Well, here is how it went down.

I had woken up with a nice BG reading of 91. I got ready and went to work. On my way there I stopped and got me some breakfast tacos and a diet soda. Well I know how much carbs that works out to be, and so, when I got to work I did a Combo bolus (same as a dual wave on a Paradigm) Well I set the duration of the bolus for 2 hours because I tend to eat between work tasks over the course of a couple of hours. That was fine, but as I was sitting there, I got HUNGRY. I downed my tacos and dint think twice that I was on an extended bolus.

I checked my BG an hour and a half later and I was 366. Well I run through and check my pump and infusion site. All was well there. So I did a small 2 unit bolus to help correct (My ISF ratio is 1:12 so 2 units only drops me 24 or so on the reading.) Well another hour passes and im 278. I did possibly the dumbest thing ever. I bolused another 2 units. I checked again in an hour and I was 187, At lunch I didnt eat, as I got busy working out the details with my insurance company form my home insurance.

Well I get back to work and did a test and I was 71. I ate 15g of carbs so I wouldnt go lower. About an hour later I was feeling funky, so I checked again and was 61!!!! Well I ate some hard candy (3 small pieces) and waited. After an hour I was still feeling bad so I suspended my pump for about 30 min, ate around 40g of carbs (between a Gatorade and a small snack) After all that had passed and I felt better, I tested again. I was only 71 again!

So I spent better than 3 hours below 70, and it took a LOT to get me back to a functional state. After 2 more hours I was back to anly 115. Thats amazing because I normally get higher than that if I eat that much with no bolus.

The Lesson here: DONT OVER CORRECT! You will pay the price later! Lesson learned on that one. Also I believe, because it was a different infusion site (I usually use my arms or legs but was rotating to give them a break) that the insulin was absorbing diffrently. It hit me like a ton of bricks though.

so true I learned that the hard way myself my doctor calls it insulin stacking because we don't the results we want right away 

Yes, and with me being the control freak I am, well......You know how that goes. Ive found that with me testing 10 times a day now that I have some really funky after meal highs going on. I may have to inquire with doc on that one. It comes back down but usualy hours later. I wonder if doing Super Bolus might help. Ive done some research on the issue, and it seems interesting.

I too have read about the super bolus as well and am going to discuss it with my doc next week.

Let me know what he says. I will ask mine as well. Im just wondering what the general consensus is. I had a high carb breakfast (70g total) and tried a super bolus (regular bouls plus the total of 2 hours of basil rate while taking into account IOB) It worked pretty sweet. I got up to an amazing 126 where as I am usually 220+......So looks positive so far.

JDM at June 21, 2010 at 1:29 PM

Let me know what he says. I will ask mine as well. Im just wondering what the general consensus is. I had a high carb breakfast (70g total) and tried a super bolus (regular bouls plus the total of 2 hours of basil rate while taking into account IOB) It worked pretty sweet. I got up to an amazing 126 where as I am usually 220+......So looks positive so far.

I learned how to keep my 2 hr bg around 130 or lower it seems to work for me but I will let you know what my doc says and you let me know what yours says

I experimented with the following formula for a full day......See what you think. See I usually have bad high BG readings (250 plus) after meals that taper off over 4 hours if I eat over 40-50g of carbs. So, I used the foumula of giving the normal bolus, plus 2 hours of basal insulin (for me thats like ~5 units) Then all I do is, go in and turn on a temporary basal of 0% for the 2 hours because I already gave the basal units up front. It works ery well. I dont go low because im not over bolusing, but at the same time, the bigger up front dose kills any chance of me going Hyperglycemic after meals. Worst BG I had all day was 133 and that was just before bed. I tested like 16 times during the day to make sure. It realllllllllly does help in my case. Will keep you posted with what doc says.