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What Does “Insulin on Board” Mean? Decoding Diabetes Jargon

You’ve probably heard doctors or other people with diabetes use terms like “insulin on board” and wondered what in the world they’re talking about. This quick guide breaks down what it means and hopefully will help you make smarter decisions related to your insulin dosing and timing.

Introducing “Insulin on Board”

When you take insulin for mealtime or correction doses, that insulin stays active in your body for several hours. The amount of insulin still working in the background is insulin on board or IOB. Simply put, it is insulin that’s been injected but hasn’t finished acting yet. Fast-acting insulin, for example, will remain active in your system 3 – 5 hours after dosing.

Your insulin pump can actually calculate your IOB for you based on the details of your recent boluses. This helps prevent stacking multiple doses too close together and risking hypoglycemia from too much active insulin. It is important to frequently check Continuous Glucose Monitor (CGM) readings throughout the day as well. If you do not have one, we at Medically Modern would be happy to delivery one to you, completely covered by your insurance!

Why is IOB Important?

Knowing your IOB helps ensure you give the right amounts of insulin at the right times. If you have too much IOB, taking another bolus dose could drop your blood sugar too low. Not enough IOB means your previous doses may have worn off, putting you at risk for hyperglycemia. Monitoring IOB, especially when making dose adjustments, helps keep your blood sugar in a safe range.

How is IOB Calculated?

Insulin pumps use the details of your recent boluses – the type of insulin, the dose, and the time administered – to determine how much of that insulin is still working. Most pumps assume fast-acting insulin lasts 3 to 5 hours based on the specific type. So if you took a bolus 2 hours ago, your pump would calculate you likely have 1 to 3 hours of insulin still active, depending on the insulin. IOB is an estimate, but following the guidance can help improve your control.

Understanding insulin on board is key to effective diabetes management. Talk to your doctor or diabetes educator to learn more about how IOB applies to your specific treatment plan. Monitoring IOB and factoring it into your dosing decisions will help you keep your blood sugar levels on target.

Continuous Glucose Monitoring

CGMs can help you stay ahead of the highs and lows, providing real time alerts so you can properly detect and treat out-of-range levels. For more information, visit and fill out a 30-second patient intake form.


So there you have it – now you’re in the know when it comes to that mysterious term “insulin on board.” Understanding diabetes jargon like this empowers you to have more informed conversations with your healthcare provider. Don’t be afraid to speak up and ask for clarification whenever you come across terminology you don’t grasp. The more you know, the better you’ll be able to manage your condition. And who knows – maybe someday you’ll be the one explaining “insulin on board” to a newly diagnosed person. Paying it forward with your hard-earned knowledge is one of the most rewarding parts of living with diabetes.

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