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I dont understand insulin stacking

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bennyg70

bennyg70

Well-Known Member
Relationship to Diabetes
Type 1
I understand that if you lose track of the dose youve taken then it can all add up too one almighty low say for example trying to correct afer an hour and a half from you last injection in accordence with your current reading, when you potentially still have 50% on board. However if you always keep track of you insulin on board in one form or another then why is it not safe.

Why is square wave dual wave and split injections not insulin stacking, Is drip feeding fast acting as your basal in a pump not insulin stacking?

Sorry if im been dumb, its just a concept ive never really understood and would like to understand further!
 
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Sounds like you've got it spot on Benny. Or at least... your understanding matches mine 😉

The only problem with 'stacking' as far as I can see is losing track of how much IOB, and where different bits of it are in their own rise-and-fall activity curves.

Lots of people think that their insulin lasts 2 hours, but this seems *far* too short for me pharmacologically speaking. the 4-5 hours suggested by manufacturers are more based on their research/testing of insulin present in blood samples. After 2 hours action may seem to drop off in me, but I see that as being more that it is matching ongoing food digestion rather than that the insulin has finished.

If you only ever take insulin 5 hours apart you won't get 2 lots of action one on top of another, but sometimes that's exactly what you *do* want!
 
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Can't answer your questionsbecause I don't know either. Just wanted to say you're not dumb, you are trying to understand.
 
That's pretty much my understanding too, and I agree that if you're keeping account of your IOB it should be OK to "stack". If I know I still have active insulin and I want to eat something else, I avoid testing so I'm not tempted to "correct" something that doesn't need correcting! I just inject for the extra I'm eating. Right or Wrong that's how I manage 🙂
 
Good.. I thought I was missing something important! Seems I manage stacking and IOB in a similar way!

Phew,
 
Pretty much my understanding of it also.........

I pictured there being several different peaks going on and so each one would enhance the other, like ripples in a pond.......but it would have to many doses within a 4-5 hour period.....which is rare for me at least......


Although i have found when I have been snack/grazing small amounts of carbs my blood sugar stays pretty steady....
 
novorapidboi26 said:
Pretty much my understanding of it also.........

I pictured there being several different peaks going on and so each one would enhance the other, like ripples in a pond.......but it would have to many doses within a 4-5 hour period.....which is rare for me at least......


Although i have found when I have been snack/grazing small amounts of carbs my blood sugar stays pretty steady....
Click to expand...

Yeh Im with you. I cant do that sort of grazing though, I think I must be pretty carb and insulin sensitive. A 5g snack is all i can get away with between meals, and I still expect that to shift my bloods 1.5mmol. Any think higher Ill consider a small dose for.
 
Ditto Benny. If it gets near the 10g mark, I do have to bolus. But of course on a pump you can cheat and put on a slightly increased basal for half an hour or summat.

The difference square wave and all that jazz makes is you don't deliver the insulin a a great lump. You drip it in. And I agree if you delivered say 10u over 5 hours, the last drip would still be active some 9 hours after you started the thing. But - it's only a drip and not the whole 10u tailing off all at the same time because all the drips before the 5 hour point will already have tailed off by the time you get to 9 hrs, won't they? and will therefore have far less effect, at that point.
 
I'm trying to get my head around insulin stacking as well.

I found this when searching...
http://www.diabetesnet.com/about-diabetes/insulin/insulin-action-time/duration-insulin-action

Written by John Walsh who co-wrote a very well recommended book called Pumping Insulin (if anyone's interested).

I think the article explains stacking very clearly. however, i'm still left confused about some of it, because if you take a dose for a certain amount of carbs, then have more carbs later, do you not still need a certain dose for those carbs? I understand it adds to existing active insulin, but that insulin is there for the original carbs surely? So in my mind, this adds up to carbs uncovered by insulin the second time round because you've subtracted insulin for active insulin that's already "spoken for"..... that's what i can't quite get my head around.

I've been having hypo issues, and my consultant yesterday suggested that I now start using the bolus wizard on my Animas pump (after 4 years of not using the wizard!). and I have to say, although speaking early.... seems to be working...🙄
 
Stuboy said:
I'm trying to get my head around insulin stacking as well.

I found this when searching...
http://www.diabetesnet.com/about-diabetes/insulin/insulin-action-time/duration-insulin-action

Written by John Walsh who co-wrote a very well recommended book called Pumping Insulin (if anyone's interested).

I think the article explains stacking very clearly. however, i'm still left confused about some of it, because if you take a dose for a certain amount of carbs, then have more carbs later, do you not still need a certain dose for those carbs? I understand it adds to existing active insulin, but that insulin is there for the original carbs surely? So in my mind, this adds up to carbs uncovered by insulin the second time round because you've subtracted insulin for active insulin that's already "spoken for"..... that's what i can't quite get my head around.

I've been having hypo issues, and my consultant yesterday suggested that I now start using the bolus wizard on my Animas pump (after 4 years of not using the wizard!). and I have to say, although speaking early.... seems to be working...🙄
Click to expand...


Hi Stuboy

Welcome to the forum!

Lots of us on pumps swear by 'Pumping Insulin' too. It's known as the pumpers bible with good reason!

Well done on starting to use the wizard on your pump - it should allow you much more fine-grained dose control once you have got the settings tweaked right as it will allow very tiny ratio alterations and the pump can micro-correct (+ or -) based on the ideal range you have set for different times of day.

Have you done much in the way of basal testing yet? Highly recommended if you are wanting to get your pump to work harder for you.
 
Stuboy said:
I'm trying to get my head around insulin stacking as well.

I found this when searching...
http://www.diabetesnet.com/about-diabetes/insulin/insulin-action-time/duration-insulin-action

Written by John Walsh who co-wrote a very well recommended book called Pumping Insulin (if anyone's interested).

I think the article explains stacking very clearly. however, i'm still left confused about some of it, because if you take a dose for a certain amount of carbs, then have more carbs later, do you not still need a certain dose for those carbs? I understand it adds to existing active insulin, but that insulin is there for the original carbs surely? So in my mind, this adds up to carbs uncovered by insulin the second time round because you've subtracted insulin for active insulin that's already "spoken for"..... that's what i can't quite get my head around.
Click to expand...

I agree completely with this. In my mind the only insulin stacking I worry about is corrections. If I'm taking insulin for carbs and my ratio is right, then if I have more carbs, I take more insulin. I reckon I'm stacking carbs, so I need to match the insulin to the carbs!
 
Nothings exact being T1. I dont think too hard about it all 😉
 
robofski said:
That's pretty much my understanding too, and I agree that if you're keeping account of your IOB it should be OK to "stack". If I know I still have active insulin and I want to eat something else, I avoid testing so I'm not tempted to "correct" something that doesn't need correcting! I just inject for the extra I'm eating. Right or Wrong that's how I manage 🙂
Click to expand...

Thats what I find works too Not always correctly but it makes sense to me to do it that way
 
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