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Carb/insulin ratio

palm_tree

palm_tree

Member
Messages
20
Type of diabetes
Type 1
Over the last week I have been intensively monitoring my glucose readings and counting carbs and adjusting my bolus dose. It turns out I need a carb/insulin ratio of 1:1. Yes, one unit of insulin for every gram of carbohydrate I consume. This seems rather high? Does anyone have any idea as to whether this is normal or satisfactory? It seems higher than the advice on carb counting I read online.
 
It does seem quite high but then everyone is different.
When I went on a carb counting course in July the range of carb ratios was between 1:2 (1 unit insulin to 2 carbs - so quite close to yours) and 1:50 (wowsers!)
 
Thanks. I’m wondering if my basal insulin affects the bolus / carb ratio? I take 70 units a day of Levemir which I think is pretty high too.
 
Hi @palm_tree, From my experience as a T1D, and not as professional advice or opinion.
1) Does your C/I ratio of 1:1 apply for all meals? With use of my insulin pump my ratios are different between morning and evening meals.
2) What type of carbs do you eat? If your carbs are the type that are absorbed quickly you may need more bolus (short-acting) insulin to deal with the high rise BSL compared to lower GI/GL carbs (please see mendosa.com, GI, GL definitions and Glycaemic Values for an explanation). Basically not all carbs are created equal.
3) Levemir is reputed to last 12 to 16 hours, sometimes stretching to 24 hours - so it may be that your basal insulin is running out and so one meal time eaten in the hours before the next daily shot of Levemir might require more short-acting compared to another time of day.. Many of us take Levemir twice daily to avoid this problem.
Of course please discuss 1) and 2) with your DN or doctor before making any alterations.
Best Wishes and please let us know how things go !!
 
@Rokaab As far as basal dose is concerned I don't think it's quantity that matters - I'm on slightly more Levemir than you. It's whether it is "correct". Otherwise you are compensating for too low a basal dose with more bolus or vice versa.
I'm in the middle of "resetting" my basal as I'd let it drift (too low) & as I get closer my boluses get smaller.
Carb ratios can be confusing as we used to call 10gm a "Carb". In the USA I think it was 15gm.
 
Wow that's a lot of insulin! But not saying it's wrong either, so long as your BGL is stable and in the right 'zone' :)

I was going to say - Could I ask if you are on the slightly large than most body scale?!? but it's only in the last week(or so) that you're insulin needs have gone up, no one puts weight on that quickly!

You may be coming down with something? illness does raise BGL.

Maybe if it continues you could see about getting metformin if it is insulin resistance.
 
Thank you for your detailed response. I am using a ratio of 1:1 for all my meals, though I find it best if I have my evening meal as early as possible as later in the evening the insulin appears to be less effective.
I need to look into the different types of carbs in a bit more detail. I am aware that there are differences and I try to avoid the
Rokaab said:
It does seem quite high but then everyone is different.
When I went on a carb counting course in July the range of carb ratios was between 1:2 (1 unit insulin to 2 carbs - so quite close to yours) and 1:50 (wowsers!)
Click to expand...

Thanks. I am thinking of going on a carb counting course soon!
 
slip said:
Wow that's a lot of insulin! But not saying it's wrong either, so long as your BGL is stable and in the right 'zone' :)

I was going to say - Could I ask if you are on the slightly large than most body scale?!? but it's only in the last week(or so) that you're insulin needs have gone up, no one puts weight on that quickly!

You may be coming down with something? illness does raise BGL.

Maybe if it continues you could see about getting metformin if it is insulin resistance.
Click to expand...

I tried Metformin and it just made me feel very very sick. I don’t think I can handle it! My BMI is just over 30 so im ask trying to lose weight. I have no idea how long I have had an Insulin resistance problem as I am not a good role model for Type 1 diabetes with very poor monitoring and pretty much oblivious to how much insulin I have been taking. I now realise that has to change and I need to take things much more seriously! Thank you
 
kitedoc said:
Hi @palm_tree, From my experience as a T1D, and not as professional advice or opinion.
1) Does your C/I ratio of 1:1 apply for all meals? With use of my insulin pump my ratios are different between morning and evening meals.
2) What type of carbs do you eat? If your carbs are the type that are absorbed quickly you may need more bolus (short-acting) insulin to deal with the high rise BSL compared to lower GI/GL carbs (please see mendosa.com, GI, GL definitions and Glycaemic Values for an explanation). Basically not all carbs are created equal.
3) Levemir is reputed to last 12 to 16 hours, sometimes stretching to 24 hours - so it may be that your basal insulin is running out and so one meal time eaten in the hours before the next daily shot of Levemir might require more short-acting compared to another time of day.. Many of us take Levemir twice daily to avoid this problem.
Of course please discuss 1) and 2) with your DN or doctor before making any alterations.
Best Wishes and please let us know how things go !!
Click to expand...
I have made an effort in the last few weeks to eat less carbs and to make sure they are at the lower end of the GI scale. I already split the Levemire into two doses, 40 at night and 28 in the morning and I think that does help as it doesn’t last anywhere near 24hours if I inject once a day. Waiting for an appointment with the dietician to discuss a way forward! Thanks for your helpful advice. Best wishes
 
DunePlodder said:
@Rokaab As far as basal dose is concerned I don't think it's quantity that matters - I'm on slightly more Levemir than you. It's whether it is "correct". Otherwise you are compensating for too low a basal dose with more bolus or vice versa.
I'm in the middle of "resetting" my basal as I'd let it drift (too low) & as I get closer my boluses get smaller.
Carb ratios can be confusing as we used to call 10gm a "Carb". In the USA I think it was 15gm.
Click to expand...
Thanks. Do you know if there is a way of testing to work out what my basal dose should be?
 
There is an often reccomended web site which takes you through this - can't find it at the moment, sorry. Hopefully someone else will come along with it soon.
The best way is to use a Libre or CGM if you can afford it.
I had to split my Levemir to make it work though it took me quite a while to get the split "right" even with the help of my Dexcom.
 
palm_tree said:
Over the last week I have been intensively monitoring my glucose readings and counting carbs and adjusting my bolus dose. It turns out I need a carb/insulin ratio of 1:1. Yes, one unit of insulin for every gram of carbohydrate I consume. This seems rather high? Does anyone have any idea as to whether this is normal or satisfactory? It seems higher than the advice on carb counting I read online.
Click to expand...
At the moment mine is quite high too but mainly because my levimir is not working! I have an appointment with the DSN in 2 weeks who is usually very helpful but tomorrow I have to go and see the useless nurse from my surgery to get my bloods done. I’ve decided to just agree with everything she says instead of fighting her - it’s too exhausting!
 
In your position I'd be suspecting that you've got some insulin resistance going on (ie "double diabetes" you've got a bit of T2 as well as T1). I'd be tempted to go lower carb just to see if it helps, but everyone's body is different and if what you're currently doing is working for you then there's probably no need to change.
 
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