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Beware the Forgotten Bolus...

On my iPod Diabetes Pilot app, my glucose readings are color-coded so I can immediately tell how I am doing. Black readings are in the desired range, blue are lows and reds are for those infernal highs. I was in the black all of yesterday (even with Mexican for lunch!) then ended the evening and early morning in the red. Why?

I was a victim of the forgotten bolus.

What is the forgotten bolus, you ask? Actually, if you ask that you probably aren't a diabetic. All real diabetics have experienced the forgotten bolus, when they get so caught up in the moment that they actually forget that they have diabetes and neglect to bolus.* Believe it or not, it actually sometimes happens. In my case it occurred at my daughter's birthday party at her favorite restaurant, Famous Dave's BBQ.

Here's how I was attacked by the forgotten bolus. We sat down at the restaurant and I decided what to eat. I decided upon the BBQ pork sandwich, a diet Coke and some baked beans. I knew the baked beans were going to throw a complication into the mix, but I was ready for the challenge. I dutifully input all my info into my trusty little iPod app and it calculated the total to be 94 carbs. I input that into my pump and pushed the magic ACT button and it told me that I needed 13.4 units of insulin.

Because of prior experience, I knew that sometimes the food took a bit longer than expected to arrive, so I refrained from giving myself the bolus at that time. Then she opened her birthday gifts and suddenly the food arrived, we hurried to clear the table and set about enjoying a nice meal, complete with a birthday sundae for the girl.

Things went so well I didn't even notice that I had forgotten to bolus. A few hours later, about 8:30pm, I tested at a whopping 311! I figured that I had woefully underestimated the amount of BBQ sauce I had used--that or perhaps that diet Coke wasn't really a diet Coke--and gave myself the recommended 9.5 units of insulin. Two hours later: 345. 345? how could my blood sugar have gone up in two hours? Unless....

That was when I checked and realized that I had become a victim of the forgotten bolus. The insulin units I gave myself at 10:30pm wasn't enough, which prompted another round at 2:40am (238, 5.9 units) until the morning arrived at a cool blue 70. A bit lower than I would have liked, but I wasn't going to complain and could certainly use the difference to offset twelve hours or so of being too high.

Gee, if I'm already forgetting stuff at this age, what will I be like when I am really old? Like at, say, 50?!


* Not to be confused with the neglected bolus, which occurs when you know you really should bolus for something and you decline to do so out of laziness.

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