Combo bolus question

We really did not talk to much about this today and I was wondering other then pizza what do I use this for??? I just got it today and don’t know alot yet about combo bolus but I thought I would get some advice Everything else is pretty easy but before we actually hook up to this thing I thought I would ask!!! Thanks ~Korin~:)
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Hi Korin,

I like using the combo bolus for high fat, high carb meals. I don’t actually use it when I eat pizza at this time but I like using it when I eat casserols or pasta dishes, especially lasagna. Anything made with starches and combined with cream sauce or cheese sauces also seem to give me that odd 3 or 4 hour later high glucose reading so I started using the combo bolus then too and it really worked in keeping that later glucose normal.

I hope this helps!

Besides pizza, I will often use the combo bolus for Mexican food. Also, I happen to love cheese and will sometimes eat a lot of straight cheese, and I need to bolus for that, too, but will often use just the square bolus part, not the combo.

I think it’s common for people to use a combo bolus for high fat or high fiber foods (because they take longer to digest). I also use it really high carb foods, but that’s just me. I think it really depends on your body and how quickly your body can process different types of foods.

I use a combo bolus (called Dual Wave on my Minimed pump) every day for lunch, no matter what I eat, but I generally do NOT eat high fat. I use the combo because I go for a walk after lunch every day. If I took my entire bolus up front, even with a very high carb meal, I’d drop low just a short time later. So, I do a combo and usually give less than half right away and stretch the rest out over 2-3 depending on what I ate and how long I’ll be walking.

I do also use it for high fat meals like pizza, which I don’t have often. It’s also good for party situations if I know I’ll be grazing.

As most people mentioned, it is mostly used for foods that are high in fat and carbs.
We have that option on my daughter’s pump, but don’t really use it. When we first started, our educator said not to worry for now, get used to all the other features, then turn it on.
A regular bolus works for us just fine. Plus, we would have to figure out how long we want this “waves” to be and at what percentage split (i.e. 4 hours, 60% now + 40% later, at least that’s how I remember it…) and I simply don’t have the time for it right now.

I take a walk immediately after lunch, so that is an interesting idea. I noticed that I have gone down right after I get back from my walk, but then it goes back up within half an hour or so. Hmmm.

I am on Symlin, which slows down the absorption of food, so I use it all the time because of that. However, there are times when I use a combo bolus without the Symlin, mostly for higher fat foods that are absorbed more slowly anyways. Mostly, this boils down to almost any time I eat out for dinner.

We do a combo bolus for ice cream every single time and it usually keeps my daughter pretty even. I have heard that a lot of people use the combo bolus for Chinese food, too. Best of luck!

I use the combo or extended boluses for anything that has at least 50% as many fat grams as carbohydrate grams. Oh, and pasta, too.

i use the dual wave bolus for any meal that has more than 15 grams of fat. basically, i consider the first 15 grams of fat to be “free,” and then keep track of any extra fat grams beyond that. then i do a dual wave and bolus for the carbohydrates i eat upfront, and then do a dual wave to cover the extra grams of fat over a period of several hours.
does that even make sense when i type it out? anyhow, it’s worked wonders for me-- it really helps with delayed highs and is great. if anyone needs me to explain that better, just let me know, and i will try my darndest!

That makes sense to me! Last year I had pizza for the first time since I started pumping. Two huge slices of real NYC pizza (not fast food Dominos or anything like that). I looked up nutrition facts for generic cheese pizza on I weighed my slices and laughed at Calorie King’s serving size of 5 oz. per slice. I forget how much mine weighed but it was at least twice that. I did the math using CK’s figures to figure out fat, protein & carbs. I had found a formula online somewhere for translating a high fat meal into carbs (counting x% of fat and y% of protein plus the actual carbs) and I think I ended up bolusing for 200g of carbs!! I gave the bolus for the actual carbs up front and squared the rest over 4 or 5 hours.

That was the first time as a diabetic that I ate pizza without going low 60-90 minutes later, and then climbing sky high hours after that.

I haven’t had real pizza again since then (the nutrition facts scared me, with all of that fat!) but I have also successfully eaten Chinese food. Haven’t been able to master Indian food yet, though. I also make my own pizzas on pitas, flat bread or tortillas but I use fat free or low fat cheese and I know exactly what I’m eating. I do a normal bolus for my own pizzas.

We always use 30/70 combo for pasta over 8 hours. It works well for her.

I have a different way that I use my combo bolus.I bolus normally for the carbs then I cut the carb amount in half and bolus for that amount.It seems too work well.The only thing I have trouble with is the duration.I think it is around 2.5 to 3 hours.

I use a combo bolus for chinese food. I’ve also used it when at a party and I’m just sort of “grazing” food off of my plate because I’m eating slower than I would for a normal meal, usually because I’m too busy visiting instead of eating. I use this same concept when I’m at work and I’m either in a lunch meeting or I choose to stay at my desk and work through my lunch. It seems to work pretty good.

Same as Emily, I take Symlin and so all of my boluses are dual or square wave (always square if my BG is normal when I bolus).

I am like oneless. When my BG is normal I square my bolus and I do the time based on what my food is. I don’t take Symlin so on my foods when I look at them I look for quick absorbing carbs and complex. Then I look at the fat. So pasta is all slow but pasta with an orange spinach salad means I need to cover that orange upfront. Anything with meats if it is above 3oz of meat is going to slow my digestion down so I will duel or square wave that meal. You probably need to look at how you break down foods since it is so different for everyone. I don’t have the problem with pizza that most diabetics do but I have major problems with a 6oz steak so. Test after a complex meal and see what happens then eat it again and adjust to duel or square and see.

Be well and be loved

Hi John, I have a minimed pump also and I was having issues with me bs being too high when checking 2 hours after a meal. When I talked to my endo about it she changed my carb ratio on my pump from 13 to 1, to 11 to 1. Personally I know if I’m going to have pizza (and I usually have no more than 2 slices) I’ve learned for myself that I need to use 2.5 units per slice. 5 units over all. I dual wave bolus that by taking 1/2 right away and the other 1/2 in an hour. this works very well for me. Good luck, and talk to your endo, they should be educated about your pump.

Two words. Chinese Food. The rice and noodles will shoot your sugar through the roof if you’re not careful! Beware of the sweet and sour chicken…that did me in the last time I ate it.

I also use it for times when I will be eating over a longer period of time. Like family functions, staff parties, luncheons. If you eat something like ice cream too it helps. Depending on the food determines what percent is given now and what later.

Amen to that! I love Chinese Food but steer clear of it for that same reason.

It also depends on what your glucose reading is when you test before you eat as to how to divide up the dosage. Probably shouldn’t do this, but sometimes if I wake up in the middle of the night with a low, I usually find myself very hungry. I usually eat more than I should to cover for the low, then I’ll set my dual wave to cover for the carbs a couple of hours later. I know this is probably bad, but when you wake up with a bad low and your hungry, sometimes you feel like you just can’t stop.