combo bolus for high fat meals.

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Permalink Reply by Dave   _ on July 5, 2009 at 7:45pm

Trial and error. For pizza I do 60% upfront, the rest over 3.5 hours. For other meals like Mexican, I have a hard time finding the perfect method. Just keep trying and record what works and what doesn't. You'll hit on the "ballpark" method before long--just don't expect perfect bgs from meal time, through the next 1/2 day, as the best attempts can still fall short. But give it a try! We have to have SOME fun eating! :)

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Permalink Reply by Ahmad ( Al ) on July 5, 2009 at 8:33pm

I agree with what Dave said and would like to add, regarding the trial and error if you want to start testing certain food, you need to keep buying or doing the same thing from the same source.
EX: Pizza
Every restaurant or even frozen food company has it is own receipt for the dough and the ingredient. I will stick to one restaurant or frozen type and start my trials.

Good luck

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Permalink Reply by Susi on July 6, 2009 at 5:12am

When are you bolusing? How long after dinner do you have a probllem? Is it at 2 hours or at 4 hours or some other time? Can you see any definite pattern? Are you sure your insulin to carb ratio is ok for evening? Do you go low first then high?

So many different factors to consider, and probably not enough info in your post.

Some people, if they find they're rising too high, too quickly after dinner, then giving a bolus about 15 minutes before dinner can help.

I'm trying a combo for the first time tonight (pumping about 4 weeks with Animas 2020), and so far it's working ok. I tend to have more problems 4 & 5 hours after dinner (probably some gastroparesis), so this combo might be the trick for me. I've tried 50% up front and the rest over the next 3 hours.

It's a meal I have maybe once a month, so will definitely be writing down results and re-adjusting if necessary.

Dave and Ahmad are right... everyone's different. Anywhere from 40& to 70% to start and the rest over whatever time you think - 2-4 hours. Guess this isn't very helpful... someone else would tell you completely different numbers. It's whatever works for you. Let us know how you go?

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Permalink Reply by Dee Meloche on July 7, 2009 at 2:03pm

I think I will stick to my old way of doing a bolus for high fat meals.I have tested my basal rate between supper and bedtime and I find that my blood sugar actually goes down a bit.What I do is I bolus normally at supper and do a combo of about 2 units at 100% over 2.5 hours and that usually works.

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Permalink Reply by Dee Meloche on July 20, 2009 at 6:51pm

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Permalink Reply by Sharon Jones on July 28, 2009 at 10:39am

hi dee :)

2 things pop into mind when reading your post.

1. how many carbs are you eating during your regular meals, and what type of carbs?
2. have you tried to tweek those evening/bedtime basals?
3. (i know ! i know ! i said 2! lol) everyones mileage varies on this one. for large meals i dont bother taking the combo bolus option now, i take what i calculate for the carbs at hand, for this read fries, rice and pasta, pizza....then check again at the 2 hours and 4 hours mark. as we are pumping we can bolus/correct at will.

i know this sounds reckless, but i do manage a stable A1c of 5.7% using this method. ;-)

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Permalink Reply by Dee Meloche on July 28, 2009 at 1:17pm

Last night I tried bolussing for the amount of carbs.I ate spaghetti,but usually my supper consists of boiled potatoes,a piece of meat such as pork chop and vegetables.I cut out the apple pie for a bit to see if it made a difference.Anyhow,I ate a small amount of fat.About 5 grams.My 2 hour reading was 8.2.At 730 I did a combo bolus of 1.05u at 100%over a period of 2.5 hours.I had to cancel it near the end because I went down too low.So i ate 8 carbs suggested by my pump.My 2 amreading was 7.1.I was so happy.But I went up at 5 am to 14.3 but I think that was my basal rate.I will try it again tonight.

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