Accu-Chek Aviva Expert Owner's Booklet
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- Page 1 BLOOD GLUCOSE METER Advanced Owner’s Booklet © 2015 Roche Diabetes Care Roche Diabetes Care GmbH Sandhofer Strasse 116 68305 Mannheim, Germany www.accu-chek.com ACCU-CHEK, ACCU-CHEK AVIVA, and ACCU-CHEK AVIVA EXPERT are trademarks of Roche.
- Page 2 United Kingdom Roche Diabetes Care Limited Charles Avenue, Burgess Hill West Sussex, RH15 9RY, United Kingdom Accu-Chek Customer Careline UK Freephone number: 0800 701 000 ROI Freephone number: 1 800 709 600 calls may be recorded for training purposes www.accu-chek.co.uk www.accu-chek.ie...
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Page 3: Table Of Contents
Contents Introduction 1 Bolus Advice 1.1 Overview 1.2 Before Using Bolus Advice 1.3 Calculating a Bolus Using Bolus Advice Appendices Appendix A: Bolus Advice Appendix B: Bolus Advice Calculations Appendix C: Explanation of Symbols Index... -
Page 5: Introduction
Introduction Whether the Accu-Chek Aviva Expert meter is your first blood glucose meter or you have used a meter for some time, please take the time to read the Getting Started Guide, the Standard Owner’s Booklet and the Advanced Owner’s Booklet carefully before you use your new meter. To use it correctly and dependably, you need to understand its operation, screen displays and all individual features. -
Page 7: Bolus Advice
Bolus Advice 1.1 Overview 1.2 Before Using Bolus Advice 1.3 Calculating a Bolus Using Bolus Advice... -
Page 8: Overview
1.1 Overview Important information regarding the use of bolus advice is presented in this chapter. Read it carefully and completely before you begin using bolus advice. • It is recommended you discuss your bolus advice settings with your healthcare professional prior to setting up this feature. - Page 9 • This booklet shows sample screens. The screens in this booklet may look slightly different from the screens on your Accu-Chek Aviva Expert meter. If you have any questions about the meter screens, contact the Accu-Chek Customer Careline on 0800 701 000 (UK) or 1 800 709 600 (ROI).
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Page 10: Before Using Bolus Advice
1.2 Before Using Bolus Advice Intended Users As with any specialised feature, you need to understand certain information in order to use bolus advice. Working closely with your healthcare professional, you must be completely familiar with your diabetes therapy. You must also be able to judge your current situation accurately. Bolus advice calculates boluses for you. - Page 11 Safety Information Regarding Bolus Advice WARNING • It is very important you follow the safety information in this chapter. • Always compare your result with how you actually feel and adjust the recommended bolus, if necessary. • Always carry out the actions entered into bolus advice in a timely fashion. Eat the carbohydrate amount you entered and administer the insulin dose.
- Page 12 The following information is not taken into account when bolus advice is used: • It is possible the values entered when setting up bolus advice do not match how your body actually feels. In this case, you can increase or decrease the bolus insulin dose to adjust it to your needs. •...
- Page 13 Warning messages about your blood glucose test result After performing a blood glucose test, warning messages about your blood glucose test result may be displayed. Please take careful note of these messages. If your blood glucose test result is too low, you are prompted to eat a certain amount of fast acting carbohydrates to prevent the risk of hypoglycaemia.
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Page 14: Calculating A Bolus Using Bolus Advice
1.3 Calculating a Bolus Using Bolus Advice bG Test Result Recommended Bolus Amount Active Insulin Carb Entry Health Event Entry Bolus Basal... - Page 15 To Deliver a Bolus Main Menu > Bolus Advice a blood glucose test. When the detailed bG Result screen appears, select Bolus. To Enter a Carbs Amount: Select the Carbs entry field and press =. Set the amount of Carbohydrates and press =. From the Main Menu, select If you have not completed Bolus Advice and press =.
- Page 16 To Enter a Health Event: Select the Health entry field and press =. Select a health event and press =. To Adjust the Bolus Amount: Select the Bolus entry field and press =. The bolus amount is displayed on Set the bolus insulin amount the meter screen.
- Page 17 WARNING • Bolus advice provided by the meter is solely advice. Contact your healthcare professional prior to changing your diabetes therapy. • It is important to make the correct selection for the carbohydrate ratio and insulin sensitivity. If you select the wrong ratio (the basis for all calculations), all future bolus advice recommendations will be wrong.
- Page 18 NOTE • 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 displayed, press .. This is not available if your bG result is below your hypo warning limit (red colour bar is displayed). •...
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Page 19: Appendices
Appendices Appendix A: Bolus Advice Bolus advice is only available if you have set up bolus advice on the Accu-Chek Aviva Expert meter. For instructions on how to set up bolus advice, see the Standard Owner’s Booklet. Along with the basic blood glucose and carbohydrate values, there are several meter settings required to optimize the bolus advice feature so the recommendations match your insulin needs to the greatest possible extent. - Page 20 Bolus Advice Meter Settings This section contains an overview of the information that must be entered into the meter for accurate bolus advice recommendations. Carbohydrate Units • Bolus advice recommendations are based on the units of carbohydrates selected. • The right choice of carbohydrate units is important for bolus advice recommendations to be accurate. •...
- Page 21 Insulin Increment • The meter rounds off the insulin amount to be delivered, which the meter calculates if bolus advice is set up, or when you manually enter bolus and basal insulin data into the diary. • The insulin increment can be set to 0.5 or 1 U. Max Bolus •...
- Page 22 Warning Limits • You can select hyper (high) and hypo (low) blood glucose limits that best fit your needs. • Whenever a blood glucose test result is above the hyper warning limit or below the hypo warning limit, the meter displays a warning. •...
- Page 23 Target Range • The desired upper and lower limits of your blood glucose level considered acceptable as set by your healthcare professional. • The meter automatically calculates the target blood glucose level as the average between the upper and lower blood glucose target limits. •...
- Page 24 Insulin Sensitivity • For the current time block, the insulin sensitivity (correction factor) is the amount of insulin necessary to lower your blood glucose by a certain amount. • Talk with your healthcare professional to determine the appropriate insulin sensitivity settings. Your meter comes with the following preset time blocks: Time Block 24-Hour Format...
- Page 25 Talk to your healthcare professional about setting up time blocks to help you manage your diabetes. Here is a suggested pattern: Time Block Start Time End Time 1. Night time Midnight The time you normally wake up 2. Breakfast The time you normally wake up 1½...
- Page 26 Setting Up Time Blocks: Important Information • Time blocks cover a 24-hour time period (from midnight to midnight). • You can change the time period for any of the preset time blocks. • When setting up bolus advice, you must complete and save the settings in at least one time block. •...
- Page 27 Health events available on the meter are: • Exercise 1 • Exercise 2 • Stress • Illness • Premenstrual • Fasting Bolus Advice Options Meal rise, snack size, acting time and offset time are bolus advice options. Below are detailed descriptions of each of these settings.
- Page 28 Snack Size • The snack size is the amount of carbohydrates that should not be counted as a regular meal with the expected meal rise. Acting Time • The period of time from the start of the meal rise or the delivery of a correction bolus until your blood glucose level is expected to return to the target level.
- Page 29 Bolus Calculation The bolus recommended by the bolus advice feature of the meter consists of two components: A recommendation for a meal bolus that covers your food intake and a recommendation for a correction bolus to adjust your blood glucose level if it is not within the target range. The correction bolus can be positive if your current blood glucose level is above your target range or negative if it is below your target range.
- Page 30 Correction Bolus If your current blood glucose level is not within your target range, a correction bolus is recommended. Blood Glucose Limits bG Result Hyper Warning Upper Target Limit Target Lower Target Limit Hypo Warning Discuss your blood glucose limits with your healthcare professional.
- Page 31 The calculation for the recommended correction bolus depends on your current blood glucose test result, your insulin sensitivity for the current time block, and whether you are planning to eat. Example Bolus Advice Calculations Blood Glucose Level Without Food Intake (No Carbs) Prior to a Meal Above Upper Target Limit (bG –Target bG) x Insulin Sensitivity (bG –Target bG) x Insulin Sensitivity...
- Page 32 Other Boluses Subsequent Meal Boluses If you are planning to eat several meals or snacks in a short period of time, you should administer a meal bolus for each meal. The calculation is always the same as a meal bolus. Correction Bolus After a Meal After a meal, it is normal to allow for a rise of your blood glucose level even if you administered the correct meal bolus.
- Page 33 Acting Time bG Level Hyper O set Time Target Value Target Range Hypo Time Current Currently Allowed bG Value: Bolus Not Meal Bolus bG Values Meal Rise Required The dotted line shows how your blood glucose level might change after a meal bolus. Bolus advice tolerates an increase in your blood glucose level within the meal rise range (green) without calculating an extra correction bolus.
- Page 34 Subsequent Correction Boluses The difference between your current blood glucose level and your target blood glucose level is called Delta bG. A correction bolus administered according to the previous conditions covers this difference for a certain period of time. As the correction bolus starts to take effect, your current blood glucose level should fall and the covered Delta bG decreases after the offset time.
- Page 35 Examples of Bolus Advice Recommendations The following graphs provide differing examples of how bolus advice considers different factors when calculations are made. The currently allowed blood glucose value considers the following factors: • Target Range Mean Value • Meal Rise •...
- Page 36 After a Correction Bolus Acting Time bG Level O set Time Hyper Target Value Target Range Hypo Time Current Bolus Not Currently Allowed bG Value: Bolus bG Values Required Corrected bG The above diagram shows an example of the effect of this rule. The first correction bolus at 12:00 remains active during the acting time (the width of the blue area).
- Page 37 bG Level Hyper Target Value Target Range Hypo Time Current Bolus bG Values When a blood glucose test result is greater than the currently allowed blood glucose value, a bolus is calculated (light blue) that only considers the difference between the current blood glucose value (orange dots) and the currently allowed blood glucose value (the top of the blue area).
- Page 38 bG Level Hyper Target Value Target Range Hypo Time Current Currently Allowed bG Meal Bolus Bolus Not bG Values Value: Meal Rise Required Subsequent Meals If you eat several meals in a row, the meal rise is restarted for each new meal bolus.
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Page 39: Appendix B: Bolus Advice Calculations
Appendix B: Bolus Advice Calculations The Mathematical Basis for Bolus Calculations The following is a list of the most important formulas and the calculation principles on which bolus advice is based. It is difficult to accurately calculate a bolus yourself using these formulas when the acting time and offset time of recent meals and correction boluses are considered. - Page 40 Meal Bolus The following formula is used to calculate the bolus for meals: Insulin Meal Bolus = Carbohydrate Intake × Carbohydrates from carbohydrate ratio Currently Allowed Blood Glucose Value The target range average value used in the calculation of the correction bolus, as shown below, changes with the definition for the time blocks.
- Page 41 Correction Bolus Generally, a correction bolus is only calculated if the current blood glucose value is above the hypo bG warning limit and outside the target range. If the current blood glucose value is above the target range, the currently allowed blood glucose value must also be exceeded. Only correction boluses greater than “0” trigger a corresponding acting time.
- Page 42 Correction Bolus with Carbohydrate Intake Whenever carbohydrates have been entered, the related meal bolus is always offset against any (even negative) correction bolus. When a meal is eaten, the correction bolus is also calculated for blood glucose test results that fall within the target range if: •...
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Page 43: Appendix C: Explanation Of Symbols
Appendix C: Explanation of Symbols You may encounter the following symbols on the packaging, on the type plate (back of meter), and in the instructions for the meter, shown here with their meaning. Consult instructions for use Caution, refer to safety-related notes in the instructions for use accompanying this product. -
Page 45: Index
Index bolus advice options, 25–26 acting time, bolus advice recommendations, examples, active insulin, 26, 33–36 bolus amount, adjust, bolus calculation, basal amount, adjust, correction bolus, basal insulin, examples, bolus advice, meal bolus, intended users, bolus, delivery using bolus advice, 13–16 meter screen features, overview, 6–7, 17–26... - Page 46 health events, 14, 24–25 safety information, bolus advice, 9–11 bolus delivery, 15–16 insulin increment, snack size, insulin sensitivity, symbols, explanation, lower blood glucose target limit, target range, time blocks, 20, 22–24 max bolus, meal rise, upper blood glucose target limit, neutral protamine hagedorn (NPH), warning limits, o set time,...