Dual Wave & Square Boluses, References and Updated materials

Diabetes Technology Insulin Pumps
1

Does any one have and updated presentation or document that shows examples of foods and how to process these foods using Dual Wave Boluses…

It could be so simple like some insulin now and then some insulin later ( 3 to 4 hours) … but does any one attend to the Joslyn Clinic seminars or have updated information about the daily bases use for Dual Wave Boluses for Insulin Pumpers ?

Thanks

2

Never found anything like this. But if you do, I’ll pay mega-$$$ for it.

3

Everybody’s body processes food differently, that being said I think it would be hard to come up with really specific guidelines for Dual wave and Square boluses.

4

Hi, Héctor. There is a book called Pumping Insulin by John Walsh and Ruth Roberts, which is said to be the bible for insulin pumpers. I myself have been trying to get information on patterns during the day for my daugther seems to have a different sensitivity to insulin depending on the hour of the day. I think you can get the book by Amazon. I tried to purchase it in Barnes and Noble, but they said they did not have it and they’ll have to order it; didn´t have the time to wait for it.

Melissa

5

My personal experience with the dual wave is:

  • I set the duration of the square wave (the delayed insulin) to go up to 3-3.5 hours. This time is what works for me, but it may be more or less for you.
  • Carbs: I count carbs at face value. If you are discounting grams due to the fact that you are eating high-fiber or low-glycemic index carbs, then treat them however you would normally. Call this number C.
  • Fats: I count the grams and calculate 10%. Call this number F. If the number of grams of fat is negligible, I round F to 0.
  • Proteins: I count the protein grams and calculate 50% of them. Call this number P.
  • Add F + P (remember this number, so you may have an idea of the proportion between it and the total, C+F+P)
  • Enter C + F + P for the total number of grams to bolus for.
  • Select the Dual Wave.
  • Split the percentage of the bolus to give yourself into
  • “Now” - the percentage corresponding to C divided by (C+F+P).
  • “Square” - the percentage corresponding to (F+P) divided by (C+F+P).

Hope this makes sense! :slight_smile:

6

I’ve been winging it. I’m a lazy procrastinator.

Generally I’ll square 2u over 2.5 hours for “normal” protein content. I double or triple that depending on portions. I also add two units up front for “large” meals and two more for “larger” ones, even if just rabbit food. I don’t consider fat at all.

One of these days I’ll try to quantify things better, but I’m happy with my 6.1A1C. Getting lab work this week and am hoping for sub-6 again. Only two nasty hypos so far in 2009. 15 in 2008 and 12 in 2007.

I also Super-Bolus in the mornings, but that’s another discussion.