Insulin / Carb ratio

[steveamos1234]

Hi,

I've been T1 for nearly 18 years but never really got into counting carbs. Generally I can estimate the insulin needed for a meal but only really through past trial and error. I do get caught out though.

Decided to start a diary at the weekend to see if I can improve on the accuracy. Also a change of diet to lose a few pounds! So far a bit surprised by the results though.

My average insulin to carb ratio seems to around 2.5 units to 10 grams of carbs. Which seems high? I'm also very sensitive in the mornings where the ratio is nearer 4 to 10. For example: This morning had 25 grams of carbs and injected 10 units of insulin, which kept my numbers steady to lunch.

Not that I guess it matters, but interested to know how this compares to others? Seems that most online resources claim 1 to 10 is normal?

 

[mo1905]

Guess we're all very different. I use much less. 1 unit for every 12g approx.


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[Redjason2373]

Hi Steve,

I have been type 1 for the past 21 years and I have just started carb counting and meeting with the dietician at my diabetic clinic and from what I understand the ratio should be close to 1 unit = 10 carbs.

Like you previously my levels were controlled using high units of insulin that i guessed at and altho my BS were in good range my body was turning the excess insulin into fat (because the insulin dose was too high for my requirements).
A typical evening meal for me would have been 30 units of novorapid which after meeting with the dietician is now sitting at around 10 for the same meal.

In my case it was discovered that I was also taking to high a dose of levemir in the morning which resulted in hypos around dinner time and that the ideal outcome for the time spent with the dietician is to determine what dose of levemir will keep my blood sugar readings level when no food is consumed. This might be a good starting point for your morning levels, to skip breakfast and test your BS at lunch to see if it is in the same ballpark as the morning reading, if the readings are similar then your body will probably need a bigger carbs/insulin ratio.

I hope I didn't ramble on too much and this is of some benefit. Also if your clinic has a dedicated diabetic dietician It might be worth trying to arrange an appointment with then. I'm sure they could help determine what ratios would suit you best.





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[Pepsi Max]

Hi,

I've been T1 for nearly 18 years but never really got into counting carbs. Generally I can estimate the insulin needed for a meal but only really through past trial and error. I do get caught out though.

Decided to start a diary at the weekend to see if I can improve on the accuracy. Also a change of diet to lose a few pounds! So far a bit surprised by the results though.

My average insulin to carb ratio seems to around 2.5 units to 10 grams of carbs. Which seems high? I'm also very sensitive in the mornings where the ratio is nearer 4 to 10. For example: This morning had 25 grams of carbs and injected 10 units of insulin, which kept my numbers steady to lunch.

Not that I guess it matters, but interested to know how this compares to others? Seems that most online resources claim 1 to 10 is normal?

My morning ratio is same, 2.5 units for every 10g, I used to think its high but it works for me! Other meals of the day are a little less 1.5 for every 10g. I'm using a low carb diet at the moment so I'm taking less insulin over all! It may seem high but it's whatever works for you!


Diabetic warrior since 2005!

 

[mrman]

First to do before carb counting correctly to find correct meal time ratios would be to ensure your basal is correct.


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[steveamos1234]

Thanks for the replies.

If I skip breakfast and eat nothing my numbers will rise by lunch time. But, if I increase my evening Lantus much further (currently 38 units), then I go low overnight or early in the morning.

Open to suggestions!

 

[mrman]

I was in the same situation before I got my pump. That is the best solution, as I now have alot more basal per hour early hours but reduced basal rate per hour later. That way the insulin stops the early morning rise known as dawn phenomenon, without risk of hypo. Some would split their basal if on injection so have more at night but less in the morning 12 hours apart. Some do this without problem but couldn't get that to work for me so now on pump.

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[Hooked]

Being diabetic for about 26 years now and still hanging on to the old "Exchanges" regime I was started on back then, I decided to sign up for a course with the local diabetic team to learn about carb counting and insulin adjustment. (I was changed onto novorapid and lantus years ago, but no one took time to explain to me then how much more flexible they were!) The course was excellent and real eye opener to me. If there is one local to you, I'd strongly advise signing up for it, ask your diabetic team about it.

What shocked me was just how bad I've become at counting carbs, some of my guesstimates were way off; with lots of diff foods available now that back when I was first diagnosed. Coupled with the fact that I wasn't really bothering much about my diabetes for years, my counting was sometimes way out.

Adjusting insulins to both correct AND according to what you felt like eating was mind blowing for me. I've never felt so empowered when it comes to managing my diabetes as I do since learning all this!

In the group that took part in the course, we seemed to range between 1 - 3 units per 10g of carbs. Most of us needed a slightly higher number of units per 10g in the morning compared to the rest of the day. One person was having problems with insulin resistance, sometimes taking huge amounts for certain meals, the team were talking about starting him on metaformin to help with his insulin resistance.

I too find my sugars rise by lunch time if I miss breakfast and no injection; I now make the effort to have at least 10g of carbs (usually some fruit) and my injection and it's def helping me get things more settled. It MAY be your liver putting out glucose as your body has no energy coming from food - but don't quote me on that, I'm no expert!

EDIT to add: You might be interested in the Carbs and Cals book; I find it useful for counting carbs.