Sudden changes in I:C ratio.

[geckowacko]

Hello, I'm jeff. Diagnosed type 2 and apparently later type 1 diabetes for 2 years now. There are changes in my Basal and Bolus insulin and I use Lantus and novorapid..


First the lantus change when visiting hot countries. I'll have to double my lantus dosage when visiting countries like Thailand and when I return to my country, I cut it in half again due to the weather differences and changes in the metabolic system. I've just discovered these changes and record data on how to adjust it in the nearest of time. When I'm in Thailand I use a dosage around 38/40 lantus and when I'm back my country (Nehterlands) 20/18. Already had a few nightly hypos at the 20 range, now I'll think I need to change it to 16 this time.

However I just needed to change the Basal lantus and didn't had any changes in my Bolus novorapid before. It was always 1u-10CBH. Now with my latest visit to Thailand, I'am at home again and within a few days I started to have high blood glucose levels and noticed my novorapid ain't working how it supposed to work. I gradually started to change my I:C ratio from 1u-9CBH, 1u-8CBH, 1u-7CBH and today I'm starting on my 1u-6CBH. It worked just fine the first few days, but within a few days later my bolus starting to end in the 10/15 rates after a meal. I weigh my food on a scale and us app's and labels to make out how many carbs I'm eating, which I have done for a while now and never faced these issues before.

However since short I started experimenting with low carb dieet to get better HBA1C (It ain't that bad or anything well under the 7 range), but wanted it under the 6 range. Sadly these changes make it hard to have a fair control over my blood glucose and I always record everything in the app ''my diabetes'', eating schedule, glucose levels, carbs intake, exercise regime, as much as possible. I'm not sure why this is happening and ask for any advice on this topic. Also I changed the insulin vial thinking there might be something wrong with the insulin, due to traveling and left the medicine in the checked baggage (headpalm), but that ain't it. Different vial, same changing results....


Why suddenly almost a double of injection units from the fast working insulin? What am I doing wrong? What might be happening? Any advice will be appreciated.

 

[himtoo]

Hi there @geckowacko
welcome to the forum !!

there is a lot of information in your first post, which is really helpful.

many of us T1's find our insulin needs change in warmer and colder weather -- so your changes do sound appropriate to you -- we are all different in amount of changes with climate( seasonal ) change.

as for I:C ratios there are a few things going on that could be involved :

honeymoon period ending so insulin requirements increasing

lowering carb intake ( assume substituting with protein and higher fat )
-- many of us find we need to bolus for very low / no carb meals. again this is pretty individual , I tend to bolus at around 40% of the protein value as carbs -- so a 3 egg omelette at 20 carbs protein = ( equivalent 8 gram carb to me ) I bolus at 1u per 4 carbs so that would be a 2u bolus

I DO STRESS that we are all individual and that you would be wise to speak with your care team regarding the changes in BG's you are experiencing

 

[geckowacko]

Yes low carb mainly means for me things like, eggs allot, meat mainly chicken (high proteïne), nuts, some fruits, veggies, coconut oil (main oil), butter. High fatty products most likely. Cholesterol they say? I burn that in the gym and cholesterol is also caused by high carb intake, being overweight, lack of exercise. I hit the gym 3-4 days a week and try not to be overweight too much, I'am slightly right now. Working on getting it down till I'm in a healthy weight 97kg right now, 1,90m tall, preferred weight 88kg. Had it down to 91KG, but do illness decrease my exercise regime for a while, but didn't decrease calorie consumption.

Honeymoon period is basically the pancreas still slightly working or hormones more insuline sensitive?

I never watched the protein as an carb factor. My brother had told me the excessive protein you take in will be changed into carbs. So never thought it would be an issue. I keep protein intake around 120 grams of protein a day, due exercise regime.

 

[himtoo]

Honeymoon period is basically the pancreas still slightly working or hormones more insuline sensitive?

I never watched the protein as an carb factor. My brother had told me the excessive protein you take in will be changed into carbs. So never thought it would be an issue. I keep protein intake around 120 grams of protein a day, due exercise regime.

yes - honeymoon period is the body getting a bit of a rest from injected insulin , so sort of starts trying to help as well.
bloods can be erratic during this phase so lots of testing and adjusting doses .

protein and fat are utilised by the body but not as quickly as carbs -- but they do need to be thought about if eating a very low / no carb meal / diet.

 

[geckowacko]

I'll keep these tips in mind. Gradually I'll adjust it to a better insulin ratio for now, then I'll test with the protein numbers. Thanks for the advice.

Been insulin dependent for 2 years, but still learn things over time. When you become diabetic it seems like an education which quite can take a while to manage. Always a work in progress, that sense I have now. I used to beat myself up over the fact I had high blood glucose rates with every high measurement. Luckily, I learned myself not to beat myself too much over this and just try to adjust and learn to find what works best for me. Still I had on the app one week 95% green measurements, no purple (hypo), blue (low), orange (high), red (hyper). Still wanting to get that 100%, but its challenging xD.

Also how to quote? Where is the button or what code is used again?

 

[himtoo]

I'll keep these tips in mind. Gradually I'll adjust it to a better insulin ratio for now, then I'll test with the protein numbers. Thanks for the advice.

Been insulin dependent for 2 years, but still learn things over time. When you become diabetic it seems like an education which quite can take a while to manage. Always a work in progress, that sense I have now. I used to beat myself up over the fact I had high blood glucose rates with every high measurement. Luckily, I learned myself not to beat myself too much over this and just try to adjust and learn to find what works best for me. Still I had on the app one week 95% green measurements, no purple (hypo), blue (low), orange (high), red (hyper). Still wanting to get that 100%, but its challenging xD.

Also how to quote? Where is the button or what code is used again?

to quote -- use the reply button

not beating yourself up is a very important tool in the managing of your D.
Of course learn and remember ( or keep a diary ) to assist in not repeating things that could have caused the hypo or hyper.

D keeps us on our toes most of the time !!