Active Insulin Time using medtronic 640g pump

[Alison204]

Hello all,

Just wondered what everyone's active insulin time setting was if they use the medtronic 640g insulin pump?

Mine is currently 4 hours (which was set when I got the pump)

The only reason I'm asking is when I used to use the Animas vibe my boluses seemed to be delivered much quicker than they are with the medtronic - could that be correct or is it just my imagination?

My medtronic is set to 'regular speed' so I asked the DNS if I could set it to deliver using the 'fast speed' but he said no - that is more for type 2's and type 1's should stick to the regular setting.

Any advise / thoughts / comments welcome
Thanks
Alison

 

[Deleted Account]

I can't comment on the Medtronic but, activation times on insulin are always given as a range as they vary from person to person.
In addition, the active time varies according to the type of insulin.

I had been using NovoRapid for years - with MDI and then with my Animas pump. By testing with Libre, I realised I was having to bolus earlier and changed to Fiasp. I do not know if this time was getting worse for some reason or whether it was always that slow.
Fiasp has helped me but I know it does not work for everyone.

In addition, my understanding of the "active time" is the time during which the bolus is active which is used to calculate insulin on board (for bolus). I did not think it was related to the time it takes before it becomes active. Maybe it is different for Medtronic: on Animas it is "IOB Duration".

 

[tim2000s]

Have a read of this: http://bit.ly/InsulinDuration

 

[Juicyj]

Hi @tim2000s can you check that link as its not working ?

@Alison204 Unsure where your DSN has obtained the knowledge regarding bolus speed, but mines been set at 'quick' for well over a year now, no issues, so as soon as I know what I'm going to eat I want that insulin delivered asap so type should not make a difference either. I have also set my active insulin time to 2.5 hours, I am on novorapid and have reduced it gradually from 4 hours over time and this seems to be working fine but have been able to check Libre and Dexcom to track this, as already said by Helen it varies from person to person.

 

[tim2000s]

Hi @tim2000s can you check that link as its not working ?

Just checked it and it seems okay. Direct link: https://www.diabettech.com/insulin/...n-action-dia-times-we-use-and-why-it-matters/

 

[tim2000s]

My medtronic is set to 'regular speed' so I asked the DNS if I could set it to deliver using the 'fast speed' but he said no - that is more for type 2's and type 1's should stick to the regular setting.

There are some interesting views on bolus delivery from pumps. Some HCPs are of the opinion that the fast delivery speed reduces the speed of absorption in the body, which is why they recommend using the slower speed. If I'm honest, I've not seen any delay in absorption by using fast, so I always use that where it is an option. There's also next to no research on this so it's all hearsay.

Some people also find the fast delivery stings, which is why they prefer slower.

 

[Leeannea]

Hi Tim. I’ve just signed up for a Medtronic 670 but I’m dismayed to read in that article that it’s basically aiming for a HbA1C of 6.5, as at the moment mine is 5.7 on MDI.
You allude that it may be possible to lower the target bl glucose of 6.6. Is this feasible?
Many thanks
Leeanne

 

[kitedoc]

There are some interesting views on bolus delivery from pumps. Some HCPs are of the opinion that the fast delivery speed reduces the speed of absorption in the body, which is why they recommend using the slower speed. If I'm honest, I've not seen any delay in absorption by using fast, so I always use that where it is an option. There's also next to no research on this so it's all hearsay.

Some people also find the fast delivery stings, which is why they prefer slower.

Hi @tim2000s, I have wondered about infusion rate/speed also. The Vibe had a more rapid infusion rate than the Tandem Slim X2 but neither had/have an option to change the rate. As least the Tandem Slim x2 tends not to sting but as you say there is next to no information about differences in insulin absorption between the two rates nor about whether either contributes to cannula leakage, displacement etc.
The latter is of particular to me as I assume I have a degree of scat=r tissue subcutaneously after 52 years on insulin.
As I mentioned in a thread on needle port problems for me one answer was to vary sites more and use of a slightly longer steel cannula, 8 mm vs 6 mm to see if that would avoid the scar tissue in old sites.
Whilst a cannula tip in scar tissue is a reason for variation in absorption of insulin and for kinking or bending of plastic cannulas, what does the fast or slow infusion rate do?
Might fast infusion disperse scar tissue or lead to increased pressure fluctuation in the available space more quickly and with that more cannula leakage or dislodgement?
And slow infusion not be able to increase the available space but allow slower build up of pressure with less or more delay until absorption and cannula problems?
Whilst there are a number of imaging techniques in research studies, MRI is expensive, fluoroscopy involves more Xray radiation than Xray shots but provides more info and ultrasound, the least troublesome one would think, is not as popular for some reason. Now that new ultrasound shows colour this may change. Fingers crossed for better info soon,