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<blockquote data-quote="Jeremy.M" data-source="post: 2404699" data-attributes="member: 522049"><p>[USER=507802]@Hertfordshiremum[/USER]</p><p></p><p>Perhaps I'll try switching up the foods I'm eating then. My initial intention was to have one of my meals be the same, every day for one week, in order to attempt to figure out what my insulin-to-carb ratio is as well as how many millimoles per liter each unit of insulin seems to be dropping me by when it comes to corrections.</p><p></p><p>I had a fraction of the meal I mentioned again today (22g net carbs, 12g protein & 30g fat [Oat Bran mixed with almond milk, a bit of cinnamon & 3 tbsp of almond butter]) and took 4 units of insulin beforehand. My pre-meal reading was 6.7 mmol/l and my 2 hour postprandial reading was 10.2 mmol/l, so I took 3 units as a correction. Two hours later, my reading was 8.0 mmol/l. At said time, I also had a salad with some lean protein, some cheese and walnuts on my break at work (roughly 25g of protein, 10g of fat and virtually no carbs). I took 3 units of insulin prior to eating and ended up with 5.4 mmol/l two hours later, so I did not administer any additional insulin. A couple hours following that last reading, I finished working and headed home. My blood sugar level was roughly the same.</p><p></p><p>It seems like my insulin-to-carb ratio could be as low as 1:5, which sounds insane. I wonder if it has something to do with my HbA1c being as high – or even slightly higher – than 9% for the last 6 months. With said ratio being so low, it doesn't surprise me that protein and fats seem to be having a higher than anticipated effect on my blood glucose levels as well. If I'm going to be consuming a balance of the three macronutrients, I think I'm going to continue taking an extra fractional dose of rapid-acting insulin 2 hours after my balanced meals in order to somewhat cover the impact of protein and fats.</p><p></p><p>With Oat Bran already being a low GI food, it looks like I'm going to be taking upwards of 5 to 6 units of insulin for a balanced meal that has at least 20g of net carbs. Does that sound right based on the numbers I have reported? It seems to be what's close to working for the time being. As long as I keep an eye on things, should I be safe sticking with my assumptions that my insulin-to-carb ratio might be 1 unit for 5 carbs in accordance with 1 unit of insulin bringing my blood sugar down by roughly 1.5 mmol/l? My basal insulin dose is 6 units nightly and I seem to be waking up with a glucose reading between 5 - 7 mmol/l IF I go to bed with a glucose level within said range as well.</p><p></p><p>I don't follow up with my endocrinologist until June 28th. Should I keep fine-tuning things with trial and error, or should I contact my endocrinologist? She advised me to use 3 - 5 units of insulin for my meals as a start and lower my basal dose from 8 units to 6 units, the latter of which I started doing on Wednesday May 19th, as I was waking up with glucose readings in the high 3s if I went to bed with a reading between 5 and 7 mmol/l.</p></blockquote><p></p>
[QUOTE="Jeremy.M, post: 2404699, member: 522049"] [USER=507802]@Hertfordshiremum[/USER] Perhaps I'll try switching up the foods I'm eating then. My initial intention was to have one of my meals be the same, every day for one week, in order to attempt to figure out what my insulin-to-carb ratio is as well as how many millimoles per liter each unit of insulin seems to be dropping me by when it comes to corrections. I had a fraction of the meal I mentioned again today (22g net carbs, 12g protein & 30g fat [Oat Bran mixed with almond milk, a bit of cinnamon & 3 tbsp of almond butter]) and took 4 units of insulin beforehand. My pre-meal reading was 6.7 mmol/l and my 2 hour postprandial reading was 10.2 mmol/l, so I took 3 units as a correction. Two hours later, my reading was 8.0 mmol/l. At said time, I also had a salad with some lean protein, some cheese and walnuts on my break at work (roughly 25g of protein, 10g of fat and virtually no carbs). I took 3 units of insulin prior to eating and ended up with 5.4 mmol/l two hours later, so I did not administer any additional insulin. A couple hours following that last reading, I finished working and headed home. My blood sugar level was roughly the same. It seems like my insulin-to-carb ratio could be as low as 1:5, which sounds insane. I wonder if it has something to do with my HbA1c being as high – or even slightly higher – than 9% for the last 6 months. With said ratio being so low, it doesn't surprise me that protein and fats seem to be having a higher than anticipated effect on my blood glucose levels as well. If I'm going to be consuming a balance of the three macronutrients, I think I'm going to continue taking an extra fractional dose of rapid-acting insulin 2 hours after my balanced meals in order to somewhat cover the impact of protein and fats. With Oat Bran already being a low GI food, it looks like I'm going to be taking upwards of 5 to 6 units of insulin for a balanced meal that has at least 20g of net carbs. Does that sound right based on the numbers I have reported? It seems to be what's close to working for the time being. As long as I keep an eye on things, should I be safe sticking with my assumptions that my insulin-to-carb ratio might be 1 unit for 5 carbs in accordance with 1 unit of insulin bringing my blood sugar down by roughly 1.5 mmol/l? My basal insulin dose is 6 units nightly and I seem to be waking up with a glucose reading between 5 - 7 mmol/l IF I go to bed with a glucose level within said range as well. I don't follow up with my endocrinologist until June 28th. Should I keep fine-tuning things with trial and error, or should I contact my endocrinologist? She advised me to use 3 - 5 units of insulin for my meals as a start and lower my basal dose from 8 units to 6 units, the latter of which I started doing on Wednesday May 19th, as I was waking up with glucose readings in the high 3s if I went to bed with a reading between 5 and 7 mmol/l. [/QUOTE]
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