How to calculate insulin to carb ratio in a type 2?

goji

Well-Known Member
Messages
251
Hi

I'm wondering if anybody could explain how to calculate an insulin to carb ratio? It's not for me but for someone else.

He takes large amounts of insulin and keeps gaining weight and wants to have a go at low carbing but I don't know how to advise him on adjusting his insulin when he starts to cut the carbs as I don't know what his insulin/carb ratio is and neither does he.

At present he just takes the same doses every meal as laid down by his doctor. His current HbA1c is around 10.

thanks
Goji
 

phoenix

Expert
Messages
5,671
Type of diabetes
Type 1
Treatment type
Pump
Some suggestions , I’m not type 2, t you really need to take care, make any changes gradual!, dealing with larger amounts of insulin can result in larger mistakes. He should really discuss any plan with his doctor.
First Do some basal testing and try to get basal correct.
Method?? 1
Has some info on type 2 worth reading but I find the rest of it a bit confusing
http://www.diabetesnet.com/diabetes_control_tips/carb_factor.php

Method 2 ( slow steps that seem sensible to me)
1)test glucose level
2)Count carbs in normal meal
3)take normal amount of insulin for that meal
4)Test and record at 2 hours and again before next meal
5)Repeat test, on other days to show pattern ( eat a similar amount of carbs to that on the first test)
If level is generally within target at the following meal, then he took the right amount of insulin for that amount of carbs.
If level is higher than target, he took too little etc. (the 2 hour will show the 'spike' and should be within 2-3mmol of pre meal figure, but remember that insulin will still be active for another couple of hours)
6) adjust by altering insulin gradually up or down until the right dose is achieved for that amount of carbs.
7)when 'correct' divide carbs eaten in test meal by amount of insulin taken to get ratio.
8 ) test new ratio with a slightly reduced/increased carb meal,
(thats where you find out that the type of carb, the protein and fat content also play a part :mrgreen: )
Remember that carb ratios vary during the day (many type 2s need more insulin at breakfast , so
its probably best to work it out on a meal by meal basis ie work compare breakfast with breakfast, lunch with lunch etc

Method 3
very similar to above but using specific carb quantities for each meal, it's really a protocol for adjusting rather than setting ratios so you would have to make an informed starting point (based on his normal dose and the estimated quantity of carbs normally eaten)
http://www.leedsth.nhs.uk/sites/diabetes/food/CarbohydrateTestMeals.php
 

goji

Well-Known Member
Messages
251
Thanks Pheonix - I really appreciate you going to the effort to write all that info down - it is a major help!! :D