Coordinated Basal–Bolus Infusion for Tighter Postprandial Glucose Control in Insulin Pump Therapy

I came across this paper on the weekend when I was getting frustrated that I couldn't control my blood sugar after meals. I can't actually post the paper for copyright reasons but if you have access to it through some subscription I suggest taking a look. Basically it talks about giving extra bolus insulin in replacement of basal insulin for a meal as a method to keep blood sugars below 140 mg/dl two hours after a meal without going low. Something you might notice though, is that the insulin is given at meal time, meaning the blood sugar spikes up and then is down below 140 before two hours after eating. That being said, I've tried giving myself 'super boluses', where bolus insulin directly replaces basal insulin (I reduce my basal by about 70% for 3 hours and give that insulin in a bolus) has worked very well for me to never go above 160 mg/dl, although I give my insulin about 20 minutes before meals. Anyways, just thought I would share, and I suggest giving super-boluses a shot if you find you cannot avoid postprandial highs without going low later.