Insulin 101 – did I miss that class?

I swear I know how insulin works. Really, I do! I’ve always been told that NovoLog in my pump has an active life of about 3 hours, with it’s highest time of effect being within 1-2 hours of taking it.  (Of course, I just bulled my way through the ho-hum boring patient information leaflet and it says it sticks around and is active for 3-5 hours. Learn something new every day!)

Blue skies.....reminds me of a songSo WHY then, after I did a site change before lunch, do I end up crashing and staying low all evening (after micro-bolusing for a high carb dinner even), which was like, close to 8 hours after last taking a rage-bolus of insulin?

Seriously, it drives me nuts. The hanging out in the 200s for several hours after a pump infusion set site change is bad enough. But then, add insult to injury when suddenly, all those attempts at correction boluses come avalanching (is that a word? It is now!)  into effect 8 hours later? It makes no sense!! Are the cells around the new infusion set site area just holding onto the insulin for a while until it calms down from some sort of site trauma? Do I really not understand Insulin 101 and how long it works in your body/ what it’s time-frame of effect is?

Whatever the issue with me and my insulin education, I am happy to have my Dexcom CGM clue me in when the sugars-tumbling-down begins. Guess it’s time for some more learnin’, ya’ll.

5 thoughts on “Insulin 101 – did I miss that class?

  1. “Are the cells around the new infusion set site area just holding onto the insulin for a while until it calms down from some sort of site trauma” <–it HAS to be this! What else could it be?? You are totally on to something here.

  2. It’s not so much about how insulin works, but rather how your body works. The insulin you’re taking within 2-3 hours after site change isn’t really going to work until the “injury” and inflammation from insertion has gone down. Once this is gone, the site tends to want to start working… all at once. Try taking an Advil or two about an hour before a site change if you can. 😉

  3. So, it is kind of “pooled up” then, you think? I guess I always imagined it was being absorbed, and starting the ticking clock of how long it worked, but then it was just not working. Now (light bulb!) it seems it’s not being absorbed – like you said, until the inflammation/injury goes down – and then suddenly, it’s there and working when I least expect it and for longer than expected, but really for it’s true lifetime. Advil is a good idea, but I hate taking meds upon meds, and worry about Advil’s long term affect on my stomach (with which, I already have gastro-intestinal issues.) Just another variable to deal with!!

  4. site trauma for sure.
    can’t tell you how many times this used to happen to me. bolus, bolus bolus and nothing nothing noth…. BAM!

    Glad you have a CGM. My life is so much better when I can afford one (which is like never)

  5. I’ve also read that it’s a little bit like carving a new stream. Insulin that is already flowing works great, but insulin that needs to push through a new area is slower, which is why people go high after an insertion. There’s also insulin absorption to factor in, which can keep insulin from working at other times.

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