Insulin to carb ratio

[Deleted member 391597]

Hi,

I have been told that it will be trial and error over the next few weeks for me to work out my insulin to carb ratio. Out of curiosity, what are other people's insulin to carb ratios and do they vary over the course of the day?

Thanks in advance.

 

[Amy993]

Yes it will be. I was diagnosed 7 months ago, and things are still changing! My ratios all started off as 1:5, making me go low a lot of the time! Now my breakfast is 1:15, lunch 1:7, dinner 1:7.5 and overnight 1:10

 

[Ann1982]

My ratio in morning is2:10 and rest of the day is ok @ 1:10. Really weird and no idea why but that works for me whether it is low carb or medium carb breakfast.

 

[Kristin251]

Mine is about 1:10 lunch and dinner but I bolus for half my protein as I am very low carb.
Mornings vary and I eat the same exact thing every morning. Half an avocado. Depending where I wake up I have to generally bolus 3 times before lunch. I eat bf at 7ish and lunch at 3. I need one unit and two half units about 2 hours apart.
My lantus is LONG gone by morning.

 

[Sibyl]

It does vary throughout the year too. At the moment I'm 1.8 breakfast, and 1.6 for lunch and dinner. I inject 11 units of Lantus at 8 am. My last hba1c was 43.

 

[GrantGam]

Hi,

I have been told that it will be trial and error over the next few weeks for me to work out my insulin to carb ratio. Out of curiosity, what are other people's insulin to carb ratios and do they vary over the course of the day?

Thanks in advance.

A lot of T1 diabetics will find that they are least sensitive to insulin first thing in the morning and more sensitive as the day goes on. My ratio is technically 1:12, but I just use 1:10 as on MDI, there is no way to discriminate between 1:12 and 1:10 unless you eat >50g in one go. Which reminds me, I should really get a half unit pen for that reason...

Anyway, I just use 1:10 throughout the whole day and I seem to be sound. I do go to about 1:20 for meals following fairly strenuous exercise, as the exercise makes me very sensitive to insulin but only for 4 hours or so after the activity.

 

[Deleted member 391597]

Thank you for all of your replies! I'm only 2.5 weeks in to this but I think I'm 1:5 at breakfast...this seems high since I'm only just diagnosed?! Still working on my lunch/dinner ratios but I'm eating pretty low carb most days...

 

[Kristin251]

Breakfast usually requires more insulin to carbs as our hormones ( cortisol and adrenaline) are waking up. As said, were most carb sensitive in the morning. For lots of us even if we don't eat we get a good size rise.

your ratios may change as you lower and stabilize bg.

 

[azure]

Thank you for all of your replies! I'm only 2.5 weeks in to this but I think I'm 1:5 at breakfast...this seems high since I'm only just diagnosed?! Still working on my lunch/dinner ratios but I'm eating pretty low carb most days...

@Hollieo4 Where did the 1:5 come from? Was it a DSN suggestion? Was it based on high bloods?

You need what you need, so don't worry, but do keep testing so you can see if your ratios are working.

You don't need to go very low carb. Most Type 1s eat moderate carbs. The Low Carb program here is aimed at Type 2s.

 

[Deleted member 391597]

@azure I met with my DSN yesterday and she looked at my results and said it looks like 1:5. My post breakfast numbers are usually in the 6s and 7s but I eat no more than 25g of carbs for breakast using 4 units of insulin. My lunch and dinner numbers are more varied as I tend to eat different things on different days. I was thinking though, if I am on a 1:5 ratio and wanted to eat something with say 80g of carbs as a one off treat, this would require me to take 16 units of insulin! This seems like so much so early on!!

 

[azure]

Don't get too hung up on the insulin amounts. You'd be surprised at the huge variance in doses here. There's only one right dose - the right dose for you. It doesn't matter what you need as long as you get good control There are people here on much larger doses than you.

The morning is a time when people often need more insulin, so what you're describing is nothing weird

Remember too, your basal may be altered as time goes by and the balance between basal and bolus may change. Just roll with it, eat well and keep testing

 

[catapillar]

4 units for 25gs of carbs is 1:6 not 1:5. Might not sound like much difference but, using your 80g carb sweet treat example it makes a difference of 3 units, 80/6= 13 rather than 80/5 = 16.

You say you eat no more than 25g of carb for breakfast. I would really recommend getting a weighing scale out so you can be sure exactly what your intake of carbs is. It sounds like a pain, but while you're figuring out your ratios it's worth ensuring your basing it on accurate measurements before you decide whethe that ratio is right for you or not.

 

[Deleted member 391597]

Thanks again @azure. Always so helpful! Xx

 

[GrantGam]

@Hollieo4 You don't need to go very low carb. Most Type 1s eat moderate carbs. The Low Carb program here is aimed at Type 2s.

I second that. Low carb is mainly a T2 dietary choice for many reasons that I'm not going to bother discussing.

You have insulin and you also don't have insulin resistance, because of this - there is no need for LCHF. There is no reason why you can't eat a diet that is very similar to a non-diabetic and still have an HbA1c well below the level deemed as good control. It's about being clever with your insulin to give you the best results A lot of us do it; @azure and I to name a few.

I'd imagine that your 1:5 morning ICR is because you're either honeymooning, have an incorrectly set basal rate or both. This will make setting multiple ICR's impossible as your requirements will more than likely continue to change over the coming months. It's very early days though, so if I were you, I'd stick with 1:10 all day and just keep accurate BG logs for your health care team.

No disrespect, but 14 days in from diagnosis - you simply don't have the knowledge and understanding to be manipulating ICR ratios - it's counterintuitive and you'll just get muddled. Take it easy and walk before you run, get the basics sorted and then once you're comfortable and steady in your routine, then you can look at changing things without the support of your diabetes care team.

Oh, you may want to get this book though - it's really good, interesting and helpful:

https://www.amazon.co.uk/gp/aw/d/B06XCDTPP1/ref=tmm_kin_title_0?ie=UTF8&qid=&sr=

 

[Deleted member 391597]

Thanks for your reply @GrantGam. Although if I was honeymooning, wouldn't my insulin to carb ratio be a lot higher than 1:5?

 

[GrantGam]

Thanks for your reply @GrantGam. Although if I was honeymooning, wouldn't my insulin to carb ratio be a lot higher than 1:5?

The honeymoon period for many doesn't just mean that less insulin is required, it can leave many experiencing spurts of pancreatic function which appear to be random in nature. The result is that some days they require more insulin, other days significantly less. When I was referring to a possible honeymoon period, I was more meaning that your requirements are almost certain to change as time goes on, specifically with your basal dose and subsequently your I:C ratio (the two are closely related).

I'd suspect that you're overcompensating with bolus insulin for a lack of basal; but that's just an educated guess.

Don't worry too much about it though; the good (or bad; depending on your outlook) news is that you've a long time ahead to fine tune things

 

[azure]

Thanks for your reply @GrantGam. Although if I was honeymooning, wouldn't my insulin to carb ratio be a lot higher than 1:5?

I had highs in the morning during the honeymoon yet lows at other times. Usually as @GrantGam says, you start off on a lowish basal because you're honeymooning, but that can mean more bolus is sometimes needed to keep BS down due to the random nature of your own insulin production.

 

[GrantGam]

I had highs in the morning during the honeymoon yet lows at other times. Usually as @GrantGam says, you start off on a lowish basal because you're honeymooning, but that can mean more bolus is sometimes needed to keep BS down due to the random nature of your own insulin production.

Good point @azure.

There is also an issue known as a "waking rise" @Hollieo4, which is basically your liver pumping glucose into your blood to wake you up in the morning and set you up for the day. I have to combat that with a 2u injection of bolus insulin as soon as I get out of bed. If I didn't, I'd have high BG very shortly after getting up - even though my waking BG was fine.

It's entirely possible that you are experiencing a waking rise too and that's why you're needing more insulin (1:5 ICR) with your breakfast in the morning. Again, just an educated guess but you can talk about that with your DSN next time you see her as it's fairly common

 

[Deleted member 391597]

Thank you both @GrantGam and @azure your answers are really helpful. I suspected myself I needed more basal insulin. I currently take 8 units of Lantus at 8pm. My fasting number today was 4.8, although I am usually in the 5's. However the lowest I get before meal times is somewhere between 6-6.8 which I know is in target but still a little higher than I would like. I spoke to my DSN about this but she is relucant to increase my basal as she was worried about me having hypos in the morning. Still waiting for an appointment to see my consultant...so many unanswered questions!

 

[azure]

Don't worry about the basal too much @Hollieo4 It's still so early for you and things can change so much during the honeymoon.

Although tight control is obviously good, do be careful about setting your range too low. There's nothing wrong with being in the 6s before a meal.