Super Bolus – A Game Changer in Diabetes Care

Most of us are familiar with the Super Bowl, but you may not be familiar with a super bolus. Here is all you need to know about this relatively new concept in diabetes care.

What is a super bolus?

A super bolus is a 1.5x normal pre-meal dose of insulin and suspension of basal insulin for 2 hours.¹ Stopping the basal insulin helps ensure that there is not too much insulin circulating in the bloodstream at once and lowers the risk of low blood sugar from the bolus.

Why would you do a super bolus?

This is typically done when people are eating very high glycemic index foods. It can be really difficult to avoid an after-meal glucose spike, especially with foods that have high glycemic index. High glycemic index foods are foods that get absorbed in the blood stream rapidly such as:

• White bread
• White rice
• Juice or regular soda
• Potatoes
• Candy
• Most breakfast cereals
• Couscous
• Pasta – especially not whole grain or protein type pasta

Many gluten free alternatives for pasta and bread are made with rice flour, which can make the glycemic index higher. This makes this a potential benefit for people with established celiac disease. However, if someone has been recently diagnosed, they may want to wait until their intestines have healed to try something like this, just in case.

When would not be a good time to super bolus?

There are sometimes where you may not want to try using a super bolus, here are some examples:

• When your blood sugar is low
• When you are eating foods that have lower glycemic index
  • Higher in protein
  • Higher in fat
  • Whole grain
• If you have exercised recently more than usual – which may increase your risk for lows
• If you have delayed absorption or digestion
  • Gastroparesis
  • Newly diagnosed celiac
  • Other intestinal disorders

It’s always better to be safe than sorry, and it may be wise to discuss the super bolus with your diabetes care team before trying it. This being said, diabetes is often full of self-experimentation. If you are going to try it, you may also want to take note of how it went for you and when it was most helpful.

Happy Bolusing!

1. Super Bolus: a remedy for a high glycemic index meal in children with type 1 diabetes on insulin pump therapy?—study protocol for a randomized controlled trial

Written and clinically reviewed by Marissa Town, RN, BSN, CDCES