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…
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.