Extended Bolus with an Insulin Pump

Important information:

Most of the time, insulin pumps deliver bolus doses of insulin right away. The extended bolus feature allows part of the dose to be delivered immediately, and the rest of the dose to be released slowly over a set time period. An extended bolus is useful for the following scenarios:

  • Meals with high fat or high protein that cause a delayed high blood sugar spike

  • When eating a meal over an extended period like at a party, food buffet, or holiday gathering

  • Conditions where digestion is slower such as gastroparesis

  • You notice that your sugar drops low or lower shortly after eating but then rises high 2-4 hours later

An extended bolus is similar to the way the pancreas works when you eat a meal that takes longer to digest. Fat slows down digestion and blood sugars stay high for a longer time.

High-fat foods that may require an extended bolus:

  • Pizza, hoagies and cheesesteaks

  • Buffet meals

  • Holiday meals

  • Ice cream, milk shakes

  • Macaroni and cheese

  • Fast food meals

Foods like those above may cause delayed blood sugar spikes and you may need more insulin later. Learn more about how food affects blood sugar.

Please note that if you are using an automated insulin pump, you may not need to use extended boluses. Depending on the type of insulin pump you are using, the extended bolus feature may or may not be available in automated mode. It may require additional actions to use this feature, or you may need to reach out to your diabetes educator to learn more about this feature.  Please refer to your pump user guide or pump website for more details.

Patient instructions:

Learn how to deliver an extended bolus with your:

If the blood sugar is too high or too low during or after the extended bolus, you may need to change the way it is delivered. Talk with your Diabetes team to review other suggestions.

 

Reviewed July 2025 by Cathy Kropiewnicki RN, BSN, CDCES, CPT and Trish Lieberman, MS, RD, LDN, CDCEs, CPT