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blood levels spiking

so how do you decide how much insulin to give when you carb count? What ratio do you use? or don't you use one?!
 
was using 1 unit to 20grams carbs this was decided by the diabetic nurse in may 2010
this was changed to 1 unit =15grams in july 2010
this was changed to 1 unit = 9grams at breakfast 1 unit = 20grams at dinner 1 unit = 10 grams at tea time all these changes are given to me in a letter with no explanations given which i find very upsetting they do not ask me for any information from me all they use are the readings i put in the record book
 
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