In the past, these situations were addressed by recommendations to either split larger boluses into multiple smaller boluses spaced throughout a long meal, or to set a temporary basal rate to function as an extended bolus. Both of these situations were complicated and presented the possibility of making errors.

To make this process safer and easier, Medtronic Diabetes developed the Square Wave and Dual Wave Boluses. The Square Wave Bolus allows patients to easily select an amount and duration (from 30 min to 8 hrs) over which time a meal bolus is to be delivered. The Dual Wave Bolus simply combines a Square Wave Bolus with a Normal bolus and delivers them at the same time.

The Variable Boluses can be helpful in the following situations, whether using regular insulin or the newer rapid acting insulin analogs, when they become available for pump use.

Use Variable Boluses For:

• Prolonged Meals Banquets
• Formal Dinners
• Holiday Feasts
• Extended Snacking
• Receptions
• Spectator Sporting Events
• High Fat Meals (e.g., pizza)
• Gastroparesis (delayed digestion)

Matching Insulin Action With Carbohydrate Digestion:

For prolonged meals, the insulin action of a standard bolus is too quick to adequately compensate for the carbohydrate (CHO) digestion. Glucose levels go high after meal.

For gastroparesis (slow digestion), insulin action peaks before carbohydrate digestion occurs. Glucose levels run high after meal.

Using a Square Wave Bolus, insulin action matches the carbohydrate digestion of prolonged meals or gastroparesis. Insulin levels remain in target range after meals.

Using The Variable Bolus
The 507C and the 508 feature both the Square and Dual Wave bolus. To use them, "Variable" must be turned on in the "Set Up II" menu.

The 507 features the Square Wave bolus. To use it, "Square" must be turned on in the "Set Up" menu.

Refer to your pump Users Guide for instructions on programming the Square and Dual Wave boluses, or call Medtronic Diabetes's 24-hour Pump Help Line (800-826-2099) for assistance.