Large boluses

[sviskan]

Hi

I am pregnant and at a point where I need a large amount of insulin when I eat; about 15 units for each meal. It does not feel right to take that large a bolus all in one 3-5 times a day for 3 days in the same site. What do you others do with this kind of problem?

All answers are welcome: Sviskan

[ant hill]

Hey i bolus 30U a go and i'm quite big aka heavy, I even do a dual bridge bolus like say if the insulin lasts 3 hours then i take the second shot in 1 1/2 hours later making the peak longer.
Given the fact that you are pregnant that you have the baby to add to that equation. ;)

[xMenace]

Can I assume you are pumping? Bolus away! But keep mindful of absorption problems.

[Emm]

15u Might seem like a lot to you, but to some people that would be piddly.

Don't worry about it - take as much as you need to counter your meals.

Or, if you really don't like taking that much, change what you eat, have a little less carb (and if you can, a little more exercise).

As a pregnant woman it's much more important for you to look after that body and keep the numbers down. Forget the numbers, just make it work :)

[w5wjp]

15u???? For most meals, I bolus around 60-75 units. If you are pumping, you might need to change the site every 2 days to prevent absorption problems.

[sviskan]

I am pumping, and I think that I have absorption problems after 1,5-2 days in the same site.

I wonder if I should just use the syringe to bolus. But is it likely to have the exact same effect?

How does one inject 70 units at a time?

[JaxTerri]

Here's a silly question....what do you mean when you say you "bolus around 60-75 units"? I take Lantus at bedtime and am up to 75 units and my doc told me to half the dosage and give myself 2 shots instead of one. He said after 60 units it isn't all absorbed. However, I'm giving my shot in my belly every time. Reading these posts I'm wondering if I need to be finding other locations.

[GrammyByer]

A suggestion I have for large boluses is to use the dual wave bolus so that you take half the amt at once and then the pump gives you the other half over a period of time. On my pump I can set the dual time in 30 minute incriments. This works well for me.

[Cyborg]

A suggestion I have for large boluses is to use the dual wave bolus so that you take half the amt at once and then the pump gives you the other half over a period of time. On my pump I can set the dual time in 30 minute incriments. This works well for me.

Exactly! Start your bolus 15-30 minutes before eating and use a 1/2 hour extended bolus. It will help with post meal bg spikes also... :vroam:

[jimbob]

I regularly inject 15u from my pump, never had any problems at all.

[BlueSky]

I am pumping, and I think that I have absorption problems .... I wonder if I should just use the syringe to bolus. But is it likely to have the exact same effect?...
In general, injecting smaller amounts (splitting the dose if neccessary) and moving the site improves absorption. But the only way you will know how much of a difference it makes to you, is to try it out.

So that you make a valid comparison, you could keep the pump supplying basal while you test out bolusing with a pen or syringe. If you think 15 unit boluses are too big for optimal absorption, you can try splitting them into two shots, one 7 units and the other 8 units, which you give in different places. You will quickly see if it makes a worthwhile difference.

[sviskan]

Thanks for all the response.

I use the dual bolus when I can, but I am not comfortable using it when I eat out, which happens a lot.

[Cyborg]

Try the dual bolus, but do it when your food gets served if you are at a restaurant. My pump can lower the duration of a combo bolus down to 6 minutes. I wish pumps were more flexible so that we could set the duration of a combo bolus down to the minute. I hate preset slots...

[andypoo]

I take lantus in two parts for my basal 50 morning,50 at night. the boluses are novolog at each meal of 10- 30 units sliding scale,depending what my bgs are at the time and depending what I'll be eating. I take mine with the pens.

[sviskan]

I have used the syringe now for the last two large boluses and it works fine, so I will keep it up. This way I dont have to change the cartridge so often either. I will still use the pump for the basal and for smaller boluses (< 10 units).

[Cyborg]

If you do that then your pump has no way of accurately calculating the IOB used for correction boluses...

[jleonard]

I am a pumper who has been traditioanlly very weary of large boluses. So much that more than 8 units and I begin to freak thinking I just OD'd myself.

Are these large (more than 10+) boluses really no problem for most of you? I can't imagine having, say a 120 BGL, and adding 12 units on top.

What about when you over dose, how do you counter so much insulin? Can you tell I was hit hard once with NPH and left on a stetcher :) ? Makes for a nervous tick, you know...

[dgrilli]

Try the dual bolus, but do it when your food gets served if you are at a restaurant. My pump can lower the duration of a combo bolus down to 6 minutes. I wish pumps were more flexible so that we could set the duration of a combo bolus down to the minute. I hate preset slots...

Cyborg can you explain the procedure for setting up a dual bolus on the Animas 1250?

[Cyborg]

You can take a bolus all at once, a normal bolus, or you can take your bolus as a combo bolus (sometimes called an extended bolus).

When you choose a combo bolus, you enter the duration and the percentage split up front. The pump then gives you the percentage up front immediately and the remaining percentage gets evenly dispersed over the duration of the combo bolus.