Insulin action profiles for pumps?

[Spiker]

Does anyone know of any action profile graphs for the different insulins when delivered via pumps, as opposed to when injected? Or if not, what differences would you expect between the two?

 

[Hooked]

Would be interesting to see.

 

[CarbsRok]

Does anyone know of any action profile graphs for the different insulins when delivered via pumps, as opposed to when injected? Or if not, what differences would you expect between the two?

The profile would be the same whether injected or pump. Obviously you have to sort your duration of insulin and set the basal pattern for optimum results. Then your body has to work like clockwork (dream on) for everything to work perfectly 24/7 365 days of the year. **** I just woken up dreaming again.
I do have a chart showing insulin profiles if you want that?

 

[Spiker]

The profile would be the same whether injected or pump.

That's good to know. I thought the onset times were different on pumps.

I've got the charts for the injected insulins. Thanks though.

 

[CarbsRok]

That's good to know. I thought the onset times were different on pumps.

I've got the charts for the injected insulins. Thanks though.

Well bolus on a pump is exactly the same 15 or 30 mins before eating (Depending on the spike you get with food) Basal is 1 or 2 hours before a change is needed. Obviously on MDI you wouldn't be using the same insulin for both basal and bolus, so perhaps that's where the confusion lies

 

[Spiker]

The confusion comes from asking the pump nurse how long a Suspend takes to impact your blood sugar, and her saying 1-2 hours. If she had said 15-30 min (injected analogue insulin onset time) or 3-4 hours (injected analogue insulin action duration) I would have understood. Instead I was confused into thinking pump onset times are different. Though I didn't see any reasons why they should be, as they are subcutaneous delivery just like injections.

Sent from the Diabetes Forum App

 

[iHs]

The acting time of most of analogue bolus insulins is about 4 to 5hrs

Sent from the Diabetes Forum App

 

[iHs]

The suspend function will only stop insulin from being delivered from the time the suspend is activated but it wont do anything to the insulin that has alresdy been delivered....that is still active. The suspend will start chsnging bg levels about an hour later so dsn is correct

Sent from the Diabetes Forum App

 

[aditi]

from what my doc tells me.. that if insulin delivered slowly (via pump) is more effective than being delivered via an injection.. and yes i second iHs's reply here.. acting time is 4-5 hours with a 2 hour peak..so ideally even in pumps you just take insulin prior to meals.. it depends on which insulin ur using and if ur required to take it 15-30 mins before or just immediately before.

I always see the food on my plate and take insulin when i begin eating.

 

[Spiker]

The suspend function will only stop insulin from being delivered from the time the suspend is activated but it wont do anything to the insulin that has alresdy been delivered....that is still active. The suspend will start chsnging bg levels about an hour later so dsn is correct

I don't understand why Suspend doesn't start reducing BG levels until after an hour. Injected analogue insulin doesn't have an onset time of an hour. It has an onset time of 15-30 minutes. So if the onset time is the same in a pump, the blood insulin level should start to drop 15-30 minutes after you hit Suspend.

 

[aditi]

I don't understand why Suspend doesn't start reducing BG levels until an hour. Injected analogue insulin doesn't have an onset time of am hour. It has an onset time of 15-30 minutes. So if the onset time is the same in a pump, the blood insulin level should start to drop 15-30 minutes after you hit Suspend.

Based on my experience suspend function works within 20-30 mins.. remove ur pump and check ur sugars after 20-30 mins.. u ll see a high.. but then please take a corrective thereafter.

 

[Spiker]

The acting time of most of analogue bolus insulins is about 4 to 5hrs

Sent from the Diabetes Forum App

With Humalog I get most of the action complete after 3 hrs, all at 4 hrs and nothing or negligible in the 5th hour. With Actrapid it would go 4-5 hours, but that's a synthetic human insulin, not an analogue. I don't use enough Novorapid to be sure exactly where it fits in between the other two.

Sent from the Diabetes Forum App

 

[Spiker]

I take the bolus dose at the start of eating whether it's Humalog by injection or Humalog by pump. This was as taught in the DAFNE course and the pump course.

Sent from the Diabetes Forum App

 

[iHs]

Yes it will drop but if bg is low, then the suspend wont make bg rectify itself within 15 to 30 mins..only glucose and carb will do that. The suspend will only start influencing bg levels about an hour later.....its a bit like basal rate adjusting

Sent from the Diabetes Forum App

 

[Spiker]

@Giverny, the mobile app lacks a Delete Post function.

 

[Spiker]

Yes it will drop but if bg is low, then the suspend wont make bg rectify itself within 15 to 30 mins..only glucose and carb will do that. The suspend will only start influencing bg levels about an hour later.....its a bit like basal rate adjusting

Sent from the Diabetes Forum App

I must be obtuse but I still don't see why. If blood insulin starts to drop at 15-30 min then surely BG starts to rise at 15-30 min, particularly if food is being digested, but to a lesser extent even if there is no digestion.

To put it another way, if it takes an hour for a Suspend to affect the blood sugar (upwards), how can it not also take an hour for a bolus dose to affect the blood sugar (downwards)? Surely it's got to be symmetrical? Assuming the same digestive input into the bloodstream in both cases of course.

Is it because basal doses are usually much smaller than bolus doses? Is the onset time actually dose-dependant, just like action duration is actually dose-dependant?

 

[Spiker]

I started researching it. This was interesting:

http://www.diabetesnet.com/about-diabetes/insulin/insulin-action-time/duration-insulin-action

I learned that Animas and Medtronic pumps use a curve function for IOB rather than a straight line. That 5 to 6 hours is a typical total action time but individual variation is +/- 25%. Worth a read, though it didn't exactly answer my question.

Sent from the Diabetes Forum App