We’ve all been there with the Rage Bolus. You know – the boluses you stack on top of one another when you have a stubborn high that just wont. Come. Down. Until it totally comes down – usually all at once when all of those boluses catch up with each other, sending you reeling into a down-the-whole-box-of-Girl-Scout-cookies type of low. We’ve all done it before – but have you guys met the Rage Basal yet? I did the other night. And it’s a beast.
I’ve blogged several times before about some issues I’ve been having with going high overnight. My husband and I tend to eat late-ish these days. Between both of our busy jobs and our spoiled little doggy who gets ample park time every day of the week, we often don’t have dinner until about 9pm. We cook low carb, but tend to supplement with cheeses and sauces, which, combined with proteins, can break down hours later and cause a rise in my BGs sometime after midnight.
Last Wednesday, I woke up with a blood sugar of 253mg/dL. I bolused a half unit, and went to an hour-long workout class, which did nothing to assuage the high. Suffice it to say I spent the whole day above 300mg/dL despite bolusing and slashing carbs which was a total downer. Combine this with the fact that I’ve been struggling with overnight highs at least five times a week and I decided to take action. A lot of action. Like raising my basals a full .6 of a unit per hour from midnight to 6am.
I’m always shocked by how quickly basal units can add up. .6 of a unit just seems like…nothing….Until you think about the fact that over the course of six hours, that’s almost four units, and each of those is contributing to active insulin on board. Increasing basals, even in what seems like small increments, can add up very quickly. Which is exactly what happened around 5am the next morning when I woke up in a pool of sweat, dizzy, lightheaded, and with my CGM blaring from the side table that I was under 55mg/dL. I stumbled to the fridge for some cake frosting and fixed the immediate issue, but I had quite the “low hangover” the next day. Headache, tired, and cranky. Lovely. And well-deserved for that epic fail.
Looking back, that was a drastic measure to take with raising my basals. The next night I slashed the increase in half, and that was STILL too much. I eventually found the magic number, but it wasn’t without a few more nights of nasty lows and ruined morning running plans. The right way to do things would have been to slowly increase my basals each night by perhaps .10 units per hour until I woke up with normal fastings. But the “right way” isn’t always apparent when we’re angry and frutrated, is it?
Point taken, basal rates. I’ll cool my jets from here on out, and take that slow and steady approach. Well, at least until I’m pissed off again!