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Ratio question

RosieDred

RosieDred

Well-Known Member
Messages
289
Location
South Wales
Type of diabetes
Type 1
Treatment type
Insulin
Hi all,

I've spent the past 2 weeks working out my ratio and the past week following it. Everything has gone well and my numbers have been great compared to what they were.

However, yesterday I had a hypo an hour after breakfast and then another hypo an hour after lunch. I used the same ratios I've been using all week but I did work 12 hour shift.

So I was just wondering if maybe I need different ratios when in work? And is this normal?

Thanks in advance


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Short answer, yes. It's very common to have different ratio's for weekdays, weekends etc. Even different meals. A lot of people need a higher dose of insulin to carb ratio at breakfast for instance. Keep testing and recording and adjust where necessary. Good luck.


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usually with periods or days of extra activity its worth considering dropping you background/basal dose.......

means you can keep the ratios the same and therefore simpler, just a case of chopping a percentage of your basal dose.....

this can only be really effective on Levemir though as with Lantus the effect of any dose change takes a few days to observe....

its perfectly normal for days of extra activity to give hypos due to your muscles taking up more glucose with much less insulin than usual....
 
Thank you for your response. I was quite worried that I'd just been lucky all week and was going to have to start again trying to work my ratio out.

I've been using 1:15 for all of my meals when at home so will just increase this for when I'm work.

Just one more thing, I see my dsn next week and she doesn't know I've started adjusting my own insulin. Do you think it matters that I've done it without her go ahead? I just got fed up of having to eat the same things every day to match my insulin.


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Thanks, I never thought of dropping my basal. I am on levemir. I think this would work if I was going to work a 12/13 hour shift but may not work as well if I do 8 or 4 hour shifts, which I also do.


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it shouldn't matter no, depending on your team they may be annoyed, but remember its your condition and you have to take control, your nurses should welcome it......

my visits to the clinic consist of me getting some tests and telling them what I have been doing, there's no advice from them at all really.......as no one knows better than me when it come to my blood sugars...
 
RosieDred said:
Thanks, I never thought of dropping my basal. I am on levemir. I think this would work if I was going to work a 12/13 hour shift but may not work as well if I do 8 or 4 hour shifts, which I also do.


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Click to expand...

Exactly right, the longer shift requires more hours being active and it could be that extra time that is pushing you just under target.....

test out the 12 and 8 hour shifts though, maybe reduce your dose by 5% for example and see how you get on....
 
That makes me feel better thanks. I only met my dsn once about a week after I was diagnosed. Then we spoke on the phone once a week where I would tell her my levels for the week and she would increase my insulin accordingly. The last time she said everything seemed fine so she would just see me in a month. She seems quite nice so I assume she will be okay with it


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how long have you been diagnosed........?

if its not been that long it would be good to build up a relationship with your nurse, but by all means give them your thoughts and suggestions.......
 
I was diagnosed at the end of November last year. I'm not really sure what I'm supposed to talk to my nurse about if anything. So far she asks for my bg results for the week, I tell her and then she tells me how much insulin to use. I don't really know what she's there for to be honest. She also told me a few weeks back that I have a consultant too that she will try and get me an appointment with but again I'm not sure what for.


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the normal procedure at your bi annual clinic appointments would be for you to visit the nurse to talk about:

  • your blood sugar readings, dose adjustment, tip and tricks etc

then a consultant, which can cover:

  • HbA1c results
  • kidney function
  • eye photographs
  • any other complications
  • blood pressure
then you could also see a podiatrist for your feet and a dietitian, for me these two come as and when I need them..........

for someone who has not been educated through courses such as DAFNE, the input from your nurse is crucial as you need your dose adjusted frequently.

learning to do this on your own is a must as the average person needs to adjust their dose as insulin sensitivity changes, weight changes, seasonal changes, unplanned or planned activity, illness.

so a lot of things where self adjusting is needed, and you cant wait for a nurse to get back to you when these things occur...

but it seems your are already on that path and you know the basics...........so well done......

getting your self on DAFNE or a similar course would help a lot....
 
Thanks for all the information, you have been very helpful. There is still so much I feel I don't know yet.

How will my weight affect my insulin sensitivity? I've put on 10lbs in as many days and still have another 7lb to put on so would like to be prepared if I need to be.

The next dafne course (I think it's dafydd where I am) isn't starting until July. There was one the other week but it was full.

Also I saw a dietician few weeks back and he gave me info on carb counting so that's why I decided to give it a go myself. Apart from that she just told me to eat whatever I want.


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the more of you there is, the more insulin you need............as your liver will need to produce more to fuel the bigger body and so your background theoretically will be higher....


insulin sensitivity I believe is down to how well the cells of your body take up the glucose with the insulin, so if you were really active, sporty, athletic.....you would need less insulin for your food......so being bigger isn't really connected to that as such, as you could be a body builder and weigh a lot but be really sensitive to insulin...

your trying to put weight on, so you may need to test your basal every few weeks as you put on the weight......just matching it up....
 
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