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Combo or extended boluses

S

SophiaW

Well-Known Member
Messages
1,015
Type of diabetes
Type 1
Treatment type
Pump
This may sound like a silly question but here goes anyway. If you eat a slow release meal, like pizza, and you also have something that is quicker acting like a fruit juice, do you do a combo bolus only for the pizza portion of the carbs and do a regular bolus for the fruit juice? Or would you combine the total carbs of both and do a combo bolus for the total?

Scenario two:
If we were at a restaurant for dinner and had pizza for the main meal followed by a dessert. I'd bolus (combo) for the pizza, I wouldn't know what Jess was going to have for pudding so I'd not deliver any insulin to cover a pudding to start with. Once she's decided on the pudding do I deliver a standard bolus for the pudding or should I do a combo for that too?
 
lol wish i could help with either but i cant hope u get ur answer tho as id be interested to know too :D

anna marie
 
Very good questions, I'm not sure if there is a right or wrong answer to be honest.
For scenario 1, I think that I would calculate the total carbs in both pizza and juice and then do a regular combo bolas and adjust the immediate starting amount to cover the juice, then the remainder of the combo bolas would take care of the pizza.
Scenario 2, Do a combo bolas for the pizza and then give a standard bolas for the pudding once I knew what they were going to have.
I'm not sure if this would work but you have to start somewhere and just give it your best shot. Make a note of the results and decide what to change (if anything) in future.
I'm sure there are no end of other scenarios that are going to tax us, we can only use our best judgement and hope it is enough.... or stay at home and give them what we know is safe :D and boring :(

Harry
 
Safe and boring, no way! lol

Last night Jess had pizza (one of our lovely home made ones :)) and fruit juice. I did a 35% 65% split over 3 hours (this was guessing based on our previous experiment with fish & chips takeaway). Her readings were as follows:

Starting reading: 5.0 mmol/L
1 hour later: 6.8 mmol/L
2 hours later: 8.4 mmol/L
3 hours later: 6.5 mmol/L
4 hours later: 8.8 mmol/L

Much later on at 1:30am her reading had shot up to 12.0 mmol/L. It's the same thing that happened when she had fish & chips. I think when she has a high fat content food in addition to the extended bolus I also need to set a temporary basal rate for the entire night. This morning she woke with a reading of 4.7mmol/L after three corrections during the night, one at 1.30am, 3am and 5am.

Thought I'd share the info incase it's useful to anyone else who is at the experimentation phase :)
 
Thats very interesting Sophia, the TBR might be the way to go. We are having fish and chips tonight and I will see what Lily is like after. We usually have F&C on Fridays but I haven't tested her beyond about 5 hours (she's usually OK) so we will see how she is in the night. It sound like Jess is still going up, what time did you eat and did she have any supper later?
:?

Harry
 
thanx for the info sophia im taking it all on board as still not done anything other than a normal basal we had spag bol last night and dylan was 14 at 11pm dont know if this was the spaghetti or the fact that he wasnt well after being sent home from school and sleeping on sofa for 3hrs

anna marie
 
Anna Marie, Jess' readings went high (14s) when she wasn't well a couple weeks ago so it could well be down to sickness that his readings went up. Hope he gets over it and feels better soon :)

Harry, we had supper at 7pm and she didn't eat anything else afterwards. I know on MDI we always struggled with rising readings through the night if she ate pasta, pizza or anything high fat like take-away fish & chips. It seems to be around 5am that the rising blood sugars start to level out.
 
thanx sophia he already feels better and has gone to school today which is a relief always worry so much when hes ill, did wake with bloods in the 9s so have corrected and will see at lunch. its nice we have each others support and advice any post i put both u and harry are nearly always in the first few to comment :D

anna marie
 
I think this site has helped me a lot and the support is fantastic from everyone.
It's good to be able to bounce ideas around and for someone to see things from another perspective.
Sometimes we can't see the wood for the trees.

Harry
 
Hi, We are not pumping yet so I can't offer any advice on this, but I know that if my kids eat a big meal or one that is loaded with carbs and fat, it can take 5 hours for this to be digested, especially in the evening/ sleeping as they are not as active and it seems that their digestive system slows down.
 
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