Extended boluses

I never really learned the proper uses of an extended bolus. I know it is usually used alongside fatty foods like pizza but, can you give me some examples of how and when you use it?

We use an extended bolus for: pizza, chinese, ice cream, pasta, and also with certain chicken fingers. The amount varies and I have learned what to do by trial and error and tracking Caleb’s reactions in spreadsheets and still don’t always get it right. Typically Caleb needs all the carbs up front and then an additional amount (almost always equal to the original bolus) over 6 to eight hours. I think that is abnormal though from what I have heard other people do.

I use it at the movies when I am eating popcorn for 2 hours. But I use a combo bolus (I have a cozmo). It lets me do a part percentage of my total up front and then delivers the rest over the hours. Opposed to extended bolus which just spreads it out over hours.

The Omnipod’s extended bolus can allow this as well. You start by choosing what percentage to deliver now and then how long to deliver the rest. You can extend anywhere from 5% to 100% of the bolus.

Thanks for the timely question. I didn’t remember what he extended bolus was for or how it was used… I had Icecream yesterday, I hardly ever eat ice cream. My numbers shut way up…I was sightseeing at the time and didn’t have my PDM with me. I try to watch my weight and my numbers , so Ice cream, is not a regular for me.

I use the extended bolus for fatty meals like pizza (and I’ve recently started on movie theater popcorn but it’s still throwing my sugars off hours later). I also really find that the extended bolus works well for parties where I’m going to be munching on things for hours. I’ve also heard of people using a temp basal for this but with the extended bolus I know how many carbs I’ve planned to eat so I feel I have a bit more control over where my sugars end up. It’s a really useful feature once you start playing with it. I often find that even for a low fat meal it’s better to give myself 75% of my bolus up front and then extend over 2 hours. It’s all in figuring out how the food and the insulin hit you for the best control. Finally, if you’re unsure of how much you’re likely to eat (if you have kids who may not finish dinner or you’re not feeling well) extending the bolus over even just 1 hour allows you to cancel it before full delivery if you don’t want to eat everything you thought you would.

No advice here, just gratitude. I’ve never used the extended bolus feature and am grateful that you asked about it. As a “non-gadgety” person, I tend to tinker with my settings for a few days, then leave them that way for months.

Kinda like my retirement accounts. :wink:

Seriously, I appreciate the wisdom here.

Janet

My experience is pretty much like everyone else listed here. I use it for pizza, italian, and mexican foods mostly. For me, I count the carbs, and then take 1.5 times what it suggests. So if it says take 10 units (this is including correction amount, etc) then I take 15, and for most foods I do a 75/25 or 80/20 split. The extended part is usually set for 2-3 hrs (depending on the food).

Let me just make sure I understand this Bradford, if it says 10 you add an additional 5 units to the 10 then give 75% up front and then the rest over 2 or 3 hours?

I bring this up because Chinese always kills me… I am having it today, gonna give it a shot. I’ll let you know how it turns out…

Yes theoretically you should be lower if you added an extended bolus, however, I could not speak to the amount or duration. That is something you would have to test out.

Do you go low initially and high later? Or just high later.

If just high later, you could try either the extended bolus or an increased basal. The only reason I don’t do an increased basal is because Caleb’s dosing is so small and so varied by hour that using a percentage doesn’t help because so much gets lost in rounding and a flat rate doesn’t help bc his basals can change significantly by hour. But if your basals are more significant, you won’t have the rounding issue.

Good luck!

Well, I ate at 12:30, with a starting BS of 125 i bolused 12.25u, 75% up front and 25% over 2 hours, haven’t checked yet, but my CGM says its been about a constant 98 over the past hour. I usually go low initally and then high 2 hours later… so we will see how it goes… fingers crossed!!

Sounds BE-A-OOtiful so far! Toes crossed too!

Eating candy right now… 60 blood sugar…Back to the ol’ drawing board. Cancelled extended bolus… Have to retry next time. what would you do?

60/40? Watch out. The high may still be impending. You may still want to up the basal for a little. If you do it now it won’t hit for 2 hours. Do you know how long the highs usually last?

only about 2 hours usually… I think I am just going to monitor it for the day and retry next time… I wish I could borrow you for a month, I love the food charts you have for your son, great work!

lol - Sounds like you are good then. It last for Caleb at least 8 hours after so if we see a low early on I can’t let that fool me for hours later. Hope you are feeling ok!

Yep. That’s what seems to work for me…especially for high fat foods (like some tasty fettuccine alfredo or something like that :slight_smile:

I use it went I eat a cheesburger, pizza and when eating out…knowing that the meal may last for longer than normal. I normally do a 40% to start and spread the remaining 60% over a 2-3 hour period. I have had good results with this direction.