Well, today I did learn something new from a type zero (a person who doesn't have diabetes), and I found myself thinking over and over, "Gosh, I do need to speak to a diabetes educator, after all." The woman works for a major medical company who makes insulin pumps, so she is pretty knowledgeable about them.
I thought I was pretty knowledgeable when it came to the 'betes and being a pump user. Well, I got news for myself: I have tons to learn still. After being on the pump for 10 years (yes, you read this right, I did say 10 years and I'm still learning), I just learned the difference between a dual (or wave??) bolus and a square bolus. Knowing the difference will really, really impact my blood glucose when I go to parties where I eat here and there, as opposed to sitting down for a meal.
During dinner on Christmas day, I had no idea how many cabs I had eaten or would continue to eat. It wasn't a sit down and eat kind of dinner. It was relaxed, everyone grab their plates and eat what and when they wanted. Snacks were everywhere. So, I just kept eating and figured I'd correct later. Can anyone guess my bg after all was said and done? Ya, umm, it was in the 400s. Thus, if I had known what a square bolus was and how to use it, I would have given myself between 3-5 units of insulin, throughout a 3-4 hour period. (I could have used a dual wave combo bolus, but I am re-learning everything regarding pump and diabetes, after I opened up my eyes and realized I was most likely on a downward spiral towards complication after complication by ignoring my diabetes).
So, what is a dual/wave/combo bolus? You split the amount of insulin you want to take for a meal. A couple of weeks ago, I ate Chinese for dinner (now that isn't, nor will it continue to be, a frequent thing and I'll explain why another day). If I remember correctly I ate about 74g of carbs. Due to newly learned information, I knew that Chinese food was full of fat and that would slow down my digestion/absorption of carbohydrates. So I split the total amount of insulin I would be taking. The pump calculated the total of insulin I needed to take: 74/15=4.95 units. I decided to experiment with the combo bolus. I chose to give myself 30% before I ate and 70% in the space of 3 hours (as a result of slower digestion due to fat in the food). Therefore, I took 1.48 units immediately and the pump gave me the rest, 3.47, little bits at a time. It did work out well. I didn't measure my blood sugar before bed because I went to sleep less than 2 hours after dinner, but my blood sugar was 123 (or something in that range) the next day.
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| Combo Bolus |
The square bolus is slightly different. Say I'm about to eat a bowl of cereal (I hate milk, therefore I don't really eat cereal, but this one is hypothetical), but I'm also doing a million and one other things at the same time. Maybe my 5 year old nephew is visiting and keeps asking me to play with him as I eat my cereal. I can set my bolus to dispense insulin slowly throughout 30 minutes, as opposed to taking all the units I need before I eat, which could result in a low blood sugar later.
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| Square Bolus |
Now that I know exactly what these two types of bolusing do for me, I will be sure to use it more in the future (I have never done a square bolus, ever "/).
You live and you learn, and I will call up the diabetes educator that my endocrinologist recommended to me first thing tomorrow. I thank the Guy up there for looking out for me while I was being negligent with my 'betes. Every night before bed I thank Him for giving me another day on this Earth, especially another day with no complications. I am slowly changing my diet and trying to learn all I can to control the 'betes, not let it control me.
