I few people have asked for some tips on how they are using the dual and sqare wave boluse options on their pumps.  I was hoping if anyone out there can give some advice on where to start for example for Pizza, ice cream, and other high fat foods.  The ADA recommends an 8 hour combo/dual wave bolus for pizza but I have not found that works for me.

Here is a LINK to a tudiabetes forum post about it.

Reply by Manny Hernandez on September 19, 2007 at 8:57pm

Send Message

I've found these rules to work for me when programming the dual-wave option (I also have the 515):

-I assume 3 hours for the spike due to fats and carbs.

-I assume 10% of the value for fats

-40-50% of the value for proteins.

So, if I eat something (a protein shake, for instance), that has 24 grams of protein and 10 grams of carb, I will put in 10 grs (for the carbs) + 12 grans (50% of the 24 grams of protein) = 22 grams, and as the pump to give me about 45% (or as close to it as possible, because that is what 10/22 is) now and the remainder in 3 hours.

Ever since I started applying these rules, as long as I've gotten the values of carbs, fats and protein right, I've never spiked with high fat/protein meals with the pump.

Hope this helps

Be careful bolusing fpr protein. Protein does not contain carbs and does not require insulin to digest.  I have talked to several well knownn endos about this since there is a school of thought that you need to bolus for protein. The endos do not believe you need to bolus for protein.  The endos suggest you do a test. Have a stable BG.  Eat some boiled white chicken without skin which is about as close to pure protein as you will get .Don't add any insulin and take your BG 30,60,90 and 180 minutes out.  You should not see any rise in BG if your basals are set right,  Fat does slow the digestion of any foods it is combined with and square waves may help cover them better.

Andy

Bill at 12:17PM on Aug 22, 2009

I few people have asked for some tips on how they are using the dual and sqare wave boluse options on their pumps.  I was hoping if anyone out there can give some advice on where to start for example for Pizza, ice cream, and other high fat foods.  The ADA recommends an 8 hour combo/dual wave bolus for pizza but I have not found that works for me.

 

Here is a LINK to a tudiabetes forum post about it.

 

Reply by Manny Hernandez on September 19, 2007 at 8:57pm

Send Message

I've found these rules to work for me when programming the dual-wave option (I also have the 515):

-I assume 3 hours for the spike due to fats and carbs.

-I assume 10% of the value for fats

-40-50% of the value for proteins.

So, if I eat something (a protein shake, for instance), that has 24 grams of protein and 10 grams of carb, I will put in 10 grs (for the carbs) + 12 grans (50% of the 24 grams of protein) = 22 grams, and as the pump to give me about 45% (or as close to it as possible, because that is what 10/22 is) now and the remainder in 3 hours.

Ever since I started applying these rules, as long as I've gotten the values of carbs, fats and protein right, I've never spiked with high fat/protein meals with the pump.

Hope this helps

I have just started using the dual wave feature on my pump for just about all meals and snacks. You offer some great advice there, and I have to look deeper into it. I found the following from MM regarding starting rates for dual wave. This has helped me, but YMMV

The STARTING guidelines that MM gives for squarewave bolus:

50/50 over 30 mins for all normal mixed meals

30/70 to 50/50 over 2-4 hours for high fat foods

30/70 over 30 min to 1 hour for higher fiber foods

75/25 over 30 min for all meals that include correction for high BG