In theory, but not always....! I've seen some very odd results with Pumpernickel.
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DAFNE Rules and Hypos: Accurate?
- Thread starter Bluemarine Josephine
- Start Date
Bluemarine Josephine
Well-Known Member
The 100 rule doesn't work for me. I tend to use rules like that as a rough guide only.
@Bluemarine Josephine If this drop and difficulty in getting your BS up is a reasonably frequent occurrence, then maybe look at your insulin dosages rather than the effect of glucose. I know it's much trickier to make tiny adjustments when you're on MDI rather than a pump, but what I used to do is find a way that worked for each meal/high sugar/whatever, even if my way was a bit of a hodge-podge of things.
What works for you is what's important
Hello My lovely Azure!
Thank you for your suggestion.
I must admit that I am puzzled regarding the rules as well.
For example, I did my correction factor. Here it is:
My overall daily insulin intake (basal/bolus) is 8 units Levemir + 3 units Novorapid with meals x3 meals + 7 units Levemir = 24 units overall. 100/24 = 4.1 therefore 1 unit of Novorapid corrects my BG by 4.1 mmols.
For the sake of argument and since it is not far off from the DAFNE, I assume that the correction factor could be correct.
The insulin to CP ratio, however, is a whole different story… I applied the 50 Rule, dividing the average total insulin dosage by 50 to give units of insulin per CP so, similarly, 24/50 = 0.48 rounding it to 0.50 equals ½ unit therefore, this means that I need 1/2 unit to cover 1CP or 1 unit to cover 20 grams of carbs… and I find it…awkward....?
Bluemarine Josephine
Well-Known Member
Tim, please do tell! I am very interested!
Our DAFNE educators always urged us to make low glycemic load choices.
I understand that for Type 2s they may be an optimal choice.
Is there a "trick" as to how these food choices work for us,Type 1s, who are on a basal/bolus treatment?
Ah well, that's a good example there as my insulin to carbs ratio doesn't work by the rules either. It works out pretty much the same as yours - 1 unit to 20g carbs - but in actual fact my meal ratios vary from 1:7g to 1:12g. On the other hand, my basal dose is less than the rules would suggest.
If only diabetic control was a case of good Maths skills! I find in real life with all its variables, not many textbook rules work - for diabetes or much else : D
I suggest you write your own rules - the Bluemarine Josephine Rules - that will be tailored to you. I'm only half joking there as I really do think that learning about the idiosyncrasies of your own responses is crucial.
I'd also add that when I was on MDI, I found my basal messed things up a lot, and now I'm on a pump, I do feel there's more predictability.
If only diabetic control was a case of good Maths skills! I find in real life with all its variables, not many textbook rules work - for diabetes or much else : D
I suggest you write your own rules - the Bluemarine Josephine Rules - that will be tailored to you. I'm only half joking there as I really do think that learning about the idiosyncrasies of your own responses is crucial.
I'd also add that when I was on MDI, I found my basal messed things up a lot, and now I'm on a pump, I do feel there's more predictability.
Sugar surfing is the trick. I've found that pumpernickel usually causes me to rise a bit later and needs later insulin injections, but in some (not particularly common circumstances) it hasn't.
With the Freestyle Libre or Dexcom, you can see when that point of inflexion occurs (if it does occur) and provide insulin accordingly.
Bluemarine Josephine
Well-Known Member
I completely understand what you mean. Every time something goes wrong with my readings I interpret it as a hint that my basal insulin is about to need a change (and 9 out of 10 times this has proven correct.)
My own experience is that Glucotabs are slower acting than Dextro Energy.
I find Dextro raise my sugars within 5-10 mins whereas glucotabs are similar to table sugar and often take a good 15 minutes to raise sugar levels.
Remember with hypos that you have the down action of insulin vs the up action of the glucose. If it's taking 30-45 mins to rise, that may be more suggestive of the fact that the downwards action of the insulin had probably cancelled out the upwards action of the 3 glucotabs.
It's possible that the later rise (nearly an hour after) may have been digestion of previous meal or action of glucagon on the liver raising sugar levels.
The fact that you went hypo in the first place suggests that the bread may have taken a long time to get broken down.
Pleased you got through it safely.
I find Dextro raise my sugars within 5-10 mins whereas glucotabs are similar to table sugar and often take a good 15 minutes to raise sugar levels.
Remember with hypos that you have the down action of insulin vs the up action of the glucose. If it's taking 30-45 mins to rise, that may be more suggestive of the fact that the downwards action of the insulin had probably cancelled out the upwards action of the 3 glucotabs.
It's possible that the later rise (nearly an hour after) may have been digestion of previous meal or action of glucagon on the liver raising sugar levels.
The fact that you went hypo in the first place suggests that the bread may have taken a long time to get broken down.
Pleased you got through it safely.
