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Re: [IPk] Square Wave Bolus



Dear Caroline,

Before working out how much 'tail' to give in the square wave, you need to get the first hit of insulin right.  Going hypo affects bg metabolism for up to 24 hrs after - and the well known post-hypo high is just one of the ways.

So try again, but reduce down the 'now' bit of the bolus a bit more - and also shift it to after the pizza (unless you spend a long time eating).  Don't worry too much about what happens past 2.5 hours!  Just correct for it.

Once you can start a pizza at around 6 (or whatever you like to be) and can sit at 6 for 2 hours or so, you can look at what happens over the following evening and night - you might find that you need more insulin for pizza, which usually has about 50% calories from carbohydrates) than for meals with 60% calories from carbohydrates.  Personally, I find that I need to take the 'normal' insulin for the carbohydrate (say 6 units) take half 'now' and half over 4 hours - but with a low % of calories from CHO, take extra insulin, and take it over longer - say 6 units over 8 hours.

But I'm still learning how to do this - partly because I don't keep good records, and partly because I will keep spoiling the experiment with alcohol, not eating all the pizza, eating chocolate later, etc. etc.

I still can't out why beans of all kinds send me high for hours (yould think they had secret calories), nor why moules do ... perhaps I'm extremely sensitive to protein?

Best wishes,

Pat

dm 30+, 508 1+, very fond of mussels.  


email @ redacted wrote:
> After observing what certain foods (including, you guessed it... pizza!)
> have done to my blood sugars, I decided to experiment with a square wave
> bolus last night. However, it didn't really seem to work, so I was wondering
> how others use these boluses.
> 
> Foods like these with normal bolus would usually see my blood sugar going
> too low within 3 hours and climbing at around 4 1/2 - 5 hours after eating.
> Last night I tried dividing the total bolus in half, giving half just before
> eating, and half over 4 hours. In less than two hours, I was hypo (3.1,
> having been 6.9 before the meal) and two hours after that my BG was too
> high.
> 
> I'm confident the total bolus was correct according to my usual ratio (I
> read the carb content off the back of the box!) but I was wondering whether
> besides using a square wave bolus I need to actually adjust the total amount
> of insulin to cover these foods.
> 
> Caroline
> IDDM 18+ yrs, MM507 3 weeks
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