Not a question because there is a problem, it's more that I have too much time on my hands and started thinking, which led to questions. Where better to share my musings than here, and see how others do or see things.
I know many of you use insulin to carbs ratio's, often different ratio's for different times of the day and even different ratio's for work days and weekends or time of month.
I use pens, but as far as I understand, when you use a pump you must use ratio's, as you tell it the amount of carbs you're about to eat and the pump gives you insulin according to the pre-programmed ratio, instead of just telling the pump how many units of insulin you want. (Not completely sure you can't just tell the pump the units you want though.)
My insulin need fluctuates all the time, I can't imagine working out ratio's for that. I'm wondering if there are more people like me or if I'm just weird
So here's how it works for me on 'standard' days. I'll ignore days with unusual activity or unusual food, and I'll also ignore my evening meal because the amount of carbs in that one varies a lot:
- Between 5 and 14 units upon waking (8-11 AM), to counter 'foot on the floor' and the milk in my coffee.
- Between 4 and 12 units for my first meal (12.30-2.30 PM), 4 to 8 gr of carbs. Cracker or low carb wrap, plenty of fat and protein in the toppings. Ratio 1:1 to 3:1
- Sometimes a repeat of first meal later in the afternoon. This time with 3 to 7 units. Ratio 1:2 to 1:1
- Between 6 and 14 units for 30 gr carbs in 2 Belgian beers, drank between 5 and 10 PM. This insulin seems to cover part of my evening meal as well. Ratio 1:2 to 1:6 or even higher because it partly covers my evening meal.
- Between 0 and 2 units for an unknown amount of carbs in a generous portion of nuts, humus and chicory, 85% chocolate or cheese, cucumber and bell pepper. Ratio 1:quite a lot. (Guessing the alcohol from the beers doing it's thing here.)
So my ratio's go between 3 units of insulin for 1 gram of carbs in the morning and 1 unit to 6 to 10 grams of carbs in the evening.
But more importantly, some days I need 3 times the amount of insulin for the same food at the same time of day.
This means that on some days I have as little as 16 units of fast acting (when having a very low carb evening meal) and some days as much as 44 units with exactly the same food.
I'm not complaining, it works very well for me. I simply adjust my doses depending on the amount I needed in the last 2 days, plus a bit of gut feeling. But I really don't see how to catch that in ratio's that make sense.
Which is why I don't, and just manage it the way that works for me. (Although it leads to awkward conversation with the DSN. Thankfully my internist is happy with my approach.)
For information, I was diagnosed 3.5 years ago at 39, I'm fat and obviously have a fair amount of insulin resistance going on, only C-peptide ever done was below the low-normal threshold, 1.5 years ago. I'm on Fiasp and Tresiba, of which I take about 80 units, very well controlled.
So now I'm wondering if there are others who experience the same kind of things I do. Also curious to thoughts about my approach or the way my diabetes behaves.
I know many of you use insulin to carbs ratio's, often different ratio's for different times of the day and even different ratio's for work days and weekends or time of month.
I use pens, but as far as I understand, when you use a pump you must use ratio's, as you tell it the amount of carbs you're about to eat and the pump gives you insulin according to the pre-programmed ratio, instead of just telling the pump how many units of insulin you want. (Not completely sure you can't just tell the pump the units you want though.)
My insulin need fluctuates all the time, I can't imagine working out ratio's for that. I'm wondering if there are more people like me or if I'm just weird
So here's how it works for me on 'standard' days. I'll ignore days with unusual activity or unusual food, and I'll also ignore my evening meal because the amount of carbs in that one varies a lot:
- Between 5 and 14 units upon waking (8-11 AM), to counter 'foot on the floor' and the milk in my coffee.
- Between 4 and 12 units for my first meal (12.30-2.30 PM), 4 to 8 gr of carbs. Cracker or low carb wrap, plenty of fat and protein in the toppings. Ratio 1:1 to 3:1
- Sometimes a repeat of first meal later in the afternoon. This time with 3 to 7 units. Ratio 1:2 to 1:1
- Between 6 and 14 units for 30 gr carbs in 2 Belgian beers, drank between 5 and 10 PM. This insulin seems to cover part of my evening meal as well. Ratio 1:2 to 1:6 or even higher because it partly covers my evening meal.
- Between 0 and 2 units for an unknown amount of carbs in a generous portion of nuts, humus and chicory, 85% chocolate or cheese, cucumber and bell pepper. Ratio 1:quite a lot. (Guessing the alcohol from the beers doing it's thing here.)
So my ratio's go between 3 units of insulin for 1 gram of carbs in the morning and 1 unit to 6 to 10 grams of carbs in the evening.
But more importantly, some days I need 3 times the amount of insulin for the same food at the same time of day.
This means that on some days I have as little as 16 units of fast acting (when having a very low carb evening meal) and some days as much as 44 units with exactly the same food.
I'm not complaining, it works very well for me. I simply adjust my doses depending on the amount I needed in the last 2 days, plus a bit of gut feeling. But I really don't see how to catch that in ratio's that make sense.
Which is why I don't, and just manage it the way that works for me. (Although it leads to awkward conversation with the DSN. Thankfully my internist is happy with my approach.)
For information, I was diagnosed 3.5 years ago at 39, I'm fat and obviously have a fair amount of insulin resistance going on, only C-peptide ever done was below the low-normal threshold, 1.5 years ago. I'm on Fiasp and Tresiba, of which I take about 80 units, very well controlled.
So now I'm wondering if there are others who experience the same kind of things I do. Also curious to thoughts about my approach or the way my diabetes behaves.