# active insulin



## litto-miss-loz (Jan 10, 2011)

hey all  im still really learning the bascis at the moment. ive still to be taught the bolus wizard and that but just wondered about active insulin.

see if two hours after a bolus, am i able to eat for example a bag of crisps and bolus for that?? 

cause then i see the active insulin still on board then im like ok do i bolus for it or not...

ive got the hosp tommorow to get my first pump review as i missed my one in dec due to the bad snow... so hopefully il get taught in more detail about these things


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## shiv (Jan 10, 2011)

If I was eating something extra I would bolus for it. Just be careful of the insulin 'stacking' on top of each bolus and making you go low later on - especially if you have say, 3 or 4 things to eat and bolus separately for them - if I did that I would probably hack a bit off the bolus as there would be active insulin floating around from the previous few boluses to soak up those carbs.

This is the kind of stuff I am starting to pick up with my pump. You'll pick it up in your own time too


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## Ellie Jones (Jan 11, 2011)

Consideration needs to be given to what the BG is saying...

At 2 hour point you've used about 80% of your bolus, the other 20% still reduce your BG over the next 2-3 hours slightly..

i.e  at 2 hours you BG is 4.1 and you are having a snack of 10g to bolus fully for itwould likely give you an hypo...

I've not used the bolus wizard that tells you IOB..

Not sure how they calculate after you've done a square wave or multi-wave bolus.. Is the calculation based on the being given at once, or has it adjusted it's calculation to reflect how it was delivered?  Worth asking at clinic tomorrow I think!

As Shiv says if you'll grazing then you've got to watch for insulin stacking it's one of the things we do at least once...

I get my handset tomorrow for my Combo pump, but not allowed to use it until I've recieved training with it..  Mind you this doesn't say that I can't play with it...  As long as I don't use it to tell my pump what to do


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## Liz! (Jan 11, 2011)

Oh... does this mean the minimed doesn't automatically reduce your dose for insulin already on board? Mine does this - if I think i need to do a correctio or want somethng to eat i programme in Blood sugar, and it tells me that it is reducing the amount as there is insulin already on board, I could override that but don't usually. It's very handy and stops over -dosing. I'd have thought every pump would calculate that... it's not rocket science...


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## sugarfreerach (Jan 11, 2011)

wow your pump sounds amazing! mines very simple and i have to calculate everything etc! only 3 more years til i get a new one....


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## Pumper_Sue (Jan 11, 2011)

sugarfreerach said:


> wow your pump sounds amazing! mines very simple and i have to calculate everything etc! only 3 more years til i get a new one....



Lol. Both Liz and I have the Cozmo 1800 pump  it even has a hypo manager. So if it calculates that you will go hypo if you give a correction, it tells you and even tells you how many carbs to eat  I was staggered when mine told me to eat 1 gm of carb that is 1 not 10.


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## tracey w (Jan 11, 2011)

Liz! said:


> Oh... does this mean the minimed doesn't automatically reduce your dose for insulin already on board? Mine does this - if I think i need to do a correctio or want somethng to eat i programme in Blood sugar, and it tells me that it is reducing the amount as there is insulin already on board, I could override that but don't usually. It's very handy and stops over -dosing. I'd have thought every pump would calculate that... it's not rocket science...



The combo tells you what insulin you have on board but does not reduce your bolus, thats up to you. Just like you can cancel your reduction if you so chose.

As Ellie says it depends how long since you last ate and what your bg is now,i sometimes reduce bolus if i know the active insulin will bring me down further and im near target range, if not then i will give the full bolus.

Loz, yes you can snack on a pump, you can eat whenever you choose. As others have said it will be trial and error to see what works. If your not sure at first i would reduce bolus to avoid a hypo, later you will see if it was necessary or not. If you always test before eating you will work out how best to handle you IOB.


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## Pumper_Sue (Jan 11, 2011)

Removed as misunderstood


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## shiv (Jan 11, 2011)

If you use the bolus wizard but don't put in a BG reading, it won't take into account IOB - it just tells you what amount of insulin it thinks you should have based on the food.


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## tracey w (Jan 11, 2011)

Pumper_Sue said:


> Wow how daft is that?
> I thought all pumps with wizards deducted IOB in their calculation
> Obviously you as the user have the choice to agree or disagree with the figure arrived at by the pump.



I dont think its daft, its clear to see the amount of IOB you have. You can then make an informed decision based on your bg etc. I dont see why you would want the wizzard to reduce a bolus when yor bg reading may be still high anyway?

Its the same if you dont have IOB but choose to reduce bolus because you know you are going to be active soon for example. 

Its good you have to think about things not just press buttons and hope for the best. thats how i see it anyway.


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## Pumper_Sue (Jan 12, 2011)

post removed as has been misunderstood


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## Pumper_Sue (Jan 12, 2011)

post removed as misunderstood


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