Super Bolus By Mistake - Scarry Stuff!

[Olidus]

Well - Yesterday evening I ate my spaghetti nothing special - same amount I usually eat. I go to bolus right after I eat, except this time I feel a different sharp pain when I stick my needle in my stomach. Looking back now - I know that I was flexinging and apparently injected right into an abdominal muscle.

10 - 15 minutes later - I start to see stars, feel like I was floating and knew for sure something was not right at all. I test to find myself at 2.4 mmol/l or 43.2 mg/dl.
Since DX - I may have dropped that low once. I started to pound the juice in. After 3 Juice Boxes, an Oreo Cookie, and a Muffin, I worked it out to be about close to 100gs of Carbs I finally got up to 7.0 mmol/l or 126 mg/dl.
Thank god for my wife - as I'm not sure I would have been able to fight that battle myself.

Still being new to the D - not yet a year with it - I have to say that it was a rather unpleasent experience and hope not to go though it again anytime soon.

[xMenace]

Mark, I always doubt claims that insulin works that fast, and I look for other causes. Your basal is a suspect, but I think maybe you're starting to produce insulin yourself. This often happens with newly dx'd like you. Be careful over the next while and perhaps do some basal testing. An overall reduction may be necessary. If so, contact your endo.

If not, c'est la vie!

[milfordj]

Did you test your BG a bit later -- an hour or so after recovering? It takes a minimum of 15 minutes for any carbs (other than possibly the glucose tablets or paste which EVERY D should keep on their person ALL the time) to start working. We've ALL gone too low too rapidly wherein our only thought is to keep ingesting sweets (which unfortunately we can't even taste) until we start to feel a bit of relief. Only to realize later that we "overdosed". That's why it's so important to try to sense early signs of hypo, with time to test to confirm before "treating". If caught early enough we are still aware enough to not overdose in treatment and able to avoid the "rollercoaster". I've actually caught myself trying to test my BG when I was so hypo that I couldn't figure out how to do the test. Luckily my BG tablets were nearby and I was still sane enough to take some as a precaution. Good Luck and just remember -- We've ALL Been There!

[Olidus]

From the 2.4 to the 7.0 I actually tested 3 or 4 times.
I was always told that Juice or Pop is the fastest way to get your BGs up as the liquid is absorbed directly into the bloodstream - no break down needs to happen.
As for producing my own insluin - I'm sure I still am - as my insluin MDI/intake is really low. (Using a 1/20 unit/carb).
Keep in mind that I only took 4 units after my rather large plate of spaghetti with bread.
Again the only thingdifferent that was done was the way I took my shot and felt that sharp pain deep inside. I know that I was flexing and I never do - just was not thinking.

[morrisma]

Mark,
When I was on MDI, I had this happen (really fast drop) a couple of times when I used my thigh as an injection point.

I have suspicions about whether I hit some fast absorbing tissue or I was maybe dropping rapidly before my injection. Not sure really. Glad you are ok.

[fgummett]

Sharp pain... at the risk of sounding stupid... any chance you hit a blood vessel?

[Funnygrl]

FYI, injecting into muscle isn't what makes it a super bolus. Borrowing basal to add to bolus is.

[Olidus]

FYI, injecting into muscle isn't what makes it a super bolus. Borrowing basal to add to bolus is.

Funnygrl,
What exactly do you mean by that? I am MDI. I take my basal 1 a day before I go to bed.

[fgummett]

I understand the term "Super Bolus (http://www.diabetesnet.com/diabetes_technology/super_bolus.php)" with a specific meaning has already been coined by John Walsh in his latest Pumping Insulin book... whereas I suspect you just you took a bolus that had a "super" effect..?

[ultrafine]

I'm super glad that you were able to recover! Hope that doesn't happen to you again. :D .
Good luck ! :)

[Funnygrl]

It's a pumping thing. Essentially, you can reduce your basal insulin for a few hours, and give that "borrowed" insulin up front, in addition to a bolus. It allowed you to give a larger bolus without dropping more later, since the lack of basal later saves you from the drop.

[Alice]

I find spaghetti (and other pastas depending on sauces) are very slow to digest. I normally wait a bit after eating to bolus...and even then, often split the bolus over an hour or so to see what's going on...

I have a friend who had a bad low after eating spaghetti...and I've learned from this as well.

The only problem with a "pump super bolus" is that although you are counting on your lack of basal as a cushion...you can still cross that line with enough insulin. (too much insulin)

Pasta is a slow carb for me.

[Eddy]

I find spaghetti (and other pastas depending on sauces) are very slow to digest. I normally wait a bit after eating to bolus...and even then, often split the bolus over an hour or so to see what's going on...


I also find spaghetti -- at least the whole-grain rice spaghetti that I eat -- slow to digest. I bolus for it using between 40% and 70% NPH (depending on preparation method, meal size, timing, et cetera); fortunately, NPH works quickly and predictably in me. The non-NPH balance of the insulin is about 1:2 to 1:1 rapid:R.