Samantha Walsh
Samantha Walsh has lived with type 1 diabetes for over five years since 2017. After her T1D diagnosis, she was eager to give back to the diabetes community. She is the Community and Partner Manager for T1D Exchange and helps to manage the Online Community and recruit for the T1D Exchange Registry. Prior to T1D Exchange, Samantha fundraised at Joslin Diabetes Center. She graduated from the University of Massachusetts with a Bachelors degree in sociology and early childhood education.
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How often do you “rage bolus,” giving yourself several correction doses for a stubborn high glucose? Cancel reply
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Rarely, but when I do watch out…..
I find that I have to give myself several boluses when I use protein powder for exercise (which is several times/week, 3 or 4 days) Otherwise, my Control IQ does most of the “rage bolusing” for me.
I have found using a temp increase in basal helps knock those down fairly well, pretty commonly see this on my leg sites
Ask me this question 5 years ago when I was on liquid meal time insulin I would have answered “sometimes or often.”
With inhaled Insulin…. There is no need to rage bolus at all! It works FAST!!!
I agree! Afrezza is the best insulin on the market!
Gosh, now I know what to call it. I said “often” but I have learned more how to wait to act even when the alerts and alarms are pounding me. It’s especially hard to be patient in the middle of the night’s “sleep” though.
Extremely high
I wouldn’t call it a “rage” anything because that word implies uncontrolled anger. If I am unexpectedly very high, I am aggressive, but measured.
Who calls it “rage” bolus? Why so extreme? If anything, I’d call it “why is this happening” bolus or, “damn, has my site gone bad?” bolus.
That’s my take. What frustrates me is that sometimes I then head down, like it all of a sudden “catches up” and I’ve over corrected 🤦♀️
It’s an expression that’s been around in the DOC for awhile. Slightly tongue in cheek.
It’s a common expression in the T1D world.
yes, thank you!
I know it’s a bad idea, have seen the results in messy ways, yet I can’t resist sometimes! I plan to talk to my endo about it next visit.
I find it’s more effective to use an IM injection than to rage bolus. Afrezza is also very good for managing stubborn high BGs.
If I am high I will give a correction dose and follow up with additional doses as needed about 30 minutes apart. Mostly if I am going to eat something unusual, like a desert, I will try and pre-bolus.
On MDI. Will inject into a muscle for a stubborn high. Usually the deltoid. Comes right down. Start tandem t-slim soon. Hope will keep everything stable. But last A1c was 5.3. Don’t mind if goes slightly higher if stable.
I have done that sometimes. But, depending on how high the BS is the other thing I do is inhale 4 units of Afrezza. Works like a charm and no long wait for my BS to come down.
I have found that an increased basal, up to 4X, bring s me down faster than boluses.
If it’s really stubborn it usually signifies there’s a bigger systemic problem preventing the insulin from working. So just hitting it with a stupidly outsize bolus isn’t going to help. But if it doesn’t work, that does tell you something. Bent canula (pump), bad site, clogged tubing, whatever. Or a cold coming on. I sometimes do it just for that reason. Also for the frustration, yeah.
It’s usually when I have a stubborn high and am not in a position where I can do some type of exercise to help bring it down….
after all these years, I just figured that out too! with a stubborn high, I take a bolus, then exercise. It sucks sometimes, exercising with a high sugar can make me feel sick.. but i have found that the insulin bolus works so much more efficient if I can push through to exercise
Typically after rebound highs.
For me it usually happens at the end of a cartridge. I will crank up 8 -10 units and as soon as it’s in, change the cartridge and Infusion set.
It all depends on how high the number and how frustrated I am.
CIQ is very cautious and Novolog can be very slow. I’ll inject a half to 1 unit if I’m dealing with a very rapidly rising glucose level, usually from something I’ve eaten.
I sometimes give myself several little boluses over a period of time
to correct highs when I’m outside being super active.
In the eighties, after the first blood glucose tests became available, I injected 4-6 units of “Regular,” insulin directly into the vein. This only after extreme insulin resistance and many hours above 400 mg/dl. It did help but my endo told me to never do that again. I probably did it 20-30 times in total. I was aware of not having any bubbles in the barrel and would draw-back a tiny bit to verify blood in the barrel. Then I would slowly push it in. Never had an issue, but it was “insane,” as one fellow T1D told me.
No more insane than druggies who do it and yet live to see another day. 🤷🏼♀️
I have a different definition of “rage bolus” than you so I chose “other”.
I said sometimes, but I consider a rage bolus one huge bolus well beyond what I would normally dose. Possibly more than one for one stubborn high blood sugar. I’ve bolused more than half my normal daily insulin total trying to get a high to come down before. It happens way less frequently now that my stress levels are more under control though.
“More” than I like to admit. I put “sometimes” and probably should have put “often” :-/
Less, now that I am on Lyumjev
Frustration is more the emotion, when the stars should align by the actions taken and for some unknown reason (or variable) they haven’t.
I sometimes give myself several corrections. Although it will occasionally cause my sugar to go too low, those boluses usually put my sugar where I want it to be.
I don’t typically give a “rage” bolus, I prefer to bump and nudge.
I checked-off OFTEN, because the Tandem X2, Control-IQ is far too slow to react. Normally I would walk- it off if the numbers were above 180 mg/dl, but that’s all based on where I am. Yes, I know the FDA and the Tandem Technicians/Doctors have to be conservative. But I have been doing this T1D stuff for a very long time (57 years).
Too much protein for the day will do this to me at night, especially if my lady meal was later than usual. It’s awful.
*Last meal lol!
I marked rarely because I now have a pump that will automatically bolus! Yay!
I’ve never given myself, a rage, bolus, however, I have divided my correction bolus into three or four smaller doses, and injected them in various sites across my body, in hopes that more insulin would become available more rapidly.