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Small to moderate protein intake has little effect on BG • Combo bolus is not needed Large protein intake (greater than 8 oz) • BG may increase 4-12 hours later • Combo bolus may be beneficial • Duration and dosage based on individual’s response • Consider temporary basal increase starting 3-4 hours after the meal Walsh J. Pumping Insulin, 4th Ed. San Diego: Torrey Pines Press; 2006:70.
How can we adjust the bolus to deal with these affects? • COMBO BOLUS OPTION AN EXAMPLE: CAN DELIVER 50% OF THE TOTAL AMOUNT OF INSULIN AS A NORMAL BOLUS AND THE OTHER 50% OVER AN EXTENDED AMOUNT OF TIME
Page 1 and 2: Dana Dignard RD CDE CWD Friends for
Page 3 and 4: Children with diabetes have the sam
Page 5: Most of the 128 participants had in
Page 8 and 9: Grains, Beans and Starchy Vegetable
Page 11 and 12: More liberalized Meal Planning (Car
Page 13 and 14: In a recent Italian study published
Page 15 and 16: Count exact carb grams in the food
Page 17 and 18: Detailed food, BG and insulin dose
Page 19 and 20: Insulin to Carb ratio is the amount
Page 21: FOOD GRAM VS CHOICE 1 cup mashed po
Page 24 and 25: Read and use labels Software on pu
Page 26 and 27: A SERVING is the amount of food you
Page 28: Measuring Tools Measuring cups Meas
Page 31 and 32: Look at the specific amount of food
Page 34 and 35: o Look at the fat content. o Compar
Page 36 and 37: According to the Canadian Diabetes
Page 38 and 39: ALCOHOL ITSELF DOES NOT CONTAIN CAR
Page 40 and 41: Once portion sizes and carbohydrate
Page 42 and 43: Total Dosage 2 u 4 u 6 u 1 hr 2 hr
Page 46 and 47: Effects on BG • Delayed stomach e
Page 48 and 49: Many Canadians eat double the recom
Page 54 and 55: Bolus given at least 20 minutes bef
Page 56 and 57: Various tools for diabetes meal pla
Page 58 and 59: YOU NEVER ACTUALLY GET THERE EDUCA
Page 60: Questions? Comments? Suggestions?

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