Super Bolus

[belyro]

I'm not taking the credit for this one, because xMenace sent me this link, but I had to post it.

The Super Bolus (http://www.diabetesnet.com/diabetes_technology/super_bolus.php)

The "Super Bolus" isn't for everyone, but it works SO WELL for me and has given me control that I never thought I'd be able to have. My endo thought I was crazy to be doing this, but maybe the fact that John Walsh backs the theory will change her mind. :)

(Thanks xMenace!)

[Jan B]

Wow,

I reviewed this today in "Pumping Insulin", and then had a situation where I could have used it, but didn't. I ended up with a 325 (from 85) 2 hours post prandial (oatmeal). If I end up going low later, it will tell me I could have added more correction insulin immediately (erase basal for a bit). Or, if I find that oatmeal does that to me again . . . I can super bolus for it & turn the basal off for a couple hours. I've been having oatmeal every day, and never thought this happened. Someone made me a little mad, but it wasn't that bad!!

Beth . . if you can give examples of how you use, it might help!

[BlueSky]

I can see the sense in the "Super Bolus" idea, and how it would improve one's tolerance to high carbohydrate meals. But I have to wonder why people insist on complicating their lives so much. Simply avoiding the carbohydrate would a be less risky, easier to cover and healthier. It would probably taste a lot better too! ;)

[belyro]

I don't know if I'm the best one to give you an example, Jan. The thing is, for me it's not really about using it for high-carb, high GI meals, it's about using it for basically every meal. I have a really really weird metabolism that seems to need it. I've tested the heck out of it both by myself and with my CDE, and also with the help of a couple people on here......so you might be better off asking someone who just uses it for certain foods.

BlueSky, I actually eat moderately low-carb (emphasis on "moderately", I suppose). I try to keep my meals between 30-40g of carbs or less. I seem to need this profile anyway. And even if I didn't, I love carbs, so it would be worth the extra effort. ;) Everyone's different, right?

[Funnygrl]

I can see the sense in the "Super Bolus" idea, and how it would improve one's tolerance to high carbohydrate meals. But I have to wonder why people insist on complicating their lives so much. Simply avoiding the carbohydrate would a be less risky, easier to cover and healthier. It would probably taste a lot better too! ;)
It's really not all that complicated.

Plus, it's not just good for high carb meals. I'm more apt to use it if I have a high-high I want to bring down quickly.

[xMenace]

Thanks Beth.

I use it in the morning only. I don't do it in order to eat high carbs; I do it because it's the only way I can get my BGs down after eating any carbs and not go hypo before lunch.

My reasoning is two-fold, First is the same as Walsh's. My Endo says that many of his patients can't get their breakfast post-prandials down no matter what they eat, and I fell into that boat too. I have to pre-bolus, cut way back on carbs, and super-bolus. My typical breakfast is one slice of homemade multi-grain bread with natural peanut butter. 20g or so of carbs. My normal bolusing to get me level at lunch sends me to 12 or 14 pp from a fasting of 6.

My second reason is my high I:C at breakfast compared to my low I:C at lunch. They are 2.5:10 and 1:10 respectively. This means the 2 or so hours of trailing bolus is amplified 2.5 times. Normally this trail is barely noticeable such as from my lunch to dinner. But I believe it really helps send me low before lunch. I compensate by cutting basals.

The only way I can keep level in the mornings is by following this routine. It works for me ;)

[JediSkipdogg]

I've heard of this but never actually tried it. I may have to actually try it and see how it works. I just worry about it messing up IOB though as it would be calculated in IOB and the basal rate would be 0 for that time.

[Jan B]

It's really not all that complicated.

Plus, it's not just good for high carb meals. I'm more apt to use it if I have a high-high I want to bring down quickly.

That's what I would use it for (earlier post about being high post-prandial and not getting it). I don't eat high carb, unless that's what my daily oatmeal is considered. Turns out my canula wasn't even in me, so the super bolus wouldn't have worked anyway.

I'm glad it works for your wierdness Bethany!!

[belyro]

I'm glad it works for your wierdness Bethany!!

It works for my diabetic weirdness anyway. The rest of my weirdness...well...that's another story. ;)

[ant hill]

I have decided to help dad to cut some fire wood for our winter and it was lunchtime and thought, No I will skip the bolus and had pea soup and some curly cale as I know that there is some carbs in the soup and some potato's in the cale anyway had the lunch and in the car and cut wood. Half way though the pile of wood and tested 5.6 / 100.8 Perfect!!! :D When we gotten home and had another test and 3.9 / 70.2 and had some marshmallows. :D So I'm a happy boy. :D :D

[Alice]

More power to you...it's too complicated for me. I definitely would not be able to deal with those calculations when busy with my former careers. But, if it works, fine...

I guess I try to find the simplest method to work into my life.

[HollyB]

This works great for Aaron to bring down an alarmingly high high quickly without crashing him low later, or when he's high before a meal but doesn't want to or can't wait to bring his BG down before eating. It's brilliant.

[xMenace]

More power to you...it's too complicated for me. I definitely would not be able to deal with those calculations when busy with my former careers. But, if it works, fine...

I guess I try to find the simplest method to work into my life.

It definately takes attention, but really, what part of this frickin disease doesn't?

[Alice]

Being on Lantus puts me in a different "Super Bolus" place...I often take a unit or two "additional" to a normal correction if I want to bring a high down more quickly. But, I'm prepared with additional carbs (usually a minimum) for that 1.5-2 hour point...it's not something I do if I'm going to be distracted during the peaking time...but I can see a parallel to what you are doing.

A high-carb meal such as pasta, pizza...then I normally do a split bolus with good results even with a slight increase on total carb dose...but if I took a super bolus on a slow digesting carb, then I'd do a dangerous drop...the kind where lights hurt my eyes and I keep wondering if my will is up to date...that kind of low...

Live and learn when playing with these boluses...

[Cyborg]

Couldn't you achieve the same results by pre-bolusing? Since it takes time for the insulin to work, I'm wondering if pre-bolusing might even be more effective. :hmmmm:

[duck]

This wouldn't work for me, since I have to be around Kryptonite all day...

[ant hill]

Kryptonite
LOL Duck, For me it's like having some gamma radiation to play with. :star: :laugh: :T

[gambi]

I printed the article out to take to my endo on Monday. I have a problem going high after lunch. I usually cut my pump of at 11am so I can run at 12, I'm usually 108-120. Then come back and I'm 85, so I turn the pump back on and eat my 30 (very low gylcemic) carbs and I ofter shoot up to 200 and have to correct.

Any other time during after a meal I'm perfect, maybe that because of the Byetta at breakfast and dinner, by lunch it's worn off maybe?

A nurse told me that having it off for the 2 hours and then eating and bolusing is really messing me up because my background insuling is gone.

I'd to change my schedule, and think this may work. I'll give it a try!

[ant hill]

Any other time during after a meal I'm perfect, maybe that because of the Byetta at breakfast and dinner, by lunch it's worn off maybe?

What on earth are you doing with byetta, As you're a type 1.
Byetta is not an insulin!! Do you have an endo to see?

[cheryl]

I was having issue's at breakfast mostly but only oatmeal, I realized a number one no more brown sugar boo-hiss and two, I have to wait 15-20 minutes after a bolus to eat it....it works well to wait for any hi gi food for me, I think the super bolus would work though on a high high carb meal, but then again, most of the time high carbs is followed by atleast high fat....unless it is soda, or some candy sugar candy, so I dunno if it would even work for me.....I thought I was like that but I wait now, for breakfast, but now that I work and am on my feet, I don't have to wait in the mornings at work to eat, only when I am at home....If I am at home I have to wait with all my meals....

But it is a good concept to use for high's cause i crash to correct most of them unless it is a high because I am not getting insulin, then I am usually fine...

We all have our things, don't we, LOL....

Cheryl

[belyro]

Couldn't you achieve the same results by pre-bolusing? Since it takes time for the insulin to work, I'm wondering if pre-bolusing might even be more effective. :hmmmm:

I think for some people this probably would work well. For me it's difficult b/c my problems with anxiety often affect my appetite, so pre-bolusing can end up being a bit tricky and dangerous.

[xMenace]

Couldn't you achieve the same results by pre-bolusing? Since it takes time for the insulin to work, I'm wondering if pre-bolusing might even be more effective. :hmmmm:


I do both at the same time.

[xMenace]

This wouldn't work for me, since I have to be around Kryptonite all day...


I'm just the opposite. I can't go near the stuff:eek:

[gambi]

What on earth are you doing with byetta, As you're a type 1.
Byetta is not an insulin!! Do you have an endo to see?

I have a partically functioning pancreas so I can sort of benefit from it. I am also on a pump, so I use in conjunction with insulin. Yes I have an endo, I believe only an endo can prescribe Byetta. Mainly it's for appetite control. I'm eating so much less and my numbers are getting so much better. I less I eat the less insulin I use and the more weight I loose.

I tried using Symlin and my numbers were crappy and was hungry all the time.

Byetta is being studied for use in type 1s and non-diabetic for weight loss.

It's not such a bad thing.

[cheryl]

I think for some people this probably would work well. For me it's difficult b/c my problems with anxiety often affect my appetite, so pre-bolusing can end up being a bit tricky and dangerous.

I know how you feel I really do, I had to fight my fear....I guess cause I had no support really about being so anxiety ridden, that I just had to gut it up.........Everyone even my other forum was getting tired of me being scared and nervous, what really made me get over the fear of pre bolusing was the darn endo I went to go see, and he said I was too emotionally unstable for a pump....I got upset, with him, and I just decided to wait........and even though scared out of my mind, I just waited, with the food sitting right there....I didn't like being told things by people, so I had to prove everyone wrong.....

But I know how you feel I really do...
Cheryl

[duck]

I'm just the opposite. I can't go near the stuff:eek:

I'm forced to work with it since I was abusing my X-Ray vision powers...

[Funnygrl]

I had a burrito for lunch. I should have super bolused. I'm 170 with 2 up arrows now via sensor :(