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What is a "square wave" and when do you use it?

Discussion in 'Parents of Children with Type 1' started by DsMom, Apr 27, 2011.

  1. DsMom

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    Read in another thread about "square wave" boluses. My son's Ping does not have that option, but another poster wrote that you can do it with a Ping by doing a combo bolus and making 100% of it extended. In what cases do you use this kind of bolus? I am very timid and still inept at using the combo bolus for things such as pizza--have yet to find the right formula for how much to give up front and how long to extend.:eek: Square wave sounds even more intimidating to me--but I'd like to know what it is!
     
  2. StillMamamia

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    A square wave bolus aka extended wave is a bolus which you give over a set period of time, instead of all at once. So, say you calculate you have to give 3 units but you know or suspect that the food will take a while to digest and is fairly non-spiky:rolleyes: (low GI), then you set up a square wave bolus for 3 units spread out over X hours.

    Dual wave is also known as a combo bolus - part upfront, the rest extended (or squared).
     
  3. virgo39

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    My understanding is that a "square wave" bolus is a term used for a bolus that is delivered over a period of time. We use the Omnipod, which does not use that terminology, but does permit one to "extend" a bolus.

    With a "square wave", instead of delivering 1.0 u of insulin after pressing whatever button starts delivery, the pump delivers the 1.0 u over some period of time that you specify. I'm not sure if it is still called a "square wave", but most/all pumps would also let you deliver a portion of the 1.0 u at the outset, and deliver the remainder over a period of time.

    We're still figuring out extended boluses ourselves. But people use them for:

    meals where digestion might be slowed (high fat, high protein, certain whole grains)

    meals that might be served over a longer period of time
     
  4. hawkeyegirl

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    We never extend out 100% of a dose, but we use a dual wave quite frequently. (Some up front, some extended.) We use the dual wave for pizza, pasta, other high fat foods, and exceptionally large meals.
     
  5. danismom79

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    Like others have said, a square-wave is a bolus that is given over a period of time. On the pod, we have the extended bolus, and to make it a square-wave, you set it to deliver 0% up front, and 100% over a certain amount of time, like your Ping. The only time I really use it is at parties where I know my daughter will be grazing, or at the movies where she's basically munching the whole time.
     
  6. kk4jbird

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    This is how we use it also. On my son's MM Revel there are the following types of boluses...normal (all at once), square wave (gradually being released over a specified amount of time) and dual-wave (a combination of normal [done first] and then a square wave [begins after the normal bolus].

    Just curious how long most of you do a square wave (or second part of dual wave) for?
     
  7. ecs1516

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    We never just do a square wave unless we gave part of the meal as a normal bolus up front. Then we do 0% 100% on back end for a square for th remainder. Depending on the meal how long. For simple fast food(like McDonald's) we use 1 1/2 hours. If my son orders a big fry or a big mac for example then I up it to over 2 hours. The more the fat , protein, or food I tend to increase the wave. It is trial in error in your child what works for you. Some people have told me they never have to extend the bolus.
     
  8. hawkeyegirl

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    For pizza, pasta and fast food, we generally extend over anywhere from four to six hours.
     
  9. DsMom

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    Thanks so much to everyone! Another new D fact under my belt!:D
     
  10. NomadIvy

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    We usually use the square wave when DD is on the low-ish side and she's going to eat a meal. Instead of treating the low and waiting for her BG to come back up, we just let her eat and start the meal bolus as a square for 30 minutes.

    Some people might not agree with this but it's what we do. :cwds:
     
  11. DsMom

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    That is a really interesting idea! If Daniel is maybe 75 before a meal, I am sometimes unsure of what to do. Especially at a restaurant, I don't want him to have to wait 15 minutes to eat so we can re-check. I may try that next time. Thanks!
     
  12. MReinhardt

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    I agree! :D
     
  13. virgo39

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    We do this too!
     
  14. Sarah Maddie's Mom

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    We do a "square wave" or "extended" bolus for party situations where she'll be grazing over time. We'll look at the food and get a very rough estimate of what she might eat and bolus of that swag amount over an hour or more, then check back in with her half way to find out if she thinks she's "spent" that bolus yet or if she plans to have anything else.
     
  15. emm142

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    I do this as well. Or at movies if I'm eating popcorn over an entire movie and don't want to keep bolusing in little bits, I give a bolus in a square wave over the length of the movie. Other than that I mostly use dual waves.
     
  16. GaPeach

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    Cool Idea.
     
  17. GaPeach

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    Our daughter likes her insulin delivery set on Normal. However, anytime she boluses over 4 units, she leaks insulin (skinny girl). So she starting doing a combo bolus for a very short time period. Then she gets some insulin right away and the rest shortly after.

    A bit different, but it works for her. No more leaks with resulting highs.
     
  18. denise3099

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    If dd's starts a meal lowish, I just wait a little before bolusing. For pizza and fast food, I bolus most upfront and do a temp basal of 120% for 4 hours. This is the same effect but I guess the iob is different. It seems to work for her though even though it's not as exact.
     

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