# Super bolus



## SB2015 (Aug 24, 2017)

When  using a super bolus (which I am diong for larger cabs in a meal) when you 'borrow' some basal rate insulin from the following time period, do you attach it to carbs, or let the bolus calculator read it as a correction dose.  I know the answer to this will impact on active insulin in future corrections/ bolus if I don't wit until the full action time of the insulin before needing another correction.


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## everydayupsanddowns (Aug 24, 2017)

I think the impact that has would very much depend on the pump you use. Roche pumps always only ever report correction doses in 'active insulin' (so more 'active correction' really - at least I think the Insight works the same as the Combo/Expert), while Medtronic list the whole dose in 'active insulin' as soon as it is delivered. 

Neither system, as far as I remember, actually reduce a subsequent carb bolus based on excess IOB (which has always annoyed me slightly). Allowing for overcorrections, errors and/or rage boluses does not seem to be a feature of bolus wizards .

On my MM640G I would override the suggested bolus by however many units and it would then be listed as a 'modification' in the history and shown as 'Active insulin', which would decay at the normal rate and/or be subtracted from future correction doses.


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## Radders (Aug 24, 2017)

everydayupsanddowns said:


> I think the impact that has would very much depend on the pump you use. Roche pumps always only ever report correction doses in 'active insulin' (so more 'active correction' really - at least I think the Insight works the same as the Combo/Expert), while Medtronic list the whole dose in 'active insulin' as soon as it is delivered.
> 
> Neither system, as far as I remember, actually reduce a subsequent carb bolus based on excess IOB (which has always annoyed me slightly). Allowing for overcorrections, errors and/or rage boluses does not seem to be a feature of bolus wizards .
> 
> On my MM640G I would override the suggested bolus by however many units and it would then be listed as a 'modification' in the history and shown as 'Active insulin', which would decay at the normal rate and/or be subtracted from future correction doses.


That's one of the best things about this forum. Can you imagine getting a knowledgable answer like that from any other source? I can't.


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## SB2015 (Aug 25, 2017)

everydayupsanddowns said:


> I think the impact that has would very much depend on the pump you use. Roche pumps always only ever report correction doses in 'active insulin' (so more 'active correction' really - at least I think the Insight works the same as the Combo/Expert), while Medtronic list the whole dose in 'active insulin' as soon as it is delivered.
> 
> Neither system, as far as I remember, actually reduce a subsequent carb bolus based on excess IOB (which has always annoyed me slightly). Allowing for overcorrections, errors and/or rage boluses does not seem to be a feature of bolus wizards .
> 
> On my MM640G I would override the suggested bolus by however many units and it would then be listed as a 'modification' in the history and shown as 'Active insulin', which would decay at the normal rate and/or be subtracted from future correction doses.


Thanks Mike
The Combo uses a bolus covered by carbs, along with the meal rise, to calculate where the BG should be over the next three hours.  A bolus with no carbs attached is taken as a correction,and counts as active insulin.

Still not sure which to do, and DSN no t able t say.


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## Radders (Aug 26, 2017)

Somehow I feel as if the bolus calculator isn't designed to be able to work this out. I am not even sure how I would do it myself since whatever correction I made would presumably need to take into account that there has been basal insulin "missing". 
My instinct would be to turn my basal back on if I needed a correction within the active insulin phase, I know that. I guess it would just be a matter of trial and error.


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## SB2015 (Aug 26, 2017)

Radders said:


> Somehow I feel as if the bolus calculator isn't designed to be able to work this out. I am not even sure how I would do it myself since whatever correction I made would presumably need to take into account that there has been basal insulin "missing".
> My instinct would be to turn my basal back on if I needed a correction within the active insulin phase, I know that. I guess it would just be a matter of trial and error.


Thanks Radders.  That is one solution I had not thought of.
As with all in D world it will be trial and error, but ideas from you and Mike will give me a good starting point.


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