Carb/Insulin Ratio

[Boozon]

Hi - Just wondering what the best foods are for calculating your ratios? If any.....or is it just case of eating 10g of anything and testing.
Appreciate that things/people/timings are different for.

 

[dancer]

I was supposed to start off at 1:10g but refused as I was already using the equivalent of 1:12g and knew I would go hypo if I changed to 1:10. After that it was a case of testing 2 hours after a meal. If consistently too high, lower the 'g' number in the ratio to increase the total insulin for the meal (and vice versa if low after meal).

 

[SamJB]

Try to keep the quantities of carbs as low as reasonably possible. Insulin pens have a precision of around 20%, and the quantities of carbs on nutritional labels have an accuracy of around 20% too. So if you have a large quantity of carbs, the calculated carb:insulin ratio will have a larger degree of error.

When I suspect mine are off, I do a spreadsheet and take an average after a couple of days of readings. I exclude breakfast readings as I experience the Dawn Phenomenon. As suggested by @dancer, a ratio of 1:10 is a good starting point. Although mine are 1:5.

 

[Boozon]

Thanks @dancer and @SamJB. Appreciate your advice. I've been generally trying a 1:10 but think I need to lower it as not coming down as quickly as I'd like. E.g. had yogurt and nuts for breakfast this morning which was 10g at most. Started at 7.7 took 1.5 units and ended up at 8.5 2hrs later. Thought I'd be lower.

 

[dancer]

@Boozon, you said breakfast was at most 10g which would mean you should have taken 1 unit if you are using a 1:10g ratio. Did you also give a correction of half a unit?

Actually a rise of 0.8 after 2 hours isn't that bad. What you definitely don't want is a rise of more than 2 to 3.

 

[Boozon]

Yes @dancer. Been finding that 1 unit hasn't been enough and I been going over 10 after 2 hrs so increased it to 1.5 over the last couple of days.

 

[dancer]

Yes @dancer. Been finding that 1 unit hasn't been enough and I been going over 10 after 2 hrs so increased it to 1.5 over the last couple of days.

So for breakfast you are using a ratio of around 1:6.5g. You could find that this ratio gives too much insulin for meals later in the day. It'll be trial and error to find out.

 

[SamJB]

I agree, a 0.8 change means you got it correct. As mentioned, breakfast is tricky as you may bend extra insulin to counteract the Dawn Phenomenon. I don’t take this into account when calculating ratios.

 

[Boozon]

@dancer. Only been on insulin for two weeks so trying to figure out how my body reacts at different times of the day.

Just out of interest how did you get to the 1:6.5 ratio?

 

[dancer]

@dancer. Only been on insulin for two weeks so trying to figure out how my body reacts at different times of the day.

Just out of interest how did you get to the 1:6.5 ratio?

1: 6g for 10g carbs would be ( 10 divided by 6 ) units which is 1.67units.

1:7g for 10g carbs would be (10 divided by 7) units which is 1.43 units

1:6.5g is between these two ratios. You took the nearest amount of insulin which is 1.5 units.

When I was on injections, I just stuck to whole numbers in my ratios. If I needed to increase or decrease my bolus, I just tried the next whole number that would give a half unit change in my dose.

 

[LooperCat]

I have a different ratio for breakfast as I’m more insulin resistant and carb sensitive in the mornings. So it’s 1:7 until midday and 1:10 after that.

 

[Boozon]

Thanks all......made my first miscalculation last night.

Weighed my food and it was a 100g of carbs.....Thought 10units is a lot so thought I'd better take 6.5 units.....halfway through my dinner I thought.....sh*t.....not 100g 0f carbs it's 26g/100g.......spent the next couple of hours eating bread to bring my carb volume up......doh!

 

[SamJB]

Thanks all......made my first miscalculation last night.

Weighed my food and it was a 100g of carbs.....Thought 10units is a lot so thought I'd better take 6.5 units.....halfway through my dinner I thought.....sh*t.....not 100g 0f carbs it's 26g/100g.......spent the next couple of hours eating bread to bring my carb volume up......doh!

Oops - we've all been there though! I've made many silly mistakes and I'm sure I always will do!

 

[LooperCat]

Thanks all......made my first miscalculation last night.

Weighed my food and it was a 100g of carbs.....Thought 10units is a lot so thought I'd better take 6.5 units.....halfway through my dinner I thought.....sh*t.....not 100g 0f carbs it's 26g/100g.......spent the next couple of hours eating bread to bring my carb volume up......doh!

Yup, we’ve all done it once (or will do ) I had to call paramedics as I’d accidentally dosed for the dry weight of spaghetti instead of the cooked weight (my husband had weighed it after cooking) because I misread the packet. I was at 2.3, falling fast and physically couldn’t fit any food in as it was a big meal and I didn’t realise until half an hour or so after. They were great, had the glucagon ready but didn’t need it, glucogel did the trick.

I went low carb the next day.

 

[sl0042]

I have been on FIASP for several months now but I find it not very successful when I add extra insulin to my dosage if my blood sugar level is a bit high; does anyone else have a problem with dosage correction?

 

[becca59]

I think it would be helpful if people said they were on a pump before posting finite ratios. You just cannot do those ratios on ordinary pens. And it can be very confusing. To anybody struggling with their doses, I got a half unit NovaEcho pen this week. It has been a revelation!

 

[becca59]

I have been on FIASP for several months now but I find it not very successful when I add extra insulin to my dosage if my blood sugar level is a bit high; does anyone else have a problem with dosage correction?

Not so far in the 5 days that I have been on it. In conjunction with my new half unit pen, I have not been out of my target range on my Libre since the change. Early days I know, but in 5 years my levels have not been this consistent. Despite a pretty low carb diet.

 

[sl0042]

Not so far in the 5 days that I have been on it. In conjunction with my new half unit pen, I have not been out of my target range on my Libre since the change. Early days I know, but in 5 years my levels have not been this consistent. Despite a pretty low carb diet.

I agree being on the Libre & FIASP has been totally beneficial but on the odd occasion my sugar level is high I have problems bringing it down

 

[dancer]

I think it would be helpful if people said they were on a pump before posting finite ratios. You just cannot do those ratios on ordinary pens. And it can be very confusing. To anybody struggling with their doses, I got a half unit NovaEcho pen this week. It has been a revelation!

What on earth do you mean by "finite ratios". You find a ratio that works for you. You may need different ratios for different times of the day. If you're on MDI all you need is a half unit pen in order to give more accurate doses for your needs.

Ok it can be easier on the pump to make smaller changes to ratios but on MDI all you have to do is work out the ratio that would give an increase or decrease in dose.
Changing from 1:10g to 1:9g might not work for your usual breakfast (i.e. give an increase of half a unit), so you could try 1:8g to see if that works. Everyone on the pump has previously used MDI, so had to figure it out the same as you.

 

[Norman83]

Try to keep the quantities of carbs as low as reasonably possible. Insulin pens have a precision of around 20%, and the quantities of carbs on nutritional labels have an accuracy of around 20% too. So if you have a large quantity of carbs, the calculated carb:insulin ratio will have a larger degree of error.

When I suspect mine are off, I do a spreadsheet and take an average after a couple of days of readings. I exclude breakfast readings as I experience the Dawn Phenomenon. As suggested by @dancer, a ratio of 1:10 is a good starting point. Although mine are 1:5.

Im 1:5 too. Is this considered poor ratio?