Low carb insulin confusion

Chloelox said:

I’ve gone back to a low carb diet after a couple of weeks of binging on higher carb foods.

I’m taking less fast acting than I usually would be as my carb intake isn’t as high, but my basal has stayed the same to the point I’m only taking 2 units more a day in total novarapid than my 11 units of basal. Is this normal? I’ve tried cutting basal down a bit to try and avoid hypos but I ended up really high. Bit confused lol, I can’t remember what my regime was when I last went low carb. My ratio is 1:10 and I’m eating around 60 carbs a day.

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If it works, it works. Let your meter be your guide. It's certainly logical that your bolus would reduce dramatically if you are eating less carbs. We are all so individual that "normal" is not a very applicable word, though your changed insulin needs don't seem surprising. My only recommendation would be to keep an eye on that ratio, as it may change if your low carbing makes you (even) more insulin sensitive. Many T1s have different ratios at different times of day, but you can't really calculate it till you've got the basal right. And be aware that basal needs and insulin ratios aren't static, they change with time, so what worked for you a year ago may not work for you now.

Do you talk to your team about this sort of thing? Some people feel confident to do their own thing and then just present their team with their results when they next go for a check up. Others like a bit more hand holding, particularly if they are relatively newly diagnosed.

This is something that's always confused me. The 50/50 split between Basal and Bolus is something my Consultant started mentioning around 7 years ago, but if 50/50 is something that we should be aiming for then it suggests neither DAFNE nor Low Carb are valid ways of treating Diabetes because the amount of Carbs you would be eating per day would be strictly determined by the amount of Basal you required and your Carb to Bolus ratio.

Furthermore, as a heavier person typically requires more Basal than a lighter person I'm not sure why would be suggesting that heavier Diabetics must eat more Carbs than lighter Diabetics. Further furthermore, not all Basal have the same level of potency. So if I move to a more potent Basal, why does it follow that I must drop my total daily Carb intake to match the potency of the Basal? Further further furthermore, if I reduce my Basal because of Physical Activity, why should I also lower my Carb intake?

Also treating Diabetes in this fashion seems to take away one of the main advantages of a Basal/Bolus regime because to maintain that 50/50 ratio you'd have to do the sorts of things with your diet that were more typical when we were using mixed Insulin.

Chloelox said:

but I was told basal reflects 40-50% of daily insulin intake but feel that hasn’t been the case for me lol.

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Just ignore that, it just isn't the case for many
If I had 40-50% basal I'd be hypo'ing a lot and having to constantly eat

Rokaab said:

Just ignore that, it just isn't the case for many
If I had 40-50% basal I'd be hypo'ing a lot and having to constantly eat

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I think a roughly 50:50 split between basal and bolus insulins is only used as a crude starting point. As noted above, it needs fine-tuning for each individual and can be influenced by many factors.

Hi. Forget the 50/50 stuff. Try to balance the Basal by seeing what your BS does over a few hours of fasting. If BS goes up then you need to increase the Basal and vice versa.

Chloelox said:

I have communicated with the DSN about it and she said she would have expected my basal to be reduced and told me to knock a couple of units off, then I was suffering highs through the night and my basal testing indicated I needed those units, I’ve been gradually reducing basal since then and I’ve gone from 14 units to 11 in just over a week. And the 11 seems to be sticking, but I was told basal reflects 40-50% of daily insulin intake but feel that hasn’t been the case for me lol.

my insulin needs can change dramatically though so it’s entirely possible my sensitivity will return with a bang at some point in the near future.

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With weight loss your basal will need reducing on low carb diets. Give it a few days of adjustments and with less circulating insulin your basal will be used more effectively. Test heavily and adjust accordingly.
Because I'm type2 (most likely) I adjust constantly. I get bored with the same foods and experiment with high protein meals.
Basal insulin is great for me whilst metformin isn't as effective during a new repair to a bariatric operation which is more common than 2/3rds of bariatric ops.
Touch wood I've only had 1 hypo in a year. Rebounding hypos from Carbs started but I kick it into place with Protein.
Obviously I hv a different system than yours but insulin need is insulin need.
Are you looking to lose weight or more calmer bg peaks and troughs?