Since very beginning attempt utilize Combo Bolus pump feature, Bigfoot/B. Spouse more likely hack combo bolus. E.g. bolus, eat, if eat little more, bolus little more, if eat dessert little bit later, bolus little more that time too. In this family mind, it like supersafe Combo Bolus because more flexible, easy halt extra insulin if Type 1 diner in question change mind re food amount.
But no. Endo say Stop This. Can cause lows. “Stacking.” Familiar that term from insulin pen times. Thought stacking concern pen/syringe user only, because pump calculate IOB. Hmmph. Bigfoot explain why think little bolus + bolus little more 1x, 2x for extended meal experience better for Bubs than Combo Bolus. Because unreliable predict what eat. Actually say this:
Why is giving increments of insulin over time different from a combo bolus? Sometimes I know he will be eating more over time, but don’t want to do a combo bolus because I don’t think I can cancel it or decrease the amount after I enter it.
Endo say no. Better use actual Combo Bolus. This paragraph not medical advice but it email from endo:
I am not sure why there is a difference between frequent bolusing and using the combo but experience has shown us that there is a difference. Even with the combo bolus, we still suggest not to rebolus for at least an hour after the whole bolus has been delivered. It is a difficult balance to decide how often to bolus and each child is different but repeated boluses every hour or so seem to “stack up” and cause lows later on.
And so this happen: Bigfoot Spouse think ahead, make lowish carb dinner (grilled mustard-y pork tenderloin, one carrot, half apple, water) because aunt bring elaborate homemade Christmas cookie gift. (That not true, it Bigfoot think ahead/tell spouse grill this pork tenderloin from a bag. Cookie part true.) This cookie delivery major event of ring in holiday season. OK. So. Figure 12g CHO dinner + 25g CHO 2 cookies. Bolus for 37g CHO. Cookie time Jack Wouldn’t some milk be so good with these cookies? It true. Should have thought. Seem impossible deny Bubs milk–this once a year cookie heaven experience!–so break rule, bolus additional 6g CHO. Tiny speck insulin. OK. Hour later hear I’m hungry. Could I have a graham cracker?
BIGFOOT: Sorry, no (<–because try adhere anti-stacking policy, not because controlling bitch)
BFOOT: Nuh-uh. How about a cup of tea?
BFOOT: How about a piece of cheese?
BUBS: Provo-lohhhne (said with low, drawn-out final syllable to show dejected mood)
JACK: May I have cheese too?
BFOOT: Sure! (feeling peppy now: someone’s making cheese seem like fun)
JACK: Ooh, and a glass of that mango juice?
JACK: Bubs! This mango juice is so good!
BF: shut up (<–say in head only)
BUBS: I’ll just have water
**Obvsly, I am hoping that someone reputable will tell me this is a smart and very fine thing to do–and not just on special cookie occasions