Bolus/Standard Bolus – refers to insulin that is bloused at one time for to cover the consumption of carbohydrates and correction of high blood sugars (if needed). MDI or pump users use this type of bolus.
Extended/Square/Delayed/Pizza Bolus* – Pump users can deliver equal small quantities of insulin over an extended/chosen period of time by setting up an extended bolus. The types of food consumed and rate of digestion per person determines the timing and duration of the extended bolus. An extended bolus is programed to allow for flexibility in the timing of the consumption of the carbs; fruits may digest faster and high amounts of fat and protein are slower to raise blood sugar (fat and protein can cause a rise in blood sugar hours after a meal is consumed).
Combo/Multiwave/Dual Bolus* – pump users can create a combination of standard and extended bolus. A standard bolus is given to correct a high blood sugar and for the consumption of fast acting carbs. Then an extended bolus is programmed to allow for flexibility in the timing of the consumption of the carbs (for either grazing meals or slow digesting foods.
Super Bolus – pump user use a super bolus, basal + carbohydrates + correction (if needed), all delivered at one time as a standard bolus. The basal insulin is then suspended or partially reduced for the amount of time that is equal to the amount that was bloused. Bolusing basal insulin up front helps in situations when insulin is needed quickly:
- Eating high glycemic index foods
- Larger intakes of carbohydrate
- Correcting a fast elevation of blood sugars
Un-Tethered – traditional pump users that have tubes find that they have to disconnect their pump for certain activities for long periods of time (ie, swimming or sports). Being unconnected from the pump means that basal insulin is not being delivered and can lead to high blood sugar. The un-tethered regimen refers to pump users who no longer have their pump deliver basal insulin and switch to MDI injection(s) of long acting insulin instead. This means the pump is only used for covering carbohydrates and corrections; the basal insulin is suspended.
*One bolus type may have several different names. This is due to different pump manufactures creating specific nomenclature for their pump.