For those of you who use the super bolus, I have a question. For your upfront basal, how far ahead do you use your basal? For instance, my basal is mostly set at .6 an hour. So if I give a super bolus, do I just give an extra .3 with my bolus and cut my basal in half for an hour, or should I do it for 2 or 3 hours (.9 ahead with 1/2 basal for 3 hours)? Thanks for any direction.
I just wanted to bump this question-- cause I’m curious too!! Any ideas? I haven’t been using the super bolus, but would like to…
I just found an old discussion – where Michelle asked the same question…
I might try it for 1-2 hours…
Thanks Kristin. I went to read the old post, but the two links on that page were both outdated. Hopefully we get some other people’s experiences. I just got back from 5 days of camping, so now that I’m home, I’ll probably be playing around with it myself. One hour just doesn’t seem like much extra upfront for me.
I’m not sure I understand the term “superbolus” unless you are just referring to the volume bolused.
I have always used my basal to “cover life” and my bolus to cover food eaten. ie…I would personally not deduct my basal…my bolus would be in addition to my basal. If there is a concern, of going low, then reduce your bolus rate.
Maybe I am not understanding the term “Super Bolus”
Hi Bob! Super Bolus is a method recommended by John Walsh. For more information about Super Bolus, click here.
The point of a super bolus is to lessen post meal highs by giving a few hours of basal as a bolus when you give your meal bolus. This means that you would then turn your basal rate down or off. For some people this prevents their blood sugars from going high after eating.
Hope this helps!
Ditto what Kristin said on the bolus, only I am mainly wanting to use it when I am high pre-meal. I am pretty good about not peaking high after a meal, as I dose ahead, but it’s when I’m high and want to come down sooner, I give some of my basal ahead of time. I am just wanting to hear from others how much time ahead they cut their basal.
I mostly use the super bolus approach to speed up the reduction of highs. What you’re really doing is adding to the bolus by taking some of your basal insulin a little early. You’ve got two choices in how you do this: sneak the early basal insulin in by using the cannula filling technique or take it as an added bolus amount.
The first approach is what I call a super bolus. Most (maybe all?) pumps don’t count basal insulin in their insulin on board (IOB) calculations. So ideally you want to take the insulin in a way that the IOB calculations are correct.
If my blood sugar is about 260 mg/dL I’ll first bolus to correct it. I’ll then switch my Cozmo to a temporary basal rate of 10% for 1.5 hours. My basal is usually 0.7 units, so I need to take 1.0 units to replace the missing basal. To do this I use the Load command and choose Fill Cannula, I’ll fill it once with 0.3 units and the second time with 0.7 units. This means that when I’m really filling the cannula the right amount for my set is still in place.
This approach moves my basal forward without affecting the IOB math. It does mess with the daily insulin totals, since insulin taken via a cannula fill is not counted. But it only changes the daily totals for that one day and only for the amount of the early basal.
If my bg is above 300 mg/dL then I’ll use 2 hours worth of basal insulin. And if it’s high 300s or above I’ll use 2.5 hours.
For the most part, this technique works really well, without causing any bad lows. I probably end up using it a few times each month.
My blog post about the super bolus shows how to do it on the Animas 2020, Cozmo 1800 and Minimed 512 insulin pumps.
Thank you so much Bernard! This is very helpful. I have an Animas pump, so it does take my IOB into consideration. I would’ve never thought of using the Fill Cannula option so that it doesn’t read it as IOB, but that makes sense. The sliding scale is very helpful too. I feel more confident using it now and will play around with my numbers. Hopefully I don’t get too many opportunities with highs though:)
My new Animas 2020 gets shipped next week, so I will check out your blog for more tips. Thanks again.