Questions about Extended/Combo Bolus

[BrendaK]

How many of you have used the Extended or Combination Bolus features on your pump? The Cozmo pump has an extended bolus where you give for example 5 units of insulin over a specified period of time (maybe 1 or 2 hours)
For the combination bolus, you give a certain percentage of the insulin immediately and the rest of it over a period of time. (Other pumps have different names for these features -- maybe MiniMed's is the Wave??)

Anyways, Carson's been pumping for a little over a year and it's probably time to try one of these features. Especially for eating high fat foods. We're going to a graduation party today -- every time Carson has pastry or frosting, he's fine 2-3 hours later, but 6 hours later he's in the 300-400 range and it takes almost double the normal amount of insulin to get it down. I'm thinking we should use the combination bolus today if Carson eats cake. A pump rep told me that he usually boluses for 50% immediately and 50% over 2 hours. Does this sound right? I'm just worried he be really high at first with only 50% immediately given.

Would you ever use the extended bolus w/a 5 year old? In what circumstances? The trick today is that he'll want to eat cake AND want to graze on food for 4 hours. (It's his aunt's party and we'll be there for the entire party.) Any advice is greatly appreciated.

[nantomsuethom]

We use the extendend bolus when Thomas eats pizza, ice cream or mac and cheese (high fatty stuff). It is hard to gage. It takes practice. For pizza we do 30/70 for the others we do 50/50. We have never been successful with the grazing:( We try not to do this too often, but come football season every Sunday is a challenge!

[faithe113001]

I also use a combo bolus when eating things like pizza, or when I'm at a party and grazing/drinking punch. It works wonderfully! It does take practice, you have to find what works for you. I usually do the 50/50. Good luck!

[kiwikid]

We use a 70/30 combination bolus over 4 hrs for Rachel when shes having 2 min noodles.:)

[selketine]

We use the combo bolus frequently - especially if William is eating high fatty food or eating perhaps more food than usual (like on vacation or a party). We've been using it since he started pumping when he was 2 yrs old - and he is 4 now. We used the combo bolus his first day of pumping actually - LOL!

We sometimes bolus as he eats but if he is eating alot of carbs we usually do give about 70% up front and the rest spread over 3 hours or so. I will add that even when we are just about exactly sure how many carbs he had and bolus correctly with the combo that he still needs more insulin after the 3rd hour. We usually do that by upping his basal 20 or 30% (this is usually overnight cause the big meal was dinner).

When he is grazing we tend to bolus as he eats rather than do a combo. I have sometimes given him a combo for something I'm not sure he'll eat all of or that takes awhile to eat - like a lollipop. It takes him about 30 mins to eat a small one (say 10 carbs) and sometimes he won't eat all of it. Sometimes though he eats it all at once by chewing it up. So I do a 30 min combo for 10 carbs which I can cancel if he puts it down after 5 mins and says no more. Or I can cancel it and give the rest of the insulin immediately if he eats the whole thing fast. Or I let it go if he eats the lollipop the usual way. Hope that made sense!

[Hollyb]

We've just started experimenting with it -- for pizza, did 50% upfront and 50% over 3 hours and it worked out just about right.

[lisamomtotwins]

WE are new to it for Hailey but my DH has used it as well. WE do use a 25:70 over 1/2 hr for every meal with her because she is a slow and picky eater so if she doesnt finish or takes a real long time to eat she will be covered. Idont know how i would do it if he goes high 6 hrs later, maybe i would temp basil rate and just raise it a little around 5 hrs after? I dont even know if it can be spread out over 6 hrs? I am not sure what the max is? We used a 1 hr combo yestorday when we were at a party because she was graising in the afternoon and it worked out great. Give it a try or contact a rep or endo for more guidance.