Extended bolus question

Coming out of dinner on target for BG…two hours later, I am high. I eat a large salad with dinner and am wondering if I may need to use an extended bolus. I have not used one before so I am looking for info from anybody who has a similar issue or has used the extended bolus in such a situation.

I always use the extended bolus when I eat pasta, which is VERY OFTEN. i am a true Italian, and eat like one. I think i(depending upon what you put in the salad) it would be a good idea to teat an extended bolus once before you make it a habit, just extend it by going 50% upfront, and the other 50% after 1 hour. test once in between. I like the extension feature, and, like i said, use it all the time! Good luck, and PEACE!

It really depends on what you’re eating, and when you’re testing. When you say you’re on target coming out of dinner, how soon after are you testing? You may not be bolusing enough for your meal to begin with if you’re high at two hours. We use extended bolus for my daughter almost any time we eat out because the food is inevitably fatty. Definitely any time she eats pizza or chinese food, and ice cream. Her post-ice cream spike actually comes about FIVE hours later! The extended bolus is definitely a great feature – play around with it, and you’ll find what works for you.

I’m fine two hours after I’ve had dinner it’s over the next 2-4 hours that I rise.

Sounds like you could definitely benefit from the extended bolus. My daughter’s endo recommended starting with a 70/30 percent over 4 hours, and then tweaking it from there. Good luck!

I use an extended bolus for any time I eat out to account for the fat from food prep (plus I add a unit or two for good measure). I continually tweak. For pizza/Tex-Mex/Chinese food, I extend about 35-40% for 3 to 3.5 hours. For other foods, I might do 20% over 1-1.5 hours. It’s always a work in progress, but I can usually do better playing with it than I would do if I had taken all of the insulin up front! Play with it with your trouble meals and see what works for you.

I use extend for my favorite chicken with broccoli and pork fried rice. Not a great meal for a diabetic, but I allow myself once in a while. Without extending, I keep rising and rising - sort of like the Energizer Bunny (going and going). I still haven’t found the perfect formula. Last time I extended all of my insulin for 4 hours and it worked fairly well.

The other time I extend is when I am below about 80 when I eat. I let the PDM calculate the bolus and the negative correction, but I don’t want the insulin upfront. Rather I extend about 1 hour so the food gets a chance to kick in and bring me back up a little before the insulin starts covering it. Again, it’s not perfect, but it works reasonably well for me. Definitely better than trying to deal with a small low on MDI.

Christine, did you eat the large salad “for” dinner or “with” dinner? Are you wondering about the fat in the dressing, the fiber, carbs, protein, amount of food? Dr B says that large amounts of any food, even no/low carb greens will raise your numbers.
I extend the bolus almost everytime I eat. I went to an advanced pumping class offered by my Insulet rep and the CDE said that her boss uses the extend function at every meal so I have been playing with it.
As Brad brought up, you take your pre meal BS #'s into account and then consider the quantity, fat and protein and fiber. I try to bolus 20 minutes before I eat. For a low fat all carb meal, I might extend only 20 percent over 1/2 hour, the shortest offered time. Higher fat, I extend an extra amount of insulin for an extra amount of hours. I don’t have the math fixed yet. I sort of do it intuitively, like I cook…if that makes sense. (What are my numbers now? How far ahead of eating am I bolusing? Then extend and add insulin for fat, add for caffeine, extend for protein and fiber, subtract for anticipated activity and insulin on board…lots of variables).
As everyone has said, it requires experimentation. I should say that I feel my lows so might sound sort of cavalier about playing around with it. If you don’t have awareness or don’t have a CGM, I’d think that your endo and/or CDE should probably be involved. Good luck. Keep us posted during your experimenting.

I think “Stevie D” sounds better, for an Italian.

Christine…check out the TAG group in the forum.

My real name is Chico DeGiorgio…how is that for Itailian?

Chico? Sounds like an American melting pot situation!

Actually, It’s an overdose of old Marx Brothers movies!

Your parents sound fun!

They had their moments.