I just want to make the best informed decision about this.

I have been on the 508 for several years. Last year I got the Paradigm because I thought it was an
upgrade to the 508. It was not. However, I recently had to start using the Paradigm because I ran
out of supplies for the 508 before Medicare could authorize more. (No one told me that I must have
an actual visit with my Endo every 3 months for Medicare to pay for the supplies.) Now I realize
that they are totally different, almost like they were designed by totally different people. The
logic in each is totally different. Also, the orientation of the screen with respect to where the
infusion set comes out is completely opposite. What were they thinking? I don't understand why they
couldn't have just IMPROVED the 508 without making it so substantially different. I've reviewed all
the pumps on the market, and, in my opinion, MiniMed still has the best laid out display screens and
program features. Also, paramount for me is the ability to wear the device like a pager so I don't
look like a freak with a medical device. My only wish is that they would make the Silhouette
infusion set with completely clear tape so I don't have a white spot on my abdomen. Oh well, such is
the life with a chronic illness that sucks.

--
Antonio
Age 37, Type 1 for 10 years
On Insulin Pump

"William C Biggs, MD" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Antonio,

Quoted message said:

Does anyone have a MiniMed Paradigm 512 that is using the Link feature?

Our patients are using the link to the BD meter and like it.

Quoted message said:

I
would like to find out more about this. In particular, I am concerned
because I was told by a MiniMed rep that, once you check your BG and are
advised of the correction and meal boluses, these cannot be altered.

You

Quoted message said:

Quoted message said:

must either accept them totally, or just enter the bolus amount

manually,

Quoted message said:

You can use the Bolus Wizard feature with or without input from the BD
meter, if you are concerned about that. You can set the BG manually

without

Quoted message said:

the direct radio data link with any meter you like.

Of course you set the carb intake yourself.

The insulin sensitivity factor can be set at any level you want, and you

can

Quoted message said:

use different sensitivities for different times of day if you like. Ditto
for the carb to insulin ratio, you can pre-set it for various levels
according to time of day.

We found that those patients who were getting boluses that were too high

or

Quoted message said:

too low either had their carb ratio set incorrectly, or they were counting
carbs wrong.

Quoted message said:

which kind of defeats the whole purpose of the Link. If your blood

sugar

Quoted message said:

is

Quoted message said:

LOW, can it correct for that as well, by giving a lower bolus?

Yes, it reduces the dose for you. Plus the "Target" glucose is adjustable.
Some people use a target of 110, some use 125 for instance. It can be set

in

Quoted message said:

steps of 1 mg/dl anywhere between 80 and 160
.
The bolus is corrected depending on how much it differs from the target
value.

If you are below 70, the wizard won't let you bolus until you are above

70.

Quoted message said:

Quoted message said:

I was also
told by a MiniMed rep that the pump reminds you to check your BG 2 hours
after each meal bolus. Is this true?

There is a personal reminder alert feature. This is defaulted to off.

Have

Quoted message said:

to set a specific time for it to go off.

Quoted message said:

Can it be changed to say 3 hours, or
deactivated entirely. Can you set it so that it doesn't do this at

night

Quoted message said:

Quoted message said:

and wake you up? How does it "remind" you?

It displays the word REMINDER on the screen. It's basically just an alarm
clock, you need to set the times of day in advance to get the reminder.

This

Quoted message said:

might be useful for patients that do a lot of testing where timing is
critical.

You can download the users guide at
minimed.comParadigm 512 User Guide.pdfOpen ↗

Quoted message said:

Thanks for any information and assistance.

Good luck Antonio,

William C Biggs, MD

William, I retract what I wrote about "oversimplification". I WAS gonna go to bed, but kept
reading the pdf. Page 83 explains that you can set various sensitivities throughout the day. VERY
COOL! I LIKE! I'm hoping there is a way to change the number of hours that "active" insulin
remains in the body...

dave

Bay Area Dave said:

thanks for the link. I just started reading the pdf file. What jumps out at me immediately is the
oversimplification that MiniMed uses by incorporating "insulin sensitivity". The real fact of the
matter is insulin sensitivity varies by the time of day, plus the current bg level. For example my
i.s. is 1/38 during the day, and a paltry 1/22 during the dawn period. Also, when I get really
high, like 275 or greater, you can throw those numbers right out the window. Which is why I spent
a lot of time analyzing what happens under different circumstances and set up some reference
charts to get me in the ballpark for those times when everything's gone wacky. Like when I get too
high from a dislodged set, or eat something more naughty then I'd anticipated it was. If only it
were all so simple...

I will read more of the pdf tomorrow. just wanted to mention this before I forgot. Thanks again
for the link...

dave

William C Biggs said:

Antonio,

Quoted message said:

Does anyone have a MiniMed Paradigm 512 that is using the Link feature?

Our patients are using the link to the BD meter and like it.

Quoted message said:

I would like to find out more about this. In particular, I am concerned because I was told by a
MiniMed rep that, once you check your BG and are advised of the correction and meal boluses,
these cannot be altered. You must either accept them totally, or just enter the bolus amount
manually,

You can use the Bolus Wizard feature with or without input from the BD meter, if you are
concerned about that. You can set the BG manually without the direct radio data link with any
meter you like.

Of course you set the carb intake yourself.

The insulin sensitivity factor can be set at any level you want, and you can use different
sensitivities for different times of day if you like. Ditto for the carb to insulin ratio, you
can pre-set it for various levels according to time of day.

We found that those patients who were getting boluses that were too high or too low either had
their carb ratio set incorrectly, or they were counting carbs wrong.

Quoted message said:

which kind of defeats the whole purpose of the Link. If your blood sugar

is

Quoted message said:

LOW, can it correct for that as well, by giving a lower bolus?

Yes, it reduces the dose for you. Plus the "Target" glucose is adjustable. Some people use a
target of 110, some use 125 for instance. It can be set in steps of 1 mg/dl anywhere between 80
and 160 . The bolus is corrected depending on how much it differs from the target value.

If you are below 70, the wizard won't let you bolus until you are above 70.

Quoted message said:

I was also told by a MiniMed rep that the pump reminds you to check your BG 2 hours after each
meal bolus. Is this true?

There is a personal reminder alert feature. This is defaulted to off. Have to set a specific time
for it to go off.

Quoted message said:

Can it be changed to say 3 hours, or deactivated entirely. Can you set it so that it doesn't do
this at night and wake you up? How does it "remind" you?

It displays the word REMINDER on the screen. It's basically just an alarm clock, you need to set
the times of day in advance to get the reminder. This might be useful for patients that do a lot
of testing where timing is critical.

You can download the users guide at
minimed.comParadigm 512 User Guide.pdfOpen ↗

Quoted message said:

Thanks for any information and assistance.

Good luck Antonio,

William C Biggs, MD

Dave (and anyone else who cares to answer),

I could swear that I was told by my Endo that, if the basal rate is set correctly, the insulin to
carb ratio and correction ratio remains the same throughout the day. For example, I have my basal
set higher during the pre-wake hours and the breakfast to lunch hours, to compensate for my dawn
phenomenon, and my insulin to carb ratio remains the same.

Perhaps this is another case with diabetes where everyone is different?

--
Antonio
Age 37, Type 1 for 10 years
On Insulin Pump
"Bay Area Dave" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

thanks for the link. I just started reading the pdf file. What jumps
out at me immediately is the oversimplification that MiniMed uses by
incorporating "insulin sensitivity". The real fact of the matter is
insulin sensitivity varies by the time of day, plus the current bg
level. For example my i.s. is 1/38 during the day, and a paltry 1/22
during the dawn period. Also, when I get really high, like 275 or
greater, you can throw those numbers right out the window. Which is why
I spent a lot of time analyzing what happens under different
circumstances and set up some reference charts to get me in the ballpark
for those times when everything's gone wacky. Like when I get too high
from a dislodged set, or eat something more naughty then I'd anticipated
it was. If only it were all so simple...

I will read more of the pdf tomorrow. just wanted to mention this
before I forgot. Thanks again for the link...

dave

William C Biggs said:

Antonio,

Quoted message said:

Does anyone have a MiniMed Paradigm 512 that is using the Link feature?

Our patients are using the link to the BD meter and like it.

Quoted message said:

I
would like to find out more about this. In particular, I am concerned
because I was told by a MiniMed rep that, once you check your BG and are
advised of the correction and meal boluses, these cannot be altered.

You

Quoted message said:

Quoted message said:

Quoted message said:

must either accept them totally, or just enter the bolus amount

manually,

Quoted message said:

Quoted message said:

You can use the Bolus Wizard feature with or without input from the BD
meter, if you are concerned about that. You can set the BG manually

without

Quoted message said:

Quoted message said:

the direct radio data link with any meter you like.

Of course you set the carb intake yourself.

The insulin sensitivity factor can be set at any level you want, and you

can

Quoted message said:

Quoted message said:

use different sensitivities for different times of day if you like.

Ditto

Quoted message said:

Quoted message said:

for the carb to insulin ratio, you can pre-set it for various levels
according to time of day.

We found that those patients who were getting boluses that were too high

or

Quoted message said:

Quoted message said:

too low either had their carb ratio set incorrectly, or they were

counting

Quoted message said:

Quoted message said:

carbs wrong.

Quoted message said:

which kind of defeats the whole purpose of the Link. If your blood

sugar

Quoted message said:

Quoted message said:

is

Quoted message said:

LOW, can it correct for that as well, by giving a lower bolus?

Yes, it reduces the dose for you. Plus the "Target" glucose is

adjustable.

Quoted message said:

Quoted message said:

Some people use a target of 110, some use 125 for instance. It can be

set in

Quoted message said:

Quoted message said:

steps of 1 mg/dl anywhere between 80 and 160
.
The bolus is corrected depending on how much it differs from the target
value.

If you are below 70, the wizard won't let you bolus until you are above

70.

Quoted message said:

Quoted message said:

Quoted message said:

I was also
told by a MiniMed rep that the pump reminds you to check your BG 2 hours
after each meal bolus. Is this true?

There is a personal reminder alert feature. This is defaulted to off.

Have

Quoted message said:

Quoted message said:

to set a specific time for it to go off.

Quoted message said:

Can it be changed to say 3 hours, or
deactivated entirely. Can you set it so that it doesn't do this at

night

Quoted message said:

Quoted message said:

Quoted message said:

and wake you up? How does it "remind" you?

It displays the word REMINDER on the screen. It's basically just an

alarm

Quoted message said:

Quoted message said:

clock, you need to set the times of day in advance to get the reminder.

This

Quoted message said:

Quoted message said:

might be useful for patients that do a lot of testing where timing is
critical.

You can download the users guide at
minimed.comParadigm 512 User Guide.pdfOpen ↗

Quoted message said:

Thanks for any information and assistance.

Good luck Antonio,

William C Biggs, MD

Antonio,

Quoted message said:

Furthermore, if I'm sitting down at a meal and my BG tests at 70, then I don't want to have to
wait until I have eaten enough for it to come up then have to

retest

Quoted message said:

just so the pump will let me bolus. That seems idiotic.

You can use a manual bolus if you like. The lockout is only if you use the bolus wizard.

Quoted message said:

My one question that's probably not covered in the manual is: Can the target BG be set

with

Quoted message said:

a range, and for different times of the day? For instance, I have been taught over the last 10
years that my BG should be between 80 and 120, but that my BG should be 140 at bedtime.

Indeed. You can have up to 8 different targets, depending upon the time of day.

Quoted message said:

Now I realize that they are totally different, almost like they were designed by totally different
people. The logic in each is totally different. Also, the orientation of the screen with respect to
where the infusion set comes out is completely opposite. What were they thinking?

I

Quoted message said:

don't understand why they couldn't have just IMPROVED the 508 without

making

Quoted message said:

it so substantially different. I've reviewed all the pumps on the market, and, in my opinion,
MiniMed still has the best laid out display screens

and

Quoted message said:

program features.

The 508 design was pretty long in the tooth, so to speak. It is essentially the same drive mechanism
& syringe case that was in the 504 pump from the mid to late 1980's. The electronics was updated
with each revision. I think we had the largest number of pump failures with the 508, and IMHO the
device needed a complete overhaul. I wish that MiniMed would get the U-200 insulin going for the
Paradigm to get by the 175 unit limitation.

Quoted message said:

Also, paramount for me is the ability to wear the device like a pager so I don't look like a
freak with a medical device.

It looks very much like a pager.

Quoted message said:

My only wish is that they would make the Silhouette infusion set with completely clear tape so I
don't have a white spot on my abdomen. Oh well, such is

the

Quoted message said:

life with a chronic illness that sucks.

The original metal needle sets can be applied with clear tape. We have many people that prefer them
for various reasons, the biggest of which is they rarely occlude.

Best wishes,

William C Biggs, MD

It's my understanding that Humalog's potency declines by about 30% every hour. It's helpful to know
when you are taking an additional supplemental or correction bolus to know how long the Humalog in
your body will continue to remain active.

--
Steve Type 1 DM since 1967 MiniMed 508 since early 2002 Toronto, ON Canada

"Bay Area Dave" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

William, I retract what I wrote about "oversimplification". I WAS gonna go to bed, but kept
reading the pdf. Page 83 explains that you can set various sensitivities throughout the day. VERY
COOL! I LIKE! I'm hoping there is a way to change the number of hours that "active" insulin
remains in the body...

dave

Bay Area Dave said:

thanks for the link. I just started reading the pdf file. What jumps out at me immediately is
the oversimplification that MiniMed uses by incorporating "insulin sensitivity". The real fact
of the matter is insulin sensitivity varies by the time of day, plus the current bg level. For
example my i.s. is 1/38 during the day, and a paltry 1/22 during the dawn period. Also, when I
get really high, like 275 or greater, you can throw those numbers right out the window. Which is
why I spent a lot of time analyzing what happens under different circumstances and set up some
reference charts to get me in the ballpark for those times when everything's gone wacky. Like
when I get too high from a dislodged set, or eat something more naughty then I'd anticipated it
was. If only it were all so simple...

I will read more of the pdf tomorrow. just wanted to mention this before I forgot. Thanks again
for the link...

dave

William C Biggs said:

Antonio,

> Does anyone have a MiniMed Paradigm 512 that is using the Link

feature?

Quoted message said:

Quoted message said:

Quoted message said:

Our patients are using the link to the BD meter and like it.

> I would like to find out more about this. In particular, I am concerned because I was told by
> a MiniMed rep that, once you check your BG and

are

Quoted message said:

Quoted message said:

Quoted message said:

> advised of the correction and meal boluses, these cannot be altered. You must either accept
> them totally, or just enter the bolus amount manually,

You can use the Bolus Wizard feature with or without input from the BD meter, if you are
concerned about that. You can set the BG manually without the direct radio data link with any
meter you like.

Of course you set the carb intake yourself.

The insulin sensitivity factor can be set at any level you want, and you can use different
sensitivities for different times of day if you like.

Ditto

Quoted message said:

Quoted message said:

Quoted message said:

for the carb to insulin ratio, you can pre-set it for various levels according to time of day.

We found that those patients who were getting boluses that were too high or too low either had
their carb ratio set incorrectly, or they were counting carbs wrong.

> which kind of defeats the whole purpose of the Link. If your blood sugar

is

> LOW, can it correct for that as well, by giving a lower bolus?

Yes, it reduces the dose for you. Plus the "Target" glucose is adjustable. Some people use a
target of 110, some use 125 for instance. It can be set in steps of 1 mg/dl anywhere between 80
and 160 . The bolus is corrected depending on how much it differs from the target value.

If you are below 70, the wizard won't let you bolus until you are above 70.

> I was also told by a MiniMed rep that the pump reminds you to check your BG 2

hours

Quoted message said:

Quoted message said:

Quoted message said:

> after each meal bolus. Is this true?

There is a personal reminder alert feature. This is defaulted to off. Have to set a specific
time for it to go off.

> Can it be changed to say 3 hours, or deactivated entirely. Can you set it so that it doesn't
> do this at night and wake you up? How does it "remind" you?

It displays the word REMINDER on the screen. It's basically just an

alarm

Quoted message said:

Quoted message said:

Quoted message said:

clock, you need to set the times of day in advance to get the reminder. This might be useful
for patients that do a lot of testing where timing is critical.

You can download the users guide at
minimed.comParadigm 512 User Guide.pdfOpen ↗

> Thanks for any information and assistance.
>

Good luck Antonio,

William C Biggs, MD

wrong...yes, this is a case were everyone is different...many people have
different insulin to carb ratio's during the day.
"Juan Antonio" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Dave (and anyone else who cares to answer),

I could swear that I was told by my Endo that, if the basal rate is set correctly, the insulin to
carb ratio and correction ratio remains the same throughout the day. For example, I have my basal
set higher during the pre-wake hours and the breakfast to lunch hours, to compensate for my dawn
phenomenon, and my insulin to carb ratio remains the same.

Perhaps this is another case with diabetes where everyone is different?

--
Antonio Age 37, Type 1 for 10 years On Insulin Pump "Bay Area Dave" <[email hidden]> wrote in
message "]news:[email hidden]...

Quoted message said:

thanks for the link. I just started reading the pdf file. What jumps out at me immediately is
the oversimplification that MiniMed uses by incorporating "insulin sensitivity". The real fact
of the matter is insulin sensitivity varies by the time of day, plus the current bg level. For
example my i.s. is 1/38 during the day, and a paltry 1/22 during the dawn period. Also, when I
get really high, like 275 or greater, you can throw those numbers right out the window. Which is
why I spent a lot of time analyzing what happens under different circumstances and set up some
reference charts to get me in the ballpark for those times when everything's gone wacky. Like
when I get too high from a dislodged set, or eat something more naughty then I'd anticipated it
was. If only it were all so simple...

I will read more of the pdf tomorrow. just wanted to mention this before I forgot. Thanks again
for the link...

dave

William C Biggs said:

Antonio,

>Does anyone have a MiniMed Paradigm 512 that is using the Link

feature?

Quoted message said:

Quoted message said:

Quoted message said:

Our patients are using the link to the BD meter and like it.

>I would like to find out more about this. In particular, I am concerned because I was told by
>a MiniMed rep that, once you check your BG and

are

Quoted message said:

Quoted message said:

Quoted message said:

>advised of the correction and meal boluses, these cannot be altered.

You

Quoted message said:

Quoted message said:

>must either accept them totally, or just enter the bolus amount

manually,

Quoted message said:

Quoted message said:

You can use the Bolus Wizard feature with or without input from the BD meter, if you are
concerned about that. You can set the BG manually

without

Quoted message said:

Quoted message said:

the direct radio data link with any meter you like.

Of course you set the carb intake yourself.

The insulin sensitivity factor can be set at any level you want, and

you

Quoted message said:

can

Quoted message said:

Quoted message said:

use different sensitivities for different times of day if you like.

Ditto

Quoted message said:

Quoted message said:

for the carb to insulin ratio, you can pre-set it for various levels according to time of day.

We found that those patients who were getting boluses that were too

high

Quoted message said:

or

Quoted message said:

Quoted message said:

too low either had their carb ratio set incorrectly, or they were

counting

Quoted message said:

Quoted message said:

carbs wrong.

>which kind of defeats the whole purpose of the Link. If your blood

sugar

Quoted message said:

Quoted message said:

is

>LOW, can it correct for that as well, by giving a lower bolus?

Yes, it reduces the dose for you. Plus the "Target" glucose is

adjustable.

Quoted message said:

Quoted message said:

Some people use a target of 110, some use 125 for instance. It can be

set in

Quoted message said:

Quoted message said:

steps of 1 mg/dl anywhere between 80 and 160 . The bolus is corrected depending on how much it
differs from the

target

Quoted message said:

Quoted message said:

Quoted message said:

value.

If you are below 70, the wizard won't let you bolus until you are

above

Quoted message said:

70.

Quoted message said:

Quoted message said:

>I was also told by a MiniMed rep that the pump reminds you to check your BG 2

hours

Quoted message said:

Quoted message said:

Quoted message said:

>after each meal bolus. Is this true?

There is a personal reminder alert feature. This is defaulted to off.

Have

Quoted message said:

Quoted message said:

to set a specific time for it to go off.

>Can it be changed to say 3 hours, or deactivated entirely. Can you set it so that it doesn't
>do this at

night

Quoted message said:

Quoted message said:

>and wake you up? How does it "remind" you?

It displays the word REMINDER on the screen. It's basically just an

alarm

Quoted message said:

Quoted message said:

clock, you need to set the times of day in advance to get the

reminder.

Quoted message said:

This

Quoted message said:

Quoted message said:

might be useful for patients that do a lot of testing where timing is critical.

You can download the users guide at
minimed.comParadigm 512 User Guide.pdfOpen ↗

>Thanks for any information and assistance.
>

Good luck Antonio,

William C Biggs, MD

Juan, sorry, I WISH it were that easy. Carb ratio will change from low in the morning to higher
during the day and early evening with most folks. As always, YOU will have to do empirical testing
to find out if YOU experience varying carb ratios, based on time of day.

dave

Juan Antonio said:

Dave (and anyone else who cares to answer),

I could swear that I was told by my Endo that, if the basal rate is set correctly, the insulin to
carb ratio and correction ratio remains the same throughout the day. For example, I have my basal
set higher during the pre-wake hours and the breakfast to lunch hours, to compensate for my dawn
phenomenon, and my insulin to carb ratio remains the same.

Perhaps this is another case with diabetes where everyone is different?

--
Antonio Age 37, Type 1 for 10 years On Insulin Pump "Bay Area Dave" <[email hidden]> wrote in
message "]news:[email hidden]...

Quoted message said:

thanks for the link. I just started reading the pdf file. What jumps out at me immediately is the
oversimplification that MiniMed uses by incorporating "insulin sensitivity". The real fact of the
matter is insulin sensitivity varies by the time of day, plus the current bg level. For example my
i.s. is 1/38 during the day, and a paltry 1/22 during the dawn period. Also, when I get really
high, like 275 or greater, you can throw those numbers right out the window. Which is why I spent
a lot of time analyzing what happens under different circumstances and set up some reference
charts to get me in the ballpark for those times when everything's gone wacky. Like when I get too
high from a dislodged set, or eat something more naughty then I'd anticipated it was. If only it
were all so simple...

I will read more of the pdf tomorrow. just wanted to mention this before I forgot. Thanks again
for the link...

dave

William C Biggs said:

Antonio,

>Does anyone have a MiniMed Paradigm 512 that is using the Link feature?

Our patients are using the link to the BD meter and like it.

>I would like to find out more about this. In particular, I am concerned because I was told by a
>MiniMed rep that, once you check your BG and are advised of the correction and meal boluses,
>these cannot be altered.

You

Quoted message said:

Quoted message said:

>must either accept them totally, or just enter the bolus amount

manually,

Quoted message said:

Quoted message said:

You can use the Bolus Wizard feature with or without input from the BD meter, if you are
concerned about that. You can set the BG manually

without

Quoted message said:

Quoted message said:

the direct radio data link with any meter you like.

Of course you set the carb intake yourself.

The insulin sensitivity factor can be set at any level you want, and you

can

Quoted message said:

Quoted message said:

use different sensitivities for different times of day if you like.

Ditto

Quoted message said:

Quoted message said:

for the carb to insulin ratio, you can pre-set it for various levels according to time of day.

We found that those patients who were getting boluses that were too high

or

Quoted message said:

Quoted message said:

too low either had their carb ratio set incorrectly, or they were

counting

Quoted message said:

Quoted message said:

carbs wrong.

>which kind of defeats the whole purpose of the Link. If your blood

sugar

Quoted message said:

Quoted message said:

is

>LOW, can it correct for that as well, by giving a lower bolus?

Yes, it reduces the dose for you. Plus the "Target" glucose is

adjustable.

Quoted message said:

Quoted message said:

Some people use a target of 110, some use 125 for instance. It can be

set in

Quoted message said:

Quoted message said:

steps of 1 mg/dl anywhere between 80 and 160 . The bolus is corrected depending on how much it
differs from the target value.

If you are below 70, the wizard won't let you bolus until you are above

70.

Quoted message said:

Quoted message said:

>I was also told by a MiniMed rep that the pump reminds you to check your BG 2 hours after each
>meal bolus. Is this true?

There is a personal reminder alert feature. This is defaulted to off.

Have

Quoted message said:

Quoted message said:

to set a specific time for it to go off.

>Can it be changed to say 3 hours, or deactivated entirely. Can you set it so that it doesn't do
>this at

night

Quoted message said:

Quoted message said:

>and wake you up? How does it "remind" you?

It displays the word REMINDER on the screen. It's basically just an

alarm

Quoted message said:

Quoted message said:

clock, you need to set the times of day in advance to get the reminder.

This

Quoted message said:

Quoted message said:

might be useful for patients that do a lot of testing where timing is critical.

You can download the users guide at
minimed.comParadigm 512 User Guide.pdfOpen ↗

>Thanks for any information and assistance.
>

Good luck Antonio,

William C Biggs, MD

14 Oct 2003 07:43:59 GMT said:

I could swear that I was told by my Endo that, if the basal rate is set correctly, the insulin to
carb ratio and correction ratio remains the same throughout the day.

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

true if you don't have much day to day variance of your basal needs

in other words, i tend to agree with your Endo, with at least one proviso (see below)

Quoted message said:

For example, I have my basal set higher during the pre-wake hours and the breakfast to lunch
hours, to compensate for my dawn phenomenon, and my insulin to carb ratio remains the same.

Perhaps this is another case with diabetes where everyone is different?

what tends to be overlooked is how long digestion of a meal really goes on for and how that can
cloud the issue of why one's active insulin (assuming Velosulin-BR, or a 4 hour square wave with
lispro or aspart) doesn't seem to have as much effect at 4 hours after the meal as it does at 6
hours after the meal

bill t1 since '57, ex 8-yr pumper, beef-L 1x, simple MDI/DAFNE

Antonio,

I can only speak for myself but my correction ratio changes. In the morning I am super sensitive to
insulin. Been this way all my life whether I have been on shots with a high blood sugar from dawn
phenomena or on the pump with a constant blood sugar.

--
Marilyn

"Juan Antonio" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Dave (and anyone else who cares to answer),

I could swear that I was told by my Endo that, if the basal rate is set
correctly, the insulin to carb ratio and correction ratio remains the same
throughout the day. For example, I have my basal set higher during the
pre-wake hours and the breakfast to lunch hours, to compensate for my dawn
phenomenon, and my insulin to carb ratio remains the same.

Perhaps this is another case with diabetes where everyone is different?

--
Antonio
Age 37, Type 1 for 10 years
On Insulin Pump
"Bay Area Dave" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

thanks for the link. I just started reading the pdf file. What jumps
out at me immediately is the oversimplification that MiniMed uses by
incorporating "insulin sensitivity". The real fact of the matter is
insulin sensitivity varies by the time of day, plus the current bg
level. For example my i.s. is 1/38 during the day, and a paltry 1/22
during the dawn period. Also, when I get really high, like 275 or
greater, you can throw those numbers right out the window. Which is why
I spent a lot of time analyzing what happens under different
circumstances and set up some reference charts to get me in the ballpark
for those times when everything's gone wacky. Like when I get too high
from a dislodged set, or eat something more naughty then I'd anticipated
it was. If only it were all so simple...

I will read more of the pdf tomorrow. just wanted to mention this
before I forgot. Thanks again for the link...

dave

William C Biggs said:

Antonio,

>Does anyone have a MiniMed Paradigm 512 that is using the Link

feature?

Quoted message said:

Quoted message said:

Quoted message said:

Our patients are using the link to the BD meter and like it.

>I
>would like to find out more about this. In particular, I am concerned
>because I was told by a MiniMed rep that, once you check your BG and

are

Quoted message said:

Quoted message said:

Quoted message said:

>advised of the correction and meal boluses, these cannot be altered.

You

Quoted message said:

Quoted message said:

>must either accept them totally, or just enter the bolus amount

manually,

Quoted message said:

Quoted message said:

You can use the Bolus Wizard feature with or without input from the BD
meter, if you are concerned about that. You can set the BG manually

without

Quoted message said:

Quoted message said:

the direct radio data link with any meter you like.

Of course you set the carb intake yourself.

The insulin sensitivity factor can be set at any level you want, and

you

Quoted message said:

can

Quoted message said:

Quoted message said:

use different sensitivities for different times of day if you like.

Ditto

Quoted message said:

Quoted message said:

for the carb to insulin ratio, you can pre-set it for various levels
according to time of day.

We found that those patients who were getting boluses that were too

high

Quoted message said:

or

Quoted message said:

Quoted message said:

too low either had their carb ratio set incorrectly, or they were

counting

Quoted message said:

Quoted message said:

carbs wrong.

>which kind of defeats the whole purpose of the Link. If your blood

sugar

Quoted message said:

Quoted message said:

is

>LOW, can it correct for that as well, by giving a lower bolus?

Yes, it reduces the dose for you. Plus the "Target" glucose is

adjustable.

Quoted message said:

Quoted message said:

Some people use a target of 110, some use 125 for instance. It can be

set in

Quoted message said:

Quoted message said:

steps of 1 mg/dl anywhere between 80 and 160
.
The bolus is corrected depending on how much it differs from the

target

Quoted message said:

Quoted message said:

Quoted message said:

value.

If you are below 70, the wizard won't let you bolus until you are

above

Quoted message said:

70.

Quoted message said:

Quoted message said:

>I was also
>told by a MiniMed rep that the pump reminds you to check your BG 2

hours

Quoted message said:

Quoted message said:

Quoted message said:

>after each meal bolus. Is this true?

There is a personal reminder alert feature. This is defaulted to off.

Have

Quoted message said:

Quoted message said:

to set a specific time for it to go off.

>Can it be changed to say 3 hours, or
>deactivated entirely. Can you set it so that it doesn't do this at

night

Quoted message said:

Quoted message said:

>and wake you up? How does it "remind" you?

It displays the word REMINDER on the screen. It's basically just an

alarm

Quoted message said:

Quoted message said:

clock, you need to set the times of day in advance to get the

reminder.

Quoted message said:

This

Quoted message said:

Quoted message said:

might be useful for patients that do a lot of testing where timing is
critical.

You can download the users guide at
minimed.comParadigm 512 User Guide.pdfOpen ↗

>Thanks for any information and assistance.
>

Good luck Antonio,

William C Biggs, MD

Thanks, again, for another very informative response. That is very good information and makes me
want to give serious consideration to the 512 "Pathway" (upgrade from 511).

I understand what you're saying about all the improvements and I appreciate them. FWIW, I just wish
they hadn't changed the screen orientation and removed the clock from the home screen. I don't
understand why they did that.

--
Antonio
Age 37, Type 1 for 10 years
On Insulin Pump
"William C Biggs, MD" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Antonio,

Quoted message said:

Furthermore,
if I'm sitting down at a meal and my BG tests at 70, then I don't want

to

Quoted message said:

Quoted message said:

have to wait until I have eaten enough for it to come up then have to

retest

Quoted message said:

just so the pump will let me bolus. That seems idiotic.

You can use a manual bolus if you like. The lockout is only if you use the
bolus wizard.

Quoted message said:

My one question
that's probably not covered in the manual is: Can the target BG be set

with

Quoted message said:

a range, and for different times of the day? For instance, I have been
taught over the last 10 years that my BG should be between 80 and 120,

but

Quoted message said:

Quoted message said:

that my BG should be 140 at bedtime.

Indeed. You can have up to 8 different targets, depending upon the time of
day.

Quoted message said:

Now I realize that they are totally different, almost like they
were designed by totally different people. The logic in each is totally
different. Also, the orientation of the screen with respect to where

the

Quoted message said:

Quoted message said:

infusion set comes out is completely opposite. What were they thinking?

I

Quoted message said:

don't understand why they couldn't have just IMPROVED the 508 without

making

Quoted message said:

it so substantially different. I've reviewed all the pumps on the

market,

Quoted message said:

Quoted message said:

and, in my opinion, MiniMed still has the best laid out display screens

and

Quoted message said:

program features.

The 508 design was pretty long in the tooth, so to speak. It is

essentially

Quoted message said:

the same drive mechanism & syringe case that was in the 504 pump from the
mid to late 1980's. The electronics was updated with each revision. I

think

Quoted message said:

we had the largest number of pump failures with the 508, and IMHO the

device

Quoted message said:

needed a complete overhaul. I wish that MiniMed would get the U-200

insulin

Quoted message said:

going for the Paradigm to get by the 175 unit limitation.

Quoted message said:

Also, paramount for me is the ability to wear the device
like a pager so I don't look like a freak with a medical device.

It looks very much like a pager.

Quoted message said:

My only
wish is that they would make the Silhouette infusion set with completely
clear tape so I don't have a white spot on my abdomen. Oh well, such is

the

Quoted message said:

life with a chronic illness that sucks.

The original metal needle sets can be applied with clear tape. We have

many

Quoted message said:

people that prefer them for various reasons, the biggest of which is they
rarely occlude.

Best wishes,

William C Biggs, MD

yes, Humalog seems to last longer in me than the literature I received when it hit the market. Do
you know what the official word from Lily currently is regarding length of activity?

dave

Hypo Man said:

It's my understanding that Humalog's potency declines by about 30% every hour. It's helpful to
know when you are taking an additional supplemental or correction bolus to know how long the
Humalog in your body will continue to remain active.

bill, most folks on a pump will use quite a few basal rates to cover a 24 hr period. It isn't so
much a "day to day" thing as it is a circadian rhythm thing do to hormones changing ones insulin
levels. Same reasoning as most pumpers use a lower insulin to carb ratio at breakfast than at lunch
or supper. It has nothing to do with varying DAYS as it does with the TIME OF DAY.

The 508 allows the pumper to set up to 3 basal profiles, allowing the user to quickly switch to a
different set of preprogrammed basal rates. For example, one could be set to a "typical day".
Another one for a more active lifestyle that persists for at least a day, and another one for a more
sedentary period. A different basal profile for weekends versus weekdays is another option...

After seeing you write about so many erroneous ideas, I can now see why you gave up pumping. You
don't understand the fundamentals. And you tend to stubbornly cling to your mistaken beliefs, which
causes me to abbreviate most of my responses to you, as I feel it's a total waste of time to try to
help you understand.

dave

willbill said:

14 Oct 2003 07:43:59 GMT said:

I could swear that I was told by my Endo that, if the basal rate is set correctly, the insulin to
carb ratio and correction ratio remains the same throughout the day.

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

true if you don't have much day to day variance of your basal needs

in other words, i tend to agree with your Endo, with at least one proviso (see below)

Quoted message said:

For example, I have my basal set higher during the pre-wake hours and the breakfast to lunch
hours, to compensate for my dawn phenomenon, and my insulin to carb ratio remains the same.

Perhaps this is another case with diabetes where everyone is different?

what tends to be overlooked is how long digestion of a meal really goes on for and how that can
cloud the issue of why one's active insulin (assuming Velosulin-BR, or a 4 hour square wave with
lispro or aspart) doesn't seem to have as much effect at 4 hours after the meal as it does at 6
hours after the meal

bill t1 since '57, ex 8-yr pumper, beef-L 1x, simple MDI/DAFNE

this is nice graphic on the peaks and duration levels of various insulin types, including Humalog.

lillydiabetes.comTimeActivityProfiles.cfmOpen ↗

--
Steve Type 1 DM since 1967 MiniMed 508 since early 2002 Toronto, ON Canada

"Bay Area Dave" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

yes, Humalog seems to last longer in me than the literature I received when it hit the market. Do
you know what the official word from Lily currently is regarding length of activity?

dave

Hypo Man said:

It's my understanding that Humalog's potency declines by about 30% every hour. It's helpful to
know when you are taking an additional

supplemental or

Quoted message said:

Quoted message said:

correction bolus to know how long the Humalog in your body will continue

to

Quoted message said:

Quoted message said:

remain active.

14 Oct 2003 20:05:28 GMT said:

You don't understand the fundamentals...

as best i can tell, i understand the fundamentals a lot better than you do

bill t1 since '57, ex 8-yr pumper, beef-L 1x, simple MDI/DAFNE

ya sure, you betcha!

dave

willbill said:

14 Oct 2003 20:05:28 GMT said:

You don't understand the fundamentals...

as best i can tell, i understand the fundamentals a lot better than you do

bill t1 since '57, ex 8-yr pumper, beef-L 1x, simple MDI/DAFNE

willbill,

what are your BG readings between breakfast and lunch at approx two and three hours intervals after
your morning injection. I had a very dramatic drop at around the 3 hour point with the Beef and Pork
Lente. Also, sweated profusely, which later stopped when I went on Lily Humulin biosynthetic, when
BG levels went south. Do you have any of these problems?.

--
Steve Type 1 DM since 1967 MiniMed 508 since early 2002 Toronto, ON Canada

"willbill" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

14 Oct 2003 20:05:28 GMT said:

You don't understand the fundamentals...

as best i can tell, i understand the fundamentals a lot better than you do

bill t1 since '57, ex 8-yr pumper, beef-L 1x, simple MDI/DAFNE