Rage Bolus, Baby, Bolus

I’ve been plagued with absolutely stubborn blood sugar levels since Friday morning. I’ve been taking crazy amounts of insulin. I really have no explanation for it, other than being sick.

I probably eat the fewest carbs, and take the least amount of insulin at breakfast time. On Friday, it was a slice of Burgen Low GI toast topped with a boiled egg and a milky coffee. 18g of carbs in total. 4 units of insulin should have been more than enough to cover it. Yet, when I went to check my blood sugar levels 2 hours after breakfast, I was 14.6. I corrected with a very conservative 2 units, which should have brought me back down to the 8-10 mark. An hour and a half later, I was still 14.0, and ready for a rage bolus of 5 units.

This trend continued throughout much of the weekend. By Sunday afternoon, I was injecting around double my normal rapid acting insulin dose for a meal. I would test 2 hours later, with results typically hovering between 14 and 19. I’d rage bolus another 5ish units, which would eventually bring me back down to earth. I was feeling a lot like Basil here…


I wasn’t staying stable through the night either, so I upped my Lantus dose from my usual 9 units. I started conservatively with a 1 unit increase on Friday night, and 2 units on Saturday.

This was a phenomenon I don’t experience too often. Mind you, I don’t get sick too often. I really had no explanation for it. I could only presume that stress hormones from being unwell were affecting my insulin sensitivity. Thinking about it now, I probably should have checked for ketones and drank more fluids as well.

The scariest part in all of this was the unknown. Normally, I have a good idea of where an insulin dose will take me after a meal. I know how much insulin will correct a high blood sugar. I know how many carbs will correct a hypo. I have a good intuition of where my blood sugar is headed when I test 2 or 3 hours after a meal. But through all of this, I was flying blind.

I was borderline hypo when I was ready for bed on Saturday night. I had no idea whether my blood sugar levels were going to fall further, or whether they were going to start rising again. I had no idea whether my normal hypo fix would be enough, or if it would send my levels skyrocketing. I was dead drowsy from the flu tablets I’d been taking, yet I had no choice but to sit up, test, test, test and wait this sticky situation out.

I’m proudest of the caution I exercised through this situation. I can’t say that I was following a textbook, but I didn’t go too crazy with my corrections either. One of the things on my mind was the fact that I didn’t have the energy to deal with a hypo. The last thing I felt like doing was shoving skittles down my already sore throat and going through the exhaustion and frustration that would inevitably follow. 

I’m not really sure what today holds in store for me, but I am feeling better. I’m heading back to work where I’ll be on my feet, rather than on the couch all day. I’m going to try to go easy on my blood sugar levels, and stick to small simple meals.

One of the hardest things about diabetes is that it’s always changing. Why can’t it just sit quietly on the couch and take the day off with me?


  1. Frank, wellcome to being unwell whilst having diabetes. Now you know why my pump and cgm are like an angel when i get unwell. Hope you are feeling better real sooon.

  2. rickphilips

    Yes liver dumps are the pits. I am a long term rage boluser. In fact i want rage bolus twice in 4 days. Come to think of it I may be a rage eater before bed. LOL I love your writing and your blog.

    I included your blog on the TUDiabetes blog page for the week of March 21, 2016.

  3. I have been sick for the past week and know exactly what you mean! I have doubled in insulin requirements and I barely eat anything. I did check ketones and never had any but am still sky rocketing. Worse is, I can just feel the high sugars slowing down the healing process. I’ve had my pump on 175% for the past week and that barely cuts it….

    Let’s hope we feel better soon !

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