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. We recommend using Accu- Chek Multiclix at the palm of the hand when performing AST.
  
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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.
  
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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 reuse a drum?
  No, without manipulation this is not possible. Safety hooks prevent accidental reuse of a used drum. A used drum is easy recognised 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 lancing. This is diminished with multiple use.
  
  However, a lancet may be used more than once.
  
  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 safely dispose of a used drum?
  The drum can simply be disposed of in the household waste. Since all lancets are concealed safely in the drum, you no longer have to reapply any safety caps.
  
  Please note: If a lancet drum containing used lancets is dropped on the 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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• How do you store the lancing device properly?
  Keep your Accu-Chek Multiclix lancing device and the lancet drums at room temperature and protect from dirt and extremes of temperatures such as in a hot car or a cold refrigerator. Always store the lancing device unprimed.
  
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• How to prepare for blood sampling?
  Wash your hands well with warm water and soap, and dry them. This will improve circulation and ensure a clean penetration site.
  
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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 I have problems changing lancets?
  Check the lancet display to see whether a number appears in the lancet display. When the number “1” shows, you are using the last lancet. After that the lancet drum needs to be changed.
  
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• What if someone else wants to use your Accu-Chek Multiclix?
  The Accu-Chek Multiclix system is intended to be used by only one person. If someone else uses your lancing device, there is an increased risk of infection. You should ensure that only you use your Accu-Chek Multiclix system.
  
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• What if the Accu-Chek Multiclix does not Click? -> leaflet
  Check whether the priming button is jammed. If this is not the case, make sure you have inserted a lancet drum and see whether the yellow area is visible on the transparent release button. Check whether you can see the lancet display. If not, turn the priming button back until the window becomes visible again.
  
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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 if there is insufficient blood?
  Massage your finger slightly before Clicking to stimulate the circulation. Hold your hand under warm running water. Dry carefully before using the Accu-Chek Multiclix system. Press the lancing device firmly against your finger. Squeezing the fingertip gently will encourage a drop of blood to form. If this is insufficient, increase the penetration depth one step at a time.
  
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• What if you have sensitive skin?
  The thinner and softer your skin, the lower the penetration depth should be. After blood sampling you should wipe the skin with a clean cloth and keep dirt off it. Changing the lancet after each Click will also contribute to a soft sampling and will protect against infection.
  
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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 from it 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 time to dry thoroughly.
  
  Never dip Accu-Chek Multiclix in water, isopropanol or any other liquid. This may damage internal parts, so impairing 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. Do not store them in a hot car or in the refrigerator. Always store the lancing device unprimed.
  
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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 Plus

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

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

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• Can Accu-Chek Softclix Plus lancing device be used on more than one person?
  No. Accu-Chek Softclix Plus lancing device is intended to be used by only one person. If someone else uses your lancing device there is an increased risk of infection.
  
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• Can Accu-Chek Softclix Plus lancing device be used to obtain blood from pets?
  No, Accu-Chek Softclix Plus lancing device lancing device is not designed for use with pets.
  
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• Can I also obtain blood with Accu-Chek Softclix Plus lancing device detached from the meter?
  Yes, Accu-Chek Softclix Plus lancing device gives you the flexibility of choice: You can leave the lancing device attached to the meter to collect blood or, if you prefer, you can detach it and use it as a single lancing device. Just as you wish. When on the go, most people prefer to have the lancing device docked to the meter because of easy handling and packing.
  
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• Can I change the lancet while the device is attached to the meter?
  Yes, the device can be used attached to or detached from the meter, including lancet exchange.
  
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• Can I continue to use Accu-Chek Softclix Plus lancing device if I dropped the device?
  Dropping the lancing device with a lancet inserted may loosen the lancet in its holder. In that case the lancet is no longer properly lodged and cannot be used to obtain blood. In rare cases the lancet may even protrude from the cap. In a case such as this you might injure yourself on the lancet. Therefore, take great care not to touch the front of the cap.
  
  Should you drop the lancing device, please pick it up with care. Remove the cap from the lancing device. Take care to avoid the lancet so as not to injure yourself. Always eject and dispose of the lancet if the lancing device has been dropped. Afterwards reattach the cap without inserting a lancet. Press the plunger all the way down twice. Only after this should a lancet be inserted.
  
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• Can I exchange the lancet while the device is primed?
  If no lancet has been left in the device, a new lancet can be inserted in the primed device. Nevertheless, for safety reasons we highly recommend not to exchange the lancet while the device is primed.
  
  If a lancet has been left in the primed device, please press the plunger (without pressing the device against the skin) to trigger the device. Then remove the cap and press the plunger a second time, holding the device upright above a waste bin. The lancet will be ejected and a new lancet can be inserted.
  
  Note: Keeping the lancing device in a primed state can cause parts to become misshapen through tension and impair its operation.
  
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• Can I use a lancet more than once?
  You should use a new, sterile lancet every time you test. This is based on hygienic considerations. In order to reduce risk of infection, the medical device directive (93/42/EEC) in the EU requires 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 needle 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 Plus lancing device or the Accu-Chek Softclix lancets contain latex?
  No, Accu-Chek Softclix Plus lancing device and the Accu-Chek Softclix lancets do not contain latex.
  
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• How do I safely dispose a used lancet?
  The lancet should be disposed of in a 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 and 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 prerequisite for an optimal glucose measurement.
  
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• May I squeeze the fingertip to get more blood?
  Yes! Blood should be sampled by gently squeezing the fingertip (the tissue is pressed together and blood is forced out of the incision), since it minimises lancing pain (shallower penetration) and reduces the risk of scarring and residual. Squeezing the fingertip does not significantly dilute capillary blood with ‘tissue water’.
  
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• What can I do to avoid obtaining too little 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 your finger.
  • After lancing, massage your finger towards the tip.

  Only if all of the above 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, if 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 drawing too little blood.
  
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• What if the Accu-Chek Softclix Plus lancing device does not prime?
  Check whether the cap has been reapplied to the device. If not, please reapply the cap.
  Now the device is ready to be primed.
  
  Note: In order to prime the device properly the plunger has to be pressed down all the way. If you are unsure of the priming status, please press the plunger until it shows full size. Then prime the device by pressing the plunger all the way down.
  
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• What if the lancet does not drop out by pressing the plunger?
  Please proceed in the following manner:
  
  

  • Make sure that the cap of the lancing device has been removed.
  • Hold the lancing device upright above a waste bin and press the plunger until it clicks.

  The lancet should drop out now.
  
  If, in rare cases, the lancet does not drop out, keep the plunger pressed down. Use the white “collar” of the cap to pull the lancet out by hooking the edge of the collar behind the platform of the lancet. A cut-out area on the inside of the lancet holder makes it easy to hook the lancet platform.
  
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• What is the right way to clean Accu-Chek Softclix Plus 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 Plus lancing device time to dry thoroughly.
  
  Never dip Accu-Chek Softclix Plus 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. Do not store them in a hot car or in the refrigerator.
  
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• Where can I buy Accu-Chek Softclix Plus lancing device?
  Accu-Chek Softclix Plus lancing device is sold only as a kit together with Accu-Chek Compact Plus system. The kit is available at many retail and online pharmacies. Please view list of retailers for more details.
  
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• Which other lancets are compatible for use with Accu-Chek Softclix Plus lancing device?
  Due to its unique mechanism (Clixmotion technology) only the Accu-Chek Softclix and Accu-Chek Softclix XL lancets are to be used with Accu-Chek Softclix Plus lancing device. Using any other lancets may damage the lancing device or impair its function.
  
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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.
  
  Accu-Chek Compact Plus meter only requires 1.5 micro litres of blood for determining the blood glucose level. Always start with a low setting when using the lancing device for the first time. Should you not obtain enough blood, dial to a higher setting until blood volume is right. Please also refer to the following questions for further details on how to draw sufficient blood.
  
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• Why does the plunger serve several functions unlike other devices?
  The plunger is a multifunctional button used to prime, trigger and eject the lancet. This allows you to operate the device with just one hand, easy and convenient!
  
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Accu-Chek Active

• Can the user delete stored results?
  With the new Accu-Chek Active meter it is not possible to delete stored results.
  
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• Does the meter provide information if the test strip has expired?
  Yes, the meter will show exp inside the strip icon if the test strip has expired and the date and time are set. Nevertheless, a measurement will still be possible although we do not recommend using this result for therapeutic decisions.
  
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• How long does the battery last?
  A battery will last for at least 1,000 measurements (based on 3 tests/day) within one year. The internal clock permanently draws power irrespective of the number of tests taken, even when Accu-Chek Active is turned off.
  
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• How many test results can be stored?
  The new Accu-Chek Active meter can store up to 350 test results.
  
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• Is Accu-Chek Active suitable for use in the professional sector?
  Yes, for professional use, we recommend the use of Accu-Chek Active in outside dosing mode to minimise hygiene issues. Regular cleaning of the test strip guide and control measurements are required as described in the Owner’s Booklet. The meter provides a facility for flagging control measurements as such, which is very important in the professional setting.
  
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• Is cleaning required for Accu-Chek Active?
  We recommend regular cleaning of the test strip guide and the optical component underneath it as described in the Owner’s Booklet. In the professional area, regular cleaning is even more important in order to minimise the risk of cross-contamination.
  
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• What type of measurements can be flagged?
  When the result is shown you can use 4 different flags by pressing the S button.
  The flags will appear in the following order:
  
  

  1. before the meal (pre-prandial)
  2. after the meal (post-prandial)
  3. general flag
  4. control solution

  (This value will not be included in the average calculation)
  
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• What types of averages are available?
  There are 3 types of average available:
  
  
  

  1. for all values
  2. for values before the meal
  3. for values after the meal

  For each group the average is shown for 7, 14 or 30 days.
  
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Accu-Chek Compact Plus

• Can Accu-Chek Compact Plus system be used in the professional sector (hospital)?
  If it is misused and the meter is held upwards instead of downwards when drawing up blood, there is a risk of blood running into the casing. When the next strip is ejected, it may be contaminated by the blood that entered earlier. Then there is a risk of cross contamination.
  
  If Accu-Chek Compact Plus system is used in the professional sector, special cleaning and handling requirements apply. The appropriate literature reference is quoted in the package leaflet and the instructions for use. (See "Does Accu-Chek Compact Plus meter need to be cleaned?")
  
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• Can I use rechargeable batteries?
  Yes, you can. Since, rechargeable batteries normally have a voltage of just 1.3 V instead of the AAA batteries’ 1.5 V, the measurement cycles will be reduced. Additionally, the discharging characteristics are completely different, therefore it must also be remembered that when the battery icon appears the minimum safety buffer of 50 measurements can no longer be guaranteed. In addition, we do not have any control over the quality of the rechargeable batteries nor the recharger.
  
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• Can I use the clear control solution with my Accu-Chek Compact Plus meter?
  Yes, but you need to manually flag the control measurement. Automatic control detection only works in the combination of Accu-Chek Compact Plus and the dark blue Accu-Chek Compact Autocontrol.
  
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• Can I use the dark blue Accu-Chek Autocontrol solution with any Accu-Chek Compact meter?
  Yes, but you may need to manually flag the control measurement. Automatic control detection only works in the combination of Accu-Chek Compact Plus and the dark blue Accu-Chek Compact Autocontrol.
  
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• Can the brightness of the new OLED display be adjusted?
  Yes, by pressing the “S”-button, the second step within the setup mode is the adjustment of brightness. Three levels are selectable with “M”-button.
  
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• Can the strip also be removed manually?
  The ejected strip can be removed manually without damaging Accu-Chek Compact Plus. However, by removing a used strip manually there is a risk of contamination, so this should be done only in exceptional circumstances.
  
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• Can the system be used for neonates?
  The system cannot be used for neonates.
  
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• Couldn’t Accu-Chek Compact Plus meter be made thinner?
  Since the 17-test-drum determines the thickness of the meter, this was not possible. To ensure stability and robustness of the drum the round shape and size of the drum could not be changed.
  
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• Does Accu-Chek Compact Plus meter need to be cleaned?
  Accu-Chek Compact Plus does not require cleaning if the system is handled as instructed. However, if it is misused (the ejected strip is not held slanting downwards when drawing up blood or control solution) the optics part can become dirty.
  
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• Does Accu-Chek Compact Plus system offer the opportunity to redoes after blood has been applied?
  Yes, Accu-Chek Compact Plus system has a re-dosing option within 25 seconds.
  
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• Does the OLED display need more power?
  Yes, it does. As higher the level of brightness selected, more power is consumed.  Default setting is Level 2.
  
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• How long do the batteries last?
  High energy batteries last at least 1,000 measurements or one year.  The internal clock uses power irrespective of the number of measurements, even when Accu-Chek Compact Plus meter is switched off.
  
  The number of measurements may be reduced when the measurement frequency is extremely low (1 measurement per week) and the meter is left unused. The number of measurements may be improved where the measurement frequency is high.
  
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• How reliable is the barcode reader?
  The bar-code reader has an automatic error detection which meets the highest reliability standards.  If an error is detected, an error message appears. The customer should then proceed as described in the instructions and take another drum from the same package to continue with his / her measurement (see the section on error messages in the instructions for use).
  
  All drums produced by Roche Diagnostics have been tested and passed 100% by video control.
  
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• How robust is the motor and the mechanism?
  The motor as well as the mechanism has been designed to last for at least 6,000 measurements. Additionally, the stability has been successfully tested with a number of drop tests and vibration tests.
  
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• If it is the colour that is detected by the meter, can we then also use other Autocontrol solutions, e.g., from Accu-Chek Performa?
  Control solutions are individually designed and developed for each Accu-Chek system.  The viscosity of Accu-Chek Compact Control and Accu-Chek Compact Autocontrol is higher than for other Accu-Chek control solutions.
  
  In addition, the Accu-Chek Performa Autocontrol solution will not be automatically detected by Accu-Chek Compact Plus. The feature of automatic detection is only given with the respective components of the system: Accu-Chek Compact Plus together with Accu-Chek Compact Autocontrol.
  
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• Is it possible to insert the drum incorrectly?
  No, it is not possible to insert the drum the wrong way. Accu-Chek Compact Plus meter has been designed to enhance safety.
  
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• Is strip transportation still a problem?
  No, strip transportation problem is solved by a redesign. Tests showed reliability of the process.
  
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• Is the measurement result affected by altitude?
  The Gluc-Dor enzyme used has a negligible dependence on the atmospheric oxygen level. For this reason its altitude dependence is also extremely small. We guarantee full functionality for up to 4,000 meters.
  
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• Is the measurement result affected by plasma coded strips?
  With test strips calibrated for whole blood your meter shows values that differ from those obtained with test strips calibrated for plasma.  Please make sure that you always use the same type of test strips for your blood glucose meter.
  
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• Is the OLED display readable in bright sunlight?
  The readability in bright sunlight is a disadvantage of the OLED. By covering the display with your shadow it is readable again.
  
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• Is under-dosing possible and how reliable is the control mechanism?
  The strip has a capillary designed so that measurement does not start until there is sufficient blood in the capillary. A symbol has also been incorporated to show when measurement starts. In the event of under-dosing, measurement does not start or the error message appears when the test strip is not re-dosed within 25 seconds.
  
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• What happens if I insert a used drum?
  What happens if I insert a used drum?  If a used drum is inserted the code on the drum is first read automatically.  Accu-Chek Compact Plus meters then search for the next chamber containing a strip, always starting with the first one. For example, if just 1 strip is left in the drum, the meter checks 16 chambers before it finds the last strip.
  
  Warning: The period quoted for using up the Accu-Chek Compact drum is no longer valid because the drum compartment was opened (see "Error messages" in the Owner’s Booklet).
  
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• What happens if I insert the batteries incorrectly?
  Since the batteries do not complete the circuit, nothing happens.
  
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• What is the strip quality check? How does it work?
  Accu-Chek Compact Plus system checks each strip for quality before measurement. Because of this check, the meter’s strip advancing mechanism needs to pause briefly before ejecting the strip completely (see "Why must I wait before I can apply blood?").  If the strip is spoilt, an error message appears.
  
  Warning: The strip quality check can only check the strip, not the whole system (meter, meter optics). For this reason it is not possible to completely eliminate performance checks in addition to the inbuilt strip quality check.  Checks are made to ensure that the test area changes colour in a particular way, e.g., when moistened.
  
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• Why are the batteries inserted when Accu-Chek Compact Plus meter is delivered?
  Accu-Chek Compact Plus is delivered with time and date factory-set. Power supply is necessary to retain pre-settings.
  
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• Why can’t we only have one range of control values?
  Due to the contribution of the colour (which is needed for the auto detection) to the optical signal, the amount of glucose has to be reduced. Especially the low control solution contains only an amount of glucose which is at the lower detection limit of the chemistry. Together with the signal contribution of the colour it sums up to 70 mg/dl instead of 50 mg/dl for the clear control solution.
  
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• Why do I have to wait until the strip and drop icon appears in the display before I can start to measure?
  The meter is performing the strip quality check. Strip position and other details are tested before the strip is advanced in total. The total time required is about 1.5 seconds.
  
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• Why do we need two sets of control solutions, the clear and the dark blue solution?
  The new Accu-Chek Compact Plus system offers a new feature: automatic detection of control solution. This is an additional safety feature, because often the consumer tends to forget to flag control measurements. The unflagged control value would then be stored as a normal bg value in the memory and used for the statistics calculation. The automatic detection of Accu-Chek Compact Autocontrol requires a colour in the control solution.
  
  Today the clear Accu-Chek Compact Control solution is still on the market and patients need to check their system with that solution.
  
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• Why do we use the word “Autocontrol”? The system still requires control checks and does not check itself automatically.
  A complete check of the system includes testing the chemical reaction. Thus we need to apply glucose to the test field. However Accu-Chek Compact Plus automatically distinguishes between applied blood and control solution.
  
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• Why does Accu-Chek Compact Plus meter not need the display cover?
  Accu-Chek Compact Plus has a newly designed “Test button” which prevents the system from being switched on inadvertently. Otherwise a strip would be wasted each time this happens, because switching on the meter with the Test button immediately starts the strip advance mechanism.
  
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• Why does the Accu-Chek Compact Plus strip advancing mechanism stop briefly before the strip reaches the measuring position?
  See "Strip quality check"
  See "Why do I have to wait until the strip and drop icon appears in the display before I can start to measure?"
  
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• Why does the vial label show so many control values?
  For the current clear Accu-Chek Compact Control solution we offer the respective control values on the vial label. In most countries 2 levels of control are offered: 50 + 150 mg/dL. In addition, some countries offer mg and mmol.  For an overlap time of approximately 18 months we need to offer control values for Accu-Chek Compact Control and Accu-Chek Compact Autocontrol.
  
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• Why is the drum labelled with two bar codes?
  The Accu-Chek Compact strip container can be used for Accu-Chek Compact and Accu-Chek Compact Plus meters – 1 code for each bg meter.
  
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• Why must the drum be left in the Accu-Chek Compact Plus for no more than 90 days?
  All test strips (including those of our competitors) are moisture-sensitive. The drum contains a desiccant which protects the strips from moisture for 90 days (in all climatic zones). After that time the desiccant is used up and the strips are exposed to moisture.
  
  They become unusable after just a few days. An additional desiccant protects the strips in the unopened tube until the printed expiry date.
  
  When a drum is placed in the Accu-Chek Compact Plus, the display shows the drum icon and "control bottle" after 90 days. This means that the drum can no longer be used. If the drum continues to be used, Accu-Chek Compact Plus prompts the user to perform a control check. Legally, the strips must not be used. If they are, the readings obtained must be used for guidance only. The meter registers every opening of the cover and sets its internal timer to 0, i.e., the message "Drum-Icon + Control-Bottle-Icon" appears. To prevent incorrect results, the quality of each strip is also checked again before it is used (see "strip quality check").
  
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• Why should I change the batteries only when I change the drum?
  Each battery change is a break in the power supply. This means that Accu-Chek Compact Plus meter does not know whether or not the cover was opened and the drum was changed. In this case the meter assumes, for safety reasons, that the cover was open and reads the code again. Accu-Chek Compact Plus accesses the first chamber and if this is empty the meter identifies the drum as having been used.
  
  Another old, used drum could have been inserted during the battery change. That is why, for safety reasons, Accu-Chek Compact Plus meter now prompts the user to carry out a performance check.
  
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Accu-Chek Go

• Can Accu-Chek Go Meter be used in neonates?
  The Accu-Chek Go system does not fulfil the neonatal claim.
  
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• Can Acoustic Mode be used for the visually impaired?
  Yes, Acoustic Mode is intended for persons who are visually impaired so that they can be more involved in the management of their diabetes.
  
  However, they should only use Acoustic Mode with the help of a sighted person.
  When Acoustic Mode is turned on, the meter guides the user through the testing process using beep tones; it also announces the test result as a series of beeps. The meter beeps additionally whenever the battery symbol, the thermometer symbol, the exp symbol or an error message is displayed.
  
  Visually impaired persons:
  
  

  • Need a sighted person to instruct them in the use of the meter and to assist them with all aspects of its operation
  • Must not test their blood glucose without the assistance of a sighted person

  An intimate knowledge of how results are represented as beeps and how to distinguish results from other beeps is crucial to reliably recognising the result. A training program that lets the customer practice interpreting the beeps in Acoustic Mode, called ‘Beep Learn for Acoustic Mode’, is available on a CD. If you are interested in this CD, please contact your local customer service.
  
  In December 2004 / January 2005, a user evaluation to test Acoustic Mode was conducted on 31 partially sighted volunteers. During the test, 95 % of all acoustically output measured results were correctly recognised by the volunteers.
  
  As there is a 5% risk that individuals cannot recognise the beeps correctly, the full dependence on Acoustic Mode to deliver results is not for everyone. Acoustic Mode is also not suitable for individuals with certain medical preconditions (e.g., affecting their hearing faculty or power of concentration).
  
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• 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 left arrow or right 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 left arrow or right 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 left arrow button or right arrow button 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 Accu-Chek Go meter have the same precision and accuracy as other Accu-Chek meters?
  The Accu-Chek Go system is one of the most precise and accurate in the world. For more details on precision and accuracy of the Accu-Chek Go system, please refer to the evaluation report.
  
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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 is 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 is 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 the PC.
  
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• How do I interpret results in Acoustic Mode?
  In Acoustic Mode, whenever your meter displays a result following a blood glucose test, it also announces the result as a series of beeps. The result is not treated as an entity, but is broken down into individual digits.
  
  Examples:
  
  

  • The result 138 mg/dL is announced as 1 – 3 – 8.
  • The result 7.6 mmol/L is announced as 0 – 7 – decimal point – 6.

  Each digit is represented by the corresponding number of beeps; e.g., 4 beeps for the number 4 ( – – – – ). Zero is represented by a long beep ( — ). The decimal point is represented by a very short beep ( · ). As soon as the meter displays the result, two short beeps signify that it is also about to announce the result acoustically ( - - ) mg/dL meters.
  
  Example:
  
  

  • The result 72 mg/dL is announced as follows: 1 long beep (for 0 hundreds) – pause – 7 beeps – pause – 2 beeps ( — – – – – – – – – – ) mmol/L meters.

  Example:
  
  

  • The result 13.8 mmol/L is announced as follows: 1 beep – pause – 3 beeps – pause – 1 very short beep (for decimal) – pause–8 beeps ( – – – – · – – – – – – – – ).

  The result announcement is repeated twice.
  
  Again, two short beeps precede each repetition.
  
  Results that are lower than 10 mg/dL or 0.6 mmol/L and are displayed as Lo are announced acoustically as 0 – 0 – 0 and 0 – 0 – decimal point– 0, respectively.
  Results that are higher than 600 mg/dL or 33.3 mmol/L and are displayed as Hi are announced acoustically as 9 – 9 – 9 and 9 – 9 – decimal point – 9, respectively.
  
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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 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.
  
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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:
  
  

  1. Long beeps if the test result is below the lower limit
  2. Short beeps if the test result is above the upper limit

  The lower limit can be set to a value of 60 to 599 mg/dL (3.3 to 33.2 mmol/L). The upper limit can be set to a value of 61 to 600 mg/dL (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 1 mg/dL (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 new Accu-Chek Go 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 Setup 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) followed on by pressing the button again and holding it down for at least 3 seconds. This will lead the user to the time-and-date format, time and date set-up mode.
  
  In Quick Set-up mode, press the On/off button down for longer than 3 seconds. This will lead the user to the F1 (time-and-date format/ time/ date setup) mode, pressing the On/off button will allow the user to choose which modes: F2, F3 or F4 to set-up.
  
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• How long is the test strip shelf life?
  The target 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 will not last as long.
  
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• Is Accu-Chek Go meter suitable for use in the professional market sector?
  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 especially recommended in the professional sector. Cleaning instructions can be found in the Owner’s Booklet.
  
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• Is it possible to deactivate the beep tone, target range or alarm times?
  Yes. This can be done easily using Quick Set-up mode and selecting either F2, F3 or F4 respectively. Please refer to the instructions for use for details.
  
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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 the left arrow and right arrow buttons at the same time (for longer than 3 seconds) until ‘CLR’ appears.
  • Press and hold down the left arrow and right 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 the left arrow and right 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 off the meter.

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• Is re-dosing possible in the event that the first attempt to get enough blood was unsuccessful?
  Yes, re-dosing is possible within 15 seconds of adding the first drop of blood.
  
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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. Eject the test strip and repeat the test with a new test strip.
  
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• What is special about the Accu-Chek Go hinge-top vial (HTV)?
  The Accu-Chek Go HTV test strip container features a flip-top cap with the Accu-Chek logo moulded on it.
  
  The new design with a prominent ‘lip’ makes it much easier to open the container, even with one hand.
  
  A hinge attaches the cover to the tube so that the cover is never misplaced. This helps make sure the container is closed properly and promptly, which may help increase testing compliance and decrease strip exposure. A desiccant is located in the cover. This helps ensure test strip stability and protection from environmental factors.
  
  The container is also shorter – making it more convenient for customers to carry.
  
  The code chip is stowed away at the bottom of the container. This makes it much more convenient to locate and less likely to be misplaced.
  
  The Accu-Chek Go test strip comes in a tamper-proof sealed box for better assurance and discourages pilferage.
  
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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 left arrow button or right 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 HTV?
  The desiccant in the cap of the HTV is a non-toxic silicate-based drying agent.
  
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• Which AST areas can the system 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.  
  
  Alternative site testing is only recommended under steady blood glucose level conditions.
  
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• Why is the test strip so short?
  This is necessary to keep the meter small and the testing time short. You will also notice that the Accu-Chek Go test strip is not shorter than some other brands of blood glucose test strips.
  
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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?
  For your safety, the Accu-Chek Performa system 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.
  
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• Do any other substances interfere with the Accu-Chek Performa test strip?
  Only 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 doctor.
  
  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 metabolised 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 doctor.
  
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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 results to a computer simply by pointing the infrared (IR) window on the top of the meter toward the IR window of the Accu-Chek download cable. The 2 windows should be 3 to 10 cm (1 to 4 in) apart.
  
  To enter download mode:
  
  

  • Turn off the meter.
  • Press and hold the left arrow button and right arrow button until 2 arrows in the display flash alternately.
  • Initiate the data download by following the instructions provided with the supported software.

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• How do I exit setup mode?
  Press and hold 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 recognises Accu-Chek Performa Autocontrol 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 Autocontrol 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 testing system (the meter), 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
    • Show user if more sample is needed
    • Permit re-dosing within 5 seconds
    • Detect whether sample is blood or control solution
  • 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 or to produce an error message if unable to compensate
  • System checks
    • Check for variations in:
      • Hematocrit
      • 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 symbol of a strip with a drop of blood 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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• In addition to the fingertip and palm, from what other sites can the Accu-Chek Performa system test samples?
  The Accu-Chek Performa system will test blood samples from 4 alternative sites (called Alternative Site Testing): forearm, upper arm, thigh, or calf.
  
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• Is it possible to get an incorrect test result?
  Yes. Although the Accu-Chek Performa system adheres to the same high standards of clinical accuracy as other Accu-Chek systems, no blood glucose monitoring system is 100% accurate.
  
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• Is the Accu-Chek Performa system approved for use in clinical settings such as hospitals?
  Yes. Because the Accu-Chek Performa system 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 Active system, Accu-Chek Compact system, and 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 Autocontrol solution bottle?
  The system differentiates between Autocontrol solution and blood because controls have a higher salt concentration.
  
  However, if the Autocontrol 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 systems, which require you to scroll through multiple numbers to code the meter manually, the code key for the Accu-Chek Performa system just snaps in 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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• Why doesn’t the Accu-Chek Performa system have a backlight?
  A backlight would substantially increase the meter’s size and cost, and decrease battery life. Affordability, small size, and long battery life outweighed the benefit of a backlight.
  
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