The dual-wave bolus feature in continuous subcutaneous insulin infusion pumps controls prolonged post-prandial hyperglycaemia better than standard bolus in type 1 diabetes

Scott W. Lee*, M. Cao, S. Sajid, M. Hayes, L. Choi, C. Rother, R. de León

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

56 Scopus citations

Abstract

The dual-wave bolus delivers a combination of an immediate normal pre-meal insulin bolus (∼3 min) followed by an extended (or square-wave) bolus that is evenly delivered over several hr as programmed by the patient. The purpose of this study was to compare post-prandial glycaemic excursions following a high-fat meal after administration of insulin by normal vs dual-wave bolus. During this prospective, cross-over, repeated measures study, subjects with diabetes and treated with insulin pump therapy were evaluated using the continuous glucose monitoring system (CGMS) following three combinations of meal and bolus type. A control meal or a high-fat meal was given in place of the evening meal on three separate occasions and comparisons were made between: a) the control meal with normal insulin bolus delivery, b) the high-fat meal with normal insulin bolus delivery, and c) the high-fat meal with dual-wave insulin bolus delivery. Although mean baseline CGMS values were similar in each of the three combinations of meal and bolus type (p=0.54) and in the three hr immediately following the meal (p=0.64, p=0.83, p=1.0), when compared to the control meal/normal bolus and high-fat meal/dual-wave bolus combinations, CGMS profiles disclosed significantly elevated post-prandial glucose in hr 5 through 14 (p<0.05) following the high-fat/normal bolus combination. Prolonged post-prandial glycaemic excursions are identified using the CGMS. Treating post-prandial hyperglycaemia with dual-wave insulin delivery may help manage chronic hyperglycaemia in patients with diabetes.

Original languageEnglish (US)
Pages (from-to)211-216
Number of pages6
JournalDiabetes, Nutrition and Metabolism - Clinical and Experimental
Volume17
Issue number4
StatePublished - Aug 1 2004

Keywords

  • Continuous subcutaneous insulin infusion (CSII)
  • Dual-wave bolus
  • Post-prandial hyperglycemia

ASJC Scopus subject areas

  • Internal Medicine
  • Medicine (miscellaneous)
  • Food Science
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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