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Type 1 Diabetes
Help with insulin/carb ratio
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<blockquote data-quote="Dillinger" data-source="post: 356841" data-attributes="member: 13582"><p>Hello Samantha,</p><p></p><p>You are getting some good advice here I'm a Type 1 as well and would just say you need to think about 3 things and tinker with them;</p><p></p><p>1. Your insulin to carb ratio by time of day; you are saying at the moment you take 1 unit for 5 grams of carb.</p><p>2. Your correction dose; you haven't said what dose you are using; you need to get a figure for how much 1 unit of insulin reduces your blood sugar.</p><p>3. You need to know how much 5 grams of carbohydrate raises your blood sugar levels (for hypo management).</p><p></p><p>You also need to know how long your short acting insulin lasts (for correction doses if nothing else).</p><p></p><p>Once you have a handle on those you can really start fine tuning; I change my insulin/carb ratio and insulin correction dose by time of day.</p><p></p><p>I would suggest that you address the short acting insulin first; your blood sugars are high but that seems related to the carbs/insulin ratio you are on; whilst high these readings are pretty steady.</p><p></p><p>I think that you should increase your short acting insulin ratio to 1 unit for 3 grams of carb. Once you get this ratio right all the others will fall into place.</p><p></p><p>Once the short acting is right I think that you should start a correction dose at say 1 unit to lower your blood sugar by say 3 mmol/l and test to see that that is correct (ideally without eating when you start seeing if that is correct).</p><p></p><p>Obviously I'm guessing; and you need to do things safely and carefully so my figures could well be out, but you need to start somewhere and change until it's right.</p><p></p><p>I agree that splitting Levemir (50/50) is the way to go.</p><p></p><p>The problem with the overnight reading is that you are clearly showing normal liver dumps going on in the early morning; if you increase your bolus at night you will hype at around 2:00 am (dependent on when you take it) and then between 4:00 and 7:00 your blood sugar will rise because your liver is releasing glucose as part of its normal routine.</p><p></p><p>You should do a correction dose as soon as you get up if you cannot eat breakfast then and then when you have breakfast later take the normal amount of insulin for the carbs.</p><p></p><p>Best</p><p></p><p>Dillinger</p></blockquote><p></p>
[QUOTE="Dillinger, post: 356841, member: 13582"] Hello Samantha, You are getting some good advice here I'm a Type 1 as well and would just say you need to think about 3 things and tinker with them; 1. Your insulin to carb ratio by time of day; you are saying at the moment you take 1 unit for 5 grams of carb. 2. Your correction dose; you haven't said what dose you are using; you need to get a figure for how much 1 unit of insulin reduces your blood sugar. 3. You need to know how much 5 grams of carbohydrate raises your blood sugar levels (for hypo management). You also need to know how long your short acting insulin lasts (for correction doses if nothing else). Once you have a handle on those you can really start fine tuning; I change my insulin/carb ratio and insulin correction dose by time of day. I would suggest that you address the short acting insulin first; your blood sugars are high but that seems related to the carbs/insulin ratio you are on; whilst high these readings are pretty steady. I think that you should increase your short acting insulin ratio to 1 unit for 3 grams of carb. Once you get this ratio right all the others will fall into place. Once the short acting is right I think that you should start a correction dose at say 1 unit to lower your blood sugar by say 3 mmol/l and test to see that that is correct (ideally without eating when you start seeing if that is correct). Obviously I'm guessing; and you need to do things safely and carefully so my figures could well be out, but you need to start somewhere and change until it's right. I agree that splitting Levemir (50/50) is the way to go. The problem with the overnight reading is that you are clearly showing normal liver dumps going on in the early morning; if you increase your bolus at night you will hype at around 2:00 am (dependent on when you take it) and then between 4:00 and 7:00 your blood sugar will rise because your liver is releasing glucose as part of its normal routine. You should do a correction dose as soon as you get up if you cannot eat breakfast then and then when you have breakfast later take the normal amount of insulin for the carbs. Best Dillinger [/QUOTE]
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