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Discussion Starter · #1 ·
I still would like to know about "insulin on board". If you are taking rapid acting insulin and you have covered your carbs precisely, how can you still have insulin that is active for up to 4 hours? I don't understand this. :noidea:
 

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I should have been more specific about my question. If I take Novolog at mealtime and cover my carbs with insulin and then in 2 hours I want to have a snack with carbs. Most will say not to take more insulin because you still have insulin on board. How do we still have active insulin on board if we have used that insulin to cover the mealtime carbs? If I don't cover my carbs with insulin everytime that I eat, then I will end up with a high reading.
 

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Ok-then why are we advised not to stack insulin doses? Say I eat my meal and cover my carbs and this would mean that that injection is all used up. In 2 hours, I eat a snack with carbs and inject more insulin and this injection will cover the carbs for the snack. Many experts say that this type of "stacking" doses will often result in a low blood sugar reaction. I am not new to using insulin, but I have this question about still having insulin on board and no one can explain how this can be true. I guess there are some questions that can't be answered. I have asked an expert on another diabetes forum the same question and got no reply. I have asked 2 diabetes educators, my pharmacist and my PCP and a rep from Novo Nordisk and no answers. I guess I will continue to cover my carbs whenever I eat and hope that I don't go low after all is settled.
 

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Discussion Starter · #8 ·
Breeze, Novolog and Humalog take 4 hours to work their way out of your syste, If you inject or pump 6 units of Novolog at mealtime, that 6 units will take 4 hours to be be used up. About one quarter of the insulin is used each of the 4 hours. If you initially bolused 6 units, and you have a snack two hours later, then only half of the initial dose has been used, and the other half is still in your body (3 units still on board). If your snack requires 3.5 units (using carb counting and your carb ratio) then you would subtract the 3 carbs still on board from the 3.5 needed for the snack and bolus only 0.5 units. That is easy to do with a pump, I can even bolus 0.1 units. A half unit can be done with a syringe if tou have a syringe that has half unit markings, otherwise you do the best you can with other syringes.

If you had that snack 3 hours after the initial bolus then there would be one quarter of the initial bolus (one quarter of 6 is 1.5 units). You would subtract 1.5 from the 3.5 units needed and bolus 2 units. Taking the IOB into account avoids stacking, and hypos are not likely to occur.

Has old man Richard explained things OK, or do you have more questions? Lol!
I will make this my last attempt...If I need 5 units of insulin to cover my carbs, how can I still have any active insulin left? I know it stays in your body for 4 hours.
 
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