# Dual Wave v Square Wave



## Gillsb (Mar 4, 2011)

My daughter has been pumping for 4 weeks now and things are going ok.  Early days but already she is saying she will never give it back! 

All I really need to know is the difference between a square wave and dual wave and when to use them.  We did try one with a high fat meal but not sure we got it right.  

Any advice would be great.


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## Adrienne (Mar 4, 2011)

Hiya 

There are three ways to give  bolus :  normal, square and dual.    The dual wave is a combination of normal and square.

Normal =  all the bolus is given altogether at the same time.

Square =  all the bolus is dribbled in over a period of time that you set ie 30 minutes or 4 hours etc.  You decide the time and it dribbles in, there is none given up front.

Dual wave =  you decide the percentage of what you want to give up front ie a normal and the rest will be like the square wave and dribbled in over a period of time.

Example of dual wave =  6.0 units to be given.   You do a 50/50 over 3 hours. 

This means that 50% will go in as a normal bolus ie 3 units upfront altogether and the remaining 50% (3 units) will be a square wave, dribbled in over 3 hours.

For pasta we use a dual wave of 30/70 over 4 hours and it works for us.  That means 30% will be normal and all go in together up front and 70% will be dribbled in as a square wave over 4 hours.


I hope that helps.


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## Gillsb (Mar 4, 2011)

Now that makes more sense, thank you.  Do you ever use the square wave? Just trying to understand it all and a bit of information overload going on at the moment.


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## Adrienne (Mar 4, 2011)

It is a lot of information overload in the first few months.    When we started we didn't use any dual waves or anything other than normal for about 6 months although people do.   

I don't tend to use squares on their own as I always find with Jessica she needs some of it up front even if it is a smaller percentage like with the pasta.

However it is trial and error.

Popcorn in a cinema - I have tried that will all bolus' including a square wave but again I found that a dual of something like 50/50 over an 1.5 hours works better.

A chinese in a restaurant tends to take a while and the spike hours later from that is horrendous so for that we would use 50/50 over 6 hours and we guess the carbs.  When she was 6 we used 80 cho so we have upped it now and we use 100 cho as you just never know what goes into it all.  I know they put sugar in main dishes !


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## Gillsb (Mar 4, 2011)

Adrienne said:


> It is a lot of information overload in the first few months.    When we started we didn't use any dual waves or anything other than normal for about 6 months although people do.
> 
> I don't tend to use squares on their own as I always find with Jessica she needs some of it up front even if it is a smaller percentage like with the pasta.
> 
> ...



Thats a great help, thank you.  Will give it a go and see how she gets on.


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## bev (Mar 4, 2011)

Hi Gillsb,

I cant add much to what Adrienne has said - but we dont often use the 'square wave' on its own - not sure why anyone would need it to be honest as most people do need some 'up front'. It is supposed to be for 'grazing' at a buffet sort of thing.

What we find is helpful is to do a 'dual/square wave'. If Alex isnt sure whether he is having a desert - we do the first part of the meal at say 50 carbs as a straight bolus and then we just add on the carbs using the 'square wave' over 5 hours or whatever. It just saves cancelling the second part of the 'dual wave' if you want to add other items in - but you are still getting the 'up front' part first.It is all trial and error - you need to find out what is right for your daughter.Bev


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## Ellie Jones (Mar 4, 2011)

I very rarely use the square wave, and most of my meals are dual wave's..

I tend to only use a square wave if my BG is in the low to mid 4's. and I'm either eating protien ie omlette (all egg with a dash of milk) or if I'm eating another snack of around 10-20g (biscuts) the later I will only square wave for 15 minutes, protien based I tend to run between an 30-60 minutes...

I find I'm eating something like pasta or very high fats foods, because of the delayed hit I will check at the two hour mark, and make a judgement call on the BG, setting an TBR if it looks like it's going to raise my levels abouve my target range..  It's a bit of trial and error to find out what is best call and when


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## Pumper_Sue (Mar 5, 2011)

Hi Gillsb,
Have you got the book pumping insulin by John Walsh?
If not that's a def item for the book list.
As everyone else says trial and error is the way to go. Try keeping a note book and write any experiments down. This works well in finding out what works and does not 
Glad to hear your daughter loves her pump


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