Best dual/combo match for pizza, icecream, ...

What's the best match you've found for different foods/snacks?
Let us know what you use for pizza, icecream and any other 'complicated' food. Let us know the pecentage and duration of the dual boluses you found to match better. Pizza and icecream are just examples. What other foods you use dual for? How?
Since everybody's MMV! your 'best match' may be used as a good starting point for other parents.

 

Pizza 40/60 over 2.5hrs
Chinese 60/40 over 3 hrs
Pasta 40/60 over 2.5 This is only if she eats the whole 2oz serving
Ice cream 60/40 over 3 hrs This also depends on the fat content of Ice cream. Something with a higher fat content might require that we "flip" to a 40/60 instead. We don't combo for frozen yogurt
Once in a while we do McDonalds and that too is a combo, generally 70/30 over 2hrs.

As you can see, 40/60 and 60/40 are our magic numbers. This came from our CDE's suggestion and tweaking over time.

 

We only use the combo bolus for a couple of foods. Here are our magic formulas

Pizza at Pasquales (our fav pizza parlor) 50/50 over 2 hours
Mc Donalds 6 nugget happy meal w/ french fries 75/25 over 1 1/2 hours
Daddy's Homemade burritos 75/25 over 1 1/2 hours
La Bamba Mexican Restaurant burritos 50/50 over 2 hours
Mommy's famous homemade Swiss German chocolate cake 50/50 over 2 hours

Mmmm, I am hungry now.

 

We are still experimenting, too with a lot of these rates. One thing we do is a 50/50 combo for 2 hours for pizza AND a temporary rate of 130% over 4 hours as well.

I think next time we have a happy meal we'll do the 75/25 -- the 50/50 didn't work for that -- he'll be SO high after 2 hours!

 

What about the following?

. Snicker Bars (has ~a lot offat in it)
. Mars Bars (has ~a lot offat in it)
. Macaroni/spaggeti/lasaigna/...
. French fries (has ~a lot offat in it)
. Potato chips (has ~a lot offat in it)

 

Most of the things mentioned we give William all of his bolus - plus sometimes extra insulin given as a combo for 4 hours. So - for fries he gets 100% of the insulin at once plus some extra over 4 hours. For pizza he needs a 70/30 combo. But for ice cream, chips, happy meals he just gets his usual insulin. If the happy meal has fries then he'll need extra.

I guess my point is that I wouldn't necessarily use a combo unless you find that the regular bolus drives him too low shortly after he eats it....and then he shoots up later.

 

Question

I don't understand these ratios. Can you explain. Does it apply to the pump? Thanks.

 

Yes, it applies to the pump. A combo or dual wave bolus means that you get a certain amount of insulin immediately and the rest of it over a certain amount of time. For example, if you were to do a 50/50 over 2 hours for pizza and you would normally give 4 units for the carbs in the pizza, you would get 2 units immediately and 2 units spread evenly over 2 hours. People use these boluses a lot for high carb/high fat foods that spike blood sugars hours after they are eaten.

An extended or square wave is when the insulin is divided evenly over a certain period of time. You may, for example, get 4 units spread evenly over 2 hours. We use this bolus for "grazing" -- like eating popcorn at the movies. You need insulin for it, but it takes a long time to eat the popcorn.