How do you handle 15 g of carbs when starting at a low/normal BG?

Just what we do, but the only circumstances (usually) where we use the extended bolus (exceeding 1 hour) is for high-starch foods that “kick in” (begin digesting) 1 - 5 hours after you eat. The extended bolus (exceeding 1 hour) allows for the insulin to be injected coinciding with the digestion of the high-starch foods.

In this situation, for Liam (yes, he loves salads), that’s actually the perfect scenario we would PREFER him to always eat in. Nothing in salad (unless you’re using a dressing that has a low glycemic index value and digests slower) is low GI value so it digests fairly rapidly (at least to my knowledge and from our experience with Liam).

We would typically, in this scenario, bolus + feed him at the same time (if he were 70) OR bolus him 25% up front with the other 75% over the next THIRTY MINUTES, AND feed him at the same time.

We would ensure that he eats at the same time that he gets his bolus in this situation since he’s right on the border (70), and waiting the usual 15 minutes could make him go under 70, which we want to avoid.

So, although we DO use extended bolus, it’s not extended in the same sense that a high starch (low GI value) food would be extended.

For high-starch foods we give 25% up front and 70% over 1.5 - 2 hours (but it’s usually a VERY large amount of insulin being given over that time.) AND during that 1.5 - 2 hours, if he starts rising at a rate we don’t like, we suspend the extended, and re-do the remaining amount with 50% UP FRONT, and the rest extended over x minutes/hours.

For regular, non high-starch foods, we typically just do a straight bolus, wait 15 minutes, then feed OR straight bolus and feed right away (as we would probably do in this scenario), OR bolus some up front and the rest extended over just 30 minutes or so AND feed right away.

Hope that all made sense.

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