How do you Bolus with Gastroparesis


#1

I had a question regarding some things I have a problem with. I am a type 1 for 36 years, am on medtronic 723, have everything figured out on the pump except bolusing with the gp (gastroparesis) I always use the dual wave, (except with rapid carbs) but my BS bounces like a basketball.
I can't bolus until after I eat, and I was curious if anyone else has this same problem, and how do they handle it? How long of a bolus spread to you use? what percentage of now and later do you use? (50/50, 60/40 40/60 etc) Is there anything you have a really hard time with? What hour square wave time do you use? I have never really met personally anyone with gp, I have online, So as I said. I'm sure there are a lot more questions I am not asking, but I am mainly going for the basics.
I really appreciate any Answers, (of course) But I want to know how others handle it. to learn a better way for me. Oh the medications I use for the gp are Domperidone, and Omeprazole.
Thanks


#2

use the daulwave blous on ur pump it will split ur dosage in hafy 1/2 for now 1/2 for later


#3

I was diagnosed with GP three years ago. At the time the doctor told me it was moderate yet still significant delayed stomach emptying and digestion. I re-doubled my efforts at BG control and adopted a low-carb high fat diet. I lost weight, dropped my A1c by a half point, and cut my insulin usage in half.

I only take Nexium about 1 day in two for my GERD and GP. I do drink three tablespoons of potato starch mixed with water each night. That seems to help a lot with my gut health.

As far as insulin dosing goes, I deliver two separate boluses for each meal. I deliver a carb bolus first and then follow that with an extended bolus calculated by counting 50% of the protein grams and 10% of the fat grams as equivalent carb grams. I then deliver that total bolus at a maximum rate of 1.2 units per hour over as many hours as it takes. Generally my protein/fat bolus extends from 2-5 hours. I get excellent control using this method. I can usually spend 80%+ of my time in range, 65-140 mg/dl, according to my continuous glucose monitor.

I don't use a dual wave percentage split because it just causes more math confusion than it's worth. I like using two separate boluses, one for carbs and the other for protein/fat. I use the Calorie King app/website to find the nutritional info.

You will have to experiment to find what will work for you. Your insulin to carb ratio will only work well if you are riding a well-calibrated basal profile. If your basal is set well, you should be able to skip a meal and not have your BG rise or fall by much.