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Square Wave versus dual wave on Medtronic

Discussion in 'Parents of Children with Type 1' started by Hstntxag, Mar 12, 2014.

  1. Hstntxag

    Hstntxag Approved members

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    We just switched endos and now have a CDE. I am looking forward to having someone to learn from and help me figure out how to manage my son's dailyness on the pump better.

    Last Friday we were explaining why we use dual waves (breads that come in late like Subway sandwiches, donuts or muffins)and she said they are used more for fatty foods like pizza or steak. He doesn't eat pizza much but the bottom line is...if I give him the entire bolus when he eats the breads, he will go low and then high..so how else would I go about this? Square wave?

    Experienced pumpers..How do you use the dual wave and/or square wave?

    Thank you so much!
    Laurie
     
  2. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

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    I'm not sure about the Subway sandwiches, but donuts and muffins can be very fatty so I'm not sure why she's have an issue with a dual wave. Is it working to dual wave them? if so then I'd nod and go on doing what works ;-)
     
  3. Megnyc

    Megnyc Approved members

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    Dual wave is a certain % upfront and then the rest over a certain amount of time. Square wave is the bolus divided equally over a certain amount of time. If he is going low than high it might make sense to do the dual wave bolus with a very low % upfront. I like square wave bolus for things like a party with a buffet. I will give myself enough insulin for say 100 carbs over 60 minutes. That gives me about 90 minutes total to eat the 100 carbs without going low before the food starts to raise my blood sugar. You can't do a square wave bolus if a correction dose is needed.

    Hope that helps a bit!
     
  4. Hstntxag

    Hstntxag Approved members

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    Thanks for giving your 2 cents. It helps so much to have people who have walked ahead of you offer what works for them and what doesn't.

    Here's a prime example...

    Just ate dinner. Total carb count 134, 45 of that is a pizza roll. She said to do 30/70 over 3-4 hours for a normal dual wave but do you take into account how much of the total carb count the pizza roll is? Or is the thought you have to allow lots more insulin at back end to cover the entire 45 carbs when it hit in 4 hours?

    Bless...he's 13 and we are dealing with hormone spikes, sites not lasting more than 2 days and not having a lot of real estate to choose from..It's big a big 'ol party over here the past 2 weeks. I know it'll pass but dang, it all hit at once :/ Like throwing darts at a moving dart board.
     
  5. quiltinmom

    quiltinmom Approved members

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    Love this! So well said.

    It is hard when your medical team says to do one thing but from experience you know something else works better. You have to use your own judgment on things like this...especially with a teen who is always eating and food isn't the only variable.

    We mostly use standard bolus, but when we don't it is usually dual wave.

    I think it may be helpful to try to take into account what the carbs were from in deciding how to set up a dual wave bolus....for example, pizza only would probably be different than pizza as only half or third of carbs. But figuring that all out can be more complicated and confusing than it is worth, so if you figure out what seems to work best and do the same setup each time, it doesn't make you a slacker. :). Trial and error is everything. Sometimes you have to deviate from "textbook" management. All you can do is do your best and correct later if needed.

    Good luck. Try not to overthink it too much. :)
     

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