Replies to This Discussion

Permalink Reply by Scott G on August 2, 2011 at 12:21pm

Combo bolus! You'll have to play around with the percentages and timing, but what you just described is exactly what it is for.

Is the spike because of you correcting for the low?

Permalink Reply by daricel on August 2, 2011 at 12:22pm

I use a combo bolus. I usually take 50% of my insulin up front, then take the rest over the next 4 hours. Most folks use 80% up front I think. Everyone is a little different with how combo's work for them. I use different combination depending on what I eat also... Your educator should be able to give you a starting point, and you'll need to tweak from that point.

Good luck - Darice

Permalink Reply by marti w on August 2, 2011 at 12:23pm

when i'm eating carbs with fats that will slow them down, either i take a square wave bolus or i set a reminder on my phone to take a bolus later when i start seeing my glucose values rise.
if you know about when the carbs normally start to affect you, take the insulin then, not before.

Permalink Reply by Jeff on August 2, 2011 at 12:56pm

I love both. I find that you can cover half of the carbs and then the other half about two hours later and avoid the problem. Or better, use the combination ... 50% immediately and the rest over two to four hours depending on your metabolism. But everyone is different and you need to develop your own approach that works for you.

Jeff

Permalink Reply by Sindhilicious on August 2, 2011 at 1:03pm

Definitely combo bolus! Chinese food will definitely give you delayed spikes !

Permalink Reply by Janice L Cotton on August 2, 2011 at 1:30pm

Funny you should ask....just ate Chinese. I use the OmniPod and set it to deliver 25% immediatelt and the additional 75% over the next 2 1/2 hours. I came by this through a little trial and error. OmniPod calls this "extended" bolus.

Permalink Reply by Amy on August 2, 2011 at 7:43pm

I do combo bolus for chinese food :)

Permalink Reply by Zoe on August 2, 2011 at 8:41pm

I definitely agree with the combo bolus for the Italian food.

As far as the Chinese food, there are often hidden ingredients like sugar which you can ask not to be used, or just order dishes without sauces. If you eat at a more gourmet style Chinese restaurant you will find you don't have the same problems. Even better is if you cook it at home. Simple stir fries are easy and quick and can use a variety of vegies and protein that you might have in the house. I make a vegie stir fry with tofu when I don't have any other dinners made and I count it as 20 carbs, with no late rise problems. If anything I go low because 20 carbs is lower than my usual dinners.

Permalink Reply by The Diabetic Chef on August 4, 2011 at 9:26am

Thanks everyone for the tips, I used a combo bolus for the first time last night. I was at my Bible Study and there was pizza. I normally avoid pizza because I've never been able to eat it without messing up my blood sugar. I took 40 carbs and divided it into half up front then half over a one hour period. By the time I was ready to check three hours later, I was at 169! That's amazing that's never happened before. I feel as though I can enjoy some old favorites every now and then. Thanks for the tips everyone!
Blessed Diabetic

Permalink Reply by Zoe on August 4, 2011 at 9:59am

I hate to bust your bubble, Blessed Diabetic, but if your blood sugar was 169 (which isn't a great number) at 3 hours chances are it could have been higher at 2 hours when it spiked. Oddly enough, it also could be higher at 4 or even 5 hours as the fat in pizza slows it down. You might want to extend the combo for a longer period of time and then check at the 2 and say 4 or 5 hour mark.

Permalink Reply by markese on August 6, 2011 at 2:03pm

I agree, you'll need to do some "trials" with this to get it down but as Zoe said you'll find that your combo is going to need to last somewhere near 3 hours. As others have mentioned 50% initially is a good starting point, depending on what I eat I will do 30-40 sometimes and have the bolus last for 2.5 to 3.5 hours.

Permalink Reply by kim on August 10, 2011 at 6:59pm

i am pretty new to pumping (since may), and have only tried the combo bolus twice. not really sure i understand how the insulin is delivered. say i set a 40/60 split and the time is 1.5hrs. you get the first 40% right away, and the remaining 60% is delivered in an hour and a half? or is the 60% delivered like a basal over the next hour and a half???

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