Combo bolus for high fat meals

Even when I don’t have a high fat meal my sugar still rises after dinner.I tested my basals and all is good.My question is does anyone have a method for figuring out how much I should set my combo bolus for?

I agree with what Dave said and would like to add, regarding the trial and error if you want to start testing certain food, you need to keep buying or doing the same thing from the same source.
EX: Pizza
Every restaurant or even frozen food company has it is own receipt for the dough and the ingredient. I will stick to one restaurant or frozen type and start my trials.

Good luck

When are you bolusing? How long after dinner do you have a probllem? Is it at 2 hours or at 4 hours or some other time? Can you see any definite pattern? Are you sure your insulin to carb ratio is ok for evening? Do you go low first then high?

So many different factors to consider, and probably not enough info in your post.

Some people, if they find they’re rising too high, too quickly after dinner, then giving a bolus about 15 minutes before dinner can help.

I’m trying a combo for the first time tonight (pumping about 4 weeks with Animas 2020), and so far it’s working ok. I tend to have more problems 4 & 5 hours after dinner (probably some gastroparesis), so this combo might be the trick for me. I’ve tried 50% up front and the rest over the next 3 hours.

It’s a meal I have maybe once a month, so will definitely be writing down results and re-adjusting if necessary.

Dave and Ahmad are right… everyone’s different. Anywhere from 40& to 70% to start and the rest over whatever time you think - 2-4 hours. Guess this isn’t very helpful… someone else would tell you completely different numbers. It’s whatever works for you. Let us know how you go?

I think I will stick to my old way of doing a bolus for high fat meals.I have tested my basal rate between supper and bedtime and I find that my blood sugar actually goes down a bit.What I do is I bolus normally at supper and do a combo of about 2 units at 100% over 2.5 hours and that usually works.


Last night I tried bolussing for the amount of carbs.I ate spaghetti,but usually my supper consists of boiled potatoes,a piece of meat such as pork chop and vegetables.I cut out the apple pie for a bit to see if it made a difference.Anyhow,I ate a small amount of fat.About 5 grams.My 2 hour reading was 8.2.At 730 I did a combo bolus of 1.05u at 100%over a period of 2.5 hours.I had to cancel it near the end because I went down too low.So i ate 8 carbs suggested by my pump.My 2 amreading was 7.1.I was so happy.But I went up at 5 am to 14.3 but I think that was my basal rate.I will try it again tonight.

I use the combo bolus all of the time. I have had great success. I may have different results than others. I have a 1:12 I:C Ratio, and a 45 ISF set on my pump. Last a1c was 5.6%. The main thing I have found with any high fat meal, is that you must add 4-5 extra units to the total. Say you’re eating a 20 unit meal. You need to bolus for 24-25 for the extended bolus.

  1. Pizza (I indulge when I eat pizza. Pizza and breadsticks) I set a 35 unit extended bolus for 6 hours at 25/75. You know when you need to tweak the 25/75 based on a short term and long term BG result. Pizza is a trial and error thing. I’ve found that if it’s for dinner, I will check my BG before bed. I will add the FULL amount of the correction bolus disregarding the insulin on board. I will set my alarm for 3:00 AM for a BG check. I will again add the FULL amount of the correction bolus if there is one at that time. Pizza is very very tricky, and deceiving. The carbs are so compact that it requires more insulin than standard carbs. Thin crust will usually have success with just the 35 unit bolus. Now, if I don’t indulge, I’ll do a 30 unit bolus for 4 hours 30/70.

  2. Large dinners (Restaurants with no appetizer or desert). Also works for high carb home cooked meals. I do a 20 unit extended bolus for 2 hours at 50/50. This bolus is a saving grace. It has worked wonders for me. I do the bedtime check adding the full amount of the correction bolus. I don’t do a 3 AM check, but did when I first started trying this to check for lows. So I would recommend doing this for anyone wanting to try. Now if you have the appetizer or a desert, I do everything the same, but use a 25 unit bolus at 50/50 for 2 hours. Now if you have appetizer and desert, I would do the 30 units at 4 hours 30/70. This one also works excellent for grazing at parties.

Give these a shot. I love using this feature, and do several times a week. Don’t be scared by the number of units you need. If anyone has any questions, let me know.