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If you use an insulin pump that allows you to give extended boluses, on average how often do you give an extended bolus?
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I chose multiple times a month. It depends on how my BG / digestion is acting. This can be quite variable.
My husband does an extended bolus every night. Otherwise a single insulin dose would peak before the carbs in his low carb/ high fat dinner were metabolized.
🪜 BG movements are like the Weeping Angels from Doctor Who—monsters that can move only when you’re not looking at them. Therefore . . . I extend the bolus several times a week. Then occasionally take a peek.
The Omnipod 5 in automated mode does not allow an extended bolus. So I never have an extended bolus which means I have to tell the machine to give me more insulin in a few hours. It is unfortunate since the older models did. I assume they will fix this flaw when they come out with the next model in a few years.
Pumping since June 2003 and since then literally every Insulin Pump I’ve had has allowed extended Bolus options. Since 2003 I think I’ve used the Extended Bolus option a maximum of maybe 3 times in the past 19 years.
My pump can do extended bolus, but not in automode with my CGM, so I am unable to use the feature as I would like. Instead I set reminders to split a bolus, for pizza or sugary breakfast for example.
Because I eat a lot of fiber and have dark chocolate as a treat often, I use the extended wave most days. I wish it were able to go longer than 2 hours as it is hard to remember to rebolus.
Same! My pizza hits 3-4 hours post meal! I do and extended bolus and it works great while it’s running, but after it stops I still get a spike.
Rarely, only with pizza.
I clicked the wrong one. I accidentally clicked “never” but then saw the option for “my pump does not give extended boluses”
Almost every bolus.
Newish to the type 1 life will be three years for me in March. See this option on my pump don’t know what it is for how it would benefit to use it! So much to still figure out. Will see what I can learn from your comments and ask the Endo 🙂
Don’t worry about “so much to figure out”. I have been a T1D for 47 years and have been on a pump since 1983 and have never used the extended bolus or square wave option. After reading these comments I realized that extended boluses might have been beneficial to me, especially when eating pasta. I am going on the Omnipod 5 next week and am sincerely hoping that this will make my life easier.
Extended bolus gave me pizza and pasta back. Sure it’s just a slice/small bowl at a time, but using it prevents the future spike that invariably hits about an hour or two later (depending on what’s on the pizza/pasta of course). So thankful for the tech that makes this disease easier. (even if that same tech sometimes drives me crazy with beeps and unnecessary alerts)
Extended boluses are crucial to my management! MDI was not working well in the beginning at all. Novolog just does not last long in me, done acting in 2.5-3 hours. And especially now with my GLP1 regimen, even more crucial.
I pre-bolus and avoid lows during each meal, bolusing for the carbs up front and extending the protein portion (at a different ratio) over 1.5 hours.
You have an MD who prescribed a GLP1 ??? I’m jealous- would love to try that
@K Ro Yes! My Endo is at a research hospital. They understand that T1s can benefit greatly from off-label meds…being that the only reason they’re not approved for T1s is because “they can lower BG”. Duh, that’s the point.
My Endo does this only for T1s who really get the math, understand the potential dangers. We stepped into it very slowly and carefully. The GLP1 has helped calm my liver (excess glucagon), replaces the effects of amylin (she’s full!), and has reduced my total insulin needs by 50%. I do so much better. Without it, my carb ratio is 1:6 and ISF 1:80 (difficult to manage!). With GLP1, I’m 1:15 and 1:90, respectively, and basal is down by 40%.
I use less than a typical T2 dose. It’s been wonderful.
That REALLY depends on the type of meal that I’m eating. i.e. I give extended boluses when I eat high fat content meals, such as chips [fries] or pizza, but I don’t eat these types of foods on a regular basis.
Took me until fairly recently, after many years with a pump, to discover “dual wave” bolus as an answer to the Pizza Dilemma. Before that I avoided pizza like the plague for the first 20 yrs after dx, when I was on R/N and then basal/bolus MDI. Just too difficult.
Only when i have a slice of pizza, maybe once every 6 months.
It us useful for a little movie popcorn. I also use with temporary bolus often with extend bolus. Fast acting insulin is amazing, and so grateful for pumps that can help with special treats. That said, I don’t generally use for food, but unexpected highs when sick. T1 is not casually managed. I monitor bg’s more closely during these uses. I know question wasn’t about how or why, so monthly multiple times!
On a Tandem w/CIQ, who needs that?
George – how do you deal with Gastro (or are you fortunate enough to have avoided it). I’d love to discuss IQ with you as has failed for me when I tried it
Yerachmiel, I have been fortunate enough to avoid Gastro and lucky enough to have such ease with the Dexcom
Almost every meal bolus is a dual bolus (extended and straight) due to gastroparesis.
When I was pregnant I used extended boluses all the time because I was much more vigilant about having good control. Now I hardly ever use it.
extended bolus dont seem to work for me with my tandem pump. i always end up cancelling them and adding a bolus later on
A large number of foods hit me quite a while after eating them, so I use it often. Most of the time, it’s 25% right after I eat and the other 75% over the next 1/2 to 1 hour. With something really high in fat, like pizza, I have to wait for 1/2 hour after eating to start the bolus.
I said never. I use the Medtronic 770 with the sensor 3. When I use the “Auto Mode” extended boluses are not an option. On the rare occasion when I’m not in Auto Mode, then extended boluses are an option. I wish Medtronic would allow extended boluses with Auto Mode.
When I used Medtronic, and when not on Auto Mode, I would _always_ used dual wave for pizza. In my experience pizza hits my BGs about 6 hours after eating. Worked a charm except for the Auto Mode business. Didn’t like that at all.
Now I’m on the Tandem and while I really love the possibility of adding an extended bolus, I do _not_ like the limit to 2 hours! 😉
I use an extended bolus several times a week to help with pasta/cream sauces and fried rice dinners. I would extend the bolus longer than 2 hours if I could. Since the extra time isn’t allowed by my pump I almost always need a correction bolus 4 house later.
hours later
Multiple times per week because I have mile gastroparesis and I sometimes can get ahead of it using extended boluses, especially midday.
Rarely for me. I use extended bolus for high fat foods. I don’t eat a high fat diet.
I use extended bolus for pizza and Indian food. Both of which spike me hours after eating.
I use a temporary basal rate instead of extended bolus. Works pretty much the same way.
I have Medtronic and use manual mode. I am very sensitive to insulin later in the day and no matter what I eat for dinner I absolutely need a dual wave bolus or else I will crash. I use it when I eat out every time. I think Tandem is the only algorithm that allows an extended bolus and I would love to be able to try that pump.
I use the extended bolus almost always at dinner, and especially if my pre-dinner BG is below 100. I decide on the percentage of immediate bolus on the basis of that BG. The lower the BG the lower the percent of total bolus. I, too wish I could extend for longer than 2 hours.
I use extended bolus a few times each week in several instances. 1) If my blood sugar is low-ish before I eat, I’ll extend some of the bolus over 30 minutes to alleviate the potential low. 2) If my bolus is going to be over 3 units, I’ll extend over 30 minutes to prevent leaking / tunneling which happens to me with bigger boluses. 3) High protein meals, which for me is dinner most nights. I use the Warsaw method to figure out the dose and duration and extend for 4-5 hours to prevent a protein / fat rise.
What is the Warsaw method?
Only for Pizza.
Not currently using a pump
Not currently on a pump
Only for pizza (which only happens 1-2 times a month) and other fried food (which is also rare). I use increased temp basal after a meal with more success. I wish extended boluses could be extended for more than 2 hours as my daughter peaks 4-5 hours later.
I haven’t started using my insulin pumps yet
Depending what I eat is what determines if I do extended bolus or not
Have never tried it, enough to deal with already
Nearly every bolus is Extended. I have a lot of scar tissue and very little fatty tissue, so infusion sites give me problems. Medtronic had a ‘slow delivery’ option that helped, but Tandem shoots the insulin into the site in ‘spurts’. I’ve found the Extended bolus over 15 mins (the minimum time) emulates the ‘slow delivery’ option and has increased my TIR and site comfort.