Playing with the super bolus

23 06 2008

Now that I’ve got Charlie, I’ve been feeling more confident about trying new tricks in managing my diabetes.  Specifically, I have been using the super bolus.  Actually, to be more accurate, I have been using what GiR and I like to call a super correct.

From what we can guess, it’s EXACTLY like a super bolus, but it’s just used to correct a very high blood sugar.  Just like a “correction bolus” is just a meal bolus without the meal, a “super correct” is just a “super bolus” without the meal.

I have found that if my blood sugar is above 200, a “2 hour super correct” does the trick.  I take 2 hours of basal ahead of time as a bolus, then reduce my basal to 0 for those 2 hours.  If I’m hovering in the 160-ish range, a “1 hour super correct” is fine.

HOWEVER!  I will guarantee you right now that I am not doing this correctly.  According to Bernard, the basal portion of the super bolus should be taken via the “fill cannula” method so as to not mess up IOB calculations.  I do not do this.

My #1 biggest fear about using the fill cannula method is the fact that my Cozmo defaults to the last amount used.  For example, if I use the fill cannula to deliver 1.2 units of basal, then the next time I go to fill my cannula, 1.2 will be auto-filled.  Now, when I switch out my infusion set, I do this VERY FAST.  I have got this down to a science, people.  So, imagine with me the horror of accidentally delivering 1.2 units instead of .2.  This spells serious trouble.

I know for a fact that delivering the basal portion directly via the correction mechanism really messes with my Delivery Summary.  So according to my pump, I have occasionally taken a LOT of correction, when in fact some of that has been basal.  Of course, my diabetes control should take into a large number of factors and not just my Delivery Summary, but that’s a discussion for another time.

So what do I do?  Right now I am doing my own vague mental calculations of IOB, but that’s not very effective.  I suppose I could learn to slow down and pay more attention to filling my cannula, but that will be a hard habit to break.  Any tips/suggestions?

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6 responses

23 06 2008
Bernard Farrell

Amalas

So I figured out how to fix the Cozmo ‘challenge’. I do hate to mess with my IOB and this method helps.

If I need to super bolus and the amount of basal that I’m moving forward is (say) 1.2 units then I break it into 2 loads. My fill cannula amount it 0.7 units. So I use the fill once for 0.5 units and then again for 0.7 units.

The next time I load a new set (when I’m not always thinking much about it) it works fine. The little calculation works OK because when I’m doing a super bolus I’m thinking about numbers and being very deliberate.

Try this out and see if it helps.

I use the SB anytime I get a high over 240. Generally I wimp out and only move 90 minutes of basal forward. Note that I also set the basal rate to 10% instead of zero. That way there’s a time amount moving in the tube from time to time. I’d had to switch the basal off for 2 hours and run a higher risk of occlusion.

23 06 2008
Amalas

Splitting the super bolus into two load is brilliant! This is why the OC is awesome. Then I don’t fuss with IOB amounts and I preserve my fill cannula amount. I knew there was a solution, but I just didn’t know what it was. THANKS!

Also, turning it down to 10% or 5% is a good idea to avoid occlusion. I’ve wondered about that as well.

23 06 2008
Bernard Farrell

Unfortunately I can’t go to 5% because the Cozmo counts down in 5% increments until it gets to the 10% mark.

When I set it to 10% I ignore the small amount that’s still being given. 90 minutes of basal for me is typically 1.0 units. So I don’t load cannula with 0.9 units, I use the full amount. I figure that small difference isn’t going to affect me much.

As always, your results may vary. (Mostly for the benefits of other readers).

23 06 2008
Amalas

I also have a Cozmo, so I understand about the no 5% thing. I don’t know if other pumps go that low. And I totally get what you’re saying about that small amount not making that much of a difference. I’m reminded of when people talk about pumping Symlin. They put in a very very small basal just to avoid occlusion, and that small amount doesn’t matter that much.

23 06 2008
Scott K. Johnson

Prior to using Symlin I did start experimenting with the super bolus for meals and it worked well. Not sure why I never tried it when high (maybe because my mind was all clogged up with glucose!).

7 10 2009
Another trick up my sleeve « Plastic Pancreas

[…] trick up my sleeve 7 10 2009 I’ve been using the super correct method to get my blood sugars down.  I have updated my technique to make it work a little […]

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