What Is Insulin On Board
Insulin on board is how much active rapid-acting insulin you have in your body. Ive also seen it described as BOB , or unused insulin.
Rapid-acting insulin is the type of insulin people living with insulin-dependent diabetes use when we eat or need to correct highs. Common brand names of active insulin are: Humalog, Novolog, and Fiasp. Its also the type of insulin that is used in insulin pumps.
Too much IOB will lead to low blood sugar and too little to high blood sugars .
IOB is important since injected rapid-acting insulin can last in the body for 3-5 hours. That means that you should be paying attention not just to how many units of insulin you inject but also to how much is left of that dose up to 5 hours after your injection.
How long insulin is active in the body is a range because we all metabolize insulin at a slightly different rate. Most insulin pumps will be set to 3 hours, and most doctors recommend testing ones blood sugar about 2 hours after a meal bolus, in part to check IOB and if a sufficient meal bolus was administered.
If you use an insulin pump, the pump will tell you your IOB from all boluses.
However, its worth noting that it does not include the basal which is also rapid-acting insulin. Overlooking the pump basal insulin when discussing active insulin is problematic especially for exercise, since too much IOB, from boluses or pump basal, will make blood sugars drop.
Total Daily Insulin Requirement
= 500 ÷ TDI = 1unit insulin/ 12 g CHO
This example above assumes that you have a constant response to insulin throughout the day. In reality, individual insulin sensitivity varies. Someone who is resistant in the morning, but sensitive at mid-day, will need to adjust the insulin-to-carbohydrate ratio at different meal times. In such a case, the background insulin dose would still be approximately 20 units however, the breakfast insulin-to-carbohydrate ratio might be breakfast 1:8 grams, lunch 1:15 grams and dinner 1:12 grams.
The insulin to carbohydrate ratio may vary during the day.
The Difference Between Estimated Average Glucose And A1c
Remember, the A1C measurement stems from the two or three months that your red blood cells are alive. So, the test provides your doctor with much-needed visibility into how sugary your blood has been recently. They’re able to see this for a more extended period than with CGM and glucometer measurements. But because A1C represents sugar levels over such a long period, your doctor reads the results as an average percentage. This differs from the volumetric measurement of your other glucose readings.
Still, A1C is not a count of your blood sugar: it’s the measurement of how much hemoglobin has sugar stuck to it. The blood sugar measurements youâre used to are from the glucose floating around your blood plasma when your meter or CGM takes the reading. So, while A1C can be a helpful tool to estimate how your blood sugar has been on average, itâs not literally your blood sugar count.
You may have had your doctor explain your A1C levels in terms of Estimated Average Glucose, or EAG. Studies have linked EAG and A1C through formulaic conversion. Like A1C, it is an expression of your blood sugar over a few months. Itâs convenient for those monitoring their blood sugar since EAG is a more relatable measurement of mg/dL, the same units used on any glucometer or CGM.
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When Should I Test My Blood Sugar
You may need to check your blood sugar several times a day, such as before meals or exercise, at bedtime, before driving, and when you think your blood sugar levels are low.
Everyone is different, so ask your doctor when and how often you should check your blood sugar. If you’re sick, you’ll probably need to test your blood sugar more often.
Why Are Blood Sugar Levels Important
Measuring blood sugar levels and understanding what your glucose levels should be is an essential part of diabetes treatment for many people with diabetes.
Blood sugar level refers to the total amount of glucose circulating in the blood. In different parts of the world, different units for measuring blood glucose are standard.
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How To Calculate Your A1c
The Hemoglobin A1c test is a blood test used to measure the average blood glucose concentration in your body in the past 1-3 months. For diabetics, this is the standard way of determining how well the diabetes is controlled. An A1c of less than 7% is considered good.
Getting the test every 3 months is usually enough. But sometimes you may want to just estimate your A1c level based on the data from your regular self-tests. The formula below could help in this case.
Accuracy, of course, could vary depending on how often and when you check your blood sugar. I found it pretty accurate last time I used it. My calculation was off only by 0.1%. This is the same formula GlucoseTracker uses in the app’s dashboard.
Glucose in mg/dL:
Glycemia Or Blood Glucose Definition
Glycemia indicates the presence of sugar in a persons blood, but the term can also indicate the sugar concentration in the blood. Glucose is a vital energy source persons body can make, however glucose generally comes from the food a person consumes. The blood sugar analysis gives the most precise results in venous blood serum because sugar in capillary blood utilized by the known glucose meters is expected to grow considerably towards the higher point after having food.
There are other sugars as well present in the blood besides glucose. Food is composed of numerous types of sugars like fructose from fruits, maltose, sorbitol, galactose, and lactose from dairy products. These sugars are inert pertaining to the human metabolism and its regulation by the hormone insulin, and consequently, sugar in the blood tends to denote glucose alone.
- Hypoglycemia: in healthy individuals, glycemia under 2.8 mmol/L , in diabetics when the levels reach under 3.9 mmol/L .
- Normoglycemia: also called normal blood glucose, the levels are between 2.8 mmol/L and 5.5 mmol/L as well as for diabetics, 3.9 and 5.5 mmol/L .
- Hyperglycemia: when the glucose levels are greater than 11.1 mmol/l , the condition is called hyperglycemia. Long-term hyperglycemia is linked to heart or kidney problems, diabetes mellitus, whereas hypoglycemia can cause tiredness, shaking, sweating, muscle fatigue as well as hindered mental ability.
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How To Calculate Iob
If you dont have access to any devices or apps that calculate your IOB for you, or if you want to know your pump basal IOB, you can calculate your IOB fairly easily on your own.
In this video, Ill walk you through examples of how to calculate your pump basal IOB and your IOB from injections.
Id recommend going through the exercise of calculating your IOB a few times and start paying attention to how different levels of IOB impact your blood sugar in different situations.
Here are two additional examples
Basal IOB Example
Basal per hour is 1 IU, assuming insulin is active for 4 hours in the body:
1 IU x 25% + 1 IU x 50% + 1 IU x 75% + 1 IU x 100% = Total: 2.5 IOB
Bolus IOB Example
1 IU injected 1 hour ago and 2 IU injected 3 hours ago, assuming insulin is active for 4 hours in the body:
2 IU x 25% + 1 IU x 75% = 1.25 IOB
Quick A1c Calculator: All You Need To Know About A1c In 2017
Have you heard your doctor or friends mention the term âA1Câ and wonder to yourself what in the world does it mean? Or its could be familiar word, but you never really understood what it meant for you? Fret not. After reading this, youâll know exactly what A1c is, what your ideal A1c should be, and how you can estimate A1c using an A1c calculator/converter. And I promise Iâll make it easy for you to understand. What does A1c stand for? HbA1C is a medical term, and refers to glycated haemoglobin. Haemoglobin is the oxygen-carrying molecule in your red blood cells. So this is actually a measure of how much glucose is attached to the haemoglobin in your red blood cells. It is done as a blood test, usually ordered by your doctor every 3 â 6 months if you have diabetes. Youâll see your result displayed as a percentage in your blood test report . Since your red blood cells typically live for approximately 8-12 weeks, your A1c number serves as a marker of your average blood glucose levels over the past 2 â 3 months. This is how a typical A1c result will look like in your blood test report. What is a normal A1c level? And how about in diabetes/ prediabetes? A healthy person has an A1c of 5.6% or less. A person with Prediabetes usually has a A1c between 5.7% and 6.4% A person is diagnosed with Diabetes when his or her A1c is more than 6.5%. The higher your average blood glucosContinue reading > >
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You’ll Need To Calculate Some Of Your Insulin Doses
You’ll also need to know some basic things about insulin. For example, 40-50% of the total daily insulin dose is to replace insulin overnight.
Your provider will prescribe an insulin dose regimen for you however, you still need to calculate some of your insulin doses. Your insulin dose regimen provides formulas that allow you to calculate how much bolus insulin to take at meals and snacks, or to correct high blood sugars.
Why Are Blood Glucose Levels Significant
Blood sugar measurement and understanding what the sugar levels must be is an important part of diabetes management for lots of diabetics these days. Blood glucose level is nothing but the total amount of sugar circulating in the bloodstream. Various parts of the world have diverse units for measuring blood sugar levels as their standards.
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How To Check Blood Sugar Without A Meter
Diabetes is a chronic condition where the body either doesnt make enough insulin or doesnt use insulin properly or both. This can lead to a higher than normal blood sugar level.
Uncontrolled blood sugar levels can lead to complications, such as:
- heart disease
- nerve damage
For these reasons, its important to monitor your blood sugar if you have diabetes.
Prior to using meters, people with diabetes would monitor their blood sugar by testing their urine. This method, however, wasnt as accurate, nor did it provide real-time results.
If you self-test your blood sugar several times a day using a glucometer, or meter, it requires that you prick your finger to draw blood to test. Due to the discomfort of this method, you might look for a way to monitor your level without this tool.
If finger pricks are very bothersome for you, dont worry theres hope. Advances in blood sugar monitoring technology could mean no more finger pricks in the future.
If you have diabetes, there are several portable devices you can use to check your blood sugar level and not all of them require a finger prick.
How Do I Keep My Blood Sugar Normal
To keep your blood sugar normal:
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Glycemia Definition And Measurement
Glycemia means precisely the presence of glucose in one’s blood, but the term is also used for the concentration of glucose in the blood. The analysis is most accurate in venous blood serum, as glucose in capillary blood used by popular glucose meters tends to grow significantly higher after meals.
2.8 mmol/L and 5.5 mmol/L and 3.9 and 5.5 mmol/L for diabetics.
Try Our A1c Calculator
Not everyone loves crunching numbers, so if that formula is too much of a hassle, try our handy estimator:
Remember, you only see a rough estimate when calculating your A1C without using a proper lab test. Any calculator will use your blood glucose to estimate your A1C. As you now know, this is only a derivation and not an actual measurement.
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How Is Glucose Measured In The Lab
While most conventional laboratory techniques measure blood glucose as concentration in plasma or whole blood, direct-reading electrode systems measure it as molality in mmol/kg water, which is numerically greater, but results are often factorized and expressed, e.g. as plasma glucose concentration.
Why Do Blood Sugar Checks
HbA1c blood sugar check is highly recommended for those who have diabetes. The goal is clear, to monitor blood glucose levels in the body. In addition to people with diabetes, someone who is at risk or suspected of having diabetes or who was previously diagnosed with prediabetes, also needs to undergo this test.
A person is recommended to do an HbA1c test if they experience symptoms of diabetes, such as:
- Its easy to feel thirsty even though youve been drinking.
- Increased frequency of urination, materials to disrupt sleep.
- Its easy to feel tired.
- Blurred vision
In addition, HbA1c blood sugar checks are also recommended for those who have a risk of developing diabetes. For example:
- Overweight or obese.
- Physical inactivity or infrequent exercise.
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Tips For Checking Your Blood Sugar With Less Pain
Fingertips have more nerve endings, so this part of the finger tends to be the most sensitive.
If you use a finger prick to check your blood sugar level, a few techniques can make the process less painful whether youre using a glucometer or a continuous glucose monitor.
Blood sugar testing is crucial to diabetes management because high or low blood sugar can cause severe complications. If too much blood sugar accumulates in your bloodstream, you can experience major complications such as:
- nerve damage
- difficulty speaking
Blood sugar can fluctuate throughout the day especially after meals, after exercising, and during stressful events. So its important to carefully monitor your blood sugar and keep it within a healthy range.
A blood sugar level less than 140 milligrams per deciliter , but greater than 70 mg/dL is typically considered in the target range.
You should check your blood sugar regularly, even if you arent experiencing symptoms of a high or low glucose level. Some people with high and low blood sugar dont have any symptoms.
How To Calculate Your Blood Sugar Level: The Complete Guide
To get an accurate reading of your blood sugar level, the best and most effective method is using a glucose meter. This will involve a small prick in your finger so receive a blood sample. The strip is then inserted into the meter and tested.
You may be wondering what your reading should be. There is no normal reading, an ideal reading differs from person to person. Everyone will get different readings at different times of the day. However, there is a rough range to determining a low, normal and high blood sugar level. Blood sugar level is read in mmol/L, which stands for millimoles per liter. Here is a guide as to what an ideal reading is for each diabetic type and non-diabetic patients:
|4 5.9 mmol/L< 7.8 mmol/L||4 5.9 mmol/L< 7.8 mmol/L|
It is advised to check it regularly if you are concerned, show regular symptoms or have diabetes. You should check before meals, exercise, before bedtime and after driving. Everyone is different so it is best to ask your doctor if you are unsure how many times and when you should check your blood sugar levels.
Research shows that over 50% who try to estimate their blood sugar level reading are incorrect. This may be due to over underlying medical conditions that did not know they had or poor lack of judgement. Therefore, this suggests it is very important to test at home to check in on your levels regularly to avoid any unnecessary future complications.
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High Blood Sugar Level Causes
Several types of diabetes and medical conditions are the primary cause of high blood sugar levels. Most of which are unpreventable issues but are the reason for a spike in high blood sugar. The causes for high blood sugar levels are as follows:
Causes of low blood sugar levels are very different and are as important to be aware of, as they are in fact easier to control.
When Is It Important To Pay Attention To Iob
While it is important to focus on IOB throughout the day, these are three of the most important times to pay special attention to it:
When you exercise
Your insulin sensitivity is heightened during and after exercise, increasing the risk of low blood sugar. By paying attention to your IOB, and how your blood sugars react when you do different types of exercise, youll be able to adjust your IOB so that you can exercise with balanced blood sugars.
And in those situations where you cant plan ahead, youll know if you have too much IOB and youll need a carbohydrate snack.
Getting a good nights sleep can be hard with diabetes and no one wants to deal with low blood sugars at night or waking up with a blood sugar hangover after having high blood sugars all night.
Checking your IOB and blood sugars before bed can help you assess if its safe to go to bed, if you need a snack to prevent a low blood sugar, or if you should take a correction dose for a high blood sugar.
Before meals or corrections
IOB should be part of every meal and correction calculation and can make your insulin doses more precise.
Knowing your IOB allows you to dose when needed, eat when you feel like it, and it helps to build confidence in the insulin doses you take.
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