Highest Bolus Dose?

[Tom1982]

What’s the highest bolus dose anyone has had? Still get a bit edgy if the daughter has a 9 unit monster!

 

[John Gray]

I wouldn't worry. Mine are higher than that.
But who's counting? Everyone is different...

 

[Tom1982]

I wouldn't worry. Mine are higher than that.
But who's counting? Everyone is different...

Yeah she certainly loves all the food she shouldn’t! But I’m just curious. Wonder if anyone has 20s and 30s?

 

[Satan’s little helper]

What’s the highest bolus dose anyone has had? Still get a bit edgy if the daughter has a 9 unit monster!

Hello, if the dose is appropriate for what she is consuming or factoring in a correction dose? Then it’s not that easy to compare to others.

 

[Tom1982]

Hello, if the dose is appropriate for what she is consuming or factoring in a correction dose? Then it’s not that easy to compare to others.

Yeah I know, I’m just curious. As you get older and fancy a beer or a takeaway is it a regular 20 or 30 units? Have some been up more than that?

 

[Thebearcametoo]

Some of my teen’s can be in the high 20s especially if he’s having a big meal. I don’t think he’s bolused over 30. Once she hits puberty your daughter’s dose will go up a lot for a while but will then level off again

 

[Satan’s little helper]

Yeah I know, I’m just curious. As you get older and fancy a beer or a takeaway is it a regular 20 or 30 units? Have some been up more than that?

You’re asking the wrong guy. I moderate what I eat & wouldn’t need to dose that much?

 

[Inka]

Yeah I know, I’m just curious. As you get older and fancy a beer or a takeaway is it a regular 20 or 30 units? Have some been up more than that?

I find that there’s kind of a max amount of carbs my body can deal with in one go. I can eat more than that but it’s a faff and means split boluses, etc, so I tend to stick to a max of 100-120g per meal and that, of course, also limits my bolus size.

 

[Tom1982]

I find that there’s kind of a max amount of carbs my body can deal with in one go. I can eat more than that but it’s a faff and means split boluses, etc, so I tend to stick to a max of 100-120g per meal and that, of course, also limits my bolus size.

After a couple of years carb counting Josie’s food I honestly think (and this is purely hypothetical!) I could eat 1000g of carbs if I really had to. If I had a ratio of 10/1 could I even give a dose of 100 units??? And yes….. sadly this is the kind of nonsense that fills my Saturday nights now

 

[Inka]

After a couple of years carb counting Josie’s food I honestly think (and this is purely hypothetical!) I could eat 1000g of carbs if I really had to. If I had a ratio of 10/1 could I even give a dose of 100 units??? And yes….. sadly this is the kind of nonsense that fills my Saturday nights now

It’s not to do with the ability to pack away carbs. I could do that too in theory if I didn’t have Type 1. It’s that the body can’t cope very well with a very large amount of carbs without a functioning pancreas. Because of the quantity of carbs, digestion/glucose release/whatever is slower and less predictable so it’s very hard to deal with that when you’re having to inject insulin.

 

[Tdm]

On my daphne course they suggested splitting the injection if it got bigger than around...14, i think?
I tend to rarely get into double figures, myself, but as someone said, you need what you need

 

[rebrascora]

I split anything over 10units, so this morning I woke up with really high levels.... no idea why, but that is 2 nights in a row where levels have gone into orbit whilst I slept, despite a reasonable basal dose..... Anyway, I decided 12 units was going to be needed, what with the large correction to bring me down plus my breakfast bolus and a couple of units for FOTF, so I jabbed 6 units into one site of my tummy and another 6 in the other side. You get better absorption from 2 separate sites I think. I do the same with my morning basal which is 22 units of Levemir, so I put 11u into one buttock and the other 11 into the other. I think apart from the time I accidentally injected 24 units of Fiasp instead of Levemir one morning when I didn't realise I had the wrong pen in my hand, 12 is probably the biggest I have had at one go.... but Chinese banquets need more than 12 although that is over several hours and several injections.
I used to eat mega amounts of carbs pre diagnosis, including multipacks of Snickers, but all that had to stop and I thank the big D for giving me the kick up the backside to deal with my sugar addiction.

 

[Inka]

Both splits are slightly different - the split boluses needed over time to deal with a great whack of carbs in one go, and secondly, the splitting of the bolus within the same few minutes because too much insulin in one injection site doesn’t absorb as well as that same amount in two sites.

When I mentioned splitting to @Tom1982 I meant the first type: having to do multiple injections over a few hours to deal with the slower and more unpredictable release of a large amount of carbs in one meal 🙂

 

[everydayupsanddowns]

I’m another who breaks larger doses into smaller chunks to improve absorption (or with a delay to extend the insulin action for a larger / more slowly absorbed meal.

Big doses all in one go seemed to behave more erratically for me.

These days it’s more about dual wave boluses, of course… but even a fairly short dual/extended wave seems to help bigger doses, somehow or other!

 

[helli]

My largest single bolus is about 5 units
This is a combination of insulin sensitivity and finding larger doses needing to be split to aid absorption and reduce the risk of occlusions on my pump.
So, I may dial up more than 5u but will then spread it over an hour or so
When eating pizza, I have a whole homemade thin crust with a beer and bolus 10u over 4 hours.

 

[Inka]

Gary Scheiner mentioned a max amount of carbs per meal, didn’t he? I thought he did but now I can’t find it.

 

[everydayupsanddowns]

Gary Scheiner mentioned a max amount of carbs per meal, didn’t he? I thought he did but now I can’t find it.

Not sure! I think Bernstein suggested splitting anything over about 7u (which seems a bit low?). And I think John Walsh suggests that you are likely to need a different stronger ratio roughly when the grams of carbs in your meal exceeds you weight in Kilos?

 

[eggyg]

My highest doses are usually for breakfast as I have mega insulin resistance at that time of day. I can wait up to an hour after bolusing before my BGs have dropped low enough to eat, sometimes I have to have seven units for one slice of toast and a scrapping of Whole Earth peanut butter! I had 12 units today for one small, mostly meat, Cumberland sausage, one slice of bacon, half a slice of haggis, one fried egg, small tattie scone and one slice of toast. If I had that for my evening meal I would probably only need about 5 or 5.5 units. I won’t eat lunch though as that will last me until teatime. So basically it’s what you need when you need it. Plus I’m much older than your daughter. 😉

 

[Inka]

Not sure! I think Bernstein suggested splitting anything over about 7u (which seems a bit low?). And I think John Walsh suggests that you are likely to need a different stronger ratio roughly when the grams of carbs in your meal exceeds you weight in Kilos?

I’ve confused myself now That John Walsh thing is interesting and I’d forgotten that, but I swear someone said about the max carbs per meal as I remember thinking my max was about 120g which was less than the max given, but I’m quite small so that made sense.

I’ll consult my few remaining brain cells and see if I can remember!

 

[nonethewiser]

Consultant many years ago said to split larger insulin doses to get better absorption, he was so right as it did help matters.

Before switch to pump think basal dose was 18u so 9u would go in one butt check 9u in other.

Usually if carb count is high usually spit dose anyway as meal will likely contain fat such as cheese oils & or higher percentage of meat, so to keep bg in range find prebolus & extended bolus works best.