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  • Introduction

    As an insulin pump user, you have the option to change how the rapid-acting insulin is delivered by the insulin pump. This can be done through the choice of different bolus types. For example, a Standard Bolus is best used when eating high-carb meals or for a correction because it will deliver the required insulin immediately without any delays. An Extended Bolus is a slow infusion of insulin spread over a longer period of time. It is best used when eating high-protein meals, like a steak, which will raise blood glucose slowly and for many hours after the bolus is delivered. DO NOT use the Extended bolus for when you also need a BG correction. This lesson focuses on the three bolus types, including the Multiwave Bolus, which is used for when you have situations that have a combination of a correction bolus + high fat or a correction bolus + high fat + high carbs and how to select them.

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    Additional basal rate profiles
  • Goals

    At the end of this lesson you will know:

    • The difference between the three bolus types available to you
    • How to program the bolus delivery you want
    • How to stop or cancel a bolus delivery
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    Additional basal rate profiles
  • Bolus types

    Three different bolus types are available to you on the Accu-Chek Combo insulin delivery system. Let's look at each one:

    Standard BOLUS DELIVERY

    • Complete delivery in one portion

    PROGRAMMING NEEDED

    • Bolus amount

    WHEN USED

    • Good for a correction bolus
    • Good for use when eating fast acting carbohydrates (for example fruit, cake that is low in fat, fruit juice and soft drinks, etc.)
    Next lesson
    Additional basal rate profiles
  • Bolus types

    Extended BOLUS DELIVERY

    • Delivery over period of time

    PROGRAMMING NEEDED

    • Bolus amount
    • Duration of delivery

    WHEN USED

    • Long meals, dinners, or receptions, or when you have meals that are digested slowly
    • May be appropriate for people with gastroparesis

    DO NOT use the Extended Bolus for when you also need a BG correction.

    Next lesson
    Additional basal rate profiles
  • Bolus types

    Multiwave BOLUS DELIVERY

    • Immediate bolus delivery followed by an Extended Bolus delivery

    PROGRAMMING NEEDED

    • Immediate bolus amount
    • Extended Bolus amount
    • Duration of extended delivery

    WHEN USED

    • For high fat, high carb foods, e.g. pizza or pasta with a creamy sauce
    • For meals that include both rapidly and slowly absorbed carbohydrates
    Next lesson
    Additional basal rate profiles
  • Programming an Extended Bolus via the diabetes manager: step 1

    While your diabetes manager is in the Pump menu:

    • Press Icon to move to the EXTENDED BOLUS screen
    • Press Icon to select
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    Additional basal rate profiles
  • Programming an Extended Bolus via the diabetes manager: step 2

    • The BOLUS AMOUNT screen appears
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    Additional basal rate profiles
  • Programming an Extended Bolus via the diabetes manager: step 3

    • Press Icon to raise or Icon to lower the bolus amount
    • Press Icon to move to the BOLUS DURATION screen

    Remember! You can also use the insulin pump keys for this operation. Click here to see which insulin pump keys are attributed to the diabetes manager buttons.

    Next lesson
    Additional basal rate profiles
  • Programming an Extended Bolus via the diabetes manager: step 4

    • The length of time (duration) of the last Extended Bolus delivered appears
    • Press Icon to raise or Icon to lower the bolus duration

    Press Icon to toggle between the Bolus Amount and Duration.

    Next lesson
    Additional basal rate profiles
  • Programming an Extended Bolus via the diabetes manager: step 5

    • Press Icon to confirm the bolus amount and duration
    • You will hear a melody and/or feel a vibration and the bolus delivery starts within the next 3 minutes

    You can also use the insulin pump keys for this operation. Click here to see which insulin pump keys are applicable to the diabetes manager buttons.

    Next lesson
    Additional basal rate profiles
  • Cancelling an Extended Bolus

    If you have started an Extended Bolus delivery, you can cancel it in these two situations: either during programming or during bolus delivery.

    Let's look at each option.

    Next lesson
    Additional basal rate profiles
  • Cancelling an Extended Bolus: during programming the bolus amount or bolus duration blinks

    You can either:

    a) Wait for your insulin pump to return to the RUN screen OR

    b) Press Icon to return to the Extended Bolus menu OR

    c) Set the bolus amount to 0.0 units and press Icon

    No bolus is delivered.

    Next lesson
    Additional basal rate profiles
  • Cancelling an Extended Bolus: during bolus delivery

    You can put the insulin pump into STOP mode. This cancels the bolus delivery and a Warning W8: BOLUS CANCELLED is displayed. Press Icon twice to confirm and turn off the Warning. The bolus delivery is interrupted. The bolus amount delivered up to the cancellation can be reviewed in the BOLUS HISTORY screen.

    Now let's look at how to program a Multiwave Bolus.

    If you have put your insulin pump in STOP mode to cancel a bolus, double check that you have put it back into RUN mode straight away.

    Next lesson
    Additional basal rate profiles
  • Programming a Multiwave bolus via the diabetes manager: step 1

    While your diabetes manager is in the Pump menu:

    • Press Icon to move to the MULTIWAVE BOLUS screen
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    Additional basal rate profiles
  • Programming a Multiwave bolus via the diabetes manager: step 2

    • Press Icon to select
    • BOLUS AMOUNT screen appears
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    Additional basal rate profiles
  • Programming a Multiwave bolus via the diabetes manager: step 3

    • Press Icon or Icon to increase or decrease the total bolus amount
    Next lesson
    Additional basal rate profiles
  • Programming a Multiwave bolus via the diabetes manager: step 4

    • Press Icon to move to the IMMEDIATE BOLUS screen
    • Press Icon or Icon to correct and set the immediate bolus amount
    Next lesson
    Additional basal rate profiles
  • Programming a Multiwave bolus via the diabetes manager: step 5

    • Press Icon to move to the BOLUS DURATION screen
    • Press Icon or Icon to correct and set the Extended Bolus duration in increments of 15 minutes for up to 24 hours.

    Press Icon to toggle between programming the total Bolus Amount, Immediate Bolus and Bolus Duration.

    Next lesson
    Additional basal rate profiles
  • Programming a Multiwave bolus via the diabetes manager: step 6

    • Check that the total and immediate bolus amounts and the Extended Bolus duration programmed on the screen are correct
    Next lesson
    Additional basal rate profiles
  • Programming a Multiwave bolus via the diabetes manager: step 7

    • Press Icon to confirm both bolus amounts and the bolus duration
    • The Multiwave Bolus symbol blinks for 5 seconds (bolus delivery start delay)
    Next lesson
    Additional basal rate profiles
  • Programming a Multiwave bolus via the diabetes manager: step 8

    • The insulin pump beeps and/or vibrates 3 times and the immediate bolus delivery begins
    • The countdown of the remaining bolus continues to appear on the display

    You can also use the insulin pump keys for this operation. Click here to see which insulin pump keys are attributed to the diabetes manager buttons.

    Let's take a look at how you can cancel a Multiwave Bolus.

    Next lesson
    Additional basal rate profiles
  • Cancelling a Multiwave bolus via the diabetes manager

    There are 4 ways to cancel a Multiwave Bolus using the diabetes manager:

    • During programming
    • During the start delay
    • During immediate bolus delivery
    • During extended delivery

    Let's look at each method in turn.

    Next lesson
    Additional basal rate profiles
  • Cancelling a Multiwave bolus: during programming the bolus amount or bolus duration blinks

    There are three ways to cancel a Multiwave Bolus during programming:

    • Do not press any key for 20 seconds: the insulin pump returns to the RUN screen
    • Exit to the Multiwave Bolus screen by pressing .
    • Set the total bolus amount to 0.0 units and press Icon

    No bolus is delivered

    Make sure you do not exit the function by pressing Icon before programming is completed

    Next lesson
    Additional basal rate profiles
  • Cancelling a Multiwave bolus: during start delay

    • During the start delay, the Multiwave symbol blinks
    • Press Icon or Icon
    • The insulin pump beeps and vibrates and returns to the RUN screen

    No bolus is delivered

    Next lesson
    Additional basal rate profiles
  • Cancelling a Multiwave bolus: during immediate bolus delivery

    You can cancel immediate delivery by pressing and holding Icon or Icon for 3 seconds until you hear a melody. This cancels the whole bolus (immediate and Extended Bolus delivery)

    Bolus delivery is interrupted, go into the My Data on the pump to check to see how much (if any) insulin was delivered before the action was stopped. You must then eat the equivalent amount of carbohydrates for the amount of insulin delivered.

    Next lesson
    Additional basal rate profiles
  • Cancelling a Multiwave bolus: during extended delivery

    • You can cancel the extended delivery by putting the insulin pump in STOP mode; this cancels the Extended Bolus
    • Bolus delivery is interrupted
    Next lesson
    Additional basal rate profiles
  • Click on your demo diabetes manager buttons to practice what you have just learnt. If you decide to practice any functions, on your own insulin pump, make sure the infusion set is disconnected from your body so that there is no chance of accidental insulin delivery. Ensure all your settings are put back to where they should be at the end of the practice.

    Next lesson
    Additional basal rate profiles
  • Quiz

    Which number sequence of the three bolus icons is correct?

  • Quiz

    I can deliver a bolus when the pump is in STOP mode

  • Quiz

    What is the amount of the immediate bolus shown here?

  • Congratulations!

    You have completed the choosing your bolus type section.

    Next lesson
    Additional basal rate profiles

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