Accu-Chek Combo conseils pour une utilisation de base

Comment assurer les opérations en douceur

• Toujours porter le smartphone avec vous, laissez-le à côté de votre lit la nuit.
• Toujours vérifiez toujours que la batterie de la pompe est aussi complète que possible. Reportez-vous à la section de la batterie pour obtenir des conseils concernant la batterie.
• Il est préférable de ne pas toucher à l’application Ruffy pendant que le système fonctionne. Si l’application est redémarrée, la connexion à la pompe peut s’arrêter. Une fois que la pompe est connectée à la Ruffy, il n’est pas nécessaire de la reconnecter. Même après un redémarrage du téléphone, la connexion est automatiquement rétablie. Si possible, déplacez l’application vers un écran inutilisé ou dans un dossier de votre smartphone afin de ne pas l’ouvrir accidentellement.
• Si vous ouvrez involontairement l’application Ruffy pendant le bouclage, il est préférable de redémarrer le smartphone immédiatement.
• Dans la mesure du possible, n’utiliser la pompe que via l’application AndroidAPS. Pour faciliter cela, activez le verrouillage sur la pompe sous Réglages pompe / Verrouillage des touches / On. Ce n’est que lorsque vous changez la pile ou la cartouche qu’il est nécessaire d’utiliser les touches de la pompe.

Pompe inaccessible. Que faire ?

Activer l’alerte pompe inaccessible

• Dans AndroidAPS, accédez à ** Paramètres / Alertes locales ** et activez Alerte si la pompe est hors de portée et paramétrez Seuil alerte pompe hors de portée [min] à 31 minutes.
• This will give you enogh time to not trigger the alarm when leaving the room while your phone is left on the desk, but informs you if the pump cannot be reached for a time that exceeds the duration of a temporary basal rate.

Restaurer l’accessibilité de la pompe

• When AndroidAPS reports a pump unreachable alarm, first release the keylock and press any key on the pump (e.g. “down” button). As soon as the pump display has turned off, press UPDATE on the Combo Tab in AndroidAPS. Mostly then the communication works again.
• If that does not help, reboot your smartphone. After the restart, AndroidAPS and ruffy will be reactivated and a new connection will be established with the pump.
• The tests with different smartphones have shown that certain smartphones trigger the “pump unreachable” error more often than others. AAPS Phones lists successfully tested smartphones.

Causes racines et conséquences des fréquentes erreurs de communication

• On phones with low memory (or aggressive power-saving settings), AndroidAPS is often shut down. You can tell by the fact that the Bolus and Calculator buttons on the Home screen are not shown when opening AAPS because the system is initializing. This can trigger “pump unreachable alarms” at startup. In the Last Connection field of the Combo tab, you can check when AndroidAPS last communicated with the pump.

• Cette erreur peut vider la pile de la pompe plus rapidement car le profil basal est lu à partir de la pompe lorsque l’application est redémarrée.
• It also increases the likelihood of causing the error that causes the pump to reject all incoming connections until a button on the pump is pressed.

Echec de l’annulation du débit de base temporaire

• Occasionally, AndroidAPS can not automatically cancel a TBR CANCELED alert. Then you have to either press UPDATE in the AndroidAPS Combo tab or the alarm on the pump will be confirmed.

Considérations relatives à la pile

Changer la pile

• After a low battery alarm, the battery should be changed as soon as possible to always have enough energy for a reliable Bluetooth communication with the smartphone, even if the phone is within a wider distance of the pump.
• Even after a low battery alarm, the battery might be used for a significant amount of time. However, it is recommended to always have a fresh battery with you after a “low battery” alarm rang.
• To do this, long-press on Closed Loop on the main screen and select Suspend loop for 1h.
• Wait for the pump to communicate with the pump and the bluetooth logo on the pump has faded.

• Release the key lock on the pump, put the pump into stop mode, confirm a possibly canceled temporary basal rate, and change the battery.
• Then put the pump back in run mode select Resume when lon-pressing on Suspended on the main screen.
• AndroidAPS will re-set a necessary temporary basal rate with the arrival of the next blood sugar value.

Type de pile et causes de faible autonomie

• As intensive Bluetooth communication consumes a lot of energy, only use high-quality batteries like Energizer Ultimate Lithium ,the “power one”s from the “large” Accu-Chek service pack, or if you are going for a rechargeable battery, use Eneloop batteries.

Ranges for typical life time of the different battery types are as follows:

• Energizer Ultimate Lithium : 4 à 7 semaines
• Power One Alcaline (Varta) à partir du servcie pack : 2 à 4 semaines
• Batteries Eneloop rechargeables (BK-3MCCE) : 1 à 3 semaines

If your battery life is signifcantly shorter than the ranges given above, please check the following possible causes:

• Die latest version (March 2018) of the ruffy App significantly improved pump battery lifetime. Make sure you are on that version if you have issues with a short battery lifetime.
• There are some variants of the screw-on battery cap of the Combo pump, which partially short circuit the batteries and drain them quickly. The caps without this problem can be recognized by the golden metal contacts.
• If the pump clock does not “survive” a short battery change, it is likely that the capacitor is broken which keeps the clock running during a brief power outage. In this case, only a replacement of the pump by Roche will help, which is not a problem during the warranty period.
• The smart phone hardware and software (Android operating system and bluetooth stack) also impact the battery lifetime of the pump, even though the exact factors are not completely known yet. If you have the opportunity, try another smartphone and compare battery lifetimes.

Changement d’heure (été ou hiver)

• Actuellement, le pilote combo ne prend pas en charge l’ajustement automatique de l’heure de la pompe.
• Pendant la nuit d’un changement d’heure, l’heure du smartphone est mise à jour, mais l’heure de la pompe reste inchangé. Cela conduit à une alarme en raison du décalage des heures entre les systèmes à 3 heures du matin.
• Si vous ne souhaitez pas être réveillé la nuit, désactivez Date et heure automatiques sur le téléphone mobile dans la soirée avant le changement d’heure et ajustez-vous les heures manuellement le lendemain matin.

Bolus étendus, bolus mixtes

L’algorithme OpenAPS ne prend pas en charge un bolus carré étendu ou un bolus mixte. Mais un traitement similaire peut être réalisé à l’aide de l’alternative suivante :

• Entrez les glucides mais pas le bolus correspondant. L’algorithme de boucle réagira plus agressivement. Si nécessaire, utilisez eCarbs (glucides étendus).
• If you are tempted to just use the extended or multiwave bolus directly on the pump, AndroidAPS will penalize you wth disabling the closed loop for the next six hours to ensure that no excess insulin dosage is calculated.

Alarmes à l’administration du bolus

• If AndroidAPS detects that an identical bolus has been successfully delivered at the same minute, bolus delivery will be prevented with identical numer of insulin units. If you really want to bolus the same inuslin twice in short succession, just wait two more minutes and then deliver the bolus again. If the first bolus has been interruped or was not delivered for other reasons, you can immediately re-submit the bolus since AAPS 2.0.
• Background is a safety mechanism that reads the pump’s bolus history before submitting a new bolus to correctly calculate insulin on board (IOB), even when a bolus is delivered directly from the pump. Here indistinguishable entries must be prevented.

• This mechanism is also responsible for a second cause of the error: If during the use of the bolus calculator another bolus is delivered via the pump and thereby the bolus history changes, the basis of the bolus calculation is wrong and the bolus is aborted.