FUDiabetes

The Power of the Extended Bolus (with apologies to T1Allison)

insulin
extended-bolus

#1

For pizza I’m finding a 50/50 extended bolus over 3 hours works really nicely. I recently used the same formula for mac and cheese (same amount each night, 33 g carb for 1 cup) for two nights, but forgot on the third night and did a straight-up bolus. The difference is obvious. (And sorry about the clumsy merging.)


#2

I love using dual wave boluses. I use them for nearly all my meals and that works really well for me, especially since I’d found that FIASP prebolused 100% up front was dropping me for nearly all meals


#3

@Beacher, I am curious: your upfront bolus, is it 100% of what is calculated from your ICR, or 50%? Or something else?


#4

50%, with the remaining 50% over 3 hours. I’ve also used 60% up front, 40% over 2.5 or 3 hours for pizza, but recently it wasn’t working so reliably, which is why I’ve gone to 50/50. (40/60 was a major fail.) It looks like too much up front the second night but I was probably too aggressive with my correction since I was slightly elevated to begin with.

Because I can’t bolus more than 4U at a time, the up-front portion ends up being a half-hour extended bolus, and then I have to remember to start the second bolus for the 3 hours.

Since @LarissaW says they work well for her for all meals, I just did a 50/50/3 hours for my dinner, injecting the first half. My gut tells me I’ll be low all night, but I won’t know if I don’t try! If you never hear from me again, you’ll know it didn’t work.:laughing:


#5

O gosh, now there’s pressure!!!
@Beacher omnipod doesn’t allow for extended boluses or >4u boluses???


#6

Omnipod allows 8 hour extended bolus periods.


#7

image

I’m proud of this one I did: dual wave bolus for a bag of cheddar ruffles and a 6 inch turkey hoagie with cheese, lettuce, tomato. 45/55/1hour and I was pretty stable at 90. I’d decided to do dual wave because it was a bigger meal for me and because of the protein/fat in the hoagie


#8

I am not judging you, but really, I am judging you, because there are better options out there for the carbs. No complaints with the 6 inch hoagie, especially if this is from some fancy sub shop, but come on, cheddar ruffles. Stern look…


#9

Only the fanciest and classiest- wawa :joy:


#10

It sure does, but if I bolus more than 3 or 4 U at a time, I get tunnelling. If the bolus is smallish, I’ll do 3 or 4U then extend the rest over half an hour (the minimum extended time allowed). If it’s larger, I’ll usually inject all of it.

The extended for a not-high-protein/not-high-fat meal worked quite well. I had a strange spike about 5 hours after eating that quickly turned to a steep drop, I had a couple glucose tabs when I approached 63, then I stayed flat at 70 all night. Worth trying again with some tweaks – probably more up front would be useful.