Insulin on Board

[digihat]

Hello Everyone

Hope your all doing well

Just a quick question regarding insulin on board I use the my life app to track and calculate my insulin dosed including how long it's been active etc works well for me

Say you just have had a snack about 26g carbs so 4 units in my case. Then you have a main meal 2ish hours later you work out your carbs for the meal say 50 carbs which is about 7 units for me do you knock the existing on board insulin off from the units seeing as it still active? So this would put it down to 5 units instead of 7 or do you take the full dose of 7

Hope the above makes sense I dont snack much between meals normally hence why I'm not quite sure what to do 🙂

 

[Inka]

It depends what your blood sugar is @digihat - ie is it low or going to go low? If it is, I’d knock a bit off my meal bolus, but generally if my blood sugar is ok, I don’t. Stacking is more for corrections.

 

[Lucyr]

Say you just have had a snack about 26g carbs so 4 units in my case. Then you have a main meal 2ish hours later you work out your carbs for the meal say 50 carbs which is about 7 units for me do you knock the existing on board insulin off from the units seeing as it still active?

I’d take the full dose but reduce any correction factor. The 4u you took earlier is still working and say 2u is still left then how much will that drop your bg. I’d take that off my correction factor.

I do negative corrections as well as positive so if that 2u and current bg (ignoring the meal) would drop me too low, say if current bg is 5, then my correction adjustment would be -2u off the main meal dose. If my bg is still a bit high but with the 2u it will be fine then I’d take the 7u for meal as normal but not add a correction.

 

[Inka]

Are you correcting a high sugar @Lucyr ? Obviously, if I still had snack/insulin working because I’d eaten my snack fairly close to the meal, I wouldn’t correct, but that’s no different to not correcting pre-dessert if you split your bolus for main meal and dessert.

I’m a big snacker, and, all being well (carb count and expected blood sugar trajectory) I just have my normal bolus for my meal.

 

[Lucyr]

Are you correcting a high sugar @Lucyr ?

If I was correcting a high sugar I’d take off the effect of any active insulin on my blood sugar. Eg if my bg was 15 with 2u remaining, I’d calculate the correction from 15 then subtract the 2u from it and add on the insulin for the carbs.

If bg was below target I’d subtract however much needed to bring me up to target and subtract the 2u still active.

 

[Inka]

I get you 🙂 I just go by instinct more. I know what my blood sugar should be after my favourite snacks, and I know what it should be at each point of time afterwards. So, if I eat a cereal bar 2hrs before my evening meal and my blood sugar is where it should be, I just bolus for my meal just like I would if I hadn’t had a snack. I rarely have to correct after my snacks.

 

[Lucyr]

I get you 🙂 I just go by instinct more

Problem is you can’t explain instinct calculations to someone who is asking how you’d work it out as they don’t yet have that instinct.

 

[Inka]

Problem is you can’t explain instinct calculations to someone who is asking how you’d work it out as they don’t yet have that instinct.

I just did - in my first post and in my subsequent post. There should be no need to correct at meal times after a snack unless you’re getting your snack carbs wrong. It was you who introduced the idea of correcting when the OP was simply asking about IOB.

Eat snack 3pm, eat EM 6pm - take correct bolus for snack, take correct bolus for EM, as I explained above.

 

[Lucyr]

There should be no need to correct at meal times after a snack unless you’re getting your snack carbs wrong.

There are many many reasons you may need to correct at meal times after a snack! Surely I don’t have to list those out to you

 

[Lucyr]

It was you who introduced the idea of correcting when the OP was simply asking about IOB.

Also, this was because they use the MyLife app and that is how it works. It doesn’t say oh I won’t calculate a correction because you had a snack it just works out the IOB and adjusts correction accordingly as I explained

 

[littlevoice359]

To make my life easier I added an IOB calculator to my web app using the attached graph from Think Like A Pancreas. I don’t always stick to it, but I find it extremely useful as a guideline.

 

[helli]

To make my life easier I added an IOB calculator to my web app using the attached graph from Think Like A Pancreas. I don’t always stick to it, but I find it extremely useful as a guideline.

My pump keeps track of IOB for me but it is only useful of I know how much of my last meal has been digested/converted to BG.
Like @Inka I have a "good enough" idea for regular snacks.

 

[Inka]

There are many many reasons you may need to correct at meal times after a snack! Surely I don’t have to list those out to you

Nobody asked about corrections. It was the fact that you went straight in to talking about corrections in response to a question about IOB that made me think it must be an issue for you.

 

[Lucyr]

Nobody asked about corrections. It was the fact that you went straight in to talking about corrections in response to a question about IOB that made me think it must be an issue for you.

Every insulin injection includes a correction either upwards or downwards towards your target blood sugar.

 

[digihat]

@Lucyr @Inka @helli @littlevoice359 thanks for everyone's input much appreciated given me a good idea of what to do and try thank you 🙂

 

[everydayupsanddowns]

My pump keeps track of IOB for me but it is only useful of I know how much of my last meal has been digested/converted to BG.
Like @Inka I have a "good enough" idea for regular snacks.

Yes I’m very much a rule-of-thumb person on this too. It’s all a bit fuzzy at 2 hours, because while there is insulin still working, there is most likely also food in the process of being digested.

So I wouldn’t automatically take off the IOB at 2hrs unless it looked like there was some other sort of over-reach happening (carb estimate error… activity level… warmer weather… wearing wrong coloured socks…)