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RE: [IP] dual wave & square wave bolus



 I would disagree with your CDE. Her advice only works if you know in advance
how much you're going
to eat!

 A much better plan when grazing is to bolus for each bit of food you eat, at
the time you eat it, as
 soon as you know how much you're going to (or have) eaten. If the amount you
eat is less than enough
 to make a 0.1 U bolus, wait unti you've eaten at least that much. Doing it in
very small increments
 will increase the roundoff error, so it's better to do it in 0.3 U increments
or more -- or keep
track of the roundoff errors, but that's more mental arithmetic.

 Waiting until after you eat, then using a square wave, fails for two reasons.
First, you'll forget
how much you ate; it's real easy to lose track when grazing.

 But more importantly -- it's too late. By then, you needed some of that insulin
EARLIER, and using a
 square wave AFTER you eat misses the point. By the time you're done grazing,
you need all of that
 insulin right now -- and a good part of it earlier. Of course, if you could
have a REVERSE SQUARE
WAVE -- i.e., a time machine -- that would do the trick!

 One caveat: If you have gastroparesis, bolusing after you eat, often with a
square wave, makes
sense.

 Also, Minimed won't let you do overlapping square waves, which reduces its
usefulness in a grazing
situation.

-----Original Message-----
 From: email @ redacted
[mailto:email @ redacted] On Behalf Of
Nancy Gregor
Sent: Wednesday, July 19, 2006 19:31

  I'm a new MM 715 user and I'm winding up with high BG's after eating at a
buffet. I tried to figure
 the number of carbs I'd eaten and then bolus for them using the square wave
method. My CDE said that
 when "grazing" I should use the SW bolus with the amount of carb eaten.
However, she doesn't offer
 any other assistance! Has anyone had experience with dual wave and square wave
boluses? If so,
please share your experience with me to help me judge. Thanks for your help!!
.
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