Calculating insulin on board during spontaneous situations is so tricky. My dosages never seem to work as expected, and I end up on a rollercoaster ride of blood sugar levels.
My daughter is T1D for 6 years now. Just recently started using the omnipod dash. We live in Europe so we do not have easy access to newer models. We combine the omnipod with the Freestyle libre 3. Insulin on board is alway tricky with my daughter. The reason is the time calculated. What I mean is, we calculate that an x amount of insulin will remain on board for 3 hours but in many cases eventhough we calculate carbs and regard fatty foods we are usually off. For example, she had an active day today with visits to friends house, pool time and general kids stuff. She is 9.5 btw. We can never maintain a flat line on her levels but for the most part she was between 110 - 190. Tonight though she had eaten 48 grms of carbs, (3.4 units for white rice) salad and some pork lean mostly. 1 hour in she was 120 arrow down so disabled her insulin and 5 min later she required juice for pick up as the trend was still dropping. 2 hours in and even after juice and disabled insulin she was 150 trending down with 1.3 units IOB. 4 hours later 0 IOB and high at 290. Im lost and dont know what went wrong. This is common and would love to know how u manage your sugar levels. I understand that for each person these are different but there has to be a strarting point and general guide. Also what insulin pump are you usually using. I noticed your graph if from a dexcom. Thank you for your time and sorry for the long message. Really hope you get to read it
Great podcast! I've been wondering about this topic for a while now. It's crucial to consider how insulin on board should be calculated differently when dealing with spontaneous activities and meals.
Side project- similar teachings and pep talks for kids living with TD1. Appreciate your work! Just not sure exactly how much I can put in practice for my kiddo.
Thanks for your video. I think the only struggle with IOB is knowing what is the actual IOB per hour (to estimate the remaining IOB). Any thoughts on how to estimate this? Pumps use 6 hours at the hourly rate of 15%, 30%, 25%, 15% 10% 5% per hour. Others use an estimate of 25% per hour over 4 hours. It seems impossible to know!
Quick answer: yes. But you'll have to calculate it yourself. While this isn't medical advice, I like to consider my iob to be between 3-4 hours and chunk up the "amount used" accordingly. Personally, I like the "InPen" because it's MDI but still assists in that calculation, or you could jump into our coaching program where we teach you the ins and outs of the math with blood sugar formulas. I hope that helps!
@@FTFWARRIOR I’ve tried to calculate it by myself and it’s a little bit complex so I asked maybe there is an easier way to do it, also the InPen sound like a good idea but I don’t think I’ll be able to use it. I’m actually in your Facebook group and I’ve been watching your videos for months now but I’m still struggling and need more help.
Thanks for an interesting podcast 🙏! A couple of questions with backgrounds: I'm type 1 since 2007 and found it pretty easy until this year to manage my bloodsugars. Now it's more of a rollercoaster ride. My c-peptides were at 0,36 in 2017 and last month down to 0,06. Unfortunately I didn't measure the c-peptides between 2017 and now so I don't know when that drop occured. -What's your take on if someone has a small production still of own insulin and the impact that has on the necessary calculations on dosage? I did carnivore for 3 months september-november this year and to my surprise I needed MORE insulin than when I was eating clean and around 50-60g of carbs per day. -Could this be just a coinsidence that me going carnivore came at the same time as my last insulin production died, or does the gloconeogenesis require insulin? -I did eat a lot of fat during these 3 months on carnivore. Could that be a factor in how much insulin i need and the stability over all? Up til approx 2021 I could -eating clean with around 50-60g of carbs per day- do per 24 hours like 5-6 units of long term insulin and just as much fast working. That totals 10-12 units per 24 hours which is practically nothing. Now I struggle to get below 20-25 units more often hitting between 30-40 units. I'd also like to mention that during two ultra-running projects in 2008 and 2009 where I ran first 1200km (50km per day) and then 3100km (also 50km per day) I used 8 units of the old Insulatard per day, and around 4 units of NovoRapid with no restrictions on carbs at all meaning I ate everything all the time needing a lot of energy. So a lot of choclate, energy bars, fruits, icecream, etc. Not very healthy but it fueled me running. Of course solid food as well. -What's your view on if it's possible to actually replace fast working insulin with long term physical activity like running really long distances (slow tempo, 6-7min/km)? -Or kayaking which I also did as a project in 2011 doing 1000km in 15 days. Avarage 10-12 hours per day. During kayaking i remember insulin dosis being almost zero not having access to "bad carbs" at sea. To summarize: I'd do pretty much anything to get this straight and I find it awful that it is so difficult to get hard facts around all the factors that combined make up the challenge that we're facing. Why is that so? Is the scientist and the medical companies just plain bad and incompetent, or is there an agenda behind this to keep us sick? I just put the questions out there cuz I'm really frustrated. I mean how hard could it be to solve these issues? For instance: I just got myself the Libre-3 system since things started to happen that I didn't understand. Well the system works -sort of- but is so freaking slow that it's hardly to any use. Why? Unreliable garbage is what I feel when I for instance use the system when I do a running workout. I remember when I got my type 1 in 2007 and used the old fashioned prick my fingers 10 times during a 10km lap to see what happened. A bit tricky to do (takes a while to learn to not slow down so much measuring) but at least it was accurate. Finally I concider myself a carb addict which do makes everything more difficult. This became pretty lengthy. Hope you find the time to respond. All the best // Martin Lidström -Sweden diabeticontherun.com
Also do you use excercise mode on your t slim for counter acting this as well? Nice thoughts on counteracting low I used to do that on medtronic all the time t slim little more touchy thanks matt
I actually don't use the insulin pump algorithm at all during the day (I found that my 80/20 blood sugar formula is significantly more stable and predictable). There's definitely nuances that aren't talked about with these new "smart algorithms" on the pumps. Thanks for being here!
Thank you so much for these easy to understand explanations! Big help for my pre/teen son 🙏🏻😊
Glad that you find this video helpful!
I'd rather slightly under-correct and make adjustments later if needed than risk a sudden low.
Calculating insulin on board during spontaneous situations is so tricky. My dosages never seem to work as expected, and I end up on a rollercoaster ride of blood sugar levels.
My daughter is T1D for 6 years now. Just recently started using the omnipod dash. We live in Europe so we do not have easy access to newer models. We combine the omnipod with the Freestyle libre 3. Insulin on board is alway tricky with my daughter. The reason is the time calculated. What I mean is, we calculate that an x amount of insulin will remain on board for 3 hours but in many cases eventhough we calculate carbs and regard fatty foods we are usually off. For example, she had an active day today with visits to friends house, pool time and general kids stuff. She is 9.5 btw. We can never maintain a flat line on her levels but for the most part she was between 110 - 190. Tonight though she had eaten 48 grms of carbs, (3.4 units for white rice) salad and some pork lean mostly. 1 hour in she was 120 arrow down so disabled her insulin and 5 min later she required juice for pick up as the trend was still dropping. 2 hours in and even after juice and disabled insulin she was 150 trending down with 1.3 units IOB. 4 hours later 0 IOB and high at 290. Im lost and dont know what went wrong. This is common and would love to know how u manage your sugar levels. I understand that for each person these are different but there has to be a strarting point and general guide. Also what insulin pump are you usually using. I noticed your graph if from a dexcom. Thank you for your time and sorry for the long message. Really hope you get to read it
Great podcast! I've been wondering about this topic for a while now. It's crucial to consider how insulin on board should be calculated differently when dealing with spontaneous activities and meals.
Side project- similar teachings and pep talks for kids living with TD1. Appreciate your work! Just not sure exactly how much I can put in practice for my kiddo.
Glad you found this video helpful! Let me know if you need more assistance or help. We're always happy to help
Thanks for answering this I struggle with this on the t slim and over correct all the time😊
No problem at all! always happy to help
Thanks for your video. I think the only struggle with IOB is knowing what is the actual IOB per hour (to estimate the remaining IOB). Any thoughts on how to estimate this? Pumps use 6 hours at the hourly rate of 15%, 30%, 25%, 15% 10% 5% per hour. Others use an estimate of 25% per hour over 4 hours. It seems impossible to know!
LOVE this comment... if it gets enough attention, I might have to make a video on this. Would that be helpful?
@@FTFWARRIOR That would be great! Thank you!
Is there a way to calculate IOB for MDI users? When I was on the pump things were easier!
Quick answer: yes. But you'll have to calculate it yourself. While this isn't medical advice, I like to consider my iob to be between 3-4 hours and chunk up the "amount used" accordingly. Personally, I like the "InPen" because it's MDI but still assists in that calculation, or you could jump into our coaching program where we teach you the ins and outs of the math with blood sugar formulas. I hope that helps!
@@FTFWARRIOR I’ve tried to calculate it by myself and it’s a little bit complex so I asked maybe there is an easier way to do it, also the InPen sound like a good idea but I don’t think I’ll be able to use it. I’m actually in your Facebook group and I’ve been watching your videos for months now but I’m still struggling and need more help.
I have a CGM, but not a pump!
So how do I calculate my IOB, without a pump?
Thanks for an interesting podcast 🙏!
A couple of questions with backgrounds:
I'm type 1 since 2007 and found it pretty easy until this year to manage my bloodsugars. Now it's more of a rollercoaster ride.
My c-peptides were at 0,36 in 2017 and last month down to 0,06. Unfortunately I didn't measure the c-peptides between 2017 and now so I don't know when that drop occured.
-What's your take on if someone has a small production still of own insulin and the impact that has on the necessary calculations on dosage?
I did carnivore for 3 months september-november this year and to my surprise I needed MORE insulin than when I was eating clean and around 50-60g of carbs per day.
-Could this be just a coinsidence that me going carnivore came at the same time as my last insulin production died, or does the gloconeogenesis require insulin?
-I did eat a lot of fat during these 3 months on carnivore. Could that be a factor in how much insulin i need and the stability over all?
Up til approx 2021 I could -eating clean with around 50-60g of carbs per day- do per 24 hours like 5-6 units of long term insulin and just as much fast working. That totals 10-12 units per 24 hours which is practically nothing. Now I struggle to get below 20-25 units more often hitting between 30-40 units.
I'd also like to mention that during two ultra-running projects in 2008 and 2009 where I ran first 1200km (50km per day) and then 3100km (also 50km per day) I used 8 units of the old Insulatard per day, and around 4 units of NovoRapid with no restrictions on carbs at all meaning I ate everything all the time needing a lot of energy. So a lot of choclate, energy bars, fruits, icecream, etc. Not very healthy but it fueled me running. Of course solid food as well.
-What's your view on if it's possible to actually replace fast working insulin with long term physical activity like running really long distances (slow tempo, 6-7min/km)?
-Or kayaking which I also did as a project in 2011 doing 1000km in 15 days. Avarage 10-12 hours per day. During kayaking i remember insulin dosis being almost zero not having access to "bad carbs" at sea.
To summarize:
I'd do pretty much anything to get this straight and I find it awful that it is so difficult to get hard facts around all the factors that combined make up the challenge that we're facing. Why is that so? Is the scientist and the medical companies just plain bad and incompetent, or is there an agenda behind this to keep us sick?
I just put the questions out there cuz I'm really frustrated. I mean how hard could it be to solve these issues?
For instance: I just got myself the Libre-3 system since things started to happen that I didn't understand. Well the system works -sort of- but is so freaking slow that it's hardly to any use. Why? Unreliable garbage is what I feel when I for instance use the system when I do a running workout. I remember when I got my type 1 in 2007 and used the old fashioned prick my fingers 10 times during a 10km lap to see what happened. A bit tricky to do (takes a while to learn to not slow down so much measuring) but at least it was accurate.
Finally I concider myself a carb addict which do makes everything more difficult.
This became pretty lengthy. Hope you find the time to respond.
All the best // Martin Lidström -Sweden
diabeticontherun.com
Hi Martin! I'll definitely answer your questions in a few separate reels.
Hey Martin! Just incase you missed it, here's the link th-cam.com/users/shorts4PrhDCswBsQ?si=kRxRsCX4eItZvPnb I hope it helps!
Also do you use excercise mode on your t slim for counter acting this as well? Nice thoughts on counteracting low I used to do that on medtronic all the time t slim little more touchy thanks matt
I actually don't use the insulin pump algorithm at all during the day (I found that my 80/20 blood sugar formula is significantly more stable and predictable). There's definitely nuances that aren't talked about with these new "smart algorithms" on the pumps. Thanks for being here!
So you just took the necessary carbs with you to the pool just in case you needed them ?
Did you mean on trip? When travel to another city?
Formula? I can't pay for those so on my own.