Before or After? When to Bolus

One of my classes met at the new Union South today instead of regularly scheduled classroom nonsense.

We toured the whole building. It was beautiful, spacious, inviting blah blah blah. It has a bowling alley.


Maybe I should say that again: it has a bowling alley.

I frequently get made fun of for saying things are “the best ever” or that a day is “the best day of my life” when clearly, playing Wii for an hour with my classmates will not be the best day of my life in the long run. But, at that moment I truly feel that it is the best time I’ve had in a while.

That may seem like a little aside, but the point is that I’m very excitable. Today was no exception.

I was excited because I got to interview Warren Faidley yesterday and am expecting to interview another Storm Chaser today, I was having class outside of the classroom, I was going to be with people I enjoy, and I really wanted to BOWL.

Because of my excitable nature, I was pretty much bouncing off the walls as it was… and then I saw the ice cream. I had just eaten a full meal, had dessert, and was NOT hungry. But I was excited, and ice cream was there.

Separately those two things are just fine (excitability and ice cream) but put together can lead to issues. My combo led to issues.

Any endocrinologist that I have ever had and I have gotten into arguments about WHEN to take a bolus (shot of fast acting insulin). Their camp is BEFORE I eat. This gives the insulin a chance to start working on the food as I eat it and it lessens the chance that I may forget to TAKE my insulin.

My camp, who used to get the stomach flu every week and would be forced to eat something even when she was vomiting to avoid a low blood sugar HATES those low blood sugars (and is not always great at counting carbs). To combat the possible low, I always wait until AFTER I eat to take insulin so “thine eyes are bigger than thy stomach” thing won’t come back to bite me in the ass. (For you non-TODs that means that I won’t expect myself to eat 60 carbs and take insulin for 60 carbs, but really only be able to eat 30 therefore causing a tremendous low)

BUT the endos are right, I DO forget to take my insulin. This is only in PART because of what I mentioned earlier about weight and mostly because I just forget.

Now, couple that with the uber-excitement I feel over the possibility of bowling and you’ve got a diabetic who has loaded up on carbs and completely forgotten to take any insulin.

At first this is fine, I just get a tad hyper, but as time goes on my eyes get glassy and I start to get listless. Not exactly the bucket of fun I was at the beginning of the tour. If I left this go, it could turn into Diabetic Ketoacidosis (DKA) which could actually kill me. So, funny at first, very sad at the end.

My advice to all TODs and TOD parents, encourage insulin to be taken BEFORE meals. Yes, low blood sugars suck to high heaven, but they’re better than ending up in the hospital (twice) because you let your blood sugars run high and your body couldn’t keep up.



Filed under Confessions, How to: get diabetes.

3 responses to “Before or After? When to Bolus

  1. Trudy

    Good advice, Abby! That was a strike!

  2. rof

    So early learned and so hard to apply. What a great lesson to all that they are just one step away from…

  3. Pingback: Eyes, meet Stomach. Part Duex | diabetiquette

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