What is the difference? And how do you set it up? I think I should use it after pizza and or high carb meals. Any advise. Ia am a 22 year old female grad student, moderate exerciser, 7.3 A1c

Tags: TAG, bolus, dual, multiwave, pizza, pump, square, wave

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I found this nifty chart provided by medtronic (attached). I would bet that you have not gone into your bolus setting ans allowed for dual and square wave to be active.

A square wave bolus will give you a flat bolus of insulin over a long period of time. Such as 1.5 units spread evenly over 90 minutes. This function is a bit difficult to use by itself. I believe medtronic says it may be useful for grazing and/or high protein meals.

A dual wave bolus is a combination. First it provides a fast, normal (skittle) bolus. Second it is followed by a square wave bolus. Many people find this useful for high fat and/or high protein meals (like pizza). Many have noted that the high fat content in pizza slow down their digestion. As a consequence you may notice that you go low shortly after the meal (15-45 minutes?) and then spike later (3+ hours). You can use the dual wave to try to match your insulin's activity to your digestion. If done correctly (or luckily) you will not have the low or the late spike.

Setting up how much to do up front and how much to square wave seems to be very individual and will take some trial and error. Personally I like to put 15-25% of the bolus on the square wave and spread it out for 1 to 1.5 hours. The larger the square wave, then the longer time frame I will spread it out.

I would also invite you to reveiw the Total Available Glucose (TAG) group http://www.tudiabetes.org/group/tagers. As many of these issues are discussed more indepth there.

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Thanks, I have known in general about this since I have gotten this new pump, but never tried it out. Thanks for the great info and the chart.

It is a very YDMV type of thing (your diabetes may vary). I dual wave for things like pasta, pizza, etc. Pizza - I have narrowed it down to a 50/50 dual wave over 1 1/5 hours. It is a lot of trial and error and finding out what works best for you.

Right, that what I thought. Thanks!!

Square wave is always my choice. It pumps the insulin over the time period you choose. For pizza, I do it for 1.5 hours. It allows the insulin to follow the path of a high fat food. I have used it for many years--pizza and chinese, although I have used it for a 4 hour lunch in France a few times. Yummmm.
The dual wave bolus will split your dose into two parts, depending on your percentages. So if you do 50/50 over 2 hours, it will deliver 1/2 when you program it and the other half after two hours--just 2 straight boluses. Have never used this, as the square wave is more comfortable for me

Got it, Thanks! I am planning to use for pizza. Also, starting to eat lower carb, almost Bernstein to lose some weight. Thanks again.

there is a very popular discussion here on dual wave bolusing.
http://www.tudiabetes.org/forum/topics/dual-wave-bolus

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