page_title: Minimed Paradigm
section_title: Description
hierarchical_section_title: Minimed Paradigm / Description
caption_attribution_description: English: The long acting insulin is given once (usually glargine [Lantus]) or twice (usually detemir [Levemir]) daily to provide a base, or basal insulin level. Rapid acting (RA) insulin is given before meals and snacks. A similar profile can be provided using an insulin pump (discussed later in this Knol) where rapid acting insulin is given as the basal and premeal bolus insulin.
context_page_description: MiniMed Paradigm is a series of insulin pumps manufactured by Medtronic for patients with diabetes mellitus. The pump operates with a single AAA battery and uses a piston-plunger pump to infuse a programmed amount of insulin into the patient through a length of tubing. The Paradigm uses a one-way wireless radio frequency link to receive blood sugar measurements from select glucose meters. The Paradigm RT series adds the ability to receive data from a mated continuous blood-glucose monitor. Although the pump can use these measurements to assist in calculating a dose of insulin, no actual change in insulin delivery occurs without manual user-intervention.
  In the United States, the device is regulated by a branch of the Food and Drug Administration.
context_section_description: Insulin pumps are drug delivery devices used to treat patients with type 1 and type 2 diabetes. The Minimed Paradigm REAL-Time and Continuous Glucose Monitoring (CGM) system, which received FDA clearance in 2006, uses tubing and a reservoir with rapid-acting insulin. This "infusion set" is patient-connected via a catheter to the abdomen region. The infusion set can remain in the place for three days while the pump is clip-belt worn. There is a quick-disconnect feature for the tubing. The pump delivers insulin in two modes. In Basal rate mode, the delivery is continuous in small doses similar to a pancreas, for example 0.15 units per hour throughout the day. Basal rates are set to meet individual metabolic rates. In Bolus mode, the delivery is programmed to be a one-time delivery prior to eating or after an unexpected high, for example 18 units spread out to several hours. This type of continuous treatment is in contrast to traditional multiple daily injections (MDI) that use slower-acting insulin. Continuous treatment reduces glucose variability.
  The Paradigm system consists of two basic parts: an insulin pump and an optional glucose sensor CGM worn for up to 3 days. The disposable sensor is subcutaneously-placed to make glucose measurements in interstitial fluid every 5 minutes and transmit the reading via low power radio frequency (ISM band) to the pump for realtime display. However, insulin therapy may be conducted without CGM and although there is not yet an automated insulin-regulation feedback mechanism between measure and infusion to control the amount and timing of insulin, this is clearly a future objective. So any change in basal or bolus is patient-driven by programming the pump using the Bolus Wizardᵀᴹ. The latest model pumps are the MiniMed Paradigm 522 and 722 which differ in reservoir size, 176 versus 300 units, respectively. In 2007 the FDA approved a pediatric model for patients 7 to 17 years old.
  The Minimed Paradigm System is composed of the following parts:
  Insulin pump models 522/722
  Glucose sensor kit (CGM)
  Minilink RF transmitter
  Infusion set and reservoirs
  CareLink USB upload device
  CareLink therapy management software
  In addition to system parts, there are other necessary parts associated with overall diabetes therapy including a glucose meter for finger stick calibrations and treatment verification, traditional injectors and supplies, ketones test supplies, test strip vials, skin preparation, glucagon supplements, etc. If using OneTouch UltraLink meter, readings are sent wirelessly to the pump.
  The development history of the Minimed pump goes back to the 1980s.
  1983 – 1st Pump MiniMed 502 (Eli Lilly makes synthetic insulin)
  1985 – MiniMed 504 Insulin Pump
  1992 – Launch Of MiniMed 506 Insulin Pump
  1996 – Introduction of MiniMed 507 Pump
  1999 – Launch of the Model 507C
  1999 – Introduction of MiniMed 508 Insulin Pump
  2002 – Inauguration of the MiniMed Paradigm 511
  2003 – 1st Wireless MiniMed Paradigm 512/712 (followed by 515/715)
  2006 – MiniMed Paradigm REAL-Time 522/722
  2010 – MiniMed Paradigm REAL-Time Revel 523/723
  The Food and Drug Administration has at least six classifications for the various parts of the Minimed Paradigm System.
caption: Insulin basal bolus profile.
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