Friday, March 18, 2011

calculating questions

as you all know, i use an insulin pump. animas ping - love it!

image from

when i take a bolus - for those who don't know and want to learn, bolus is basically an extra dose of insulin for food - for a meal (or ya know, a cupcake/snack), for YEARS i just left the ratio on 15:85, or 20:80 if my blood sugar was a little higher, to be delivered over one hour. - that means, 15 percent of the amount i dosed would be delivered at that moment, and the other 85 percent would be delivered over the next hour.

why? because i don't know how/when to change it. what circumstances? why would i do half now and half later, or just 20 percent now and 80 percent later? should i give 50/50 depending on what i'm eating? should i extend the delivery time past one hour if i'm having pasta? or mexican? or what if i'm just having a sandwich? what about ice cream? or a cupcake?

the amount of time it takes for my body to react is different depending on what i am eating. i have been experimenting with the options lately, trying a higher percentage now, and a smaller percentage over time, or making the time it's delivered over a longer period, or a shorter period, etc.

basically, DOC pumpers, i need some help. what do you all do? how do you decide what your percentages should be? how do you decide how long to have the second half of your bolus delivered? i want to learn, i want to have tighter control after my meals.

can you help me?


  1. i've been playing around with that too.
    depending on the food i'm eating.
    ex: bagels hit my bg later, so i'll do a 40/60 spilt. but for something like mexican i'll do 50/50 or 60/40 depending on my bgnow and what i'll be eating for my meal. sometimes it works really well. sometimes i'm way off :)

  2. I don't use delayed insulin with my daughter, she generally seems fine with all at once.

    We often bolus at different stages. For example bolus for the meal at the beginning and the desert/treat at the end.

  3. My experience has been lots of trial and error with a side of persistence.

  4. combo bolus is not something I used much of at all (I'm on animas ping as well, pumping nearly 2yrs now) new doc wants me to do 30/70 regardless at each meal but I would like to understand it better and why...or if I should play with this a bit more

  5. It's a trial and error life, this T1 thang. :-) 26 years and that still holds true, the constant in Diabetes is change.

    You just have to try it, see when it works for what. There is no set formula for it. It's a great tool for greasy foods, that fat content can take up to 3 hours to show up in your blood.

    Also for that time of month, when hormones are crazy and the insulin seems to absorb slower. Or when you are running high and need a bit extra along with the basal.

    Hope that helps! Call Animas, they are great!

    Good luck.

  6. If you have a CDE, endo or RD who is pump-literate, a discussion can be really helpful. I usually use a combo bolus of 70/30 for thin crust pizza, 60/40 for some pastas or Thanksgiving, haven't really done 50/50 yet. It's mainly about the carb to fat ratio and how much insulin you need hanging out, b/c the more fat is there, the longer the carbs may take to get into your bloodstream, so BAM! an hour or 2 later, I can get slammed w/ a big ol' 250 after thinking I was "safe." Definitely trial and error, and someone else could explain it better than I just did. My CDE/RD always reminds me about it, but I haven't played with it very much. As Crystal said, exercise, starting BG when you're eating, hormones, and timing of bolus ALSO play a role. Experiment and see what works/doesn't work. And let us know! ;)

  7. I usually only use the combo at dinner. And even then, I'm guessing.
    I've also used it when at a party/gathering where I'm "grazing." I decide on the carbs I'll eat, do a combo for one to two hours, and then stop when I've reached that number.