Does anybody low carb on a pump?

[donnellysdogs]

Hi

Does anybody low carb on a pump?

On a pump the DSN's want us to run at either 50.50 or 60/40 basal/bolus. I do this without realising, but I do eat on average about 100g CHO a day. I read about all these persons on 30g CHO or less a day, and wonder how on earth I could ever get my carbs down lower, as my ratio's then would be all out of sync between basal/bolus. I wouldn't want to change my basal's as I run perfectly on fastings.

Just wonder out of curiosity, how on earth I could cut my carbs down if I should ever want to.

I am not a low carber, I do not want to lose weight, but often wonder whether I should do less carbs...

Just a pondering I have now again, when I see other people saying they are on 25g CHO per day.........

 

[josie38]

Hi donnelly,

I dont know if this is any help but i've been told that if I have a meal that hasn't got any carbs in not to do a bolus ( been pumping since Aug).

When i saw the dietician and consultant (as i am on the chubby side) I was given a diet sheet and told that if for lunch i was having, for example, a salad with no carbs then not to bolus because if my basal rate is right then my blood sugars shouldn't have altered much within the next couple of hours.

At the moment i am fine tuning my basal rates and the other day I had two poached eggs for breakfast, no carbs, no bolus and my blood sugars had gone up 0.5 in two hours.

Hope it is of help

Josie

 

[sugar2]

Hi, I am not a card carrying lo carber either, but like Josie, I do have meals with no carbs or very low carbs...and just treat them mathmatically according to my ratios.. It seems to work OK, and teh joy of the pump is that I can, and do have a bolus of 0.2 ul on occasion...couldn't do that with a syringe.

Why are they saying that you have to be on the ratios of 60:40 etc. As it is all teh same insulin, I had always assumed that as long as I took enough to keep my BG under control...then it was better to have less insulin, rather than eat carbs, just to match the insulib...if you know what I mean?

I do undertsand that they have ratios to aim for, and I am not saying that they are wrong...but if you want to cut the amount of insulin you take, then the only way is to cut the carbs?

Sorry for answering your question with more wuestions!

 

[phoenix]

John Walsh in Pumping Insulin says
Basal:
40% kids and adults who are fit, people who eat high carb diets and sometimes people in the first five years after diagnosis (more of their own insulin)
50% most people
60% or higher Some adults, many teens, most people with insulin resistance, people using drugs like symlin

So it makes sense if you have a lower carb diet you will be nearer the 60% basal.
Small changes to carb ratios though can make quite large changes to the split. I used to use 1-11 for dinner but was persuaded to drop it to 1:15 as my doctor felt I was going to bed too low. My overall split changed from 40/60 (basal bolus)
to 48/50.

 

[donnellysdogs]

Hhmmm, I just wondered, I know all about changing all my bolus's basals etc etc, and it is my DSN and consultant that like to see the 50:50 ratio. If I changed to low carb from my current regime, I would end up at 80:20 and my HCP's wouldn't like it.

I do not know why they like a 40/50/60 ratio.......would I feel any benefit by doing less carbs? I haven't got an ounce of fat on me, so there is no way I want to do it to lose weight, but if I was going to get some other medical benefit I would consider it..... I just don't know how or why a 40/50/60 ratio is what the HCP's like to see...(I too have John Walsh's book) but can't see any actual explanation as to how these ratios were worked out.

Does anybody actually have a ratio of 10:90 or 20:80 or 30:70?????

 

[josie38]

Hi donnelly,

When i went on the pump none of my HCP's mentioned about a basal/bolus ratio so unsure how they would work. I do agree with sugar2 that it is all the same insulin so why would you have ratios for basal/bolus?

Sorry if i sound stupid but have been advised something different to you. :? :?

Josie

 

[donnellysdogs]

Don't know really, last time I saw the consultant, the main thing she was intereseted in was my diary, but the only thing she was interested in from downloading the information from my pump and remote was the basal bolus ratio to make sure that it was coming within the 40/60 or 50/50 ratio's.....don't know why.....seeing DSN in Jan so I will ask her why, and what the impact would be if it strayed to 20/80 etc from low carbing.......thought I might get my answers here as to whether anybody does low carb on a pump...and what their ratio's were...

 

[jopar]

Ratio's in the main are used as an overview quick referance for HCP, if you've got a patient who's having control issues using looking at their insulin ratio's can help indentify if how they using their insulin causing a problem.. Used a lot by HPC as well they don't encourage fasting tests, without fasting tests to see if background is correctly set, it's one of the easiest ways of seeing if it is, and which probable insulin you are using for what...

The theory that if you low carb you need lot less insulin than eating carbs isn't strictly true, as protien breaks down into glucose so will need insulin to counteract, fats increase insulin resistence so likely hood need increase insulin to counteract...

If you read some of the dose low carbers are using to counteract there carb free/mim carb meal, then work out the ratio they are using for calculating their insulin dose, compare that to carbs you will be suprised by the actual amount they are using a lot more than expected..

So the assumption would be that the ratio split may not be that much different in the end, if you using the assumption that if you use 23 units of insulin for 100g of carbs consumed! you may need 20 units to counteract the protein and fats you are eating!!!

 

[donnellysdogs]

Thanks Jopar, makes a bit more sense now.