- The Most Rapid You Have Bolused -

[Delphinus]

I know you have to cover your carbs, but is there a limit? Some kind of ceiling where the amount of insulin doesn't make much of a difference?

Seems like an odd question, and I have never really needed to bolus an unusually large amount of rapids yet, so I am curious.

Or no matter what, you match your carbs? Even if you hit a buffet and devour 235 carbs of foods?

I have a huge appetite, and don't have any weight issues... yet.

My appetite is almost legendary. Hah...

[xMenace]

A couple of years ago I ate a whole 16" pizza and a choc-pb brownie. I bolused 50 units of humalog and stayed on target!

[rak1978]

:eek: Woah! (That's all I can say about that)
The most I've ever bolused was probably 13 units of humalog for a burrito that I HAD to have when I was pregnant.

[mortis505]

I did a square wave of 30 units one night for my wifes 8 cheese lasagna and garlic bread. 2, 3, and 4 hour tests were all under 130. A.M. reading was a bit high, but not horrible.

[lorilei]

omg....i am so out of my league here....maybe 10 total and that included corrections...think I'm too carb wary to compete with you champs

[Subby]

I've probably pushed 20 units a couple of times when I thought "f it", I was really hungry, having a great time, whatever.

But anything above 12 units and I really can't remember a good result. For me, that means about... 80g carbs, and I'd have to be very lucky for it to work out and qualify as any kind of effective bolus.

[Subby]

omg....i am so out of my league here....maybe 10 total and that included corrections...think I'm too carb wary to compete with you champs

Don't forget, for some of us our insulin use stretches back over decades... in that time, I think you might need to be superhuman not to have had some more extreme scenarios once or twice... ;)

Now delph... he's something else entirely :D

[rak1978]

Or no matter what, you match your carbs? Even if you hit a buffet and devour 235 carbs of foods?

I have a huge appetite, and don't have any weight issues... yet.

My appetite is almost legendary. Hah...


Out of curiosity...
Have you been too scared/cautious/good/disciplined to eat the "235 carbs" at the buffet, or do you have a reasonably low insulin/carb ratio so that you don't yet have to take a mega bolus for that? Are you planning a trip to the buffet in the near future?;)
I'd be too scared to eat that many carbs all at once. I think I'd have to take 40 units to cover that. Yikes. Couldn't do it.

[jimhuck]

I've done 40 before in an attempt to cover an obscene amount of carbs.

It's SO unsafe to do that. When you're eating that much carb, it's a total shot in the dark to know how to cover it.


IF you push that much insulin, do it A LONG TIME before you go to bed. And don't take any naps. You may wake up in a weird place with machines hooked up to you and funny men and women in white coats all around you.

[ant hill]

Ever since that I had an idea how many carbs there is I would then be able to calculate the Bolus.
There have been cases that there have been 70U!!! I am not joking. Plus the BG was quite low too. Once that the shot was taken I had a pizza at 15" :eek::eek: Yea... I know. :o But it's the knowledge that you must know when to take that much.
McDonalds is well known to blow carb values. And of course TEST!!! Like a madman. :T

No wonder I'm FAT. :eek::eek::eek:

[Mindstorm]

I've done over 20 before, though now I have my pump limited to twenty (200 carbs) so I don't get any wise ideas.

Of course, once the carb levels get too high it does become quite a feat to try and count everything. Especially with certain fast food meals. Recently I've had days where I absolutely just HAD to eat a heck of a lot of food. My sleep's been screwed up (but not today!) and I've missed a number of meals.

As crazy as it sounds, though, this has been a GREAT time to figure out whether my basal rates are on target, hahaha.

[Scratch]

I think 16 units of Novolog is the most I've ever done and that was for correcting a badly wayward blood sugar.

[lorilei]

Don't forget, for some of us our insulin use stretches back over decades... in that time, I think you might need to be superhuman not to have had some more extreme scenarios once or twice... ;)

Now delph... he's something else entirely :D

Jason sounds rather like a hulk doesn't he??

[ant hill]

I've done over 20 before, though now I have my pump limited to twenty (200 carbs) so I don't get any wise ideas.

If I had that with my 3.5:1 Ratio So 3.5*20 (200=20CP Carb Portions) = 85U!!! :eek::eek::eek::eek::eek::eek:That's utterly insane. :(

[JJM335]

Don't forget, for some of us our insulin use stretches back over decades... in that time, I think you might need to be superhuman not to have had some more extreme scenarios once or twice... ;)
:D

Hi Subby:

Does your insulin use stretch back to the days of one-shot per day of cloudy insulin (Lente or NPH)? There was no way you could bolus, let alone bolus extra.

Actually, about the first thing I was told after I walked in the ER with a BG of >600/33, was that I would be given a strict diet and a fixed daily dose of insulin and that under NO CIRCUMSTANCES WHATSOEVER should I EVER EVER think about increasing my insulin in order to eat more! It was drummed into me that only BAD DIABETICS did this (and that the wages of sin, if not death, were most certainly amputation and blindness).

Joel

[ant hill]

Hey Joel, I would have to be go nuts if I did that and I have to admit that I have a rather high insulin resistance. :(
I was on Protaphane like your NPH and the actrapid.
The Actrapid has a working life of 8 hours and it's great for pastas. But for these days, Actrapid is considered a mid basel insulin rather than a bolus. ;)

[e||ement]

OMG i thought i was being a rebel the other night when i took 3 units to cover my meal and an enourmous bowl of caramel-o ice cream.

3u is my highest bolus.

guess i'm in the minor leagues. lol.

[JJM335]

Peter:

>>I was on Protaphane like your NPH and the actrapid.

err.... no Actrapid for me.. I was on one shot per day of mixed Lente and Ultralente. My doctor thought that R/Actrapid was "old-fashioned".

So... I was relying totally on long and medium acting insulins. I suppose it was the ultimate example of "eating to your insulin". I ran two marathons on this regime, with no Bg monitoring available - I suppose it shows that we can survive almost anything.

Joel

[Mindstorm]

If I ate that little in the way of carbs I would feel like I was starving to death all the time.

The 20U limit is usually there so I can crash a blood sugar should I eat something evil along with having a high blood sugar. This can happen when the family goes out to eat and I've been sick/had a bad infusion site/whatever. Some places you can't get anything diabeetus friendly. Even the salads are covered in sugary garbage.

[ant hill]

I would not do this too often but I bet I can half my ratios if I did do something physical.

[dandy83]

Hello! I'm brand new (diagnosed this month - this is my first post), but this topic is of particular interest to me...

I haven't yet even met with a dietician or whatever to get my Insulin:Carb ratio, but my Dr. says I'm pretty sensitive to insulin. I've been watching what I eat and have cut out excessive carbs. So far, so good - I feel like I'm getting things under control quickly.

But, like delph, I have the appetite of a horse and usually can eat anything I want and stay thin... so, I'd like to be eating more in general. More importantly, in 1.5 months, I am EXPECTED to bake my best friend's WEDDING CAKE! God knows, I will want to eat it too, and all of the other lovely food at the wedding.

So my question is, since everyone seems to be terrified of extreme lows, is it better to err on the side of having high-ish BG when using a big dosage of bolus? And then, after testing like crazy, take more bolus if you are riding quite high?

What are the dangers more specifically? I'm worried that I'll still be a relatively new diabetic at my friend's wedding, but I certainly want to enjoy it!

[andypoo]

I have to say that I never thought I'd hear from other diabetics slamming some of the other diabetics for taking the amounts of insulin that they take. It really makes me feel like a freak to hear the comparisons,because I take fairly "larger" amounts of Lantus and novolog than a lot of you. My carb/ratio is about like anthills,maybe even higher. After having the big"D" for 40 years,I am more resistant than some of you. How lucky you are to be able to make remarks like "WHOAAAA!!!!!" I'd never take that much!" or things like that. It isn't fair for some to say those things.,that really hurts,ya know? I mean if thats what we take ,then thats what we take. Sorry if we're not in the same league as you ,wait until you've had it for forty years.

[Russell A.]

Yup, I've been known to dump an occasional 20-30 units on a wild meal. I find that anything I eat above 100 grams of carbs, I have to wing it and hit for the fence with insulin. Usaully end up low within a couple of hours! LOL


Russell

[strack350]

my highest bolus was 3 weeks ago when I was on vacation "buffet time" oh yeah. I bolused 37units Humalog, tested every hour after that until bed and never went above 173. I feel I did good, My ratio is 10:1 but I did have some disgustingly sweet deserts:D and it was worth it. I feel we need to splurge now and then;)

[Subby]

Hello! I'm brand new (diagnosed this month - this is my first post), but this topic is of particular interest to me...

I haven't yet even met with a dietician or whatever to get my Insulin:Carb ratio, but my Dr. says I'm pretty sensitive to insulin. I've been watching what I eat and have cut out excessive carbs. So far, so good - I feel like I'm getting things under control quickly.

But, like delph, I have the appetite of a horse and usually can eat anything I want and stay thin... so, I'd like to be eating more in general.

More importantly, in 1.5 months, I am EXPECTED to bake my best friend's WEDDING CAKE! God knows, I will want to eat it too, and all of the other lovely food at the wedding.

So my question is, since everyone seems to be terrified of extreme lows, is it better to err on the side of having high-ish BG when using a big dosage of bolus? And then, after testing like crazy, take more bolus if you are riding quite high?

What are the dangers more specifically? I'm worried that I'll still be a relatively new diabetic at my friend's wedding, but I certainly want to enjoy it!

Hi there.

On one level it's pretty simple. The quality and length of your life depends on maintaining as good BG levels as possible. You should not take random postings on a forum about the extremes that people have experienced over the years, to indicate what's acceptable or not.

It is completely up to you what standard you set for yourself, and to find out what works for you. When it comes to diabetes, most people will look at what kind of BG results they get on a day to day basis, and your A1c, in forming an idea how well they are doing, BG wise.

There is huge variation between how carb and insulin work for people. In this time of finding your feet, I recommend you put aside any indications about other people's bodies, except to inform you of possibilities, and simply work to what you find works for your body. Again, the standard of how much you keep your BG to the norm, and what is required to do so as far as insulin approaches and diet approaches, is very much up to you.

We're always here to discuss specifics or approaches.

[Delphinus]

What are the dangers more specifically? I'm worried that I'll still be a relatively new diabetic at my friend's wedding, but I certainly want to enjoy it!

My advice to you, is to live your life.

Don't let diabetes and insulin control you so much your life is a bore, or nothing but calculations and stress. In my opinion it is pointless to be a carb/insulin Nazi, if it only saves you a few years of life, but robs you of enjoying the life you had.

Be mindful of what(Since you are newly dx'd, you don't want to be too carefree about it just yet.) and how much you are eating, but don't obsess over it, when at the wedding, cover the carbs, and my suggestion would be to pig out. You only live once, and eating "out of bounds" the odd time is good for the soul.

This is not responsible advice, but in the end, it's up to you how you want to roll.

[SammyIamToday]

I've never bolused more than 8 units since using Novolog. I can't seem to eat enough carbs to stay out of hypo if I use that many. I can spike it for the short term, but I'll go hypo after an hour with that much. Granted, I'm still honeymooning though, so I'm sure that will wear off soon enough.

[e||ement]

I have to say that I never thought I'd hear from other diabetics slamming some of the other diabetics for taking the amounts of insulin that they take. It really makes me feel like a freak to hear the comparisons,because I take fairly "larger" amounts of Lantus and novolog than a lot of you. My carb/ratio is about like anthills,maybe even higher. After having the big"D" for 40 years,I am more resistant than some of you. How lucky you are to be able to make remarks like "WHOAAAA!!!!!" I'd never take that much!" or things like that. It isn't fair for some to say those things.,that really hurts,ya know? I mean if thats what we take ,then thats what we take. Sorry if we're not in the same league as you ,wait until you've had it for forty years.

ooops. sorry if my response came off that way, that's not at all how i intended it. i am fairly new to D and realize that my insulin needs are not the same as someone who has managed D for many years and many decades. and i also realize that will change.

my apologies if that offended you; however, all i meant by it was that in my own little D world, 3 units is a lot...

[rak1978]

I have to say that I never thought I'd hear from other diabetics slamming some of the other diabetics for taking the amounts of insulin that they take. It really makes me feel like a freak to hear the comparisons,because I take fairly "larger" amounts of Lantus and novolog than a lot of you. My carb/ratio is about like anthills,maybe even higher. After having the big"D" for 40 years,I am more resistant than some of you. How lucky you are to be able to make remarks like "WHOAAAA!!!!!" I'd never take that much!" or things like that. It isn't fair for some to say those things.,that really hurts,ya know? I mean if thats what we take ,then thats what we take. Sorry if we're not in the same league as you ,wait until you've had it for forty years.

Andypoo,
If you're referring to my posts, I am TRUELY sorry if I offended you or anyone else for that matter! I guess the downfall of posting, e-mailing, writing, etc... is that you can't hear someone's tone. My reply to Delph was in jest. I thought he was making a light hearted conversation. Maybe I was wrong. Sorry! I do not at all or would not criticize anyone for taking a large bolus if that's what their body required. I was just shocked because FOR ME, those numbers would put me under for sure. I am a fairly new diabetic, so I still have a pretty low insulin/carb ratio. I'm also new to the forum, so this is the first I've heard of people taking such large numbers. When I said that I wouldn't do that, it's because I would be too afraid to. I don't have the experience to know my limits yet. It was not to criticize someone who has and does know their limits.
If that's what you need to take, then by all means, take it!
We're all just trying to find a balance for our own bodies.
I think the comparing of numbers is just out of interest, not competition! Why would we compete for who had the highest or lowest bolus? No need. We're all struggling with the same disease. It's just conversation.
Sorry again if I offended you!

Rachel

[Subby]

Hi Subby:

Does your insulin use stretch back to the days of one-shot per day of cloudy insulin (Lente or NPH)? There was no way you could bolus, let alone bolus extra.

Actually, about the first thing I was told after I walked in the ER with a BG of >600/33, was that I would be given a strict diet and a fixed daily dose of insulin and that under NO CIRCUMSTANCES WHATSOEVER should I EVER EVER think about increasing my insulin in order to eat more! It was drummed into me that only BAD DIABETICS did this (and that the wages of sin, if not death, were most certainly amputation and blindness).

Hey Joel, no it was straight onto MDI with Actrapid and NHP for me. It sounds like I missed out on a whole different world of fun before that :) But I certainly wasn't meant to take extra (a correction), it was very rigid. I ended up just "evolving" towards corrections and making more flexible dosing decisions myself, over the first few years I guess. At some stage I told an endo - again - and instead of lecture me he shrugged noncommittally and that was that - it was official, my adjustments and corrections were suddenly legal :D

[poodlebone]

I think the most I have ever taken at once was 15 units of Humalog for a large restaurant pasta meal. I find that once I hit a certain number of carbs my usual ratios no longer apply. If I would normally need 1:22 for dinner and ate 66g of carbs for 3 units, it would work. If I have a carb fest and eat 220 grams of carbs I would need more than the 10 units my ratio calls for.

[jenb]

The most I've done is 8 units of Novolog. It was at a dinner party and I did 5 shots (small doses) over about 5 1/2 hours. Did have to add a 1 unit bolus at 4:00 a.m. - all the fat from dinner kicked in at about the time my liver finally got over the wine component :D.

Jen

[andypoo]

ooops. sorry if my response came off that way, that's not at all how i intended it. i am fairly new to D and realize that my insulin needs are not the same as someone who has managed D for many years and many decades. and i also realize that will change.

my apologies if that offended you; however, all i meant by it was that in my own little D world, 3 units is a lot...


Apology accepted!, I apologize also for jumping to that conclusion,I guess I can get a little cranky at my old age,lol!
I get sensitive to this topic sometimes and I should know better than to get upset. Please,again, I'm sorry for flying off like that. and by all means keep posting and saying exactly how you feel about things,I responded sooner than I should've.

Andypoo,
If you're referring to my posts, I am TRUELY sorry if I offended you or anyone else for that matter! I guess the downfall of posting, e-mailing, writing, etc... is that you can't hear someone's tone. My reply to Delph was in jest. I thought he was making a light hearted conversation. Maybe I was wrong. Sorry! I do not at all or would not criticize anyone for taking a large bolus if that's what their body required. I was just shocked because FOR ME, those numbers would put me under for sure. I am a fairly new diabetic, so I still have a pretty low insulin/carb ratio. I'm also new to the forum, so this is the first I've heard of people taking such large numbers. When I said that I wouldn't do that, it's because I would be too afraid to. I don't have the experience to know my limits yet. It was not to criticize someone who has and does know their limits.
If that's what you need to take, then by all means, take it!
We're all just trying to find a balance for our own bodies.
I think the comparing of numbers is just out of interest, not competition! Why would we compete for who had the highest or lowest bolus? No need. We're all struggling with the same disease. It's just conversation.
Sorry again if I offended you!

Rachel
Again, I apologise also for being so testy. I don't want to scare anyone off of here because this is a great place to be. I have said things on here also that I didn't realize that I hurt someone's feelings,and certainly was the furthest thing from my mind to hurt anyone. thank you for making me realise that there are very kindhearted people on this forum.

[diabeticdoc]

One other danger to be aware of when bolusing so many units at one time (this happened to me). Soon after I was diagnosed, I was at my mom's place eating dinner. Dessert came up- cheesecake, raspberry topping, ice cream, etc, etc... So I bolus enough to cover and dive right in. Then, 15 minutes later my mom is like "oh and since you have diabetes now I made this whole thing low carb and with splenda and etc, etc". Yikes! I had to go grab some OJ and chug enough to make up the difference. You can imagine what would happen with 40 or 50 units if you all of the sudden found out that what you thought you ate wasn't really what you ate.

[thesaber2000]

i think the most i have taken is 12 i think, i ate 2 huge plate FULLS of pasta. this was back when i was just diagnosed.
id probally have to take alot more now.

the one thing i worry about is that if i do somthing like that i cant take my insulin right away, cause it will work faster than i would asorb the carbs, so i usally take my insulin 15 mins after i eat. depending of course how much i eat and what my bg is when i eat

[acstokes]

Once I bolused 25 units of Humolog. My ratio is 6:1 so that equates to about 150 carbs at one meal.

[CarlyD]

I've found I can't take more than 25u before crashing (1:7), which usually includes a correction and cake :) I can't take more than that no matter how much I eat.

[UpNorth]

I can't remember exactly how many units i've taken in one go. But 20-30 units for one meal has happened more than once;) and one unit normally covers 10g of carbs for me. You do the maths:o I'm definitely no low carber... A normal lunch for me at work means about 10 units and that is after lowering my dose with a couple of units due to my physical job.

[Delphinus]

As a bit of a follow up.

I have yet to bolus more then seven units of rapids.

See, I eat a lot, but as some other people do here, I am constantly grazing. :D

I have to eat every two hours. I am always hungry, and have been my whole life, pre-dx as well of course, and have never had weight issues. A bit of a battle of the bulge, about it.

[mjshaw]

The most that I can remember in my relatively short d-life was 30 units. This was when my I:C ratio was 1:15. Since I have had to drop that ratio to 1:10 I have had to bolus 20 units. Both times were for three cups of brown rice, one time with hamburger, the other time with ground turkey and a little spaghetti sauce. My pump is set up for max bolus of 15 units, so I had to do 15 and then turn around and do 5. I stayed on target the entire time, and the food did not spike me. Yeah!

[networkguy]

Just to give perspective...I use an average of 50-70u/day on pump, and about 40% basal/60% bolus. That said, the highest I bolused while on MDI was 40u lol. I had been out all day and hadnt eaten much, and everyone wanted to go to the buffet. I struggled with how to handle it, and said "screw it" and shot up. My goal was to end up under 250 in 6 hours and correct after that, and thats all lol. I ended up dropping to about 65 5 hours later. Glass of OJ and I was set.

[howdysf]

wow, you guys are hardcore.. the most I've ever done is probably about 18 units (at one time)... though, probably a few times I've bolused about 14, then an hour or two later, done another 6 or so...

[networkguy]

wow, you guys are hardcore.. the most I've ever done is probably about 18 units (at one time)... though, probably a few times I've bolused about 14, then an hour or two later, done another 6 or so...

Well, us vets have alot of years of resistance built up lol (43 in my case). I see alot of type 1's who take like 4u or something for a bowl of pasta and makes me think 1? nah. 2? prolly. But what do I know. hehe

[KentT]

My insulin needs are very modest. A high bolus for me is 9 units. Usually accompanied by a crash and rebound in pre-pump days. Nowadays insulin boluses are 3-6 units tops and spread out due to my cranky partially paralysed stomach muscles over 4 hours. Gastroparesis and spina bifida are common with me.

[KCP]

The most ive ever given was 25 units.. now a days that would crash me something chronic!

Now, the most ive given was 6 units and my BS were at 31.1

[TomK]

In my 25+ years as a type1, I'm starting to figure out how much my BG level affects insulin efficacy.
Many times I find myself chasing a high blood sugar level with multiple shot of 5 or 6 units of Humalog only to see it stay hovering around 12 or 13 (mmol/dL). That kind of dose when I'm normal range, like 5ish say before dinner, drop me almost instaneously if I don't eat right away.

I realize there are tons of factors like physical activity in the past few hours and stomach contents, but I can't help but feel that a high BG messes with how well my insulin works.

-Tom

[lark 27]

My daily average is 50-60 units of Humalog. Carb ratios are 1:8 breakfast, 1:10 lunch; 1:15 dinner. I've got my pump set at a max of 12.7 (just because 27 is my favorite number). I've only been pumping for 7 months, but I have yet to reach that max. I have a fear (healthy fear I think) of hypoglycemia, so even when I'm hitting the proverbial buffet (which I really try not to do). I will only bolus for what I'm eating when I eat it. Example 6 units for estimated 60 carbs on plate one at dinner plus being a bit high at say 170. Then I decide to have seconds and this might be about 15 minutes later, and I'll have 3 units for 45 carbs. Let's say I then decide to indulge in dessert (again try not to.....) and I estimate 75 carbs. At this point I'll definitely also be checking my BG (perhaps I'll try to wait a little for desert so I eat less and so I can see how the insulin is acting). If I'm pretty high (180), I'll give a full bolus for the carbs, but if not (say 100-140) I'll dual wave with most insulin being on the wave since it's going to take my stomach some time to get this food processed. If I'm lowish (80-100), I'll square wave and reduce the dosage... As always checking blood sugar several times over the next couple hours (with my meter even though I have a monitoring system) and adjusting as needed. So, in the example above I might be taking 14-17 units, but it never gets close to a high dose at a time. This came in pretty handy the other day at PF Changs. (although it wasn't a buffet it was a prixe fixe menu with app, soup, entree, and small dessert). I bolused in anticipation of app and soup and then we encountered service from ****. (40 minutes for soup). I was just about to go to the bar for some OJ when food finally came and I was able to hold off on the entree bolus since the early bolus was in full effect.

Good luck and safe eating,

[tanyatype1]

A month ago I had a bent cannula and my bg went off the charts. Over the course of a few horribly sick hours, I ended up taking 40 units just to bring me back to normal. Definately scary,...I'm not used to taking large amounts of insulin. I feel lucky that my husband was here pushing me to keep taking more, because if he hadn't, I would have been much more reserved and would have ended up throwing up for a lot more hours. He was with me the whole time and helped me to check my bg every half hour to make sure I didn't crash. I was scared of stacking so many boluses, but when your bg is really high it takes a lot more insulin than usual to bring you down again.

[Jonathan_R]

I just did 29 units. Of that, 25 units was to correct. I am still no where near target yet. I will deal with that in an hour.