Bolus dose calculation - after many years doing it my way!

andyasw

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I saw my consultant who informed me that after being type 1 for 34 years I need to comply with the "proper" insulin calculation. This requires dividing the carbohydrate gram dose by 5 to equal the number of Bolus insulin (there is a correction dose formula too).

My question is when should I start this regime? And how long is it likely to be, once started, that my Basal dose becomes apparent that a change is needed? Do I commence at the beginning of a day or at just anytime?
 

EllieM

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Hi @andyasw. That is the normal method of calculation, but the ratios vary from person to person and may need adjustment. Some people even have different insulin ratios at different times of day and some people need extra insulin to counteract the dawn phenomena even if they eat no breakfast.

I assume he suggested this because your current method isn't working as well as you'd like?

I don't think it matters much when you start. Did your consultant tell you how to do basal testing? Personally I try to get the basal right before I mess around with bolus ratios... It should be apparent that your basal is wrong when you go for a long period (eg overnight) without food or bolus and your levels don's stay roughly level....

Good luck.
 
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miahara

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Hi @andyasw !
As Ellie says you should get your basal sorted first before tweaking bolus doses. The carbs divided by 5 is a very, very broad-brush way of establishing bolus dose; you need to try it and see. My bolus insulin-carb ratio varies considerably for different meals.
Further more you'll find that you'll probably have to adjust basal and bolus from time to time. I've just lowered my basal by one unit as I've started having early morning lows and I know that once the weather warms up and I become more active I'll have to adjust bolus too.
 

Jaylee

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I saw my consultant who informed me that after being type 1 for 34 years I need to comply with the "proper" insulin calculation. This requires dividing the carbohydrate gram dose by 5 to equal the number of Bolus insulin (there is a correction dose formula too).

My question is when should I start this regime? And how long is it likely to be, once started, that my Basal dose becomes apparent that a change is needed? Do I commence at the beginning of a day or at just anytime?

Hi,

I have to concur with @EllieM & @miahara .

To draw a builder analogy. get your basal dose correct. (The foundation solid.) else you will see many cracks in the "wall plaster" wondering what's happening regarding insulin to carb ratios??

Talk to your consultant. But this link explains. https://www.mysugr.com/en/blog/basal-rate-testing/
 

andyasw

Member
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13
I saw my consultant who informed me that after being type 1 for 34 years I need to comply with the "proper" insulin calculation. This requires dividing the carbohydrate gram dose by 5 to equal the number of Bolus insulin (there is a correction dose formula too).

My question is when should I start this regime? And how long is it likely to be, once started, that my Basal dose becomes apparent that a change is needed? Do I commence at the beginning of a day or at just anytime?
 

andyasw

Member
Messages
13
Hi @andyasw. That is the normal method of calculation, but the ratios vary from person to person and may need adjustment. Some people even have different insulin ratios at different times of day and some people need extra insulin to counteract the dawn phenomena even if they eat no breakfast.

I assume he suggested this because your current method isn't working as well as you'd like?

I don't think it matters much when you start. Did your consultant tell you how to do basal testing? Personally I try to get the basal right before I mess around with bolus ratios... It should be apparent that your basal is wrong when you go for a long period (eg overnight) without food or bolus and your levels don's stay roughly level....

Good luck.

Thank you for your reply I've taken the advice onboard.
 

andyasw

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jonathan183

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I suggest you make the switch in the morning so that you are awake and can respond to any issues that result such as lows or highs and can monitor your blood glucose levels in case they develop ;)