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The dual-wave bolus feature in continuous subcutaneous insulin infusion pumps controls prolonged post-prandial hyperglycaemia better than standard bolus in Type 1 diabetes.
Diabetes Nutr Metab. 2004 Aug; 17(4):211-6.DN

Abstract

The dual-wave bolus delivers a combination of an immediate normal pre-meal insulin bolus (approximately 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.

Authors+Show Affiliations

Lee SW
Department of Medicine, Loma Linda Medical Center's Diabetes Treatment Center, Loma Linda, CA 92354, USA. slee@ahs.llmc.edu
Cao M
No affiliation info available
Sajid S
No affiliation info available
Hayes M
No affiliation info available
Choi L
No affiliation info available
Rother C
No affiliation info available
de León R
No affiliation info available

MeSH

Area Under CurveBlood GlucoseCross-Over StudiesDiabetes Mellitus, Type 1FemaleHumansHyperglycemiaHypoglycemic AgentsInsulinInsulin Infusion SystemsKineticsMaleMiddle AgedPostprandial PeriodProspective Studies

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15575341

Clinical Trial Links

Effect of Dual-wave Insulin Bolus on Postprandial Glycaemia

Citation

Lee, S W., et al. "The Dual-wave Bolus Feature in Continuous Subcutaneous Insulin Infusion Pumps Controls Prolonged Post-prandial Hyperglycaemia Better Than Standard Bolus in Type 1 Diabetes." Diabetes, Nutrition & Metabolism, vol. 17, no. 4, 2004, pp. 211-6.
Lee SW, Cao M, Sajid S, et al. The dual-wave bolus feature in continuous subcutaneous insulin infusion pumps controls prolonged post-prandial hyperglycaemia better than standard bolus in Type 1 diabetes. Diabetes Nutr Metab. 2004;17(4):211-6.
Lee, S. W., Cao, M., Sajid, S., Hayes, M., Choi, L., Rother, C., & de León, R. (2004). The dual-wave bolus feature in continuous subcutaneous insulin infusion pumps controls prolonged post-prandial hyperglycaemia better than standard bolus in Type 1 diabetes. Diabetes, Nutrition & Metabolism, 17(4), 211-6.
Lee SW, et al. The Dual-wave Bolus Feature in Continuous Subcutaneous Insulin Infusion Pumps Controls Prolonged Post-prandial Hyperglycaemia Better Than Standard Bolus in Type 1 Diabetes. Diabetes Nutr Metab. 2004;17(4):211-6. PubMed PMID: 15575341.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The dual-wave bolus feature in continuous subcutaneous insulin infusion pumps controls prolonged post-prandial hyperglycaemia better than standard bolus in Type 1 diabetes. AU - Lee,S W, AU - Cao,M, AU - Sajid,S, AU - Hayes,M, AU - Choi,L, AU - Rother,C, AU - de León,R, PY - 2004/12/4/pubmed PY - 2005/2/4/medline PY - 2004/12/4/entrez SP - 211 EP - 6 JF - Diabetes, nutrition & metabolism JO - Diabetes Nutr Metab VL - 17 IS - 4 N2 - The dual-wave bolus delivers a combination of an immediate normal pre-meal insulin bolus (approximately 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. SN - 0394-3402 UR - https://www.unboundmedicine.com/medline/citation/15575341/The_dual_wave_bolus_feature_in_continuous_subcutaneous_insulin_infusion_pumps_controls_prolonged_post_prandial_hyperglycaemia_better_than_standard_bolus_in_Type_1_diabetes_ DB - PRIME DP - Unbound Medicine ER -