#352 Defining Diabetes: Rage Bolus
Scott and Jenny Smith define diabetes terms
Defining Diabetes: Feeding Insulin. Scott and Jenny Smith, CDE define the terms that are at the center of your type 1 diabetes care.
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Scott Benner 0:00
This episode of defining diabetes is brought to you by Omni pod, the tubeless insulin pump and dexcom, makers of the dexcom g six continuous glucose monitor. Find out more at my Omni pod.com Ford slash juice box and dexcom.com Ford slash juice box on the pod we'll even send you a free no obligation demo in this episode of defining diabetes, Jenny Smith and I will be defining rage bolus. Now you know Jenny, she's an all the pro tip episodes and defining diabetes and ask Scott and Jenny. She's also a person who's been living with Type One Diabetes for over 30 years. Jenny holds a bachelor's degree in human nutrition and biology from the University of Wisconsin. She's a registered and licensed dietitian, a certified diabetes educator and a certified trainer on most makes and models of insulin pumps, and continuous glucose monitoring systems. Jenny services are for hire, check her out at integrated diabetes.com.
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Unknown Speaker 2:31
Rage Bolus.
Scott Benner 2:33
So I know that that
Jennifer Smith, CDE 2:36
hasn't rageful I mean, everybody has
Scott Benner 2:39
just like, at some point, you look at your blood sugar or someone else's blood sugar you're helping and you're like, damn it. I just don't care more, more and more. And it's always and when you rage bolus, the idea is that you know you're putting in more than you need, because you're just trying to crush the situation and you're willing to live with a low later to stop what's going on right now. Is that how you think of it?
Jennifer Smith, CDE 3:02
Oh, yes, I you know, a rage Bolus is a you know, even if it's mostly on a subconscious level, like you're not really acknowledging but you're like, I'm just take five units right now because I'm so tired of this like high blood sugar. And I know five units is too much like subconscious level. I probably only need the two units that my pump is recommending. But I just want this blood sugar down. And I'm not waiting six hours for it to happen. I'm gonna do it. Now. It's gonna work right yet.
Scott Benner 3:31
Yes, I Jenny's not wrong. I've done it. She's done it. Everybody has done it. It's actually interesting, because I've got a chance to wear a glucose monitor for a little bit. I think my body does it sometimes too. I it's very interesting. When if I eat too much simple sugar. My body appears to push back harder with insulin than it does if what I've eaten is more balanced. Yeah. Oh, it's so fascinating. But But anyway, taking me out of it and keeping it with people who are using you know, manmade insulin. When you hear someone say I rage Bolus, that's what they're talking about. They're talking about they had a high that they just couldn't do so they hit it with more insulin than they knew it needed just to make it go away. Now, there are great reasons why you could have a high stuck blood sugar. And I again think that if people listen through the pro tip episodes, they might not get into that situation is frequently I have to say that you know now for art and you know if I'm raged bolusing and now I'm making quotes, it's for like a blood sugar. That's 180 that won't move. You know, like no line. I don't rage
Jennifer Smith, CDE 4:43
Bolus is not like 10 units for that no, a lot less because you're starting at a lower high
Scott Benner 4:49
rate really crazy rage balls for us at this point would be three units now. Right But back when her blood sugar was, you know would go to 300 and sit there and I'd stare at it and be like, I don't know what's happening. But it was a lot more insulin than I was just like more and more and more. And then, you know, suddenly you're like, oh god, I gotta catch it with food. And it turns into a whole thing. But my reasoning for wanting to define it is because I think that people use the term when they use it, like in community or online. It's it's fairly accepted that this is something that has to happen. And I do believe that once in a while, you're going to need to do that. But if you're doing that constantly, again, that's a signal that something's wrong, you know, somewhere else. And so please,
Jennifer Smith, CDE 5:40
salutely, right. It's just kind of like you're bumping nudge? Yeah, if you're doing it occasionally, that's the purpose. If it comes into use every single day, there's something that's not right. It's just not right. And
Scott Benner 5:53
you and you can do something about it. I did something very uncommon for me yesterday, I saw a person in a Facebook group that was not my facebook group. And they said that they were getting low to the point of passing out every day of their life. And I just was like, I can't, I can't walk past this,
Jennifer Smith, CDE 6:13
I need to help you. I said,
Scott Benner 6:14
seriously, I can't do this. So I jumped in. I said, Look, I'm very sorry for sharing my content in here. I'm like, but this is diabetes, pro tip calm, you go listen to those episodes, this isn't gonna happen to you anymore. And so I couldn't, I couldn't leave, I just couldn't walk away for I actually felt like I saw a car accident, and the car was on fire. And I thought I might die. But I gotta try to get this person out of here. Because on social media, sharing your own content, and somebody else's place is a lot like risking your life because people can turn on you. You know, but I just couldn't, I could, I couldn't walk away from it. So I feel the same way about rage. bolusing it's, it can really be dangerous to you. And so absolutely, right. So the best way to I know I say these stupid things, but the best way to not get it you know, to not have the rage of all this is the knockout. Hi, which is like now people are like, yeah, thanks, idiot. I know, but,
Jennifer Smith, CDE 7:09
but I'd like to not get high either.
Scott Benner 7:12
Wow, do you have a don't get high episode jerk. But, but turns out I do. So, you know, I don't want to see you in that situation where you're constantly racing, but you understand what it means now. And that's the first step to enlightenment, which sounded way more high minded than I meant it to.
Jennifer Smith, CDE 7:32
We'll also talk so much about rage. bolusing and I think that there's also the opposite of it. But there's no defined like, like term for it like rage. bolusing It's not like rage carving, like when you're affecting like a low blood sugar with this amount that you know is way too much. Like even in your low brain of like fuzziness. You're like, Oh, yeah, if I eat the whole bag of taffy, that's probably gonna make me be 300 but you know what? I'm so low right now. I'm just gonna
Scott Benner 7:59
doesn't matter. And that doesn't matter. You'll get a little bonus definition here. Is that eat the kitchen?
Jennifer Smith, CDE 8:05
I that would be
Unknown Speaker 8:08
it? That's right. Yeah, the kitchen is how
Scott Benner 8:10
I hear people talking about it. Like I felt like I could have eaten everything in the kitchen. Or eat the refrigerator, fridge. The fridge, right? There's other ways to think about it. It's interesting as you describe that, I know you have to go but I really just recognized how that's one of the separation points for me not having diabetes. Like there's I have no context for that. I know what it looks like when I watch but I don't know what it feels like when it's happening. You know, I can I can describe what I see with my daughter, but I don't I imagine it's pretty frightening. And yeah, you know, in just I don't know if you imagine your blood sugar's real high, you you've been like that for hours, you're cloudy, you're moody. And you've got this, you've got this device in your hand and you're like, you know what, I just gonna give myself a lot of this right now and see what's going to be you know, feels like a feels like a jumping off a cliff and you're like, I hear water down there. I can't see it. It's probably down there. You know, you're I go. Anyway, it's, it's it's really lovely to have somebody perspective who, who genuinely has been through it. So thank you very
Unknown Speaker 9:16
much. Absolutely.
Scott Benner 9:19
Friends, it's time to get yourself a free, no obligation demo of the Omni pod sent over to the house. Okay, let's talk about the AMI pod tubeless insulin pump, besides being absolutely spectacular, is the insulin pump that my daughter who was about to turn 16 has been wearing every day since she was four years old. That's a long time. Every day on the pod comes through exactly the way we expect it to and in a myriad of ways by being unobtrusive by being tubeless by helping us with extended boluses Temp Basal rates and just being what's the word I want really just it's there, it's solid, you don't mean like it does, it does what I think it's going to do when it's going to do it, I get what I expect. And what I expect, is a quality insulin pump. That gives me the delivery and the wearability for my daughter that we need. And that means that she can stay attached to her insulin, when she's playing sports without being obtrusive, while she's taking a shower, sleeping, running around in the backyard, jumping on the trampoline, riding a bike, swimming, all of the things that your body still needs insulin for, you know, when you hear people saying, Oh, I disconnect for that? Well, they don't have insulin during that time. And that's very likely gonna cause a high blood sugar. Now, I understand that two pumps need to be disconnected sometimes. But the Omni pod never needs to be disconnected. It's tubeless. Wonderful. And you don't have to take my word for it. Because on the pod will be thrilled, happy, elated, delighted to send you a free no obligation demo that you can try it on yourself. Find out if what I just said is true. But you notice, but still try my on the pod.com Ford slash juice box. Check it out, get the demo, decide what you want to do. If you want to keep going with Omni pod, it'll be easy. And if you don't, no harm, no foul. You were just trying. That's why they call it no obligation. Now I have an obligation to tell you about the dexcom g six continuous glucose monitor. This application is both business oriented because their advertisers and moral because I think everyone should know about the dexcom g six continuous glucose monitor. Here's why. I'm gonna use an example from this morning. Arden wakes up her blood sugar is 106 I see it on her Dexcom nice and steady. I hear her moving around upstairs. No big deal. She's getting her face wash getting dressed, getting ready to actually go out right now. All of a sudden or blood sugar diagonal up starts moving up. 106 turns into 115 turns into 118 all of a sudden 125 Well, we bolus right we're trying to stop that rise before it happens. Arden's trying to go out just trying to do things she needs to eat. She doesn't need to walk into this day. 5060 7080 points higher than she needs to. But imagine had she woken up and tested her blood sugar with a meter boom, she would have saw 106 and thought, Hey, I'm doing great. And then she never would have seen anything that happened next. And then a half an hour 40 minutes later when she's sitting down to eat and tests again, you know in a world without a CGM. Who knows what she is to 25 now suddenly, the first meal is in jeopardy. It puts the rest of the day in question. You're looking at roller coaster going up and down and up and down are skipping a meal. Instead, beep beep Arden's blood sugar hits 120 she gets a little insulin right back to where we need to be ready for that meal ready for the day. That uniquely happened because Arden has a dexcom g six continuous glucose monitor. Now that's just one example. Imagine all of the other ways that technology can be used for you. Imagine that the way I found out about it wasn't because I was bugging Arden while she was getting dressed. It's because it popped up on my iPhone. Because the dexcom g six has Sharon follow. And that works on Android and iPhone. So Arden CGM told her app or app, put it up in the cloud came back down on my phone, just like that we averted a high blood sugar burden the problem at a meal. save the day Dexcom g six is going to save more than one day for you. That's for certain. Find out how you can get
at dexcom@dexcom.com forward slash juice box. There are links to Dexcom Omni pod and the other sponsors at Juicebox podcast.com. If you can't remember them, they're also right they're in the show notes of your podcast player. You can click on them right there, like click Like with your finger. very much appreciate when you support the sponsors because it supports the podcast, whether it's on the pod Dexcom the Contour Next One blood glucose meter or touched by type one. When you check out the links. You're telling those sponsors I listened to the Juicebox Podcast I heard about you there. They keep sponsoring you keep getting the podcast for free. Seems like a good deal. Alright, a little bit of music, and we're out of here. Do I have any announcements here maybe one Hold tight. You can find the rest of the defining diabetes series as well as ask Scott and Jenny and the diabetes pro tip episodes at diabetes pro tip comm you can find them too at Juicebox podcast.com But, you know, diabetes pro tips pretty easy to understand no es after the P, so just the P no si p.com diabetes pro tip.com. Also, if you have a great doctor or need one, for type one diabetes, check out juice box docs.com do cs juicebox, Doc's calm and ever growing list of Type One Diabetes healthcare professionals that listeners of the podcast have recommended. Let me give you a couple of examples. For instance, right there in Australia, Rachel Baker, Rn NCD. He does some amazing work. How about up in Canada? Dr. Jeremy Gilbert, over in Ontario, that's Toronto. You understand Toronto, Ontario, right? Like Canada does their places weird? I mean, compared to how we do it. How about Melissa and tonic? in Fairfax, Virginia. alfonzo, Armstead, Nashville, Tennessee. And many, many, many more. And people put in effort when they send in their doctors to give real examples of why, for instance, someone wrote in that Elizabeth Harris in Chapel Hill, North Carolina, she said about Elizabeth, I've worked with Dr. Harris for close to a decade and she's taking care of me through many different stages of my diabetes. From the disengaged teenager to the engaged with struggling young adult to well controlled debate goes online, check it out, juice box, Doc's calm. It's not a pay service. None of the doctors are paying me to be there. It's just me trying to take your good experiences, and putting them in one place so somebody else can get the advantage of what you've learned about your doctor. Thank you so much for listening to the podcast for sharing it for rating it on iTunes, which they don't call iTunes anymore Apple podcasts. That and I just got a great review the other day that really made me happy, and I appreciate that you guys are enjoying the show. Thanks again, keep sharing June was the most downloaded month in the history of the podcast. Not only that, but I'm talking about june of 2020. June of 2020 was for downloads 100 times greater than June of 2019. But listen to this 525 times greater than June of 2018. So we're coming up on another big milestone for the podcast. That's a try to see what I can do to celebrate 2 million downloads. I don't have any ideas yet, but I'll figure something out. I appreciate you helping me get to those downloads by listening by bingeing by sharing. They're all amazing things that you guys do it support the show. Thank you so much. I'll see you soon.
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