Insulin to Carb ratio

[floridagal]

Hi I started insulin alongside my metformin about 8 weeks ago. Saw my diabetic nurse at the clinic last week and we agreed to change to a bolus basal routine. So I take lantus at bedtime and novarapid for meals. I have been doing a lot of reading and want to adjust my bolus insulin according to my carb intake instead of the set amounts suggested by the clinic nurse.

So I have discovered I seem to require a lot of novarapid. I estimate that one unit covers less than one gram of carbs it is more like 1 unit covers 0.8grams of carbs. I am overweight and know this will have an effect on the insulin working does anyone else take this amount of novarapid to cover their carbs ? I wake with higher than wanted blood sugars so I presume I need to increase the lantus as well .

I just scared myself by reading other people insulin to carb ratios on here and some take just one unit to cover 10-20grams of carbs but these were all type 1s I cannot see any information from type 2s though. Should we not be doing this ? Am I doing things right ? or am I just insulin resistant ? Any advice appreciated thanks

 

[db89]

Hi @floridagal, I'm not Type 2 myself but I'll tag @ickihun for you who I think is on basal/bolus and may have experience of this with Type 2.

We can't advise dosages and you should contact your DSN ideally to agree a starting ratio if you feel you're ready to adjust the insulin for your needs and what to do based on results from the initial ratio (DSN may want to help you adjust whilst you get going).

 

[ickihun]

Hi I started insulin alongside my metformin about 8 weeks ago. Saw my diabetic nurse at the clinic last week and we agreed to change to a bolus basal routine. So I take lantus at bedtime and novarapid for meals. I have been doing a lot of reading and want to adjust my bolus insulin according to my carb intake instead of the set amounts suggested by the clinic nurse.

So I have discovered I seem to require a lot of novarapid. I estimate that one unit covers less than one gram of carbs it is more like 1 unit covers 0.8grams of carbs. I am overweight and know this will have an effect on the insulin working does anyone else take this amount of novarapid to cover their carbs ? I wake with higher than wanted blood sugars so I presume I need to increase the lantus as well .

I just scared myself by reading other people insulin to carb ratios on here and some take just one unit to cover 10-20grams of carbs but these were all type 1s I cannot see any information from type 2s though. Should we not be doing this ? Am I doing things right ? or am I just insulin resistant ? Any advice appreciated thanks

Hi @floridagal .
Has your dn suggested doing a carb ratio? Only very few type2s are expected to use insulin that way.
If you are a type2 with insulin resistance than you will have your own individual ratio, for now.
When are you starting low carbing?
What is your lifetime of your basal is it 12hrs? Do you inject it twice a day? @catapillar may know more about lantus as I'm on toujeo300 which is just under treble the strength of lantus for me being severely insulin resistant.
Novarapid should be 50% of your insulin need as of lantus being the other 50% but like i've said your individual insulin resistance need may not allow that but see how you get on.
How much lantus do you take and how much novarapid? Dont worry the large amounts wont scare me as i was on just under 300 mixed units myself but by doing low carb I'm currently on 51units of basal and 60units of novarapid. I'm hoping to reduce both individually again in the new year.

I found low carbing halved my insulin needs initially.
But just remember we are all different and ordering extra test strips in advance will be a good idea as whilst reducing you will need to test more than 8 times a day until you find the right amount of new units to start reducing from. Doing basal testing every so often helps too.
It's effectively like starting insulin again from scratch. And either reducing or increasing to find the right amounts for you and your new low carb meals.
Most dns wont agree it.
I did mine off my own back but have they're blessing in reducing as i lose weight. Losing just under 4st and maintenaning during xmas to resume again in the new year.

 

[catapillar]

Lantus lasts around 18 hours. Some people are fine with one shot a day, some people split it.

@floridagal sounds like you are just insulin resistant, that's is what type 2 is.

What sort of quantity of carbs are you eating and what kind of doses are you taking with meals? What is you total daily dose? Are you doing anything to try to improve insulin sensitivity? Loosing weight should help with that if you have weight to loose. Or are you just pouring more insulin in?

Has your nurse helped you with establishing your 1:0.8 ratio? Has she given any guidance on this?

 

[hognose]

i take 70 u lantus evening /bedttime about 6 to 8 u of novrapid per meal ,just had my 3month mot it was same as the last one at 51 hbA1C ,
found this to be working so far

 

[paulus1]

i have a split lantus main dose in the morning and a top up at tra time. that reduced night times raises. if your background is not quite right your nova/carb will be off. by taking it at bedtime your running out at around dinner /12 noon time. hence you may need more rapid.

 

[hognose]

i did too split lantus main dose in the morning and a top up at tea time.
6-8 of nova just depends on meals i have really.

 

[hognose]

but bg reading lastnight 7.2 at 1.00am wake up 6.20am 9.4

 

[LincolnLizzie]

I take 18units of basal Lantus one a day. It lasts me at least 24 hours and if I keep my carb intake low, I don't need to take Novorapid. So basically only take novorapid when I'm not eating at home. When I do, I find that for me (and we are all different) I need 3 units of bolus for every 10 carbs and that has consistently worked for me. I was advised to start with 1 unit per 10 carbs and work slowly upward until I got the balance right.

Btw I try to stay under 30 carbs daily. Hope this is useful