Titre du document / Document title

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

Auteur(s) / Author(s)

LEE S. W. ; CAO M. ; SAJID S. ; HAYES M. ; CHOI L. ; RATHER C. ; DE LEON R. ;

Résumé / 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.

Revue / Journal Title

Diabetes, nutrition & metabolism   ISSN 0394-3402 

Source / Source

2004, vol. 17, n^o4, pp. 211-216 [6 page(s) (article)]

Langue / Language

Anglais

Editeur / Publisher

Kurtis, Milano, ITALIE  (1988-2004) (Revue)

Localisation / Location

INIST-CNRS, Cote INIST : 21709, 35400012263670.0020