The OmniPod absolutely allows you to deliver a portion of your bolus upfront (including zero if you so choose) and the rest over a specified amount of time up to eight hours. As you are going through the screens, you should see “extend” as an option on the middle soft key.
well i havethe MM722 i use it when i eat pizza and slow acting carbs… i think it works… i will try it out for every meal and see what numbers i get… my a1c right now is at a 7.2 i was a 6.3 i need to get back on track… thanks for the suggestion…
Thanks heaps for this discussion! 4 months on a pump and I’m not quite getting the combo boluses right. Got some great hints here. I’m likely to do it over a longer time. My 5 basals are pretty much perfect. Breakfast & lunch are ok too, dinner is the problem, no matter when I eat it. Am ok for a few hours (2-3) after I eat, then up I go, way after the insulin has gone. The less carbs, the less it happens (I’m talking under 30gr for dinner), but then I go to bed hungry, or eat a snack that gets me into more trouble. And then I go low way after. I might try some of the suggestions here, but tailored for me. It’s a bit of a minefield, I know, and everyone’s different. Haven’t given much info here. I just wanted to say thanks.
Susi-
Me too. I’ve been on the pump 2 months and I’m still getting the kinks out. The only thing that has helped me with dinner is if I exercise. But I have to start it by about 8 pm or the exercise makes my bs go UP. I’m going to try the hints here.
Maria
Just read this thread today…great explanation and appreciate your insights! I have been counting PRO and fat as 1/2 the available glucose as CHO and giving it all in the same regular type bolus. I will try this w/ the square bolus option and see what happens! Thanks.
I stumbled on differnet rates for different foods by accident. I started having some irritation and stinging when dosing for a high carb meal so I thought if i spread it out over 1/2 hour it might help with the absorption. Guess what, the delay help with the spikes too. I do almost every bolus over 3 units as an extended bolus and it really allows my system to absorb the insulin better. You just have to watch for the working curve for the insulin cause you can still have some in your system later you didn’t expect and go low later or stack it into another meal. I actually reduced my daily insulin dose by about 15% by doing this.
Great post – whether or not you expect to use TAG or want to experiment with the Dual Wave Bolus, don’t miss the incredibly informative, clear and readable followup article – that Ricardo links to at the end.
It’s been 8 days since the last post and I am wondering how all the people who posted that they were going to try this have done? Any helpful advice or input. I don’t have much problems as described, but on some occasions I get challenged. I just find this thread very interesting and want to know how this has worked for these members who posted. Thanks.
Tried a 50/50 over 3 hours - didn’t work well, where it worked before. I need longer and probably more at the beginning like a 70/30. Still experimenting. Still learning. Still trying to figure out which foods will require which combo, and still experimenting with bolusing for protein.
Definitely a great discussion!
Thanks Susi and Danny. Just what I wanted to hear: Feedback.
Anxious to see if “70/30” works better for you Susi. I did a dualwave tonight for the first time in a very long time. I had black bean chilli that my wife made along with corn bread. I figured 35 carbs total. My BS was 114 before eating. 3 hours later my BS was 81. I’ll see what I am in 1-2 more hours.
I want to thank you again Danny for this thread. I’ve been on the pump 5 years and just never checkd into the dual/square wave very much. But then again, I never joined any diabetic forum like TuDiabetes.
I’m forever greatful to you all
I have been using a 70/30 and once in awhile a 50/50 for the last 10 days and I am very pleased with the results. To think, all this time I’ve been using this pump, I’ve never really messed with anything but a normal bolus. I have again re-read John Walsh’s Pumping Insulin and I’ve even MORE convinced this is a much more “natural” way to bolus. I have also tweaked my basils some to make them a bit more “natural” as well.
Danny—thanks for teaching this HarleyGuy something very beneficial to me, and perhaps for many more out there. (Gold star awaits you) 
I wonder if someone could give some examples of how you bolus this way. Maybe show how you do it for three different meals.
Thanks,
Maria
I’ve pumped for 5 years and also rarely, if ever, used it. Yes, most is 70/30 between 1-2 hrs. What duration times do you find work best for you?
If it is over 30 carbs, I usually will use the dual, esp. if some of the carbs I know kick in later.
Also, I have been “tweaking” my pump lately. Recently “reread” Pumping Insulin and I just love that book. So, (playing pancreas here) I have for the last 10 days started doing a dual-wave bolus for my 3 normal meals each day. Usually I am doing a 70/30 at 1.5-2hours and an occaisionally a 50/50 ratio. It seems to really help prevent any 3-4hr spikes for the pizza in my life.
Also, I have changed my basils some. My CGMS has allowed me to notice some DP which starts 3-4am. What I did was increase my basil just a bit(.3u) at 3am, then at 5am I went up to 1.0u.
This morning at 5am my cgms alarm told me I was at 70 and going down. Blood test showed me at 58. I looked at my trend, which indeed started around 3am but by 5am I was going down too fast. So I bumped the 5am basil from 1.0 -.8u. Woke up at 7:55 with a blood test of 95. By the way, I treated my 58 low with 6oz of OJ(18 carbs). I took no bolus for this of course.
I’m loving dual-wave bolus now and playing with basil setting look very promising.
I don’t need no stinkin Dr. to tell me how I should adjust my pump… (said jokingly)
P.S. IT’s 65* here and 70* tomorrow before the rains move in. So, I am going to saddle up and give my Harley her reigns and see where she takes me.
Let’s keep this thread going…
Update on me:
(Only on a pump 4 months - Animas 2020.)
After this post have been playing with the combo a little more than before. I think I finally nailed it tonight. After a few different experiments, I got fairly close tonight with a 70/30 over 2 hours. I didn’t have a huge volume to eat, but I did have 50 carbs, which is way more than I’d usually have. But the combo worked better than expected!
Last night, wasn’t so good, and I probably would have needed to make it over 2.5-3 hours because I went high 4 hours after dinner.
I suspect I’m dealing with some GP because I tend to go high 3 and 4 hours after an evening meal, sometimes even later. Doesn’t happen if I have a very low-carb, really light dinner, or skip dinner (very rare), so it’s not the basal at that time. Basal testing is good. I’m almost always good at the 2 and 3 hour mark after dinner. So for me the trick is getting that ratio right, at the right time.
Tested every hour tonight and I’m happy-ish with the result. @ 2 hrs 6.2 (111). What I’d really need is an extra little bit to kick in at the 4 hour mark, which was my highest tonight (per usual), but wasn’t too bad at 8 mmol/L (144). But I’d started low at 4.1 (73). Had I started a bit higher, I’d have spiked much more.
I only need to do this for dinner. Breakfast and lunch for me are always light and low carb and a basic bolus is always ok.
Maybe I should add a normal bolus at 2 hrs, if that’s possible? The 70% works great, I could even go 75%… it’s the 30% that’s the problem. I’d probably need 75/45 which equals too many percents (lol).
Any suggestions?
Susi, glad you’re seeing some good results. You could just do a normal bolus at the 2 hr mark, or set/change a basil during this time frame.
Good luck to you ALL.
Danny and all,
The example is REALLY helpful to me. Keep them coming if you would be so kind. Somehow seeing the doses for the actual food and numbers helps me more than just hearing 70/30.
Thanks very very very much. This is SO helpful.
Best, Maria
p.s. Susi I also see a spike in the PM unless I exercise pretty vigorously. Is that GP? Kind of good to know. It makes me feel less frustrated. I’m afraid I have a tendency to overeat at dinner.
Yes…Hello?..I would like 1 skinless breast combo with veggies and salad with light italian, 1 cole slaw, no NO NO, ONE cole slaw, yea, and a water. Right,…Thank you.
p.s. you post too many more menu items and I’ll have to eat again, your making me hungry.
Marvelous!!! This is exactly what I needed.
Thank you Danny.
Maria
I’ve been doing that and it’s been working better for me. The other problem for me is I have dinner, and then an hour or two later, I want something else - a snack of some sort. There’s something about evenings - don’t know what it is but I do know that lots of you can relate. I can go with practically nothing during the day - really low carb breakfast and lunch, but evenings tend to defeat me.
It would be ideal if I could give one combo on top of another. LOL
I’ve been doing nothing else but combo boluses in the evening and it’s working out much better.
And yes, examples are great, but each of us is different, so we still need to experiment.