Combo Bolus

My CDE has suggested that I set up a combo bolus to cover meals like hamburger, pizza, etc, but when I talked to her on phone she didn’t have a pump in front of her to tell me how to set it up. She did tell me to start at 50% initially and 50% spread out. She didn’t tell me how long the duration should be, I’m guessing an hour, but don’t know. Also, if I set it up for an hour, do I do my postprandial reading two hours after the beginning like usual, or wait until three hours so it will be two hours after the last part of the insulin delivery. Any help would be appreciated.

Carman, check out Danny’s TAG group to get some more information about doing that. Cheri passed the information about the group along to me when I first started pumping.

I just recently started using it more and find I am having good success with it. I was afraid to try because I have gastroparesis but now I could kick myself for not trying sooner! Danny uses 58% and Cheri uses 40%. I found that for breakfast & dinner, 40% works great for me but lunch works better with 58% and then I spread that out over 4 hours. Dinner I am using 2 hours with 40%. It is a matter of playing and finding out what works for you.

My trainer told me something wrong about how to do it on the pump. She said to first go to the ezCarb menu to calculate the amount of insulin then cancel and to the Combo Bolus menu. I accidentally discovered that she was wrong on that. If you go into the ezCarb menu, you can enter your carbs and add your BS if you want. When it takes you to the screen that you enter the amount of insulin, once you put your insulin, your cursor will come down and land on “go.” Use your down arrow one time to land on “normal,” which is next to “type” right below “go.” Hit OK so the cursor is blinking on normal and use your up arrow to change normal to Combo. Hit OK then Go and that will take you to the combo bolus screen with your units of insulin already there. You can change if you want and change your duration.

Thanks Kelly. I’m also concerned about when to do the postprandial reading. Any ideas?

Hi !

It depends on food. For example pizza has a lot of fat, which is why we use “Multiwave” bolus… And it also depends on person…

Now when I started pumping friend told me how he does it…

  • Multiwave. 80% at once, and 20% for duration of 1.5 hours.
  • After 1.5 hours he check BG. If he is over 7.5, he gives himself insulin that covers 30% of originla CH
  • Some as step 2, after 3.5-4 hours.

    For example for me last step is not needed, since I discovered that my BG is nomal at that time…

    When you eat fried meat (with crumbs and eggs, I don’t know how it’s called). I add 30 CH just for crumbs and eggs (when you fry it it uses a lot of fat), in durration for 1.5 hours, same for french fries…

    You will have to experiment a little, to see what is right for you.


Thanks. I’m still new at this. Have a great weekend.

If you have enough strips and can do every hour for a couple hours, I would try that in the beginning until you get it figured out. I know I am probably a bit on the “anal” side about testing alot (Ok, maybe more than a bit!) but the only way you will know if something is working or not is by testing. I have a Dexcom and can watch that, but I still tend to test alot as a double-check.

i change the duration of the combo depending on the time of day and the food. the more fat is has the slower i go. but the time of day is because i’ve noticed with my gastroparesis that the later it is in the day the slower i digest. a combo bolus for a particular meal at noon is going to need to be maybe an hour but the same type/quantity of food at 8 pm is more like three hours.
i have had to play around with it a lot and figure it out. which, until i got the CGMS, involved finger sticks every 15 minutes. i’m glad my insurance will cover that many strips because it was so worth it to not have a post meal crash when the insulin hit before the food while i was figuring out my needs

Hi Kelly! Glad to hear it’s working for you, too. Isn’t it great to have smoooooth sailing (most of the time, anyway)?

Just thinking out loud here - if, for lunch, you have to raise the percentage, what would that mean? That you are more insulin resistant during that time or?


Cheri, I do OK with the 40% for breakfast & dinner, but lunch is my hardest to digest meal (I have gastroparesis). When I used the 40% and a 3 hour period for lunch, I did good all afternoon until about 5. I thought if I upped the percent a little, I could stretch the time out to 4 hours instead of 3. I didn’t want to just change the hours because my BS was really good all afternoon and I thought if I extended another hour, I wouldn’t have as much insulin going into me and would go a little higher.