Super bolus

[SB2015]

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.

 

[everydayupsanddowns]

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.

 

[Radders]

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.

 

[SB2015]

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.

 

[Radders]

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.

 

[SB2015]

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.