The dual wave is a way of delivering a bolus where the pump gives a set amount ìnowî and the rest over an amount of time that you enter into the pump. People using pumps actually get better blood sugars after meals if they learn how to use this function. It is an extra step in the process therefore use it only for large meals that will take a long time to digest, or high fat /fibre meals which can slow the absorption of the carbs. So, usually not needed for breakfast or lunch though you may wish to use it. I would recommend to try starting with 50% now and the other half delivered over the next 2 hours. Some people find themselves still high at 2 hours later which would mean that they need to give 70% now and the other 30% over the next 2 hours. This is individual and like everything else, based on trial and error. It may be that you need to extend your bolus for 3 or 4 hours to cover the food. If you find yourself under 6 at the two hour mark, you may wish to cancel the rest of the bolus, do this by just putting the pump into suspend then removing the suspend the same way you would cancel any other bolus. You may be on the rise though so the only way to know, is to test your BG every hour after the 2 hr post meal sugar.

This is a confusing aspect of pump therapy, and one that I usually deal with after the pumper has been doing regular boluses for a month or so. That being said, if we are not getting good control for the next 4 hours after a Normal bolus, there is no other option but to try something different. You may be wondering why your blood sugar stays up for so long after you bolus:

• High fat meal slows the absorption of carbohydrates
• Your stomach emptying is slowed down due to a nerve problem related to your diabetes.
• High stomach acids are affecting how your food is absorbed. No matter what the reason, any or all of the above, we need to deal with the high post meal spikes.