Insulin Sensitivity

[egidioenobarbo]

Good morning to everybody, here's my dilemma:
I'm 55, T1 for the last 20, I exercise on a daily basis and my last Hba1C is 5,5. I inject about 44UI\day, so using the 1800 formula my insulin sensitivity should be 40. But it's not. It's half that. So what is it I am doing wrong?
Thank you!

 

[Tony337]

Hi and welcome
With a hba1c of 5.5 you are not doing anything wrong.
I have had to look up this formula as i've never heard of it.
Its the insulin sensitivity formula (ISF) where you divide 1800 by the amount of insulin you take per day?
Mines wrong too.
My friend who only takes 7 units of lantus plus novorapid is wrong too.
My last hba1c was 5.7 and my friend and i have over 100 years of experience between us.

We can't all be wrong surely?

Tony

 

[EllieM]

So the 1800 rule gives me 1800/38 as an insulin sensitivity factor , which is 2.63 in mmol/L . That isn't far off for me. Maybe I should enter that into my pump?

But given that my daily dose can vary between 20 and 45 units depending on my carbs, I am a little skeptical as to the accuracy...

And I agree with @Tony337 , if my hba1c was 5.5 I wouldn't care about my supposed insulin sensitivity factor, I'd just keep doing whatever I was doing now....

 

[egidioenobarbo]

Hi and welcome
With a hba1c of 5.5 you are not doing anything wrong.
I have had to look up this formula as i've never heard of it.
Its the insulin sensitivity formula (ISF) where you divide 1800 by the amount of insulin you take per day?
Mines wrong too.
My friend who only takes 7 units of lantus plus novorapid is wrong too.
My last hba1c was 5.7 and my friend and i have over 100 years of experience between us.

We can't all be wrong surely?

Tony

Hi Tony, thanks for you answer.
Yes that's the 1800 formula I'm referring to. In my experience there are too many factors playing a role in IS to have a "fixed" number. Are there other ways to determine IS?

 

[egidioenobarbo]

So the 1800 rule gives me 1800/38 as an insulin sensitivity factor , which is 2.63 in mmol/L . That isn't far off for me. Maybe I should enter that into my pump?

But given that my daily dose can vary between 20 and 45 units depending on my carbs, I am a little skeptical as to the accuracy...

And I agree with @Tony337 , if my hba1c was 5.5 I wouldn't care about my supposed insulin sensitivity factor, I'd just keep doing whatever I was doing now....

Hi Ellie,
you're right but with age I'm getting a bit paranoid...

 

[becca59]

I’ve been diagnosed twelve years. Never being told or heard of this formula. I would suspect this was from the days before CGMs and when we didn’t count carbohydrates. Nowadays we work out our own needs, adjust regularly and tend to eat what we want when we want and carb count. Or at least I do. Plus I am more concerned about time in range rather than HbAc. As is my consultant. It proves the amount of hypos and high events. It’s the modern way.

 

[CheeseSeaker]

Isn't that calc just a starting position - we then need to change it (possibly wildly) due to actual body chemistry etc?

I'd get 1800/49.5 = 36 (or 2.0) - my actual is 1.5 but as I'm using Dynamic ISF - its up and down like a <phrase deleted for sensitive readers> throughout the day (currently changing from 2.3 to 1.5 due to IOB and 'lunch' being digested)

 

[Tony337]

Are there other ways to determine IS?

Hi
I start my waking day on 5.0 take my levemir and my levels begin to rise.
My walk to work deals with that and i'm back to 5.0.
I deliberately take 2 units of levemir too much which if i'm not very active at work deals with the coffee but if i then get busy the levemir with the activity begins to pull my levels down but as its only levemir and not novorapid it doesnt pull too hard or fast and a 10g of carbs levels me off...............

Thats a typical monday to friday for me.
However if i'm resistant i take some novorapid yada yada

Its all about knowing your levels and i dare say some clever cloggs could work out an algorythm oh hang on they have!

Insulin resistance is the holy grail crack that and you could be rich oh hang on i have and i know how to deal with it oh hang on it only works for me............but i don't know the cause just the remedy.

This is my take and its fascinating and its not often questions are raised about sensitivity usually resistance because oh hang on there are different remedies for different types of diabetes.

Sorry i hope i have not gone on and on and apologise if i have.

Love the post

Tony

 

[CheeseSeaker]

Hi
I start my waking day on 5.0 take my levemir and my levels begin to rise.
My walk to work deals with that and i'm back to 5.0.
I deliberately take 2 units of levemir too much which if i'm not very active at work deals with the coffee but if i then get busy the levemir with the activity begins to pull my levels down but as its only levemir and not novorapid it doesnt pull too hard or fast and a 10g of carbs levels me off...............

Thats a typical monday to friday for me.

Hi @Tony337 - I think over the years I've accepted its whatever works for each of us.

There are lots of ways of achieving the same thing (different numbers here and there of carbs, exercise and insulin) but if thats a consistent and working pattern for you and your life - thats the best way of doing it.

I enjoy the tech, and had some really bad times on injecting (I was a b*gger for over treating high BGs etc) so even the non-intelligent pumps saved my life (quite a few times).

I like the flexibility I have (as my life is anything but consistent) and I've been known to 'give in' to a pasty or an unexpected Italian meal (other countries foods can be substituted) from time to time (hence my current diet )