Bolus requirements increasing but no change to basal?

[pinewood]

Is this normal? In the past few weeks my I:C ratio has increased to about 1 unit for every 10g of carbs; it used to be more like 1 unit for every 20g. However, my Lantus dose has remained steady at 10 units per day.

Is it a bit strange to have a 1:10 I:C for bolus but only 10 units basal requirement?

 

[noblehead]

They say it should be around a 50/50 split @pinewood between basal & bolus, but diet and exercise can alter this as we all well know.

I work on a 1:10 ratio for nearly all my meals and my basal is presently 15.85u, it is what it is and provided your bg levels are under control I wouldn't worry too much about it, anyway it may just be that your HP is coming to a end.

 

[pinewood]

Thanks @noblehead, I'm probably putting too much thought into it. I'll just keep an eye on it, hopefully my basal isn't also on the way up.

 

[BeccyB]

it is what it is and provided your bg levels are under control I wouldn't worry too much about it,

Absolutely agree. There are no hard & fast rules so if it works for you then all's good!

 

[Kristin251]

Have you changed your meals like more or less fat or more or less protein? I need to look at the whole meal not just the carbs as protein and fat change the timing of the carbs. If I eat a low fat or low protein meal I spike much faster and would require more insulin

 

[becky.ford93]

I have exactly the same thing, I was diagnosed about a year ago and my ratio over that time has gradually gone from ~1:20 to now being 1:10. However, my basal is still only 5 units (Lantus) and has been for months. I take about 20 units bolus a day so it's definitely not a 50:50 split for me, for now. If I took 20 units basal at night I'm not sure I'd wake up again!!

 

[pinewood]

@Kristin251 - good point but no, no particular changes to the food I eat and I'm pretty good at working out insulin timings depending on fat content etc.

@becky.ford93 - sounds similar, glad it's not just me! Maybe we are slowly pulling out of the honeymoon phase; it's been nearly 18 months for me now. I had 22 units of NovoRapid on Saturday, which I think is my all-time daily record (although I ate a lot that day!) ... it seems pretty crazy when compared against my 10 units of Lantus. Perhaps our beta cells are still able to manage us when fasting but are slowly getting worse at dealing with carb intake.

 

[becky.ford93]

Yeah I think that must be it. Especially because I can go to bed quite high (if it's been a bad day) and wake up fine without having a correction dose. Glad to know I'm not alone as the consultants don't seem to know what's going on and keep just putting it down to the honeymoon

 

[ArtemisBow]

I'm in the same boat - basal only about 4 units, but ratios across the day vary from 12:1 to 8:1, so most days I am around 70-80% bolus. I've done plenty of basal tests and it's in the right place, just seems to be what I need. As long as you have tested your basal I don't think it's an issue.

 

[drahawkins_1973]

The same thing happened to me. I was diagnosed 3 years ago and after about a year or so (I forget now) my bolus requirements changed from about 1:20 and eventually settled on 1:10 and they’ve remained pretty constant ever since (less predicatable in the morning but I think that’s pretty common) . I also didn’t see any increase in my basal of about 3 units at the time, however since the end of January this year for some reason my basal has shot up from 3 units to 8. It was literally overnight, but now I’ve found the right level everything seems to have settled down again. Maybe it is the last of the beta cells finally dying off
I'd agree with ArtemisBow that as long as you have tested your basal I don't think its an issue either, its just rather frustrating.

 

[staffsmatt]

They say it should be around a 50/50 split @pinewood between basal & bolus, but diet and exercise can alter this as we all well know.

I work on a 1:10 ratio for nearly all my meals and my basal is presently 15.85u, it is what it is and provided your bg levels are under control I wouldn't worry too much about it, anyway it may just be that your HP is coming to a end.

Really!? Never knew that. Don't think that would work for me either I'm on 8 basal and an average of 15 bolus. Don't think it's HP for me though

 

[azure]

My basal/bolus split isn't 50/50 either. I have more bolus than basal by a long way.

I wouldn't worry about it. We're all different and the only 'right' answer is the what allows us to control our blood sugar.

 

[iHs]

I have exactly the same thing, I was diagnosed about a year ago and my ratio over that time has gradually gone from ~1:20 to now being 1:10. However, my basal is still only 5 units (Lantus) and has been for months. I take about 20 units bolus a day so ifinitely not a 50:50 split for me, for now. If I took 20 units basal at night I'm not sure I'd wake up again!!

In general, the more basal someone uses also means a bit less bolus to balance up the effect the combination of the two insulins have on controlling bg levels but insulin is insulin and any insulin will to whatever effect, control bg levels ok or not ok and a lot does depend on food that is eaten and the tining. So on 20u basal with 20u bolus, you would most likely go hypo until you were able to adjust one with the other to get the right balance. Basal bolus is complicated