Was just wondering for what foods everyone uses the Extended Bolus?
Pizza, pasta, hamburger and fries are ones I already use it for. But what about gelato? Ice cream? Cake? Brownies? Do you vary your rate and/or time depending on the food?
Also, would love to know exactly how the extended bolus works. Does it bolus the first amount right away, and then nothing until the delayed time? Or does it bolus the first amount right away and then do small increments until the delayed time is over?
I use the extended bolus for eating out most of the time. Pizza gets a percentage extended at least 3.5 hours for me. Most other things, I extended over about 1.5-2 hours. I do vary the time and percentages extended to try to find the right balance.
The Omnipod delivers any correction up front and then allows you to choose how much of the meal bolus to take now and how much to take over the duration of that time. It delivers incrementally over the amount of time you choose.
High carb foods that take longer to digest are perfect for extended boluses. The others have already answered your second question, so I will not repeat what they have said. Your list covers the foods that I generally use the extended bolus for, but everyone is different. I don’t use the extended for sweets (although I generally don’t eat too many anyway), but I do for pizza, pasta, and things like rice or pancakes.
We use the extended bolus for all sorts of foods. Will is now 4 years old and so I think his metabolism is probably different than a grown up but usually, for us, it looks like this
Mac & Cheese - 50% upfront and extended the rest for 3 hours
Pizza - 50% upfront and extended for 4 hours
Pasta - 50% upfront and extended for 2 hours
this is good to know. We haven’t experimented with the extended bolus. I’ve been nervous to do it. My Will is 6 and still doesn’t always recognize his lows. I’d be a lot more willing to experiment on myself knowing exactly how I felt. I’ll have to try this next time we have pizza.
I like some of the comments people have made here–being nervous about extended boluses is normal, especially when you are just starting to get familiar with them. One way to see what is the right time of extension for you is to gradually extend out the time of your bolus, usually committing about 50% of your bolus to the extension. We started with 1 hour at first, rechecking sugars once or twice in a few hours, then extended out to 2 hours once we were comfortable we were not getting lows. What routinely happens with foods like pizza, or pasta, is if you use regular bolus, your BS is good at 1-2 hours after bolus, but then you get a 2-300 high 3-4 hours later. I like to encourage a 2 hour extension with about 50% of your bolus as a nice compromise for reasonable control. Tighter control, you will need to experiment a little bit, as MelissaBL says.
I use it for certain foods. The one I use it for most often is Chicken with Broccoli with Fried Rice. I extend for 3 hours for that meal.
I also use it when I am on a downward trend and below 100. I extend for 1/2 to 1 hour to give my food a chance to “kick-in”. When I am below 100 and heading down and I forget to extend, I end up going hypoglycemic; I guess because the insulin kicks-in before the food.
What really was helpful is that we got into a CGM study at Stanford - using a CGM you can really see the affect that food has on BG. We learned a lot using the CGM and will probably get one once our Will starts kindergarten.
I actually use this feature, extend option, for all my meals. However, it is due to my gastropareis. My nutritionist/diabetes educator recommended it for me. It works very well too for this purpose.
