Application of novel dual wave meal bolus and its impact on glycated hemoglobin A1c level in children with type 1 diabetes

Abstract

Patients using at least one D-W/S-W bolus per day achieved a recommended level of HbA1c. Paediatric patients with type 1 diabetes mellitus were found to be able to apply D-W/S-W boluses in daily self-treatment process based on food counting.

Potential for BIAsp70 to Control Postprandial Hyperglycemia in Children with Type 1 Diabetes Mellitus

“…Chase et al 12) first described the efficacy of a dualwave bolus in handling postprandial glycemia compared with the other insulin delivery methods on pump therapy in patients with T1DM. Pańkowska et al 15) proposed the fat-protein exchange unit (FPU) to accompany carbohydrate exchanges in calculating the correct prandial insulin dose. Taking the protein-fat content of the meal into consideration with the FPU would lead to use of biphasic supply of insulin wave on basal-bolus regimens.…”

“…Therefore, new insulin delivery method is needed in taking a protein-and fat-rich meal. Several studies [12][13][14][15][16] have demonstrated insulin delivery using a dual-wave bolus on pump therapy is better to control postprandial glycemia after taking protein-and fat-rich meals. Chase et al 12) first described the efficacy of a dualwave bolus in handling postprandial glycemia compared with the other insulin delivery methods on pump therapy in patients with T1DM.…”

The Effect of Fat, Protein and Glycemic Index on Blood Glucose in Type 1 Diabetes and Their Usage in Insulin Administration: Review

“…[40][41][42] Çalışmaların çoğunda, pompa tedavisi uygulanan Tip 1 diyabetlilerde yük-sek yağ ve/veya protein içeren öğünler için en etkili bolus şeklinin çift dalga bolus olduğu ifade edilmektedir. [42][43][44][45] Chase ve ark.nın yaptığı çalış-mada, yağlı pizza ve tiramisu öğünü için en iyi postprandiyal glisemiyi çift dalga bolus uygulamasının sağladığı saptanmıştır. 42 Benzer şekilde Jones ve ark.…”

“…Karbonhidrat içeriğine göre standart bolus, y-p ünitesine göre de kare dalga bolus uygulaması yapılmaktadır. 45 Pańkowska'nın algoritması kullanılan iki klinik çalış-mada, çift dalga bolus uygulaması ve karbonhidrat sayımına ek olarak y-p sayımının daha iyi glisemik kontrol sağladığı, postprandiyal glukoz seviyelerini düşürdüğü bildirilmiştir. Ancak, karbonhidrat sayımıyla karşılaştırıldığında bu metodun klinik olarak önemli derecede hipoglisemiye neden olduğu ifade edilmektedir.…”

Optimizing a prandial insulin dosing in patients with type 1 diabetes

“…In the study of Pańkowska et al, in which metabolic control was evaluated in a group of 499 pediatric patients treated with the use of PIP, and on the basis of analysis of the data from 2-week reports of reading the data from insulin pumps, it was demonstrated that patients using square and dual-wave boluses in the amount of two or more per day achieve a lower percentage of glycosylated hemoglobin compared to those who use these types of boluses less frequently than once a day [56]. However, the composition of different meals where the above types of boluses were adiministered was not analysed, but the focus was placed on an assessment of the degree of use of the technical possibilities offered by this method of treatment.…”