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Apidra - do you do a lot of square / dual wave

Discussion in 'Parents of Children with Type 1' started by emm142, Sep 18, 2011.

  1. emm142

    emm142 Approved members

    Sep 7, 2008
    I've had a MUCH better day on Apidra today. My basals seem marginally too low (I'm running at 115%) but not as bad as it seemed last night. I had cereal for breakfast (Weetabix with milk, so not the real sugary stuff) and where I'd usually spike to 250 or so and come back down, I topped out at 140 today which is beautiful. It also covered fruit really well. I eat a lot of fruit but usually if I eat more than about 20g of fruit at once it spikes me - today I had 40g carbs of fruit and my BGs were great, only hit 150 and drifted down again.

    The trouble came at dinner. I had rice with vegetable curry (made it myself, so although it did have some oil in, it wasn't horribly fatty) and white rice. The first 3 hours after eating (Apidra's DIA) seemed okay, my BGs were around 170. After 3 hours had passed, though, they just kept going up.. and up.. I put on a 200% temp basal and managed to curb the spike at around 300. So, it looks like the Apidra isn't going to have a long enough DIA to cover my digestion at dinner. In theory this is fine, as I can just do a dual wave bolus. Just wondering how many people on Apidra have to do this on a regular basis, and what kind of timings work for you to cover a typical evening meal of 60-70g carbs, not too fatty.

    I'm thinking I'd start with 80% up front and 20% spread over 4 hours, but probably will also need to raise my I:C to 1:9.

    I'm guessing that this kind of thing is fairly typical with the lower DIA.
  2. lisamustac

    lisamustac Approved members

    Mar 9, 2009
    Glad you are getting things back under control :) we didn't have to change much when switching so we got lucky. The post meal spikes have been under much better control since switching to apidra. Glad you are seeing that as well.

    As for dinner we only really have a problem with very fatty foods like pizza and cakes. If we have a pizza party complete with cupcakes I do an split bolus usually 60 up front and 40 over 4 hours. On top of that I find I have to do an increased temp basal.

    It doesn't happen to us that often just parties it seems like. The pizza cupcake combo always stumps me:confused:

    Keep experimenting with different dinners. You might not need a combo for every dinner.

    Good luck!!!
  3. Flutterby

    Flutterby Approved members

    Nov 11, 2006
    For dinners and large lunches we have to dual wave or squarewave. Sometimes I forget and we see a large drop, and then a spike later (because of all the carbs she had to eat to stop the drop)... dual/square waves are definitely our friends. :cwds:
  4. sarahconnormom

    sarahconnormom Approved members

    Mar 12, 2008
    Connor is on Novolog and we probably dual 90% of his meals. This is just what works best for us. Most times it is 50/50 over 30 minutes but if it is rice, pasta, pizza, etc we do longer.
  5. Ali

    Ali Approved members

    Aug 1, 2006
    It is in and out so quickly that if you miss the timing you can as you describe end up high after it has peaked. I tend to add a bit more to those carby meals and then check and bolus later if needed. Most of the time with those high carb or high fat meals, will take the full bolus plus a bit, and then do a 2 hour increase with a temp basal and check to see what is going on at the two hour mark. I check at the 2 hour mark, and take another correction if needed. I usually do need a correction but it keeps the delayed spike at bay without running a risk of a big low or frankly having to figure out the extended bolus for each odd meal. It is really a different insulin for many of us, but for me the no tail has been critical, I can correct much more accurately and bolus to cover meals better. Ali

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