- advertisement -

Pizza and extended bolus

Discussion in 'Parents of Children with Type 1' started by wilowndmomof3, Jul 13, 2008.

  1. wilowndmomof3

    wilowndmomof3 Approved members

    Joined:
    Jun 2, 2008
    Messages:
    317
    I was just reading Michellesims post about "bad night" and someone mentioned bolusing more for pizza and extending the bolus. How do you figure how much more to bolus and how long to extend it for. We had pizza the other night and both DH and DS were in the 300-400 range almost all night and pizza always does this unless I make homemade and it isn't quite as bad.

    I feel like an idiot since we have been pumping for over 5 yrs with DH, they just never showed us how to use any feature other then bolus and how to put in basal rates. With DS the more control we can get the happier I will be and DH's doc chewed him out the other day for not having his under better control. He really realizes now that he has an example to set (took an outsider, but I think it is finally sinking in).

    I figured I could try out the extended bolus when we have Pizza Hut for his birthday next weekend. And wouldn't you know he wants pan crust :rolleyes:
     
  2. Sarah Maddie's Mom

    Sarah Maddie's Mom Approved members

    Joined:
    Sep 23, 2007
    Messages:
    12,521
    Do NOT feel bad about not being the most aggressive pumper on the block.:cwds: Our endo was exactly the same and I didn't ask enough questions and they didn't offer much guidance so your not alone.

    We used Extended Bolus' for when Maddie's grazing at a party or picnic to cover snacking rather than doing 8 regular bolus's for 3 or 5 grams each.

    We use the Combo Bolus on Maddie's cozmo, ( dual wave on MM and Animas?) for high fat foods like Pizza. For two slices of pizza I might do 70 g over 5 hours, at 60 or 70% upfront.

    Sorry the endo isn't of more help. Time for a new practice???:rolleyes:
     
  3. valerie k

    valerie k Approved members

    Joined:
    Feb 19, 2008
    Messages:
    1,510
    Im with ya... I dont know near as much about that pump as I would like, and am scared to try and make small changes... it takes me a while. Im learning and willing to learn, so thats what counts. Someday, I will be brave enough to start to use squarewave and duel wave bolus's that come with matts pump.
     
  4. Twinklet

    Twinklet Approved members

    Joined:
    Jun 29, 2006
    Messages:
    2,123
    Don't feel badly; I've learned a lot from reading these forums!

    About 18 months ago, we were struggling with pizza. My DD's school orders in every Friday and she wanted to partake so we made a huge effort to learn how to bolus for it. We got a LOT of help from people on this site.

    Someone found an old MM booklet online that mentioned bolusing for fat and protein when eating things like pizza helps a lot. Fat will slow the digestion and greatly delay absorption. One study showed that it's a good 8 hours.

    So here's the formula from the MM booklet:

    Add 10% of fat grams as carb
    Add 60% of protein grams as carb

    So let's look at Pizza Hut, thick crust (which we love :)) According to Calorie King, 1 piece of a 12-inch pan Pepperoni pizza (cut into 8 slices) has 27 carbs, 12 g of protein and 14 grams of fat.

    27 grams of carb + (12g protein * .60) + (14g fat * .10)

    27 + 7.2 + 1.4 = 35.6 grams per slice for purposes of bolusing

    After MANY experimentations, we have found that my daughter requires a combo/dual-wave bolus of 70% insulin up-front and 30% extended over 8 hours. When we do this, she will only rise to about 140 and gently come down to 100 hours later. I couldn't believe how well it works.

    Of course, since you're giving so much more insulin you'll need to test more often.

    We have gotten a bit lazy lately and simply add 30% more insulin for high-fat, high-carb meals if we don't have the nutritional data handy. That works well, too--although she has gone low with this, so we have to be careful if we're guessing.

    Hope that helps!
     
  5. StillMamamia

    StillMamamia Approved members

    Joined:
    Nov 21, 2007
    Messages:
    13,195
    Don't worry, we're in the same boat as to using pump features. We're slowly trying 'more advanced' ones...and have failed a few times.:eek: But we're not giving up.

    We've yet to figure out for how long we should do a combo or extended bolus for pizza. We usually do a combo extended over 3 hours...BIG MISTAKE...it needs to be much longer. I'm going to try to increase the extended part of the combo for at least 2 other hours, making it 5 hours and we'll see.
     
  6. wilowndmomof3

    wilowndmomof3 Approved members

    Joined:
    Jun 2, 2008
    Messages:
    317
    Thank you Twinklet, that is exactly what i needed. I am going to try it and see what happens. Probably extend 30% over 5 hours since he was high quite a while and what I have read here and other places it is in your system so much longer.

    We actually did change my DH's endo, that doc only cared if his A1C was in range and didn't care about highs and lows. With my husbands neuropathy (extremely painful kind) the highs really cause problems. We finally have someone who is more than willing to help us adjust and I am going to be more aggressive at helping him get it under control.

    My sons endo and the CDE are great, we just haven't gotten to discussing the extended and combo boluses. I have been making adjustments on my own lately as I feel a lot more confident at figuring out what the problem is.

    Thanks a bunch I really appreciate it and it is good to know I am not alone out here where the extended boluses and combos are concerned. Can anyone recommend a good book. I have pumping insulin somewhere around here just cant seem to find the darn thing.
     
  7. tuckerk

    tuckerk Approved members

    Joined:
    Jul 20, 2007
    Messages:
    136
    Bolusng for High Fat Foods

    Questions:

    Is that formula adaptable to all foods with high fat?

    We are new to Cozmo pump and really trying to get the most benefit from the pump. Caitlin had pizza for a lunch at the church nursery and I wasn't really sure how to bolus (outside of the standard).

    Thanks again. No question is a dumb question, 9 times out of 10 someone else is wondering the same thing.
     
  8. Twinklet

    Twinklet Approved members

    Joined:
    Jun 29, 2006
    Messages:
    2,123
    Tucker, we do use that formula for all foods that are high-fat and high-carb (lasagne, burritos). We have found that we have to extend it out over 6-8 hours, though.
     
  9. tuckerk

    tuckerk Approved members

    Joined:
    Jul 20, 2007
    Messages:
    136
    Great. Caitie seems to be loving anything high fat right now! LOL:eek:
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice