Ruth Roberts MA |

Ruth Roberts MA

Ruth Roberts, MA, is a medical writer, editor and educational consultant on intensive self-management. She has been involved in diabetes support groups for over 20 years and has coauthored several books on diabetes. She is a professional member of the American Diabetes Association, has served on the Board of Directors for the International Diabetes Athletes Association. She manages business matters and product development for the company. Her expertise in presenting complex information in a clear, easy-to-read format benefits our publications. She worked for 20 years in academic teaching and corporate training before developing the company.

Duration of Insulin Action

The duration of insulin action time (DIA, or active insulin time) is how long a bolus of insulin lowers your glucose. The DIA time starts when a bolus is given and ends when the bolus is no longer lowering the glucose. Like any medication you take, it is important to know whether insulin is still working or is “used up” before you take more. Boluses are frequently given before the previous bolus or boluses are used up. This is called insulin stacking. In the APP study, 64% of 132,000 bolus doses from 396 insulin pumps were delivered within 4.5 hours of a previous bolus, so most boluses involve some degree of insulin stacking.1 After a bolus is given, an accurate DIA minimizes insulin stacking and lessens hypoglycemia by accurately tracking how much insulin activity remains from previous boluses. This is reported as Insulin On Board or active insulin on a pump screen.

Hepatic Activation

What is Hepatic Activation?

The theory behind the procedure is that diabetes is a complex metabolic process gone awry. Traditional diabetes therapy attempts to normalize blood sugar levels without considering the complexity of the problem. The simple strategy of most therapy is, "Give insulin when glucose is high and don't give insulin when glucose is low or normal." In contrast, Hepatic Activation attempts to reestablish the normal biochemical and physiological relationships between the gastrointestinal tract, liver and muscle.


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