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Re: [IP] Square Wave Bolus

<< I have been on a MM508 pump for about 3 weeks.  Can anyone tell me how the 
square wave bolus works?  I have read the book and understand how to program 
it, but how do you know how much of a bolus to program it for? >>

Hi Brenda,

I swear, we've all had the same question after starting on the MM508!  I 
asked my CDE; I asked this list; and the answer I got from them and came up 
with myself is this:  There is no formula anyone can give you.  It is a 
trial-and-error process, or what Jim Handsfield on this list calls a SWAG 
(scientific wild-assed guess).

I use the square wave whenever I have a higher-than-normal fat content in my 
meal, for example Caesar salad or sausage or Mexican or something like that.  
I first started my "test" by eating the food and bolusing with a Normal bolus 
to cover the carbs as usual.  Then I tested for 4-5 hours afterward so I 
could see what happened to my BGs.  

For me--and YMMV--fatty meals tend to need *less* of the normal bolus 
initially because the fat is slowing absorption of the carbs, but my BG would 
rise 4-5 hours later.  So what I do is take maybe 75% of my normal bolus when 
I eat, then do a square wave for the next 3-4 hours.  (I really use the SWAG 
method to determine how much insulin to deliver via the square wave...or 
maybe it's a good intuitive (gut) feel, based on how high my BGs tended to 
drift after a particular food.)

Then you keep records and try, try again with the same food.  It really took 
me quite a bit of effort, but even though I limit my indulgences and try to 
stick to a 10 to 15%-fat diet most days, when I want to indulge, I'm glad I 
put in the effort and know how to do it.  I've gotten good results with 
it--and I know now that I need a pretty hefty square-wave bolus to handle 
Mexican food!

good luck!
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