Does your blood sugar appear unpredictable at instances? In case you reside with insulin-dependent diabetes, it most definitely does, and generally it may be laborious to find out what’s occurring.
That’s why it’s vital to learn to calculate your insulin on board (IOB) as a result of in case you’re not taking note of your IOB, your blood sugars will proceed to appear random and unpredictable
Whereas taking note of your IOB is not going to resolve your entire each day blood sugar woes, it could enable you to out immensely. It’s a key part to raised diabetes administration and one thing that’s not introduced up typically or taught sufficient if you find yourself recognized.
Figuring out your IOB may also help you efficiently decide issues like if it’s protected to go for a stroll with out your blood sugar going low, or in case you ought to inject extra insulin to appropriate a excessive blood sugar, or in case you ought to eat a snack earlier than mattress so that you received’t should get up in the course of the evening to deal with a low blood sugar.
What’s Insulin On Board
Insulin on board is how a lot lively rapid-acting insulin you could have in your physique. I’ve additionally seen it described as BOB (Bolus On Board), or unused insulin.
Speedy-acting insulin is the kind of insulin individuals dwelling with insulin-dependent diabetes use after we eat or have to appropriate highs. Widespread model names of lively insulin are: Humalog, Novolog, and Fiasp. It’s additionally the kind of insulin that’s utilized in insulin pumps.
An excessive amount of IOB will result in low blood sugar (hypoglycemia) and too little to excessive blood sugars (hyperglycemia).
IOB is vital since injected rapid-acting insulin can final within the physique for 3-5 hours. That signifies that you need to be paying consideration not simply to what number of models of insulin you inject but in addition to how a lot is left of that dose as much as 5 hours after your injection(s).
How lengthy insulin is lively within the physique is a variety (3-5 hours) as a result of all of us metabolize insulin at a barely totally different price. Most insulin pumps will probably be set to three hours, and most medical doctors suggest testing one’s blood sugar about 2 hours after a meal bolus, partially to verify IOB and if a enough meal bolus was administered.
In case you use an insulin pump, the pump will let you know your IOB from all boluses.
Nonetheless, it’s price noting that it doesn’t embody the basal (background insulin) which can be rapid-acting insulin. Overlooking the pump basal insulin when discussing lively insulin is problematic particularly for train, since an excessive amount of IOB, from boluses or pump basal, will make blood sugars drop.
In case you use insulin pens, there are just a few apps obtainable that will help you calculate and maintain monitor of your IOB comparable to RapidCalc (not FDA accredited) or MySugr (EU solely). There’s additionally a smartpen referred to as InPen obtainable within the U.S.
Find out how to calculate IOB
In case you don’t have entry to any units or apps that calculate your IOB for you, or if you wish to know your “pump basal IOB”, you possibly can calculate your IOB pretty simply by yourself.
On this video, I’ll stroll you thru examples of the way to calculate your “pump basal IOB” and your IOB from injections.
I’d suggest going by means of the train of calculating your IOB just a few instances and begin taking note of how totally different ranges of IOB affect your blood sugar in several conditions.
Listed here are two extra examples
Basal IOB (pump) Instance
Basal per hour is 1 IU, assuming insulin is lively for 4 hours within the physique:
1 IU x 25% + 1 IU x 50% + 1 IU x 75% + 1 IU x 100% = Complete: 2.5 IOB
Bolus IOB (MDI) Instance
1 IU injected 1 hour in the past and a pair of IU injected 3 hours in the past, assuming insulin is lively for 4 hours within the physique:
2 IU x 25% + 1 IU x 75% = 1.25 IOB
Why you must care about IOB
Figuring out your IOB is usually a important part to understanding when you’ve got an sufficient quantity of insulin on board for a given exercise. It’s the one finest indicator of how your blood sugar will react throughout totally different instances and actions.
One of many first issues many individuals are taught after being recognized with diabetes is that stacking insulin is dangerous. Stacking insulin means taking multiple dose of rapid-acting insulin inside the 3-5 hour timeframe whereas it’s lively within the physique.
However what in case you didn’t get sufficient insulin in the course of the first dose, must you simply wait 3-5 hours whereas your blood sugars are excessive earlier than correcting? Your IOB may also help decide that.
While you calculate your insulin dose the IOB ought to be a part of the calculation. The calculation is that this:
Insulin for the carbs you eat +/- Correction on your present blood sugar – IOB = Dose advice
So let’s say I’m not consuming, my blood sugar is 250 mg/dL, my goal blood sugar is 100 mg/dL, my correction issue is 50, and my IOB is 1 IU, this may be the calculation:
0 IU for carbs + 3 IU Correction dose ((250-100)/50)) – 1 IOB = 2 IU
Had I not taken IOB into consideration, I’d simply have injected the three IU and most definitely had gone low.
One other important issue is lowering the danger of low blood sugars. The one cause why we go low is that if we have now an excessive amount of insulin in our programs, an excessive amount of IOB. So taking note of our IOB wants for various actions is vital to understanding if it’s acceptable for what we’re about to do or if we’d like a small carbohydrate snack first.
When is it vital to concentrate to IOB?
Whereas it is very important deal with IOB all through the day, these are three of an important instances to pay particular consideration to it:
While you train
Your insulin sensitivity is heightened throughout and after train, rising the danger of low blood sugar. By taking note of your IOB, and the way your blood sugars react if you do various kinds of train, you’ll have the ability to alter your IOB (by adjusting your insulin within the hours earlier than you train) with the intention to train with balanced blood sugars.
And in these conditions the place you possibly can’t plan forward, you’ll know when you’ve got an excessive amount of IOB and also you’ll want a carbohydrate snack.
Earlier than mattress
Getting an excellent evening’s sleep might be laborious with diabetes and nobody desires to take care of low blood sugars at evening or waking up with a blood sugar hangover after having excessive blood sugars all evening.
Checking your IOB and blood sugars earlier than mattress may also help you assess if it’s protected to go to mattress, in case you want a snack to stop a low blood sugar, or in case you ought to take a correction dose for a excessive blood sugar.
Earlier than meals or corrections
IOB ought to be a part of each meal and correction calculation and might make your insulin doses extra exact.
Figuring out your IOB permits you to dose when wanted, eat if you really feel prefer it, and it helps to construct confidence within the insulin doses you’re taking.
