Bolus much ???

By roshy Latest Reply 2011-12-19 15:08:43 -0600
Started 2011-12-15 04:34:44 -0600

Hiya friends!

I was wondering if any pumper does the same as myself!

My endo wasnt impressed when he was going through my pump and discovered i was having up to 12 boluses per day. Even though im achieving much better numbers now then i ever was he feels like i need to change this. However i have an explaination. . . .. . .

Spending my day in college ( i could be there 9am until 6pm) i tend to snack ( and bolus) on an apple, then maybe another apple, then i might have a lunch ( salad because i im celiac and as much as id like to eat a sambo i cant or get a hot meal i just dont trust the food in the canteen), then i might have a 2 or 3 lattes and i would always bolus for them because they shoot me up. Then i will have my dinner when i get home and then maybe a small cake or biscuit around 10pm.

My issue is i now feel like i have to adjust my day to accomodate my diabetes but i thought the whole idea of a pump is so an individual could be more flexible with their eating and their day.

If im achieving better numbers then whats the problem ???

21 replies

Mickey/CCHT 2011-12-19 08:06:17 -0600 Report

Howdy roshy!! I'm not a pumper, I just love "listening" to anything you post!! Love the way you put things!!
With that said, I was just curious, does your doctor understand your lifestyle? About what you are trying to do? If he doesn't like how you are doing things, has he tried actually helping you with suggestions instead of just pointing the finger at you? I don't pretend to understand about the pump cuz I don't use it, but I do understand that your doctor is supposed to be there for you and HELP you, not chastise you. I hope you are able to find the happy medium and make things work for you. You deserve to be happy and live your life. Good luck!
Have a Blessed Holiday,

jayabee52 2011-12-19 12:22:11 -0600 Report

I learned what it meant to "strike a happy medium", mickey! When the fortune teller gives you your fortune, and in payment you cross her palm with silver, then when she smiles you hit her. That's what it means to strike a happy medium. (I know BAD BAD BAD!)

Mickey/CCHT 2011-12-19 13:21:02 -0600 Report

OMG!! I laughed rite out loud!! HAHA…might have been bad, but it sure was funny!
Thanks, I needed that!!

jayabee52 2011-12-19 13:23:37 -0600 Report

I have a lot of "junk" sayings stored up in my brain. All I need is the right word or phrase to trigger its memory.

Caroltoo 2011-12-19 15:08:43 -0600 Report

They are funny ones! I'm with Mickey, I laughed so loud I woke the cat up!! He's still watching me.

Old-n-Grey-n-Wiser 2011-12-15 20:39:43 -0600 Report

Don't mean to be negative, but could he be telling you that you should not bolus to cover not following your diet.

roshy 2011-12-16 02:48:24 -0600 Report

To be honest my diet is not that bad. ok the lattes are a bit obsessive but we all have our weaknesses. (its a big improvement compared to what it used to be like). Im mainly bolusing 1 or 2 units to keep my range close to a desirable level.
Im open to all suggestions. Should i try and have a breakfast and a lunch and bolus then only??? should i take what he is saying a bit more seriously? am i only kidding myself do you reckon??

Old-n-Grey-n-Wiser 2011-12-16 07:32:45 -0600 Report

Not being in your shoes I can not and would not tell you what to or how to eat, my thought was maybe he was saying not to use the bolus feature as a cheat aid, but as a tool to better manage your B/G. I know we all cheat, I do with my pens, I take an extra unit if I have juice with breakfast. As I said I wasn't trying to be negative, just a thought from my side of the of the table. Now I on my way to your profile to ask you to be one of my friends!!

roshy 2011-12-16 18:19:25 -0600 Report

Thanks for your reply. i felt like he was viewing it the same way, as if i was allowing myself to cheat but i dont view it that way. if i eat an apple i bolus , or if i have a latte i bolus. I do this so my sugars dont rise. if my a1c is better then it ever was then i would not be better off doing what is working for me? does it really matter how many times you bolus in a day?

Young1s 2011-12-15 21:14:12 -0600 Report

That is a very good question Tom. It is important to eat healthy regardless of her class schedule. But, besides the lattes what is concerning you about her diet? Is it what she eats, when, both? Or is it something else?

Old-n-Grey-n-Wiser 2011-12-16 09:49:04 -0600 Report

PC, see my reply back to Roshy.

Young1s 2011-12-16 10:57:56 -0600 Report

I did see that Tom, thanks. I don't think you were being negative at all but instead wanted to know if Roisen was skirting around "doing the right thing". I actually get what you're saying but I was just wondering if you saw something lacking in her diet. Because, after I saw your reply, I reread her opening topic and saw that what she says she's eating may not have enough sustinance for what she's trying to accomplish during her day. As I said to Roisen below, while it's important to complete her education, it shouldn't be done at the expense of her health. But you are right, we can't presume to think we know what is best for anyone else. Roshy will have to decide for herself what amount of weight her doctor's advice will hold. By the way, I do the extra unit in my pen thing also but I try not to make it a habit.

Type1Lou 2011-12-15 15:42:29 -0600 Report

Dear Roisen, I just changed endo and asked him a question similar to what you are doing. Since we are still trying to get the correct basal and bolus pump settings for me (even though I've been pumping now since mid-August), he felt that constantly bolusing, either for snacks or to get down higher than desired BG's, would obscure how the current settings in your pump are (or aren't) working. He/she may just want to be sure that the current settings don't require adjusting. It might be worth asking him/her. I need to buy into my treatment and understand why I am asked to do things…otherwise I may be reluctant to follow directions. And you're right, the goal is better control!

roshy 2011-12-15 16:15:07 -0600 Report

Yeah i feel like that myself. I feel like im the one whose walking around with the pump attached and aslong as im reaching better bs then im doing a good job- whats the big deal!!! WELL I DIDNT FEEL THAT WAY ONCE I LEFT HIS OFFICE!!! if you have the power to do a correction bolus at the push of a buttom then why not use it??? when i was on injections there would be no way in hell id inject everytime i had a latte or an apple !! so i just feel like sayin " give me a bleedin break with your judgmental eyes and tut tutin!!! its not as easy as you think it is Doctor Judgemental!! and then he wants me to speak to a diatition!!! thats not going to achieve anything!!! i know what im eating, i know how to carb count i know i know i know!!!!! I have to go back now and see the feckers in 3 months time with diary entries and carb counting lists and numbers and results and different basal rates and less boluses and im tired just thinking about it!!!! Its not very encouraging to go back when you know theyre gona be like " sure we told you about carbs and we told you about extra boluses and we told you about the benefits of exercizing and drinkig and stress on your sugars and how to treat your hypos properly .. . . . . . .. . . . . Then i know ill just get angry and eventually give up and say yeah, but its my feckin disease and im trying to fit it into my life the best way i can and you havent any idea what i get up to and actually i feel like im doing a pretty good job so there!!!! god i went in yesterday for my appointment at 3 40pm , i didnt get out until 6 : 30 pm!! i was waiting ages ( maybe thats what put me in such a bad mood) but in anyways the nurse kept comin out and making sure none of the patients were going hypo!!! and as time went by one by one the patients would leave the waiting room and return with a bottle of coke!!! talk about a inadiquite health service!!! potentially dangerous!!! but sure here!! that feels great to get off my chest!!!

Thanks for your advise Lou !! i did up my basal however i still managed 10 boluses !! its just a habit im going to try and break to gain doctors approval!!!

Type1Lou 2011-12-16 09:04:01 -0600 Report

It is difficult! Your insulin sensitivity factor plays a role in this (mine is 120) and, did you know that once you bolus, the impact of that bolus can last for 3 to 4 hours, meaning there is "active insulin" in your body when you take another bolus within that time period. Your pump should factor that in in recommending the new bolus amount…at least, mine does. The functioning human body is truly a marvelous machine and we don't fully realize it until it doesn't work right anymore! I see the pump technician in two weeks to review my settings and do more adjusting. I'm trying to "toe the line" so we can get the settings right…then I feel I'll have more leeway and greater freedom.

Young1s 2011-12-15 16:39:44 -0600 Report

WooooSaaaaw! Boy, I'm sure glad you got that out here and not at the docs office. Good for you for wanting to cut down a little but don't do it to the detriment of your health and routine. It's just as important to complete your education, as it is to maintain your D. The last place you want to do either is from a hospital bed.

roshy 2011-12-15 16:57:09 -0600 Report

yeah!!! actually!! lemme me fill you in! Only two years ago i was admitted into hospital with a bad DKA!! i was away from home, my family and friends and trying to get my degree at the same time!!! pressure puts you in a very bad place when your just trying to get to grips with what you are capable of and only beginning to understand your limitations!!! Well after i spent a week in icu i realised that i have to try my best and thats all you can realy do!! i was such a diabetic deviant up until then, i never tested, never ate properly, never took my needles, im actually quite surprized i was only admitted the one time!!! but one time was enough to make me pull up my socks!!! i suppose i only have it 8 years and coping with it through the teenage stage and early adulthood is as hard as its going to get!!! all i want is a feckin pat on the back from someone!! just a lil aknowledgement that im actually doing well and that i am trying !! i havent missed an appointment in two years!!! thats AMAZING for me!!! so i think my diabetic deliqueint days are finialy over!!! ill try and follow doctors orders the best i can but im not going to get angry with myself if i fail to follow his every direction!! its my diabetes, mine. i own it. ill listen, ill be honest when im talking to you about but its mine and ill do what i think is right!!!! and when you annoy me doctor ill show ya how emotionaly painful diabetes can be!!!

sndky 2011-12-16 23:40:25 -0600 Report

If you can, either change doctors or see if the doctor will send you to a certified diabetes educator for help in your control. The CDE has more time to work with you and can give you small goals to work for. You really need someone to give you that pat on the back or you will burn out. You cannot please that doctor no matter what you do. He/she has a very negative manner and will not change and that is not good for us. I have had 47 years experience with diabetes type 1 and negative doctors. I now have a doctor that is better but I work with a CDE who has praised me sometimes for just still being alive and then we work on tweaking the basals and boluses. The only thing I can think of that might cause a problem with frequent boluses is:
1. don't do easy boluses, do it as a carb count so the pump can help you prevent over bolusing.
2. watch out for lows with overlapping active insulin.
If your individual blood sugars are good and you are not experiencing lows, then I personnally see nothing wrong with multiple boluses.
Also, you might investigate square wave or dual wave boluses which allows you to graze without as many boluses because you take an amount of insulin and spread it over a period of time so you can eat a little here and there.
There is a lot to learn, but you have to have a positive team willing to find ways to make diabetes fit in your life not ways to fit you into diabetes.

Young1s 2011-12-15 17:55:59 -0600 Report

Well good for you…on all aspects. I feel the same way. Fortunately, I have a doctor who works with me, not only on what I need to do but what I want to do. I swear though that some doctors ought to have to live life as we do, then maybe they wouldn't be so quick to look down on our way of doing things. If what you are doing works, if you are improving upon your health and not creating a bigger problem, then I don't see what the problem is. Of course, I'm not T1 so easy for me to say but I think that makes sense for both types.

jayabee52 2011-12-15 06:19:08 -0600 Report

Howdy again from Las Vegas Roisen

I am not a pumper but I do have some general observations.

Dr is not living your life as a student. Does your endo have diabetes personally?

If not s/he really doesn't know for sure what life is like in your shoes.

Of course if you could tweak your settings where you don't have to bolus so much, thats all the better for you and your control, but if there is NO WAY that it can be further tweaked, then he can just pound it out his/her "porthole" (arse)

BTW what is a "Sambo"?

roshy 2011-12-15 10:53:58 -0600 Report

Howdy dude!! thanks for the advise! i guess it is a typical doctor thing where they take it upon themselves to jump in and advise!!! its not as simple when your studying and running to lectures! ah sure!! all you can do is nodd your head and smile!!

Thanks again! oh and a sambo is another name for a sandwich!!! : . )