Accu-Chek 360˚

• Can I print the reports and a graph in a language other than the language in which the application is installed?
  Yes. The Accu-Chek 360° Diabetes Management system is unique in that it allows users to print out a report or graph in any of the 10 languages supported by the application. Providing information for print in multiple languages is another way the Accu-Chek 360° Diabetes Management system may help improve the communication between the patient and the healthcare team.
  
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• Does the Accu-Chek 360° Diabetes Management system address the needs of users who do not want all of the features it has to offer as well as those that want more? Can features be turned off if they are not being used or needed?
  Yes. The Accu-Chek 360° Diabetes Management system is designed to meet the personalised needs of users by employing a set-up wizard to automatically run the first time the application is used. This “intelligent” wizard customises the application to meet the needs of the specific user. Users will only see those features that they want to use, thus providing an improved personalised experience.
  
  In addition, if users have future needs, they can be addressed by simply using the Show / Hide function within the system application to activate the features to meet these new needs.
  
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• Does the Accu-Chek 360° Diabetes Management system have any advanced reporting options?
  Yes. The Accu-Chek 360° Diabetes Management system provides a variety of advanced reporting options with the intended purpose of making the user’s experience more positive and efficient. These options include:
  
  

  • Favourite reports – The Accu-Chek 360° Diabetes Management system offers the ability to define favourite reports. This is much like creating a list of your favourite Web sites in your Web browser. Once these are created, the user can return to these at the click of a button.
  • Batch reports – This option is designed to allow the user to output several different reports at the same time. For example, the user may want to always print the Trend graph and the Logbook report when his or her supported Accu-Chek device is downloaded. In this case, the goal of the Accu-Chek 360° Diabetes Management system is to make it as simple as identifying what reports should be printed together, and it does the rest.
  • Custom reports – This option is designed to allow users to create or lay out their own reports. It is intended for those users who may want the information presented in a manner different from the standard reports. This is a simple drag-and-drop feature.

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• Does the Accu-Chek 360° Diabetes Management system offer the ability to print, email and fax information?
  Yes. The Accu-Chek 360° Diabetes Management system is designed so that it offers the ability to print, email and fax reports directly from the application. In fact, its technology allows a user to perform all 3 actions consecutively, which may shorten the user’s wait time.
  
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• What is auto-detect?
  The Accu-Chek 360° Diabetes Management system offers a newly created feature that is designed to download supported Accu-Chek devices automatically. With the application closed, the user simply puts the supported Accu-Chek device in communication mode and places it in front of the Accu-Chek 360° USB cable. The Accu-Chek 360° Diabetes Management system does the rest and even auto-prints a report.
  
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• Why would a healthcare professional use the population-management tool?
  The goal of population management is to focus on a group of patients rather than an individual patient. The population-management tool is designed to offer the healthcare professional the ability to identify which therapies are working and which ones are not for a group of patients. This information can help the healthcare professional make informed treatment decisions.
  Not only does the population-management tool’s design offer the ability to prove outcomes, its intended purpose is to do it more efficiently when compared to traditional methods.
  
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• Are there disadvantages associated with steel needle sets?
  Many patients worldwide actually prefer steel needle sets. Unlike with soft cannula sets, the risk of a steel needle set becoming crimped under the skin and disrupting insulin infusion is extremely low.
  
  The needle is just as comfortable to wear as a soft cannula. According to Accu-Chek Rapid-D Link users, it is just a matter of getting used to it. Nickel, which is used in a very low concentration in the stainless steel needle, may be responsible in rare cases for an allergic reaction; a switch to a soft cannula infusion set may help to overcome this issue.
  
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• Do infusion sets contain softening agents?
  These softening agents are mainly used in PVC. Because Accu-Chek Infusion Sets are free of PVC we can exclude the content of softening agents, especially DEHP [ di(2-ethylhexyl)-phthalate ] and DBP [ dibutyl-phthalate ].
  
  A number of consumer products and surface materials contain softening agents, so called plasticizers, to make the material softer. Such materials are known to provoke allergic reactions.
  
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• Does it hurt to wear an infusion set?
  While there may be an occasional "pinch" when inserting the set, many people find inserting infusion sets more comfortable than giving injections. Once the set is under the skin, most people forget that they're wearing it.
  
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• How often do I need to change my infusion site?
  In order to help keep sites free of infection, we recommend that sites be changed at least every 48 hours for steel needle sets, and every 72 hours for soft cannula sets. It is important to always test your blood glucose level 1-3 hours after inserting a new set, to make sure that it is functioning properly.
  
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• My infusion site sometimes hurts. What can I do?
  Pain at the infusion site may be a sign that you are using a set which does not penetrate at the right depth for you (this can especially affect children or thin-build people). If you are using an Accu-Chek TenderLink, try adjusting the angle of insertion. Talk to your healthcare professional about the possibility of switching to a different needle or cannula length.
  
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• My lifestyle is active – always on the go. Can I still enjoy all my favourite activities with the pump?
  The disconnectable sets from Accu-Chek allow you the freedom to disconnect from your pump altogether for the duration or your activity. Talk to your healthcare professional about time off the pump for sports or an occasional day at the beach.
  
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• My set doesn't stick as well during the summer. How can I fasten it better?
  Water sports and heavy sweating can affect the infusion set's adhesive pad – try using an extra water-permeable adhesive patch (like Tegaderm™ or Opsite™ IV3000™) to give your site extra security. You may also try the Sandwich technique: Cleanse the skin using an adhesive wipe, allow to dry, apply a sterile dressing, insert the set into the dressing, cover the set with another sterile dressing to "sandwich" the infusion set.
  
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• What about allergies?
  The use of hypo-allergenic materials is a high priority for Roche. Our infusion sets are latex and PVC free and glues and solvents are used as little as possible. The adhesive tape is also specially designed to allow the skin underneath it to breathe. However, allergic reactions can never fully be ruled out. Sometimes they develop suddenly, even if you have used the same product for years. If an allergic reaction should occur, ask your healthcare professional about products that can help you continue a comfortable therapy.
  
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• Which pump does my set fit on?
  The Accu-Chek infusion sets offer a luer-lock connection that meets international standards and is widely used in medical engineering. Our sets fit on all Disetronic pumps as well as on all other pumps that meet the same standard.
  
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Accu-Chek LinkAssist

• Can Accu-Chek LinkAssist be used by several persons or only one?
  The Accu-Chek LinkAssist insertion device is exclusively for use on one person. It must not be used other people.
  
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• Do I have to get professional training before using Accu-Chek LinkAssist for the first time?
  Health care professionals and Diabetes Educators are a valuable source of information and training for all people with diabetes, which you should take advantage of regularly. It is not necessary, however, to get professional instruction before using Accu-Chek LinkAssist for the first time. You will find it easy to use by following the instructions for use contained in the packaging.
  
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• Do I have to pinch my skin for the insertion with Accu-Chek LinkAssist?
  No, this is not necessary.
  
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• How do I know on which side the tube connection of the infusion set is located?
  The elongated perforation mark on the self-adhesive backing directs you to the location of the tube connection.
  
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• How should Accu-Chek LinkAssist be stored?
  The Accu-Chek LinkAssist should not be stored pre-tensioned. The tensioning element should be completely outside of the base. Do not store the insertion device in extreme temperatures (e.g. in a hot car in summer).
  
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• How should I clean the Accu-Chek LinkAssist?
  If needed, wipe the outside of the Accu-Chek LinkAssist insertion device with a cloth moistened beforehand with water, a mild hand soap or a standard disinfectant (e.g. 70% ethyl alcohol). Do not dip the insertion device into the cleaning fluid. Dry the insertion device thoroughly with a soft, clean cloth.
  
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• Is it possible to activate the Accu-Chek LinkAssist with only one hand?
  Yes. This enables you to reach hard-to-access infusion sites.
  
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• What should I do if the infusion set gets stuck in the Accu-Chek LinkAssist insertion device?
  In case the infusion set gets stuck in the insertion device, carefully push the tensioning element back into the base without pointing the insertion device toward any body part or somebody else. Make sure you do not compress the base during application.
  
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• Which infusion sets can be inserted with the Accu-Chek LinkAssist insertion device?
  Accu-Chek LinkAssist has been developed exclusively for the automatic insertion of Accu-Chek FlexLink 90-degree soft cannula infusion sets.
  
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• Who can use or should use the Accu-Chek LinkAssist insertion device?
  The Accu-Chek LinkAssist insertion device has been developed for all those who prefer automatic insertion of infusion sets. Automatic insertion delivers consistent placement of the cannula ever time and helps patients to gain better access to hard-to-reach infusion sites.
  
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• Why is the Accu-Chek LinkAssist so big?
  We have designed Accu-Chek LinkAssist to accommodate all wishes and needs of people with diabetes who prefer automatic insertion. Some of them have to cope with dexterity issues and impaired vision and therefore favour a larger insertion device facilitating easy, quick and virtually painless insertion.
  
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• Why should I use the Accu-Chek LinkAssist insertion device? Isn’t it just one more thing to carry around?
  Using the Accu-Chek LinkAssist helps to ensure a consistent result every time. The use of an automatic insertion device is a matter of personal preference. It is up to you if you prefer to insert Accu-Chek FlexLink manually or with our Accu-Chek LinkAssist insertion device.
  
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• My lifestyle is active. Can I still enjoy all my favourite activities with the pump?
  Accu-Chek infusion sets are designed to be disconnected easily, allowing you the freedom to remove your pump altogether for the duration of your activity.
  
  Talk to your healthcare professional about taking your pump off for sports or other activities.
  
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Accu-Chek Multiclix

• Can Accu-Chek Multiclix be used for alternative site testing?
  Yes, it can be used for alternative site testing (AST) by using the specially designed AST cap. Check with your healthcare professional to see if AST is suitable for you.
  
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• Can Accu-Chek Multiclix be used on more than one person?
  Accu-Chek Multiclix is intended to be used by only one person. If someone else uses your lancing device there is an increased risk of infection. To avoid exposure to contaminants, do not use it on multiple users.
  
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• Can I change to the next lancet while the device is primed?
  No, Accu-Chek Multiclix is designed so that a new lancet cannot be selected if the device is primed. Nonetheless, by applying force you may be able to change to the new lancet while the device is primed. This can cause damage to internal parts of the device.
  
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• Can I re-select a lancet used before?
  No, for safety and hygienic reasons this is not possible.
  
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• Can I re-use a drum?
  No, without manipulation this is not possible. Safety hooks prevent accidental re-use of a used drum. A used drum is easily recognized by the red stripes.
  
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• Can I use a lancet more than once?
  We highly recommend the use of a new, sterile lancet every time you test. This is based on hygienic considerations and to help avoid infection. Additionally, the tip of a new needle is sharp, with optimal form and cut and therefore ensures gentle and virtually painless lancing. This is diminished with multiple use.
  
  Never use a lancet that has been used by someone else.
  
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• Does Accu-Chek Multiclix contain latex?
  No, Accu-Chek Multiclix does not contain latex.
  
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• How do I dispose of a used drum?
  The drum can be disposed of in the household waste although it is advisable to check your local council regulations. All lancets are concealed in the drum, you no longer have to re-apply any protective caps.
  
  (Please note: If a lancet drum containing used lancets is dropped on a hard surface (either on its own or in the lancing device), lancets, may in rare cases, protrude from the front of the drum. These lancets could cause injury. Therefore take great care not to touch the front of the used drum.)
  
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• What happens if expired lancets are used?
  The use of an expired lancet (drum) may cause an infection at the puncture site as the lancet may have lost its sterility. We guarantee 4 years of sterility, so you have plenty of time to use up your lancets.
  
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• What if the Accu-Chek Multiclix does not prime?
  Please proceed in the following manner:
  
  

  1. Check whether the lancet display is visible. If not, turn the priming button until the lancet display becomes visible.
  2. Check whether the yellow area in the transparent release button is visible. If this is the case, the device is already primed and ready for use.

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• What is the right way to clean Accu-Chek Multiclix and how often should I clean it?
  To keep your lancing device in tip-top condition, clean it regularly and wipe off any blood immediately. Clean your lancing device from the outside only. Follow a weekly cleaning regime using a cloth moistened with 70% isopropanol or 70% ethanol (available from your pharmacy/ chemist).
  
  In addition, thoroughly wipe the inside of the cap using a cotton bud moistened with 70% isopropanol.
  
  Allow your Accu-Chek Multiclix lancing device enough time to dry thoroughly.
  
  Never dip Accu-Chek Multiclix in water, isopropanol or any other liquid. This may damage internal parts and impair the operation of the lancing device.
  
  Use only 70% isopropanol or 70% ethanol to clean the lancing device. Other substances used for cleaning may attack the plastic and stop the lancing device from operating properly.
  
  Do not clean the Accu-Chek Multiclix drum.
  
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• What is the right way to store the drums?
  Keep your drums clean and protect them from extremes of temperature. Always store the lancing device un-primed.
  
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• Which penetration depth should I use?
  The required penetration depth depends on the following:
  
  

  • Your skin. The softer and thinner your skin is, the shallower the depth setting should be.
  • The required blood sample. The more blood you require, the higher the chosen setting.

  The optimal penetration depth is a combination of both. Always start with a low setting when using the device for the first time. Dial to a higher setting until blood volume is right.
  
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Accu-Chek Softclix

• Can Accu-Chek Softclix lancing device be used for alternative site testing?
  Yes, it can be used for alternate site testing (AST) by using the specially designed AST cap. When performing AST we recommend using Accu-Chek Softclix lancing device at the:
  
  

  • Base of the little finger
  • Base of the thumb
  • Inside of the forearm

  Check with your healthcare professional to see if AST is suitable for you.
  
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• Can Accu-Chek Softclix lancing device be used on more than one person?
  No. Accu-Chek Softclix lancing device is intended to be used by one person only. If someone else uses your lancing device there is an increased risk of cross contamination and infection.
  
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• Can I use a lancet more than once?
  You should always use a new, sterile lancet every time you test. This is based on hygienic considerations. In order to reduce risk of infection, various regulatory authorities require sterile one-time use for products such as lancets.
  
  In addition to the hygienic considerations, there are also other reasons which support once-only use: the tip of an unused lancet is sharp, with optimal form and cut and therefore ensures gentle, virtually pain-free lancing. The single use of lancets also helps prevent skin changes.
  
  Furthermore, never use a lancet that has been used by someone else!
  
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• Does Accu-Chek Softclix lancing device or the Accu-Chek Softclix lancets contain latex?
  No, Accu-Chek Softclix lancing device and the Accu-Chek Softclix lancets do not contain latex.
  
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• How do I dispose of a used lancet?
  Individual lancets should be disposed of in a sharps waste bin carefully, so it cannot cause injury.
  
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• How should I best prepare for blood sampling?
  Wash your hands with warm water and soap, and dry them carefully. This will improve circulation and ensures a clean penetration site.
  
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• Is it correct to discard the first drop of blood?
  No! In contrast to former recommendations, it is not necessary to discard the first drop of blood and to use only the second one for glucose monitoring. There is no significant difference in blood glucose values measured with the first or the second drop.
  
  However, any contamination of the fingertip with dirt or liquids (sweat, fruit juice, etc.) may affect glucose readings. Clean and dry fingertips are a pre-requisite for an optimal glucose measurement.
  
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• May I squeeze the fingertip to get more blood?
  Yes- but be gentle! Blood can be sampled by gently squeezing the fingertip (the tissue is pressed together and blood is forced out of the incision), since it minimizes lancing pain (shallower penetration) and reduces the risk of scarring. Squeezing the fingertip does not significantly dilute capillary blood with ‘tissue water’.
  
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• What can I do to ensure I obtain enough blood?
  Take the following preparatory actions:
  
  

  • Run warm water over your hands before testing to increase blood flow. Be sure to dry hands completely before testing.
  • Improve blood flow to the fingers by warming them.
  • Lower hands below your waist level and gently massage the selected finger before lancing.
  • Press the lancing device firmly against the side of your fingertip.
  • After lancing, massage your finger towards the tip to encourage a blood droplet to form.

  If all of the above steps are insufficient, increase the penetration depth of the lancet device by rotating the black dial one step at a time.
  
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• What happens if expired lancets are used?
  The use of an expired lancet may cause an infection at the puncture site as the lancet may have lost its sterility. We guarantee 4 years of sterility, so you have plenty of time to use up your lancets.
  
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• What if I obtain no blood at all?
  This can be caused by several reasons:
  
  

  • The penetration depth is too shallow for your skin. Please select a higher penetration depth setting.
  • The device needs to be pressed firmly against the skin.
  • Check that a lancet is inserted in the device.
  • Sometimes the blood does not appear immediately after lancing. Massaging the finger by gently squeezing it towards the fingertip helps to form a drop of blood.

  Please also check the preceding question about obtaining enough blood.
  
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• What is the right way to clean Accu-Chek Softclix lancing device and how often should I clean it?
  To keep your lancing device in tip-top condition, clean it regularly and wipe off any blood from it immediately. Clean your lancing device from the outside only. Follow a weekly cleaning regimen using a cloth moistened with 70% isopropanol or 70% ethanol (available from your pharmacy / chemist).
  
  In addition, thoroughly wipe the inside of the cap using a cotton bud moistened with 70% isopropanol. Allow your Accu-Chek Softclix lancing device lancing device enough time to dry thoroughly.
  
  Never dip Accu-Chek Softclix lancing device in water, isopropanol or any other liquid. This may damage internal parts, and impair operation of the lancing device.
  
  Use only 70% isopropanol or 70% ethanol to clean the lancing device. Other substances used for cleaning may attack the plastic and stop the lancing device from operating properly.
  
  Do not clean the Accu-Chek Softclix lancets.
  
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• What is the right way to store the lancets?
  Keep your lancets clean and protect them from extreme temperatures.
  
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Accu-Chek Go System

• Can Control or AST measurements be marked as such?
  To flag the result for a special event, such as an AST result or after exercise, leave the test strip in the meter and press the arrow button. An asterisk appears at the bottom right-hand corner of the display. If a control test needs to be flagged instead, pressing the right or left arrow button again after the asterisk appears will enable the control vial symbol to appear at the bottom left hand corner of the display. The result will be flagged in memory with the control vial icon and will not be included in calculation of the average.
  
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• Can the alarm clock/test reminder be silenced for a meeting?
  Yes. Simply go into F4 of Quick Set-up mode and press the arrow buttons to turn the alarm on or off. Press the ON/OFF button to save the setting.
  
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• Can the customer also pull out the strip manually?
  Yes, but our advice is to always use the test strip ejector in order to benefit from non-contact with used test strips.
  
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• Does the meter lose its memory or the time and date setting when the battery is changed?
  The stored results are kept in the meter at all times and cannot be lost even when the battery is changed.
  
  The time and date settings only remain saved as long as:
  
  

  • No more than one minute is taken to change the battery,
  • None of the buttons are pressed before the battery is inserted,
  • A test strip is not inserted into the test strip guide without the battery inserted,
  • The battery is inserted the right way up, i.e., with the + symbol facing upwards.

  If any of the above conditions are not met during a battery change, the date and time setting will be lost and must be set up again.
  
  Results stored without date and time cannot be used for calculation of the average. This could be problematic when results are analysed using diabetes software on a PC.
  
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• How do the alarm clock function/ test reminders work?
  You can use the alarm clock function to set up to 4 test reminders per day. At the set reminder time(s), the meter beeps for 20 seconds. The reminder beep will not occur if the meter is turned on at the set time. All alarms are factory set to OFF. Each alarm has a factory-set default time:
  
  Alarm1 (AL1): 8:00 (8:00 a.m.)
  Alarm2 (AL2): 12:00 (12:00 p.m.)
  Alarm3 (AL3): 18:00 (6:00 p.m.)
  Alarm4 (AL4): 22:00 (10:00 p.m.)
  
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• How does the strip expiration feature work?
  The test strip expiry date information is saved on the coding chip and refers to all strips in the corresponding container. On the first day of the month after the test strip expires, the meter will continue to provide a result, along with the flashing ‘exp’ symbol at the bottom of the display. After the test strip has expired, the user will still be able to get a result, but that reading will be stored in the memory with ‘’exp’ on the display. It is not recommended to use expired test strips as they may produce incorrect results.
  
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• How does the target range work?
  The target range feature allows the setting of personal upper and lower limits.
  
  There are 3 different options for setting the limits:
  
  

  • Just a lower limit,
  • Just an upper limit, or
  • Both limits

  As soon as a test result is below or above one of the limits of the target range, a flashing (!) symbol is displayed along with the result. If the beep tone is turned on (0n1), 3 beeps will also be heard:
  
  

  • Long beeps if the test result is below the lower limit
  • Short beeps if the test result is above the upper limit

  The lower limit can be set to a value of 3.3 to 33.2 mmol/L. The upper limit can be set to a value of 3.4 to 33.3 mmol/L.
  
  If both the lower limit and the upper limit are turned on, the upper limit must be greater than the lower limit. The smallest permissible value for the upper limit is the lower limit plus 0.1 mmol/L. The lower limit can be selected freely. If it is then greater than an already set upper limit, the upper limit is automatically set to the lowest possible value.
  
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• How does the under-dosing detection feature work?
  A third LED inside the optical unit detects whether enough blood has been applied. If the initial blood sample applied to the test strip window is not sufficient, the blood drop symbol will continue to flash on the meter display. If sufficient blood is not applied within another 15 seconds, the meter will indicate an error and the error code “E-6” code will be displayed.
  
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• How does the user exit from the setup mode?
  The ‘End’ symbol will appear at the end of each set-up stage. By pressing the ON/OFF button briefly, the meter will be turned off.
  
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• How does the user get into set-up mode?
  The Accu-Chek Go (GS) meter features 2 ways to set-up the meter: Standard set-up and Quick set-up. Standard set-up is recommended when setting up the meter for the first time because it leads the user through all available settings. Quick set-up mode is convenient when the user needs to change a setting quickly without going through the whole set-up sequence.
  
  In Standard set-up mode, press the ON/OFF button briefly (for less than 3 seconds) then press the ON/OFF button again and hold it down for at least 3 seconds. This will lead you to the time-and-date format, and time-and-date set-up mode.
  
  In Quick set-up mode, hold the ON/OFF button down for longer than 3 seconds. This will lead you to the F1 (time-and-date format and time-and-date set-up) mode, pressing the arrow buttons will allow you to choose which modes: F2, F3 or F4 to set-up.
  
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• How long is the test strip shelf life?
  The expiration date is 18 months from the date of manufacture.
  
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• How long will the battery last?
  One new battery (3V, type CR 2032) lasts for approximately 1,000 tests or one year, assuming 3 measurements are made per day. If the meter is used in Acoustic Mode, the battery life will be shorter.
  
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• Is Accu-Chek Go meter suitable for use by health care professionals?
  Yes, thanks to the capillary fill test strip, there is no direct contact between the meter and blood.
  
  The test strip ejector also ensures that there is no direct contact of the fingers with the used test strip. Regular cleaning of the test strip guide and measurement optics is recommended to minimize the risk of cross-contamination. Cleaning instructions can be found in the user’s manual.
  
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• Is cleaning required for the Accu-Chek Go meter?
  We recommend regular cleaning of the test strip guide and the measurement optics area as described in the instructions for use.
  
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• Is it possible to de-activate the beep tone, target range or alarm times?
  Yes. This can be easily done using Quick set-up mode and selecting either F2, F3 or F4 respectively. For more information please refer to the instructions for use.
  
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• Is it possible to erase results from the memory?
  You can erase the most recent result (and only this) from memory. This feature is useful, for instance, if you have obtained an implausible result. Only the result is erased; the time and date information is retained as a reminder, and the memory location remains occupied.
  
  • With the meter turned off, press and hold down both the arrow buttons at the same time (for longer than 3 seconds) until ‘CLR’ appears.
  
  • Press and hold down both the arrow buttons again at the same time (for longer than 3 seconds) until a new screen appears. The most recently saved result is displayed together with the time and date; the result flashes.
  
  • Press and hold down both the arrow buttons again at the same time (for longer than 5 seconds) until a new screen appears. The result is erased from memory and three horizontal bars appear in the display instead.
  
  • The time and date of this result are retained.
  
  • Press the ON/OFF button to turn the meter off.
  
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• Is re-dosing possible in the event that the first attempt to get enough blood was unsuccessful?
  Yes, re-dosing a test strip is possible within 15 seconds of adding the first drop of blood.
  
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• What happens if the code chip is not changed when a new vial is opened?
  The meter receives information about the properties of the test strip from the code chip that is supplied with each pack of test strips. Each time you open a new container of test strips, you will need to insert the code chip that came with that container into your meter.
  
  Code chips from other packs may contain the incorrect information for the new pack, rendering test results incorrect. Incorrect results can cause the wrong therapeutic decision to be taken and so lead to serious adverse health effects. Leave the code chip in the meter until you have used up all of the test strips from the container it came with.
  
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• What happens when blood is applied before the test strip symbol and flashing drop of blood appear?
  The meter may give an incorrect reading or the “E-4” code may be displayed. When “E-4” is displayed, eject the test strip and repeat the test with a new test strip.
  
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• What is the difference between the beep tone and Acoustic Mode?
  This setting enables you to turn the beep tone on or off and to activate Acoustic Mode.
  
  When the beep tone is turned on (On1), you hear a beep during testing when:
  
  

  • The meter is ready to test and you can let the test strip draw up blood or control solution.
  • The test strip has drawn up sufficient blood or control solution and testing has started.
  • The result is displayed.
  • The meter displays an error message.
  • The meter turned off automatically following a test and the test strip is still in the test strip guide.

  When Acoustic Mode is turned on (On2), the meter announces this when:
  
  

  • It is turned on either with a test strip or by pressing the button.
  • The right or left arrow button is pressed to review results in the memory.
  • The beep tone and Acoustic Mode settings can be made in F2 in Quick Set-up mode and is the fourth setting in Standard Set-up mode.
  • User is exiting the memory or the average screens to go directly to blood glucose testing by inserting a test strip.

  The meter emits a pattern of 6 beeps: 1 beep – pause – 2 beeps – pause- 3 beeps (- -- ---).
  
  When the Acoustic Mode is turned on, the meter guides you through the test using the beep tones as described above; it also announces the result as a series of beeps. The meter also beeps at times other than when a test is in progress: for example, when you are entering certain settings in a Setup or are navigating within the memory.
  
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• What kind of desiccant do we use with the test strips?
  The desiccant in the cap of the vial/bottle is a non-toxic silicate-based drying agent.
  
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• Which alternate sites (AST) areas can the meter test?
  The system will work on the 5 AST areas: palm (at the base of the thumb, at the base of the little/pinkie finger), forearm, upper arm, calf, or thigh. Alternate site testing (AST) requires the use of a special lancing cap. Always consult your health care professional to see if AST is suitable for you.
  
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Accu-Chek Integra System

• Can I distinguish between my capillary blood values and control readings in the memory?
  Yes, by flagging a control measurement before applying the control solution. A simple press on the ‘set’ button marks the succeeding reading as a control measurement (CTRL) in the memory. If you check up your statistical values in the memory, the flagged control readings are not included in the calculation of the average, minimum and maximum values.
  
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• Can I insert rechargeable batteries?
  If rechargeable batteries are inserted instead of AAA batteries, only a few measurements can be made before the rechargeable batteries need to be charged again.
  
  Rechargeable batteries normally have a voltage of only 1.3 V instead of the AAA batteries’ 1.5 volts. Most important, when the battery icon appears the minimum buffer of at least 50 measurements cannot be guaranteed.
  
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• Can the test strip also be removed by hand?
  The ejected test strip can be removed without damaging the Accu-Chek Integra meter. However, it is possible to soil the fingers with blood. So this should not normally be done.
  
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• Couldn’t the Accu-Chek Integra meter be thinner?
  (See "Why are there 17 test strips in the drum?").
  
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• Does the Accu-Chek Integra meter need to be cleaned?
  Due to the recurring automatic check of the measuring unit, the Accu-Chek Integra meter does not need regular cleaning. Cleaning is only required if the meter indicates that it is necessary.
  
  If the Accu-Chek Integra meter is used according to the instructions for use, numerous measurements can be made before cleaning becomes necessary.
  
  The meter always needs to be held so that the test strip is pointing downwards when blood or control solution is applied. If the meter is held with the test strip pointing upwards the sample may enter the meter and contaminate it.
  
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• Does the meter lose its memory or the time and date settings when the batteries are changed?
  When you replace the batteries, your stored results are retained in the memory.
  
  However, you will need to re-enter the time and date. If you fail to do so, any blood glucose test results you obtain from this point forward will be displayed and saved without time and date. In this case, the test results saved in memory will be numbered consecutively so you can still see the order in which you took the readings.
  
  If time and date are not set correctly, data evaluation by means of data management software is not possible.
  
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• How does the meter avoid unreliable readings from a soiled optical measuring unit?
  The Accu-Chek Integra meter runs an automatic check of the measuring unit each time before a new test strip is released from the drum.
  
  If the measuring unit is soiled or scratched the message "OFF" appears.
  
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• How does the under-dosing detection work?
  The Accu-Chek Integra meter has a two-step under-dosing detection. Firstly the meter does not start the measurement until a sufficient amount of blood has covered the reaction area. Secondly after getting the result, the uniformity of the reaction area is checked again.
  
  In the case of under-dosing, the measurement either simply does not start or the error message "Err+Hand-Icon+Test-Strip-Icon" appears. The Accu-Chek Integra meter shows an error message rather than an unreliable result due to under-dosing.
  
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• How long do the batteries last?
  Batteries generally last for at least 500 measurements within 1 year. The internal clock uses power irrespective of the number of measurements, even when the Accu-Chek Integra meter is switched off.
  
  The meter will make fewer measurements where the measurement frequency is extremely low (1 measurement per week) and the meter is left unused. The number of measurements may be higher where the measurement frequency is high. Internal evaluation studies showed the following:
  
  • 1 measurement/day: 770 measurements possible with 2 batteries
  • 3 measurements/day: 935 measurements possible
  • 7 measurements/day: 990 measurements possible
  
  The quality of the battery is also a relevant factor in this context.
  
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• How reliable is the barcode reader?
  The bar-code reader has automatic error detection which meets the highest reliability standards.
  
  If an error is detected, the error message "E-2" appears. The customer then proceeds as described in the user instruction manual and takes another drum from the same package. (see the section on error messages in the instruction manual). All drum labels which leave the factory have been tested and passed by a 100% video control.
  
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• Is data management possible with the Accu-Chek Integra system?
  Yes, blood glucose results can be downloaded to compatible Accu-Chek data management software.
  
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• Is it possible to put the drum in the wrong way?
  No. But as with any technical equipment, please treat it with care!
  
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• Is re-dosing possible if the first attempt to get enough blood was not successful?
  Yes. If the meter does not start because of under-dosing, re-dosing is possible within 25 seconds. If you get the error message "Err+Hand- Icon+Test-Strip-Icon" you need a new test strip.
  
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• Is the Accu-Chek Integra system suitable for alternate site testing (AST)?
  Yes, it is suitable for alternate site testing. The use of capillary blood samples from other sites, such as the forearm, the upper arm, the ball of the thumb or the calf is possible. Alternate site testing (AST) requires the use of a special lancing cap. Always consult your health care professional to see if AST is suitable for you.
  
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• Is there an onboard stability control?
  Yes, the meter takes the closing of the flap of the drum compartment as a sign that a new drum has been inserted. After 90 days the drum symbol in the display will indicate the expiration of the loaded drum (Drum-Icon + CTRL).
  
  All test strips (including those of other meter manufacturers) are moisture-sensitive. In the un-opened tube the test strips are protected by a desiccant in the stopper until the printed expiry date. The drum contains additional desiccant to protect the test strips from moisture for 90 days outside the tube (in all climatic zones). After that time the desiccant is used up and the test strips are exposed to moisture. They may become unusable after just a few days.
  
  If, contrary to the instructions, the drum continues to be used, the Accu-Chek Integra meter prompts the user to make a performance check. The drum must not be used for more than 90 days. If it is, the readings obtained may be unreliable.
  
  Note: When a partly used drum is inserted, the meter cannot calculate the correct expiration time outside the vial (= onboard stability). Thus, always use all 17 test strips of a drum and then open the meter to replace it.
  
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• What does automatic coding mean?
  The Accu-Chek Integra system benefits from lot-specific coding. Each time the flap of the drum compartment is closed the lot-specific bar code on the drum is automatically read by the meter.
  
  In addition to this, the bar code contains a “string” to supervise the correctness of the transmitted code information. This ensures our customers the highest standard of lot-specific coding in combination with maximum convenience.
  
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• What does the test strip quality check mean?
  The Accu-Chek Integra meter checks the test strip quality immediately before each measurement. This gives the highest standard of dependability of the test strips.
  
  If the test strip is spoilt, the message "OFF" appears in the display.
  This safety inspection triggers the test strip to pause briefly before being ejected completely.
  
  The test strip quality check can only check the test strip, but not the whole system (meter or meter optics). For this reason the Accu-Chek Integra system has more performance checks in addition to this inbuilt test strip quality check.
  
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• What happens if a partly used drum is inserted?
  If a partly used drum is inserted the code on the drum is transmitted automatically. The Accu-Chek Integra meter looks step by step for the next chamber containing a test strip. It always starts with the first chamber. For example, if there is just one test strip left in the drum, the meter first has to check 16 chambers before it finds the last test strip available.
  
  Note: when a partly used drum is inserted the monitor cannot calculate the correct expiration time outside the container (= onboard stability). The user cannot rely on the 90-day expiry period.
  
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• What happens if the batteries are put in the wrong way?
  Nothing; there is a special protection of the circuit board to prevent any damage to the electronics
  
  Note: the meter does not react at all until the batteries are fitted in the correct way.
  
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• Why are there 17 test strips in the drum?
  With 50 test strips the drum diameter would be too large and the meter too bulky.
  
  Having 10 test strips in the drum would make the diameter smaller, but that would give only about 2 days’ supply. Therefore, 17 turned out to be the optimum number of test strips in one drum.
  
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• Why does the Accu-Chek Integra test strip transport mechanism stop briefly before the test strip reaches the measuring position?
  During test strip transportation to the measurement position some inspections for the test strip quality check are done (See "What is the test strip quality check?").
  
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• Why is it crucial to wait until the hand icon appears in the display before applying blood?
  The meter checks the test strip position, performs the test strip quality check and checks other pre-analytical details. After about 1.5 seconds, the test strip is released for blood application. These checks must not be interrupted. Otherwise an “Err” message might appear and the test strip may be lost.
  
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• Why is there a display lid?
  To protect the display from dirt and scratches and to prevent the Accu-Chek Integra meter from being unintentionally switched on. A test strip would be wasted each time.
  
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• Why should the batteries only be changed when a new drum is put in?
  With each battery change the Accu-Chek Integra meter "loses" control over the flap of the drum compartment because of the interruption of the power supply. In this situation, the Accu-Chek Integra meter cannot recognize whether or not the flap has been opened and the drum changed. Therefore the meter assumes – for reliability reasons – that the flap was opened and transfers the code again.
  The drum is qualified as a partly used drum (see also: “What happens if a partly used drum is inserted?”)
  Also, changing the battery restarts the 90-day onboard stability period.
  
  Note: Appearance of the battery symbol in the display for the first time indicates that the battery is running low. You can perform approximately 50 additional tests.
  
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Accu-Chek Performa

• Can I re-dose the test strip?
  Yes. You can add blood to the test strip within 5 seconds of applying the first drop.
  
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• Can I use a test strip from another Accu-Chek system in the Accu-Chek Performa meter?
  No. Accu-Chek Performa meters are designed exclusively for use with Accu-Chek Performa test strips.
  
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• Can I use an expired test strip?
  The Accu-Chek Performa meter is designed to prevent biased results caused by expired test strips. During the last month before the code key expires, the meter continues to provide a result, along with the warning ‘code exp’ at the bottom of the display.
  
  After the code key expires, the meter displays an ‘E-5’ error and ‘code exp’ will flash.
  
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• Can I use the code keys from other Accu-Chek meters in the Accu-Chek Performa meter?
  No. Although you can insert a code key from another meter into the Accu-Chek Performa meter, you will get an ‘E-2’ error, and ‘code’ will flash. Only code keys from Accu-Chek Performa test strips will be recognised by the meter.
  
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• Can the Accu-Chek Performa be used for alternate sit testing (AST)?
  The Accu-Chek Performa system will test blood samples from 5 alternative sites (AST): palm, forearm, upper arm, thigh, or calf. Alternate site testing (AST) requires the use of a special lancing cap. Always consult your health care professional to see if AST is suitable for you.
  
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• Do any other substances interfere with the Accu-Chek Performa test strip?
  3 other substances in the bloodstream (galactose, xylose, and lipids) can interfere with the Accu-Chek Performa test strip. No other leading system has fewer interfering substances.
  
  Patients who take a xylose tolerance (D-xylose absorption test) should not use an Accu-Chek Performa meter to test their blood glucose for 24 hours after the test—and should discuss alternative testing options with their health care professional.
  
  Some interfering substances that affected the Accu-Chek Advantage/Sensor system are no longer a concern (e.g., bilirubin, ascorbic acid, and acetaminophen).
  
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• Do control test values stay in the meter’s memory?
  Control test values do not stay in the memory that you can access on the meter.
  Instead, the meter stores them in the downloadable memory, so you can view them with supported software.
  
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• Does maltose interfere with the Accu-Chek Performa test strip?
  High levels of maltose in blood can result in falsely high test results. Blood maltose levels can be high in any patient who is:
  
  

  • Undergoing peritoneal dialysis with solutions containing icodextrin (e.g., Extraneal) because icodextrin is metabolized to maltose
    
  • Receiving certain types of IV immunoglobulin therapies that contain maltose (e.g., Octagam or Gamimune)
    
  • Receiving IV solutions containing maltose as a substitute for glucose or as a means of hydration

  Patients on these therapies should not use an Accu-Chek Performa meter to test their blood glucose for as long as therapy continues—and should discuss alternative testing options with their health care professional.
  
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• How did Roche Diagnostics determine the test strip design?
  In market research that compared different test strip shapes and sizes, users considered the final end-dose design optimal. Consumers found it easiest to perform alternative site testing with an end-dose strip.
  
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• How do I download test results to my computer?
  You can transfer stored blood glucose results to a PC by using compatible Accu-Chek data management software.
  
  To enter download mode:
  
  

  • Turn off the meter.
    
  • Press and hold both the arrow buttons at the same time until 2 flashing arrows appear in the display.
    
  • Initiate the data download by following the instructions provided with the supported software.

   
  
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• How do I exit set-up mode?
  Press and hold the ON/OFF button until the flashing test strip symbol appears.
  
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• How do I perform a control test with the new automatic control ID feature?
  The Accu-Chek Performa meter automatically recognizes Accu-Chek Performa control solutions, so running a control test is easier than ever.
  
  First, wipe the tip of the control bottle with a tissue. Then put the meter on a flat surface, insert the test strip, and squeeze a drop of control solution onto the front edge of the strip.
  
  A result appears with a flashing ‘L-.’ Press once to mark the result as a Level 1 control, or twice for a Level 2 control.
  
  Press to set the level in the meter. The control result and ‘OK’ alternate in the display if the result is in range.
  
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• How does Accu-Chek Performa system technology differ from other Accu-Chek meters?
  The Accu-Chek Performa system checks for more potential issues than any previous Accu-Chek system. It achieves this by combining the power of technologies in the meter itself, the code key, and test strips with 6 gold electrodes to perform extensive quality checks during each test.
  
  These include:
  
  

  • Sample checks
    • Verify the correct amount of blood is applied
    • Signals user if more blood is needed
    • Permit re-dosing within 5 seconds
  • Strip checks
    
    • Check test strips and reagent for potential damage/abuse
      
    • Exposure to high humidity
      
    • Scratches on strip electrodes
      
    • System is designed to compensate for humidity or temperature; otherwise it will produce an error message if unable to compensate
  • System checks
    
    • Check for variations in:
      
    • Haematocrit
      
    • Humidity
      
    • Temperature

  These checks start when the meter is turned on and are complete when a blood glucose result is shown.
  
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• How does the meter determine if the control test is in range?
  The control range data is stored in the code key.
  
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• How does the under-dosing detection feature work?
  If the initial blood sample applied to the test strip window is insufficient, the blood drop symbol will continue to flash on the meter. If sufficient blood is not applied within 5 seconds, ‘E-4’ will appear on the screen, and will flash.
  
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• How long is the test strip shelf life?
  The expiration date is 18 months from the date of manufacture.
  
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• Is the Accu-Chek Performa system approved for use in clinical settings such as hospitals?
  Yes. The Accu-Chek Performa meter is cleared to test capillary, venous, arterial, and neonatal blood samples, it is appropriate for use in clinical settings.
  
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• What chemistry does the Accu-Chek Performa test strip use?
  The test strip uses glucose dehydrogenase chemistry, which prevents oxygen from interfering with test results.
  
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• What happens if the control result is out of range?
  Err and the control result will alternate on the display.
  
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• What test principle does the Accu-Chek Performa system use, and why?
  The Accu-Chek Performa system uses an electrochemical test principle instead of the photometric principle used in the Accu-Chek Integra system and the Accu-Chek Go system.
  
  Electrochemical biosensors such as those in the Accu-Chek Performa system provide high levels of sensitivity and specificity.
  
  In an electrochemical test principle, glucose dehydrogenase enzymatically reacts with glucose in a sample causing the release of an electron that then reacts with a mediator. The modified mediator is subsequently electrochemically converted to its initial state upon application of a voltage difference between the electrodes, resulting in a small electric current that is detected by the system.
  
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• What’s new about the Accu-Chek Performa test strip technology?
  The Accu-Chek Performa test strip has 6 gold electrodes that work together with the rest of the system to perform extensive quality checks.
  
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• What’s new about the test strip container?
  The Accu-Chek Performa test strip container provides several important advantages over previous designs:
  
  

  • Flip-top lid:
    • Makes opening the container easier
    • Helps ensure proper closing to protect test strips from environmental exposure
  • Smaller design helps make it more convenient to carry.

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• Why do I need to wipe the control solution bottle?
  The system differentiates between control solution and blood because controls have a higher salt concentration. However, if the control solution evaporates or concentrates on the tip of the bottle, it could cause the meter to display an incorrect control reading.
  
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• Why does the Accu-Chek Performa system still use a code key?
  Roche Diagnostics retained the code key for 4 reasons:
  
  

  • It can provide feature upgrades (such as faster test times and smaller sample sizes) without the need to buy a new meter.
  • It is designed to prevent the use of expired test strips.
  • It helps ensure more accurate results by reducing the inherent variability in all test strips.
  • It is easy to use. Unlike some meters, which require you to scroll through multiple numbers to code the meter manually, the code key for the Accu-Chek Performa system just snaps into place.

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• Why does the test start even if yellow still shows in the capillary window?
  As soon as enough blood is applied to the strip, the system automatically detects it and begins the test, even if yellow is still visible in the window. The only time you would need to apply more blood is when the blood drop symbol continues to flash in the display.
  
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Accu-Chek Performa Nano

• Can I re-dose the test strip?
  Yes, you can add blood to the test strip within 5 seconds of applying the first drop.
  
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• Can I silence the test reminders for a meeting or other needs?
  Yes. Simply turn the beeper off in set-up mode.
  
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• Can I use the code chips from other Accu-Chek meters in the Accu-Chek Performa Nano meters?
  No. Although you can insert a code chip from another meter into the Accu-Chek Performa Nano meters, you will get an error message. The error message for the Accu-Chek Performa Nano meter is ‘E-2’ and the code will flash. Because the Accu-Chek Performa Nano meter uses the same strips as the Accu-Chek Performa meter, they use the same code chips.
  
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• Do any other substances interfere with the Accu-Chek Performa test strips?
  3 other substances in the blood stream (galactose, xylose, and lipids) can interfere with the Accu-Chek Performa test strips. No other leading system has fewer interfering substances.
  
  Patients who take a xylose tolerance (D-xylose absorption test) should not use Accu-Chek Performa Nano meters to test their blood glucose for 24 hours after the test and should discuss alternative testing options with their health care professional.
  
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• Do control test values stay in the meter’s memory?
  Control test values do not stay in the memory that you can access on the meter. Instead, the meter stores them in the downloadable memory, so you can view them with supported software.
  
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• Does maltose interfere with the Accu-Chek Performa test strips?
  High levels of maltose in the blood can result in falsely high test results. Blood maltose levels can be high in any patient who is:
  
  

  • Undergoing peritoneal dialysis with solutions containing icodextrin (e.g., Extraneal®) because icodextrin is metabolized to maltose
  • Receiving certain types of IV immunoglobulin therapies that contain maltose (e.g., Octagam® or Gamimune®)
  • Receiving IV solutions containing maltose as a substitute for glucose or as a means of hydration

  Patients on these therapies should not use Accu-Chek Performa Nano meters to test their blood glucose for as long as therapy continues and should discuss alternative testing options with their health care professional.
  
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• How do I download my blood glucose results to my computer?
  You can transfer stored blood glucose results to a computer by using compatible Accu-Chek data management software.
  
  To enter download mode:
  
  

  • Turn off the meter.
  • Press and hold both arrow buttons at the same time until the display shows 2 arrows flashing alternately.
  • Initiate the data download by following the instructions provided with the supported software.

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• How do I get into set-up mode?
  With the meter turned on and the flashing strip symbol on the display, press and hold the ON/OFF/SET button for about 4 seconds until set-up appears and the hour is flashing on the display.
  
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• How do test reminders work?
  You can set up to 4 test reminders per day in 15-minute increments. At the set reminder time(s), a series of beeps will sound, up to 3 times per minute, every 2 minutes.
  
  The reminder beeps will not occur if the meter is on at the set time, or if you run a test up to 15 minutes before the set reminder time, or if the beep mode is turned off. If you turn on the meter while the reminder is sounding, the series of beeps will stop.
  
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• How does the Accu-Chek Performa Nano system technology differ from other meters?
  The Accu-Chek Performa Nano meter performs many system checks by combining the power of technologies built into the meter, the code chip, and test strips with gold electrodes during each individual test. It uses the same advanced technology as the Accu-Chek Performa meter.
  
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• How does the meter determine if the control test is in range?
  The control range data is stored in the code chip.
  
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• Is the Accu-Chek Performa Nano meter approved for use in clinical settings?
  Yes. The Accu-Chek Performa Nano meter is cleared to test capillary, venous, arterial, and neonatal blood samples.
  
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• Is the Accu-Chek Performa Nano suitable for alternate site testing (AST)?
  The Accu-Chek Performa Nano will test blood samples from 5 alternate sites (AST). These are the forearm, palm, upper arm, thigh or calf. Alternate site testing (AST) requires the use of a special lancing cap. Always consult your health care professional to see if AST is suitable for you.
  
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• What chemistry does the Accu-Chek Performa test strips use?
  The test strip uses glucose dehydrogenase chemistry, which prevents oxygen from interfering with test results.
  
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• What happens if the control result is out of range?
  An error message and the control result will alternate on the display.
  
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• What is the clock backup feature?
  An additional internal battery supports the clock when the main battery is removed.
  
  You can leave the battery out of the meter for up to 10 hours and still retain the time and date. If you replace the battery within that time, the meter will ask you to verify the time and date the next time you turn it on.
  
  When you replace the main battery, the internal battery will automatically recharge. If you do not replace the battery within 24 hours, the meter will retain the time and date that was stored immediately before the internal battery was depleted.
  
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• What test principle does the Accu-Chek Performa Nano meter use, and why?
  The Accu-Chek Performa Nano meter uses an electrochemical test principle instead of the photometric principle used in the Accu-Chek Integra and Accu-Chek Go systems.
  
  Electrochemical biosensors such as those in the Accu-Chek Performa Nano provide high levels of sensitivity and specificity.
  
  In an electrochemical test principle, glucose dehydrogenase enzymatically reacts with glucose in a sample causing the release of an electron that reacts with the mediator. The modified mediator is subsequently electrochemically converted to its initial state upon application of a voltage difference between the electrodes, resulting in a small electric current that is detected by the system.
  
  Close
• Why do I need to wipe the control solution bottle?
  The system differentiates between control solution and blood because controls have higher salt concentration. However, if the control solution evaporates or concentrates on the tip of the bottle, it could cause the meter to display an incorrect control reading.
  
  Close
• Why do the Accu-Chek Performa Nano systems still use a code chip?
  Roche Diagnostics retained the code chip for 4 reasons:
  
  

  1. It can provide feature upgrades (such as faster test times and smaller sample sizes) without the need to buy a new meter.
  2. It is designed to prevent the use of expired test strips.
  3. It helps to ensure more accurate results by reducing the inherent variability in all test strips.
  4. It is easy to use. Unlike some systems that require you to scroll through multiple numbers to code the meter manually, the code chip for the Accu-Chek Performa Nano meter just snaps into place.

  Close
• Why does the test start even if yellow still shows in the capillary window?
  As soon as enough blood is applied to the strip, the system automatically detects it and begins the test, even if yellow is still visible in the window. The only time you would need to apply more blood is when the blood drop symbol continues to flash in the display.
  
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• Why is my clock not set to the correct time?
  Some countries share meter configurations with other countries, have multiple time zones within their country, and/or change their time semi-annually. Therefore, manufacturing is unable to set the correct time for every country. In these cases the time and date function will need to be manually set.
  
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