best way to bolus?

Alaina's mum

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Hi all, my daughter is type 1, diagnosed 3 yrs ago and is now on a pump. I'm trying to cut out bread but need to send her to school with something to keep her going at lunchtime so have been trying the john west light lunch tuna pasta pots, average carbs 30 CHO. She is having huge spikes afterwards so am wondering if anybody out there knows what's the best way to bolus for them? she doesn't like to bolus 30 mins before as sometimes she can feel she's dropping, so am thinking should she dual and if so how long? all help gratefully received :)
 
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Daibell

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Hi. First, what's 'CHO'? 30 minutes may be just a bit too long before eating. Is your daughter carb counting i.e. matching the bolus to the mealtime carbs?
 

himtoo

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Hi. First, what's 'CHO'? 30 minutes may be just a bit too long before eating. Is your daughter carb counting i.e. matching the bolus to the mealtime carbs?
CHO is a pretty much universally recognised abbreviation for carbohydrate
Carbohydrate (chemical formula Carbon Hydrogen Oxygen) CHO.
 

himtoo

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Hi @Alaina's mum

30 minutes ahead does seem a stretch-- I would try "doing " this meal at home on a weekend at various timings of pre-bolus -- that will give an idea of how far ahead to pre-bolus at school

unfortunately -- there is some trial and error in these calculations.
 

GrantGam

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Hi all, my daughter is type 1, diagnosed 3 yrs ago and is now on a pump. I'm trying to cut out bread but need to send her to school with something to keep her going at lunchtime so have been trying the john west light lunch tuna pasta pots, average carbs 30 CHO. She is having huge spikes afterwards so am wondering if anybody out there knows what's the best way to bolus for them? she doesn't like to bolus 30 mins before as sometimes she can feel she's dropping, so am thinking should she dual and if so how long? all help gratefully received :)
I agree with @himtoo:)

I have no experience of using an insulin pump, but I do know that a dual wave bolus is of no use in tackling your daughter's BG spikes. Dual wave bolusing is best utilised with low GI foods/food with a high fat content; or simply when eating over a long period of time. From what you've described, the spikes are happening soon after eating - so a dual wave bolus would likely make the spike larger.

All insulin upfront and with a delay between bolusing and eating will give your daughter the best results. As already mentioned, trial and error is a large part of getting the timings perfected - but it is doable.

If you haven't got a copy already, Pumping Insulin by John Walsh and Ruth Roberts is very good:

http://www.diabetesnet.com/dmall/pumping-insulin

Good luck:)
 

claire1991

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Have got tried an extended bolus? I always have to do a two hour extended bolus after eating pasta.
 

mytype1.life

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Hi @Alaina's mum,

I eat those pasta pots and find taking my insulin 20 minutes before with an extended bolus works for me.

I have an Omnipod and enter 30% of the dose 20 mins before and extend the remaining 70% over the next hour.

I appreciate everyone is different but it might be worth a try.
 

Postleneo

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Hi there I normally have the John west Pata pots and a banana for lunch and take full dose of insulin upfront approx 5 mins pre bolus and then have banana about 45 mins to 60 mins later which works great for me. If I just have the John west Tuna pasta pot I wouldn't pre bolus and do a combi bolus of 30% upfront and 70% over 2 hrs that seems to work a treat.
 
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