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Re: [IP] square wave and dual wave bolus

>  Our family tends to eat mexican food and pasta  fairly often and
>  this
> really messes up Kara's
> night time numbers!  If we eat dinner at 7 pm by 1 am she is 250-350
> EVERY time she eats a meal like this.(and it won't go down!)  Since
> the htron does not have the square or dual bolus option I was
> wonderingif someone could please explain the concept to me.  My CDE
> never really answers my question re: this--she just says to try
> increasing the basal rate by 1/2 for a couple of hours.  This does
> not seem to work though.  Also, WHAT time do I increase??  1 hour
> after she eats?? or 3 hours?? 

Read the Square-Wave-Bolus-HOWTO  at


It does not directly address your question, but will give you good 
background information.

There are two issues. The overall carb content of the meal, and when 
it is digested. Solving the problem for our family has involved a bit 
of trial and error -- sounds like you are moving in the right 
direction. If the meal contains a lot of carb, a lot of fat, and / or 
a lot of protein, then the release of glucose into the bloodstream 
will be both extended (the fat or protein) and more than you think 
(protein converting to carb). This is the case for foods like pizza, 
macaroni and cheese, mexican, chinese and probably a lot more
(like the time when my daughter was 13 and ate TWO one pound 
cheeseburgers at a sitting -- whew!!! ). You can get a resonable 
estimate of the increased basal (for an htron) needed and for how 
long by looking at the total hbg boluses and dividing over the time. 
We've used a technique like this to adjust carb/insulin ratios as 
well. Repeated tweaking of this estimate each time the same food is 
eaten will give you a better feel for what's needed for future 

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