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For pump users, how often do you use an extended, square wave, or dual wave bolus?


More than once a day






Once a day






Several times per week






Several times per month












Never, because my pump doesn't have those options






Never, because I never learned how






Never, because it's not needed












For pump users, how often do you use an extended, square wave, or dual wave bolus?

Poll dates: September 8 - 15, 2002
Total Votes: 279

Today's insulin pumps offer several ways to take a bolus of insulin. These are called extended or square wave, and dual wave or combination, depending on the pump company, but they all change the bolus delivery pattern and can be used for different types of meals. An extended or square wave bolus might be used if you are eating an extremely high fat or very low carb meal, or for people with gastroparesis, in which the absorption of glucose it delayed. The bolus delivery is extended over a given time period so that is it slowly absorbed to allow the glucose to enter the system.

A dual wave or combination bolus allow you to give a certain amount of insulin immediately (as in a normal bolus) and then deliver the remainder over a given period of time (an extended bolus). This option is particularly useful for eating a meal in which you will be "grazing" or one such as pizza and dessert. It might also be helpful in small children who will drink their juice or milk immediately and then take a long time to finish the rest of their meal.

To decide whether you should use either of these features (if they are available to you) check blood sugars frequently after meals. If the glucose continues to rise more than two-three hours after a meal, one of these types of bouses might improve control.

A recent study conducted at the Barbara Davis Center for Childhood Diabetes compared various bolus methods in teens who had a high fat meal and concluded that the longer-duration bolus methods resulted in lower blood glucose levels than the single bolus methods. See Post-prandial glucose excursions following four methods of bolus insulin administration in subjects with Type 1 diabetes (Diabet Med 2002 Apr;19(4):317-21).

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Last Updated: Wednesday March 16, 2005 16:37:14
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