Please can someone explain insulin sensitivity?

Df in agreement with that.

Not so sure on the higher carbs needing more insulin ratio myself....
If you have more carbs it depends if it's with more fat... Ie 50g of bread wouldn't have so much fat as 100g of pizza...

I think it depends on if you're having something else higher fat mixed in with those higher carbs. Or on the type of carbs... If it's carbs for 50g of that bread again compared to 100g of icecream...I would actually need to reduce amount for the icecream as its glucose peaks quicker and I would be hypo 3-5 hours later....

I think it's more based on the type of carb and what additional fat or protein might go along with it. Ie I can't eat pasta anymore, but 20 years ago when I could I would have to give normal bolus and more basal at night to counteract it's longer lasting effects. Same with any takeaways...

julian27ish said:

As you were all so helpful with my previous question, I'm going to be greedy and ask another...

Do you find your insulin sensitivity varies depending on the amount of carbohydrate you eat? Personally I find I need to inject a lot more insulin per gram of carbohydrate if I am having a high carb meal, especially at lunchtime. For example: 90g lunch requires 1:7 ratio; 50g lunch requires 1:10.

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No, my ratio would remain the same in your example.

To reply to your original question:

If I skip a meal I USUALLY find that at the next meal I need to use an insulin ratio that is much closer to what I would use for the skipped meal.

E.g. if I skip breakfast (1:5), then at lunchtime I would use maybe 1:6 instead of my usual 1:8 for lunch.

I also have a CGM and find that the moment I get out of bed my sugars steadily rise until breakfast. On my pump I have to use a 300% basal rate to keep me flat. So if I don't have breakfast for 3 hours I need a 300% basal for that time and it works out. If I stay in bed (even if not sleeping) I can use a normal basal.

mentat said:

To reply to your original question:

If I skip a meal I USUALLY find that at the next meal I need to use an insulin ratio that is much closer to what I would use for the skipped meal.

E.g. if I skip breakfast (1:5), then at lunchtime I would use maybe 1:6 instead of my usual 1:8 for lunch.

I also have a CGM and find that the moment I get out of bed my sugars steadily rise until breakfast. On my pump I have to use a 300% basal rate to keep me flat. So if I don't have breakfast for 3 hours I need a 300% basal for that time and it works out. If I stay in bed (even if not sleeping) I can use a normal basal.

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Same used to happen to me with pump and actually getting out of bed...had to have different basal profiles according to lie ins etc and swop over the night before.
Thankfully don't have to think like that now with getting my degludec insulin. On levemir I had to give an exact 12 hour injection so had alarm set to 9am and 9pm and a bolus as well for getting up. Hopefully now I will have a bit more freedom for the basal shot timing in the mornings but will still (only summising) have to have the bolus jab just before getting out of bed.

julian27ish said:

Diamattic- that's fascinating. So it's not just because we need some extra insulin to bring our levels down, but it actually increases our insulin sensitivity?

I wonder if that's why I am not very insulin sensitive. My sugars are always messed up

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Hi, I had suffered the same problem when I was assuming many carbs per day, as a male adult one should get 260 carb gr/day for a diabetic it's advised no more than 130 gr/day. I reduced to ca. 50-70 years ago and everything improved a lot.

richyb said:

I think some of the DP symptoms might be that the long acting insulin may have run out. I used to be on Levimer which only seemed to last 20 or just about 21 hours. so in a morning for trhe first few hours my main dose had not kicked in. I am now on Toujeo which is supposed to last up to 36hours and so far my control is much better. When I did the DAFNE course it was suggested to miss out on carbs on my mid day meal and check blood sugar at about 4.30 pm to see if it had gone up or down to check basal dose.
I agree that to get sugars down with me, it seems to want slightly more bolus if sugar is high.

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When one sleeps GH peaks after ca. 1hr and returns to normality after 6-7 hrs, this most likely what causes the dawn phenomenon.
Cheers