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Scott Benner 0:00
In this episode of defining diabetes Jenny Smith and I are going to define extended Bolus. Defining diabetes is made possible by Dexcom on the pod and dancing for diabetes. Please remember that nothing you hear on the Juicebox Podcast should be considered advice medical or otherwise the Always consult a physician before becoming bold with insulin or making any changes to your medical plan.

Extended bolus

Jennifer Smith, CDE 0:30
extended bolus that's a very good one because

first of all, a lot of people don't realize how this ended Bolus works. So extended Bolus refers specifically to pumping right in an insulin pump you have the option old if your son animist pump you had something called the combo bolus. If you have a Medtronic pump you have dual bolus and square as if you have Omnipod. Extended Bolus. If you have a tandem pump, it's extended Bolus as well. They all call it something different. They all essentially works the same exact way. Extended Bolus allows you to take a bolus and extend all or a portion of it out over a designated time period. So let's say for example, like the terms that the tronic came up with, honestly, the duel in the square wave Bolus, because you can do them on all the pumps even though they're not called that in all the pumps. A duel with Bolus means that you're going to give let's say your pump recommends two units right now for what you said you were going to eat. If you choose a dual way of Bolus. The pump will ask you how much of this Bolus do you want to give right now as an upfront amount, like a normal bolus that you get, let's say you say 50%. Okay, your pump is going to give you one unit right now, the other The next screen that comes up How long do you want to deliver the other 50%? Over in this case, one unit? Do you want it over half hour? Do you want it over three hours? Do you want it over four hours, eight hours, what do you want? At that point, the pump will start a drip, drip, drip, drip drip of that one unit bolus out over the course of time you told it to deliver it out over it doesn't wait until the end. Let's say you said two hours. It doesn't wait until you get to two hours and then it delivers the one unit Bolus. That is not how extended works in any of the pumps. It is a drip drip almost like a secondary bazel kind of if you think about it, drip drip drip drip drip out over the time period you said and again the other bolus is the square wave in Medtronic. You can do it the same way and the other pumps square wave means you give no normal bolus right now and say you say zero percent. Right now the next screen will say well how long do you want to deliver this two units over you say two hours it will drip drip drip, drip drip the whole bowl is in over a two hour time period. That's extended Bolus.

Scott Benner 2:55
I will sometimes cheat on a Pre-Bolus if Arden's blood sugar is not stable enough to hold it. So like say Arden's 20 minutes away from eating lunch and this is when we get a chance to Pre-Bolus while she's at school, but her blood sugar's you know 75 then we'll do a zero percent now and the rest over a half an hour so that it starts dripping rain right away but by the time she sits down and eats about two thirds of it is in probably none of its active. It just starts becoming active as she starts to eat and the rest of its in by then too and coming online. It's just it's it's a brilliant way to manipulate insulin. And in the end, a lot of what we talked about here is ways to make the insulin do what you want it to do, but more importantly when you want it to do it. So extending the wave square. These are all ways of stretching out your your insulin boluses.

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