# superbolus



## tracey w (Nov 17, 2010)

After reading a previous thread where Shiv talks about superbolus, ive done a bit of research as i had not heard of it.

Sounds really interesting especially as i know there are certain foods that i spike no matter what.


Does anyone use this method and what do you think of it? I am definately going to try it and will let you know how it goes.


http://www.diabetesnet.com/diabetes_technology/super_bolus.php#axzz15ZM0zBpj


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## Freddie99 (Nov 17, 2010)

As I gather then you use your ordinary dose however on top of that dose you also use some of your basal rate to help attack the spike from particular food. The amount of basal used for this is part of the bolus. After that the basal is either reduced to nothing or a lesser rate than what it would normally be for the amount of time it would take the amount of basal used in the super bolus to be doled out over the length of time when a super bolus is not used?

Could someone double check this for me please as I'm not too sure I've got this straight.


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## tracey w (Nov 17, 2010)

yes thats how ive understood it Tom


sounds complicated but isnt really, i dont think  Think i will try it on a day off so i can monitor it properly, if it works it will be good.

can be used for corrections too, to bring down a high number more quickly.


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## Freddie99 (Nov 17, 2010)

I may have to invest in some Frosties or something like that with which to test the theory!


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## tracey w (Nov 17, 2010)

if it means i can eat a panini without going to 15 its worth a try!


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## Freddie99 (Nov 17, 2010)

Give it a bash then! Nothing ventured nothing gained and all that.


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## Ellie Jones (Nov 17, 2010)

I've only used the super bolus or my version of it for correction perphas, but it is very effective indeed...

I find that if my BG is above 11mmol/l it can be very stubon to come back down the super bolus or should I say my version sorts it no bother..

My version is less complicated to work out 

I take the correction I need to theortically bring my BG back into range, then set a TBR for around 140% for at hour check at the hour in norm pretty much on target or if necessary set another TBR...

For me it helps prevent stacking of the insulin as I don't have any IOB wizards so have to manually crunch numbers of active insulin etc..


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## bev (Nov 17, 2010)

I posted a thread about this ages ago but cant find it now. Anyway, we havent actually trialled it - but be careful doing this if you are using the new method of 15 minutes before - it might complicate things for you. It does work for lots of children on the list and is relatively simple to do.

At the time you peak - take out the basal for that hour and add the whole hour's basal onto your meal bolus. Then you can either do a dual wave or whatever you would normally do and see if this works for you. Have you been bolusing 15 minutes before each meal, and, if so, how have you found it. We have had to lower all the meal ratios as Alex isnt spiking so much and he was having hypo's instead. I might even think about lowering some basals - but need to see a pattern first.Bev


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## tracey w (Nov 18, 2010)

Thanks Ellie and Bev.


I understand why you do that Ellie with no IOB etc, but i think i would be a bit wary of doing that as you are giving more insulin but not subtracting at any point.

Bev I had thought about that too. I have tried the 10mins before a couple of times. Admit im struggling a bit as in the habit of weighing (eg rice), then dishing and bolusing and keep "forgetting" until i have the meal in front of me. Its just a habit i need to break.

It seems to be working OK but only done it twice so far. I have a problem with lunches too. At work i dont get an official break, so if a client comes in i have to stop eating.

I usuallly test, eat half or all then bolus at lunchtime, not ideal but would be too risky to give bolus for 15 mins and then not be a ble to eat it. 

Am definately keeping trying to do at other times.

Do you think the 15min rule, rules out the need for superbolus then? Unless maybe a correction


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## Ellie Jones (Nov 18, 2010)

With the correction I do check at the hour mark and it would be at this point if any subtraction was required it would be done...  but this is use purely for correction though..

I might give the superbolus a go just to see how it pans out, if it does or does't make any difference for me..

Can't see any reason why if the 15 minute rule isn't panning out well that a superbolus can't be used, but would hazard a guess that it would be wiser to put the basal insulin onto the second part of a duel wave though, so that you don't spike insulin too early..


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## bev (Nov 18, 2010)

tracey w said:


> Thanks Ellie and Bev.
> 
> 
> I understand why you do that Ellie with no IOB etc, but i think i would be a bit wary of doing that as you are giving more insulin but not subtracting at any point.
> ...



I do understand how difficult it can be for certain meals and you can only do what you can do. I did find it harder at mealtimes at first - but now just try to time things so that things are cooked by the 15 minutes - or sometimes just keep them sat in the pan keeping warm until its the right time. The 15 minute rule will probably give different results for each meal depending on the time of day and resistance - but I would try to do one thing at a time - it could be that for you you wont need a superbolus aswell - we certainly dont as levels are rarely over 9 or so now. We do get the odd high for unknown reasons - but we are correcting an awful lot less now. Perhaps make a determined effort at weekends so you can see what sort of results your getting - I think it will spur you on.Bev


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## shiv (Nov 18, 2010)

I'm unsure the theory would work strictly for me - I have tiny amounts of basal sometimes (between 0.1u and 0.2u for the whole time I'm on an early shift at work) - so I can't see how adding on 0.1 would make much difference, being as my ratios are relatively large at work (1u:8g carbs). I imagine I'd need to whack on a couple of extra units to see a difference - but I can't tell until I try...

It sounds like a theory I need to experiement with! Where's the white bread?!


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## tracey w (Nov 18, 2010)

bev said:


> I do understand how difficult it can be for certain meals and you can only do what you can do. I did find it harder at mealtimes at first - but now just try to time things so that things are cooked by the 15 minutes - or sometimes just keep them sat in the pan keeping warm until its the right time. The 15 minute rule will probably give different results for each meal depending on the time of day and resistance - but I would try to do one thing at a time - it could be that for you you wont need a superbolus aswell - we certainly dont as levels are rarely over 9 or so now. We do get the odd high for unknown reasons - but we are correcting an awful lot less now. Perhaps make a determined effort at weekends so you can see what sort of results your getting - I think it will spur you on.Bev



I will try, its just im so used to bolusing just before i eat. Like this morning toast ready then though oh heck. Left it sitting in front of me and thought its going to taste awful in a bit so ate it


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## bev (Nov 18, 2010)

tracey w said:


> I will try, its just im so used to bolusing just before i eat. Like this morning toast ready then though oh heck. Left it sitting in front of me and thought its going to taste awful in a bit so ate it



Alex bolus' whilst still in bed and then has a little 'lie in' for 10 minutes and then by the time he is down and eating his breakfast its been 15 minutes.Bev


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## tracey w (Nov 18, 2010)

bev said:


> Alex bolus' whilst still in bed and then has a little 'lie in' for 10 minutes and then by the time he is down and eating his breakfast its been 15 minutes.Bev



Must be nice to be waited on


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