It's 10 p.m.; three hours post a high-fat, high-carb meal. At three hours I'm 122. That's an almost perfect place to be at three hours post-meal and right before bed.

But the problem is that I'm headed to bed and I know I'll wake up wicked high. Why not use a square-wave bolus, you ask. I just may, but the real problem for me is that I'd like to be able to use a dual- or square-wave bolus up front so I can sort of fix and forget. But I can go almost low around two hours post a high-fat, high-carb meal. Even at three hours I'm in a decent place, but by four hours I've skipped right over the high 100s and am square in the upper 200s.

Diabetes and pump life are definitely about trial and error and it seems as if I've tried almost everything I can think of. What I'd really like to do is to be able to set a timer on my pump that says at 11 p.m. -- when I'm snug in my bed -- please start a square bolus that will last at least two hours. That way I may have a chance of waking up with a decent blood sugar without having to wake myself up every hour or two to test. (Hello...good argument for a CGMS.)

OK, so I know I could set a temporary basal rate, but that takes a lot of steps to accomodate just one meal. I want to be able to test at two hours post meal (forgot to do that tonight *blush*) and then again before bed to possibly establish a trend and then decide/guess when my meal will spike. For me with the kind of meal I had tonight that's usually somewhere between three and four hours. What I'll likely do is set a dual-wave bolus that gives me about 1% now and the remainder over the next three hours.

So, the trouble with designer boluses is: I haven't figured out how to make it work for me. I suppose that's par for the (diabetes) course!