# Interpreting active insulin



## SB2015 (Aug 24, 2019)

After a meal at friends, I Have only just got my BG into single figures.  

Libre 10.1 and dropping vertically
BG 9.1 with active insulin of 1.6

My question is how to interpret that active insulin.  My sensitivity ratio is 1 unit reduces my BG by 4.8.  So I could assume that 1.6 will bring me down 7.2, but I am not sure whether that active insulin is still working at full tilt.  I usually just let my meter sort things like this out, however I would quite like some sleep, but can see that I could be heading for a hypo with that interpretation.  

In practice I shall eat something to bring my calculations to a target level using the active insulin (or insulin on board) and check in a while, and then deal with any bounce back in the morning and put it down to a very pleasant evening with unknown carbs, far more than I normally eat, and very poor estimates by me.  

I have just remembered the thing about if I eat more than 60g of carbs I need to increase my dose.  That would have helped last night!!!


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## SB2015 (Aug 24, 2019)

Nearly ready for some sleep but
Now 7.2 and dropping slowly on Libre
Bg7.2 with active insulin 1.2

The drop from 9.1 matches my sensitivity calculations, so I thought I had better eat before heading off to sleep
However when I put in some carbs into my handset it suggested some Bolus for them. Weird.  
*Any explanation*?

 I shall just eat something and sleep and deal with it in the morning (or should I say later this morning!)


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## Robin (Aug 24, 2019)

SB2015 said:


> Nearly ready for some sleep but
> Now 7.2 and dropping slowly on Libre
> Bg7.2 with active insulin 1.2
> 
> ...


The other half of the equation about active insulin left on board, is active food left undigested! I had the same problem after the Dessert Buffet at our hotel last night. I was 10.0 when I went to bed, but still felt fairly full. I gave a cautious correction of 1 unit, to bring me down to 7.0, but it looked at my libre trace this morning, and ai went up further before I came down, and I woke to 8.2 this morning. (it was worth it, though)


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## SB2015 (Aug 24, 2019)

Thanks for that @Robin.  I hadn’t thought about active carbs.  
However I think my calculations were right.  I ate 6g  of carbs before getting some sleep,
 and have just woken from a hypo at 3.5.

Glad that you enjoyed the pud.
Life just have to rule over D sometimes.


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## everydayupsanddowns (Aug 24, 2019)

Am I right in remembering you are on Combo? Or have you switched to MM640G yet?

The two have always presented ‘active insulin’ very differently afaik - Medtronic shows the full dose (including any correction) reducing over time. Roche pumps (and Expert meter) have only ever tracked the correction part of a meal bolus - because their assumption was the meal dose was working on the carbs and you definitely got the carb count right and didn’t guess it 

When I used the Expert meter the only way I could get it to track the full dose was by entering a manual bolus (which had no carbs attached).

In practical terms, how to view active insulin or iob will vary very much depending on how your body responds to the insulin in question and whether the active insulin time is set right.

So I guess you’d just have to experiment really!


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## TheClockworkDodo (Aug 24, 2019)

Not on a pump, but if I had a downward arrow on my Libre and active insulin of 1.6 units and I wanted to go to sleep I'd eat cheese and biscuits to slow the drop and hopefully prevent a hypo later on.


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## SB2015 (Aug 25, 2019)

everydayupsanddowns said:


> Am I right in remembering you are on Combo? Or have you switched to MM640G yet?
> 
> The two have always presented ‘active insulin’ very differently afaik - Medtronic whites the full dose (including any correction) reducing over time. Roche pumps (and Expert meter) have only ever tracked the correction part of a meal bolus - because their assumption was the meal dose was working on the carbs and you definitely got the carb count right and didn’t guess it
> 
> ...


Thanks Mike.,  Another tick for the Medtronic.  
My swap over is not until Feb, but the support for a switch is gathering.


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## SB2015 (Aug 25, 2019)

TheClockworkDodo said:


> Not on a pump, but if I had a downward arrow on my Libre and active insulin of 1.6 units and I wanted to go to sleep I'd eat cheese and biscuits to slow the drop and hopefully prevent a hypo later on.


Thanks Juliet
I had a garibaldi, went to bed and woke up at a nice 5.3.
Slept like a log last night.


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## Asherly (Jun 14, 2020)

I can’t wait to be able to just be like this when assessing my lad and it all not seem so foreign. This was a nice thread to read guys, thanks.


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