Combo bolus

Such a difficult one to comment on, as boring as it sounds but the only way of finding the answer is by trial & error.

Depending on the food and portion size for difficult meals (like those that have a high-fat content) I bolus 50-60% upfront and extend the remainder of the dose over 3-4 hours, on a Saturday night I eat quite a high-fat meal and also use a TBR for 6 hours to counteract the slow rise in bg levels, but tbh it took me weeks get this right and it was only through trial & error that I got there.

Find you own way but just be careful and remember to test regularly so that you can learn from the experience Nikkid.

I have been reading PUMPIN INSULIN 5 th edition, excellent.

Check out this book on the iBooks Store: “Pumping Insulin” by John Walsh, PA & Ruth Roberts, MA https://itun.es/us/9h88H.l

As already mentioned it is trial and error, what works for one may not work for another, however the approach they take probably will its just the timings and dosage that will vary.

I like my indian meals, these for me are normally around 10 units, for the main meal, I take an initial 5 units (about 20 mins before we eat) then spread the remaining 5 units over next 3 hours. On top of this I take 0.5 for each poppadom and 1.5 for each Cobra. Works well for me and keeps me under 9 mmol. I do not eat the sweeter curries.

For pasta, I have a third of my insulin pre-meal and spread the remains two thirds over the next 90 to 120 mins. Rice I'm ok with.

Chinese and Indian meals I often use an extended bolus and vary it depending on what I eat, but it'd be mainly upfront insulin with say a third as an extended bolus.

This is a great question, I am getting into the same boat. I just started on my pump and would like to work up to Pizza again lol.

I have been told that a safe place to start is to calc normally what you would take, and only take half pre meal, and then stretch the rest out over 3-4 hours. I think would need some adjusting but its a good start.

If you remember when you insulin pens, and ate that meal what happened? I normally found i would inject everything pre-meal, and be fairly low for about 3 hours, and then over then next 3 hours rise until i was up around 12mmol/L and have to take a correction.

Based on that I think i would take half initially, and stretch out the other half over 4 hours, and see what happens.

Let us know what you figure out! I am curious