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[IP] Re:square wave/split bolus

MaryJean, this is of course the biggest YMMV area, where ever pumper just
has to get to know their own body's reactions.   You eat, you bolus.
Unfortunately the eating leads to changes in BG over the course of hours,
and the bolus also leads to changes in blood insulin levels over the course
of hours.  To me, it seems an almost impossible task to perfectly match
these two time courses.   Personally I'm happy if 4 hours later my pre-meal
BG is good, and that's all I shoot for.  If you have slow digestion and
rapit H absorption, well then you have to do something about that, so you
don't feel like hell.  But that's the same problem nonpumpers on MDi have
with premeal injections.  Everyone's  got to figure this for themselves.  I
too hate fussing with the square wave bolus, and that is why I just split
the meal boluses when it is necessary to prolong the insulin.  The bugger
is that once you get it figured, it will probably change next week.  And
don't even mention what restaurant meals do!   Must be all that sitting....
(for the record, H and R are metabolized the same once they enter the
blood--the difference is that H enters the blood more quickly.  That's the
poet in me speaking :-)

True, but even though I wrote the howto on using the square wave and mention
this technique there, I find it cumbersome.  Because the square wave bolus
locks up the bolus function on my MM507, I can't decide to add more to my meal
after programming the square wave.  I would have to "suspend" and then figure
out the amount already delivered, add in the extra insulin required for my
"seconds" and then reprogram the whole thing.  Also, even on those occasions
when I did use the square wave or split bolus for a regular (not high fat)
meal, I did experience the low feeling.  This is something that developed
gradually over a period of 2 months while using straight Humalog.  By the time
I gave up on it, I was routinely trying square waves to avoid the sensation.
I determined that my body metabolized the H much too quickly, and returned to
straight Velosulin for a few months.

Wayne Mitzner
Department of Environmental Health Sciences
The Johns Hopkins School of Hygiene and Public Health
615 N. Wolfe St.
Baltimore, MD 21205
Tel. 410 614 5446
Fax 410 955 0299

Insulin-Pumpers website http://www.bizsystems.com/Diabetes/