How to replace extended pump bolus for MDI?

what does 30 minutes extended mean for a pumper? is there insulin being injected for about 30 minutes? how can users of MDI attempt to extend? I do want to learn to bolus for “tricky foods”!

If the BG number at 1.5 hour or 2.0 hours since the most recent insulin injection is decent and the BG rises at 3 hours - is the cause:

  1. mismatch of insulin to carbohydrates caused by poor carbohydrate estimating
  2. food type
  3. timing of insulin injection ?

You can approximate the effect of an extended bolus with a planned second insulin injection about 30 min to an hour after you eat. We used to do this when we did MDI.

You ask a tough question. The goal is to match the insulin with your digestion. Only through trial and error with a CGM were we able to close enough through trial and error with food we made or purchased from the same place.


I want to understand this correctly : the second insulin injection is after the meal is finished? I have been trying to split my dinner injections with about 50% in the pre bolus and then 50% one hour after the pre bolus (I am still eating) The ratio may change to 60%: 40% , or 40%:60% if I snack while I cook.

Some of you prefer ‘treat aggressively with insulin’ and ‘have carbs ready’ to correct lows.

This occurred recently during one dinner meal at home.
I split my dinner insulin, 2.5 units for BBQ chicken (7 pm), 1.5 units (7:30 pm) (for bread) 30 minutes apart - I did not originally plan to eat the bread.
30 minutes after the second insulin injection (8 pm), I was at 60.
8 pm - I had about 3 oz of plain yogurt and a spoonful of paleo-seeds-granola (has sugar) and a sip of milk.

15 minutes later (8:15 pm), BG 62,
additional 15 minutes later 73 (8:30 pm).
10 pm BG 140
midnight BG 165 - took a 0.5 unit correction
1:30 am - BG 145.

I think my small yogurt granola correction was too many carbs and too complex. 8 pm I ate the yogurt, BG=165 was 4 hours later! While I would love to over bolus and have dessert, I think that may mean that I would need to over bolus by a lot, to have dessert like yogurt/granola, or 6 units just to cover a cannoli. Sigh…

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Yes, what you did there was exactly what we would have done for something complex or unknown. i.e. guessed a little bit high and eaten out of it. The only thing we would have done differently is eat a little or a lot of the dessert to land the low instead of granola and yogurt.

Additionally, for really complex stuff i.e. pizza, we would dose 100% of the the calculated carbs at the beginning and then 50% more about an hour later. For us Pizza takes close to 150% of the insulin that it should to keep a “reasonable” blood sugar curve.

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Did I eat too much of the granola yogurt?

Looks like it, but I would have done something more sugary and happy

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