The Elusive Square Wave

I’ve had two medical pros and a few other diabetics suggest I counter act my post meal spikes with a square wave bolus. For those of you following along at home, a square wave bolus is a function on an insulin pump that distributes a full dose of insulin for a meal over a longer period of time. Kind of like a basal rate on steroids.

I was once told by another diabetic educator that this is a great function for grazers. Or parties with a bunch of appetizers and you don’t want to be micromanaging your pump while you nibble on this and that.

So I was curious to see if this would help my problem. But maybe I chose the wrong meal. Because this method has never really worked before.

For the record, I don’t diet. I eat well. I maintain small portions. I exercise. I avoid fast food as often as I possibly can. (Sometimes, I do enjoy In N Out.) I try to be as “normal” as I possibly can be, even though I’m battery powered and wired for sound.

That said – I pick up a cup of my favorite type of soup from Safeway. Baked Potato and Bacon. Yum! Cream based comfort food to get me through my day. And… the bacon!

However, since I’m micromanaging everything I eat nowdays so I can record it for my doctors to micromanage, I took a gander at the label I often ignore, sans the carb count.

27 grams of fat. 28 grams of carbs.

But… The Bacon!

So since it was a high fat meal that was going to hit me later no matter what I did, I decided, hey why not experiment with a square wave? That seems smart (albeit completely incorrect!)

2 hours later I’m 251. Up from a peachy 100. Geez.

The correct answer would have been a dual wave bolus – which gives you a chunk of insulin at once, and then milks you a percentage over a certain period of time.

Well… we are having pizza tonight. (Because I’m lazy. And it’s cold. And I dropped $800+ on car repairs. I’m not cooking.)

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2 thoughts on “The Elusive Square Wave

  1. Scott E says:

    Lately, I’ve been pretty sparse on my use of square-waves for that very reason, the spike before the fall. I’ve been doing a lot more dual-waving lately, going with a 70%/30% split or even an 80%/20% split (depending on how fatty/protein-heavy the meal is, as well as the BG going into a meal) over 1-2 hours. If I’m low going into a meal, I’ll go with a 50%/50% split for half an hour (replacing my previous strategy of square-wave for a half-hour), so I’ve got a little bit of bolus to bullify the food-spike and the rest over time to keep me from going back low.

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