• Guest - w'd love to know what you think about the forum! Take the 2025 Survey »

Change in Carb to Insulin Ratio

ShellyC23

ShellyC23

Well-Known Member
Messages
169
Location
Newcastle upon Tyne
Type of diabetes
LADA
Treatment type
Insulin
When I was first prescribed Novorapid three years ago my dose was 0.5 units per 10g of carbs. Once I got the hang of it this was fine - for a while, then the rules appeared to change and I was getting higher post meal results. So I moved up to 1 unit per 10g of carbs. Same again then needed to increase to 1.5 units. Over the last couple of months I've struggled again to maintain control and gone back to the beginning, weighing and calculating everything. On Monday I had breaded cod oven baked with oven chips and counted the carbs in everything including the ketchup. My 1.5 units per 10g of carbs should have been bang on. However 2 hours later my meter have me a lovely reading of 15.4 - ***! This resulted in a temper tantrum followed by another 2 units of insulin. However after staying up way past my bedtime so I could test again it had dropped to 5.1.

So yesterday I ate minimal carbs but took 2 units per 10g and post food reading was bang on. To me it appears that rules have changed again but why has this happened? I'm not due to see Dr at Diabetic Clinic until May buy should i try to see DSN to discuss?
Sorry for long post


Sent from the Diabetes Forum App
 
Have you adjusted your basal at all during this period ? Prior to adjusting QA insulin, it's important to check your background is right. There are many whose ratio's change though. Sometimes ( and not saying this is you ), become more insulin resistant if they gain weight.


Sent from the Diabetes Forum App
 
ShellyC23 said:
When I was first prescribed Novorapid three years ago my dose was 0.5 units per 10g of carbs. Once I got the hang of it this was fine - for a while, then the rules appeared to change and I was getting higher post meal results. So I moved up to 1 unit per 10g of carbs. Same again then needed to increase to 1.5 units. Over the last couple of months I've struggled again to maintain control and gone back to the beginning, weighing and calculating everything. On Monday I had breaded cod oven baked with oven chips and counted the carbs in everything including the ketchup. My 1.5 units per 10g of carbs should have been bang on. However 2 hours later my meter have me a lovely reading of 15.4 - ***! This resulted in a temper tantrum followed by another 2 units of insulin. However after staying up way past my bedtime so I could test again it had dropped to 5.1.

So yesterday I ate minimal carbs but took 2 units per 10g and post food reading was bang on. To me it appears that rules have changed again but why has this happened? I'm not due to see Dr at Diabetic Clinic until May buy should i try to see DSN to discuss?
Sorry for long post


Sent from the Diabetes Forum App
Click to expand...
Hi ShellyC23, it's really frustrating trying to get your ratios right. I use units per grams of carbs as I find this more accurate instead og using units per CPs. I find the same happens with some meals and I end up high so I've learnt to use a different ratio(give myself a bit more insulin )for that meal. I use a different ratio for each meal anyway and when I'm at work I need a lower ratio as I need less insulin as my work is physical.

Please don't worry about the 2 hour testing as it's NOT NECESSARY......Novorapid is active up to 41/2 hours in my case and I test AFTER 4 HOURS, as recommended by DAFNE. Until I completed the course 4 months ago I used to do 2 hour test and if I was 2-4mmols higher than my before meal test, I used to do an insulin correction and at times I ended up in hypo later on and get really MAD!!! I now know that this action is so worng but my ex DSN didn't tell me not to as she kept telling me to 2 hour test. I have been referred to Addenbrookes Diabetes Team as King's Lynn couldn't help me after 4 years of THEIR treatment. However, under a new team and completing DAFNE, my HBA1C has improved from 8.9% to 7.6% and I feel so much better in mind and body. Even now I still end up high/low but I just look at my records to see where I've miscalculated or if that meal causes spikes..like one meal yesterday..Haha..bother.
 
Last edited by a moderator:
Shelly

Dont worry too much that you need to increase yr bolus in the ratio, at different times of the day, we all need to adjust them and they be different to other times of the day. Its possible that yr basal might need altering but this will be more apparent if the meal carb ratios rapidly need changing.
Its difficult to know when to correct and when not to. 15mmol 2hrs after eating is a tad too high but u probably should have waited until 3hrs and then do a bg test and if above 9mmol, then do the correction. How much of a correction should u do? Probably about half or three quarters of what you would do if u were to correct at pre meal as then about 5hrs would have gone by and Novos action would be finished. As it was, u corrected by a tiny bit too much but if u hadnt corrected at all, yr bg probably would have been on 9 or 8mmol and u might have wanted to give a bolus correction then but as many consultants are concerned about giving bolus corrections before bed cos of hypos while asleep, u, would have needed to set alarm on mobile to wake u up in the night so that u could a test.

Have u looked at the 100 rule to work out yr correction factor? If not, its fairly good and u can manipulate the factor to suit what bg target u want to get when u use it.

Sent from the Diabetes Forum App
 
Back
Top