Combo Bolus?

When do you guys use combo boluses???

The one I use the most is the dual-wave, and I use it all the time. Since I have no motility in my esophagus, food takes a long time to fully hit my stomach, and I've found that if I dual-wave my meals 50% at once/50% over 30 minutes, I get better control. So I do that with just about everything I eat. (Brought my A1c's down from 6.5-6.8 to 6.1-6.2 by doing this.)

I also use the dual-wave for high-fat foods, like pizza and ice cream. Not that I eat those foods often, but it's nice to be able to eat them! For really high-fat like pizza and ice cream, I dual wave the bolus 50/50 over 4 hours, and my bg's never go above 150.

For foods that aren't quite so high in fat, but still have a significant amount, I dual-wave over 2 hours.

Of course your mileage may vary, so you may have to experiment with how much to give up front and how much to dual-wave, as well as how long to dual-wave the second half of the bolus.

By the way, I learned all this from others here on the board - thanks to all of you who've posted on this subject before. A special thanks to Danny whose advice I took re dual-waving EVERY meal!


I use the combos bolus for eating high protein, high fat, low carb meals (almost all of my meals). Protein makes your blood sugar go up later, rather than a post meal spike, so I bolus at a calculated fraction of my carb bolus. Apparently the next generation of pumps will include a protein bolus factor since so many type 1’s are eating super low carb now.

I tend to run a combo bolus on my dd when she is eating things like pasta, pizza, rice, or high fat/protein meals. A 50%/50% 2 hour combo works for us. Its all trial error. Good luck.

When I got my MM, the pump trainer told me to always use 60-40 1 hour dual wave. Apparently for no particular reason. It never matched up with meals or worked well.

Now I only use dual wave if I'm eating a very high protein meal, like 1/2 roast chicken. I do 30min 50-50.

is there such thing as a comb0 bolus for mdi? maybe this sh0uld be a separate thread...