Dual-Wave Bolus

Dual-Wave Bolus*

When I eat a high-fat, high-carb meal it takes longer to get digested, and I need insulin right away, and a little later to handle the breaking down of the combined fat and sugar. You can administer individual insulin injections the same way, it’s just a bit more tedious.

It is essential for you to know what your carb ratio is: How many units of insulin do you need when you ingest 1 gram of carbohydrate?

For example: If I have a ratio of 1/10, meaning I need 1 unit of insulin for every 10 grams of carbohydrates I consume, and my treat is one serving of ice cream equal to 40 g Carbs. I will need 4 units of insulin (some now and some later).

Using my Dual-Wave Bolus setting I will probably need anywhere between 1/2-2/3 of my insulin right away, and the last 1/2-1/3 of my insulin dispersed over the course of 1-4 hours (this depends on your body’s specific response to the food). I can tell you how it works for me, but it may be very different for you!

That’s 2 units now +

2 Units over the next 2.5 hours

Using my Medtronic Paradigm 522:

  • Ensure that the Dual/Square Bolus feature is turned on: Click on Bolus, scroll down to Dual/Square Bolus, Click ACT, Scroll on ON, Click ACT
  1. Bolus ACT
  2. Use Bolus Wizard, ACT
  3. Enter BG if available, if not click ACT and enter TOTAL Carbohydrate amount (40g), ACT
  4. Check your Estimate Details to make sure the bolus total is correct (4 Units), ACT
  5. Scroll to Dual Wave Bolus, ACT
  6. Set Bolus Total (4 Units), ACT
  7. This next screen splits the bolus into units (2) and % (50) of Total, insulin delivered Now (2) and Square (2) (this helps to clarify this process: to see the units in percentage of total  if you’re not sure what percent you usually need now and over the duration of the square bolus). Adjust the bolus according to your needs, ACT
  8. Square Duration is any time between one 1/2 Hour and 8 Hours (mine will be 2.5 hours, but again this is different for everyone), ACT, your initial Bolus delivery will begin.

This is not a difficult process, it just takes a little time to figure out. This works much better than overdosing on insulin after a splurge, needing more sugar to get back to normal, only to find yourself way over normal blood sugar levels in a couple hours. That’s what happens to me if I don’t spread out my dosage in a square or dual wave bolus. Not only do I feel crappy afterwards, I feel like an idiot for not dosing my insulin appropriately. So talk to your educator or doctor about using these features, it makes a world of difference. The first time I used this and got it right, I was so happy, I woke up the next morning and did a little Blood Sugar Success dance!!


*Please discuss your specific insulin regimen with your doctor/Diabetes educator