Stacking

[Rexy]

Hi Everyone - I need some help. My husband is new to the pump (2 months) and had some major dental work done yesterday to be continued on Monday. He is on soft foods and can only eat a little bit at a time. I've made him puddings, hot cereal, milk shakes, glucerna, etc - and he can only eat a small amount at a time, every hour or two. I know that he is programming the correct amount of carbs into the pump for each eating episode, but by the end of the evening or by the middle of the night, he is running real low (60's). I think this is caused from stacking - any advice?

[JediSkipdogg]

I doubt that is caused by stacking if you count the carbs correctly. Stacking is only a problem if you attempt to do a bolus correction for a BG. Is he on any dental meds for the work done? Those could be causing the BG to go up or down. Or, it could be he's eating so little at a time that accurately counting the carbs is hard. But I highly doubt it's due to stacking.

[Cyborg]

If he is accurately counting carbs, and he is eating slowly, perhaps he needs to to do an extended bolus for the food. He could also do a temp basal, perhaps -10 or -20% to help from running low...

[Rexy]

Thanks Jedi! You may be right - he is over counting carbs since he is eating smaller amounts - he says he is accounting for decreased portions, but maybe not accurately. He sometimes eats several small snacks, as opposed to a regular meal, and it seems like when he does this, he always runs low - that's why I thought it was the stacking - but maybe not. Perhaps he is just overestimating the carbs during these times.

Let me ask another question - is there a problem with stacking when you eat a fatty snack and give a dual wave bolus and then 2 hours later eat another snack with, perhaps, a standard bolus, and then even later eat popcorn with an extended delivery? In essence, you've got three types of bolus' onboard - 1) 70-30, 2) standard, and 3) bolus over 45 minutes (his popcorn setting). He doesn't often do this - but when he does, it makes me nervous and it seems that he always gets low at these times.

[Cyborg]

Can you do multiple combo boluses?

[JediSkipdogg]

Can you do two boluses at the same time on the MM pump? I didn't think you could. So the first one would have to end for the second to start.

If he counts the carbs correctly there shouldn't be a problem with that scenario. Do he go low during the entire thing? Or does he return to normal later on? I wonder if his carb ratio may be off some as well. I've eaten pizza, done a combo bolus, then give multiple regular boluses for items like desserts quite often.

[Cyborg]

Simultaneous combo boluses is something I would love in a pump...

[Rexy]

He has a Cozmo - and I know you can do a combo and a standard - I'm not sure about a combo, a standard, and then the second combo - I thought that he had done that e.g., 1) fatty food 70-30, 2) standard, and 3) popcorn extended - but now that you ask, I am not 100% sure about 2 combo bolus'. I'll check it out and let you know!

[Cyborg]

It depends on the duration of the first combo bolus. :flybye:

[Rexy]

Simultaneous combo boluses is something I would love in a pump...


OK - here's what my husband did this evening with his Cozmo pump - not sure this is exactly what you were refering to above......... He took a combo bolus at 6:00PM, a standard bolus at 7:00PM and a combo bolus at 7:45 PM.

[spike]

Can you do two boluses at the same time on the MM pump? I didn't think you could. So the first one would have to end for the second to start.

If he counts the carbs correctly there shouldn't be a problem with that scenario. Do he go low during the entire thing? Or does he return to normal later on? I wonder if his carb ratio may be off some as well. I've eaten pizza, done a combo bolus, then give multiple regular boluses for items like desserts quite often.

You can do an audio bolus while an extended bolus is running.

[JediSkipdogg]

You can do an audio bolus while an extended bolus is running.

I meant two extended boluses. Left a word out.