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extended bolus

Discussion in 'Parents of Children with Type 1' started by annaluvspink, Aug 6, 2010.

  1. annaluvspink

    annaluvspink Approved members

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    We're only one month into pumping w/ Omnipod and I'm itching to do an extended bolus. We haven't tried this yet, are there any specific guidelines as to how much to bolus now and how much to extend of a certain amount of time? For example, pizza is a problem food. Her bs stays up for up to 8 hours.

    thanks.
     
  2. spamid

    spamid Approved members

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    I don't know the specifics of the omnipod, but in general you just have to try.

    The extended bolus is generally giving all of the bolus over a certain amount of time. For us, extended the bolus over 1 hr worked well for pizza.

    The combo bolus is usually give a certain part of the bolus now, and extend the rest over a certain amount of time. That sounds like what you are talking about. Again, its a matter of trial and error. We found for pizza, giving 40-60% intitially and spreading the rest out over 1 hr worked well.

    Good luck!
     
  3. virgo39

    virgo39 Approved members

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    We started on the Omnipod 2 weeks ago. Last week, the CDE suggested we do extended boluses for higher fat meals (meaning more than 8 g. fat). She suggested that we start out:

    If the meal was less than 30 g. carb, she suggested we extend the bolus by one-half our and if 30 g. or over, extend for one hour.
     
  4. MadeleinesMom

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    Extended boluses I find difficult with omnipod. Maybe I am thinking too much about it....I only was able to do one sucessfully. Mac and cheese is our biggest problem and I do +5% over 3.5 hrs. The nurse said its really trial and error, but I asked a question about them here a while back, and some people extend for up to 8 hrs. So try like 5% over 8hrs and see whatcha get. I would advise checking every couple of hours to make sure that you dont dip into lows.
    Is it Saturday pizza night at your house then??? :D
     
  5. annaluvspink

    annaluvspink Approved members

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    well, we tried the 'extend' bolus w/ Omnipod. We gave her 20% of the total bolus immediately before eating and had the rest of the bolus extended over 4hours. She was in the mid 200's and low 300's til we finally corrected at 1:00 am. She came down nicely after that. It is definitely trial and error. We think we counted carbs correctly, but pizza can be difficult because she doesn't eat the crust and each slice is a different size than the next. :confused: So, my guess is that we didn't count the carbs right.
    hmmm, we have more thinking to do w/ the 'extend' bolus.
     
  6. StillMamamia

    StillMamamia Approved members

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    Not using the Omnipod, but we only use the extended bolus for slow-digesting foods (ETA: usually low GI foods), not necessarily foods which cause a spike later, kwim? Like lentils or quinoa.

    For foods which tend to spike much later, like foods which heavier sauces we use a combo (x units upfront with the rest extended for x hours).

    It's pretty much trial and error. And what works one time may not the next.:rolleyes:

    We're pretty much upfront bolus users here, with an occasional combo.
     
  7. annaluvspink

    annaluvspink Approved members

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    Omnipod will tell me how many units it is suggesting and offer me an option to 'extend'--meaning I can give a % of the bolus right then and extend the rest--to help with slowly digesting foods. Does any other "podders" have any suggestions how to work this?
     
  8. MountainJam

    MountainJam Approved members

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    We have been working on this one for a while, especially with pizza and mexican food. We have had many instances where he goes low in a couple of hours if we give too much up front with a big spike later on

    Our best results with pizza at the moment have been to give 35% up front and extend the 65% over 4 hours.

    Of course there are a bunch of other variables involved, like activity levels, other foods eaten, time of day and any one of about 500 other things that can affect blood sugars.

    My best advice is to just keep trying. I have seen many folks on here who are far more experienced than I say that they still have issues with foods like pizza.

    FWIW, I am convinced pizza is the devil :D
     
  9. zell828

    zell828 Approved members

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    We are on the Medtronic pump. We used to do dual bolus but it just never worked, we always had a high 3-4 hours into it no matter what we did. So I started using the temp basal and that works really good. Not sure if your pump has that option.

    Everyone works differently on different things. Just play around with it and try it. That's what I did, I had to experiment and find out what worked best.
     
  10. slpmom2

    slpmom2 Approved members

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    This is your chance to consider yourself a scientist and work on systematically testing different dosing strategies until you find one that works. I know it feels a little weird to think of your kid as a science experiment, but that really is what it comes down to.

    I would suggest keeping good records of what you've tried, what happened, and what you'd do differently next time so that you're not reinventing the wheel every time. We have a "special circumstances" notebook that we keep just for that purpose - it has pages for pizza, Chinese food, tortellini, ice cream... all of our problem foods.

    As for what works for us, it depends on the food. For full-fat ice cream we dose 120% of the recommended dose, giving 40% up front, and 60% over 4 hours. Pizza also gets more than 100% of the recommended dose, but other foods we just dose the recommended amount and extend the bolus over up to 8 hours. It's all trial and error.
     
  11. annaluvspink

    annaluvspink Approved members

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    Thank-you! We'll experiment for sure!
     

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