Active Insulin

Hello all,
I am having the active insulin problem. If my sugar level is 140 and i take 45 grams i will take the full dose. but then after 2hrs i will check my sugar it will be around the 139 - 150 which is ok. But there will be around 2 units active insulin. I always freak out and start to take 15 to 20 grams without adding bolus. The problem is that if i dont take i will have hypo but if i take it i will have hyper. Ps. my carb ratio is ok + my insulin sensitivity is 65 which is ok. i told my doctor about it but he insist that the active insulin is for the food in my body but this is not the fact coz if i dont eat i go into hypo. Please not that this doesnt happen to me all the time, maybe 3 to 4 times a week other than that my basal is ok. Any tips!

I started pumping in Feb. and I seem to have the same problem.I am supposed to stay above 6.0mmol.I don’t know what that is in American measurement,but anyway,I drink a little something like juice (less than 1/4 cup)and test later and I go up to 9 or 10.I feel a little uncomfortable there.I will now just let it be and see what I am without taking anything.I usually am ok.Maybe you ISF is a little too high.

What is a hypo for you in this situation?

I don’t see a problem with numbers below 6,0 as long as you don’t go too low. My endo says anything below 3,3 is hypo. Anything above that is fine, especially before a meal as long as you don’t feel hypo. Ideally, my numbers should be between 5,0 and 6,7 before a meal, but that’s just a guideline.

BTW, 6,0mmol is about 108 mg/dl. Just multiply your numbers by 18 to get the American measurement.

Hi, Bebo

I’m not sure what you mean with two active units of insulin. If there are two units of insulin left in your system after eating 45g of carbs, I’d suggest lowering your bolus. Does this always happen at the same time of day? Maybe you need to adjust your insulin/carb ratio. It can be different for different times of day, because the natural insulin resistance varies throughout the day. It is usually highest in the afternoon and lowest around noon so you’d need less insulin for lunch than you’d need for the same amount of carbs at dinner.


45 to 50

a few thoughts , I hope will be useful ???: I changed my active insulin from 4 hours to 3 hours as recommended by my pump nurse ,( I use NovoRapid ) …I have fewer correction boluses to administer ( 522 medtronic pumper) .I had more hypo incidents , when I delivered a normal bolus …I tried square wave 1 hour for breakfast and lunch , supper square wave 1/2 hour and presently am using 1/2 hour for all meals, ( as discussed with my pump nurse… maybe my tummy does not empty as quickly as it use to do ??) unless I eat a high fat diet at supper or pasta …for instance home fried potatoes, pasta 11/2 hour . I have my usual capucino ( misspelled ??) at mid afternoon and use a normal bolus
I use 4 different carb ratios during the day with needing less in the morning …but then I also have incorperated a morning walk after breakfast.
This game of having type 1 diabetes requires constant monitoring …one day never the same as the next.

That is really to low. Like Kat I recommend to adjust your dose of bolus insulin. Most people have insulin to carb ratios that differ from hour to hour. If you experience hypos in the afternoon then the insulin to carb ratio for lunch was to high and should be lowered (just as an example). You have written that this happens sometimes and therefore it is possible that your physical activity was higher on those days where you experienced the low. In this case you can use a temporary basal rate adjustment (of maybe 80%) for the hours of higher activity. Of course you need to gain experience to use the capabilities of the pump correctly.

Thank you nel for your advice. It seems that your case is very similar to mine. I too, have four different carb ratios with different basal rates. Most of the times i’m OK, but as i mentioned sometimes this issue of the remaining active insulin worries me alot and i don’t know how to handle it!! If you were in my shoes what would you do?!

Hello Bebo ,

my pump ( 522 medtronic ) has the wizzard set up and I do not recall if the previous model had this feature , where I have programmed 3 hours for active insulin .If one bolusses at 8 am x number of carbs, by 11 am ( we assume !!) no active insulin left . Were I to ( meal ) bolus at 11 am I start with a bolus at 11 am finished by 2 pm , no active insulin left. Am I high I need a correction bolus …And I have , not always successfully so …am I impatient and want to see lower numbers ?? YES …override the correction after I checked two hours after the meal with still active insulin on board of an hour at least .Hope I am clear about your statement : " remaining active insulin worries me a lot " …this is a fact…there is insulin in the body and yes some of it is needed to take care of the carbs you have consumed , esp if you have square bolussed …please note my mention of having override the number and I may have a LO .
I hope this is not another topic, but want to share : My last A1C was 7 ; would have like to see 6.5 …however I thought about the past 3 months and declare I have had fewer lows…so I think back and quality of life has been better .

Hi BEBO! What is your insulin duration set on for your pump (i.e. the setting that tells your pump how long insulin is active in you)? I think the default for Medtronic is 6 hours. If the insulin duration is not set right, then the active insulin won’t be accurate.

To check your insulin duration:
Act- Bolus- Bolus Wizard Setup- Review settings
Scroll to the bottom and you will see “Active Insulin Time: (number)”

I have mine set on 4 hours, but people are different. Some people use 3, others 6.

Thank You Kristin for the tip, i have already set my pump on 4 hrs it was on 5 hrs, so probably that was the reason, i’ll try and hopefully it will work.