I was told by endo my ratio is 1 unit of bolus Novolog insulin to 15 grams of carbs,
What is the high and the low end in ratio variance? Does someone have 1:5 or 1:30? How is this ration calculated? I am on 16 units of basal Tresiba. What is the high end of daily Tresiba and the low end?
I don’t have a good idea of the range for others but I can tell you what mine are. My ratio on Humalog is 1:3.5 for breakfast and 1:7 from noon until late evening. I needed a slightly lower amount when I was on Apidra or Novolog. Then I was 1:4 at breakfast and 1:8 from noon on. I know that I need a higher amount for carbs than most type 1s.
However, I need a very low amount of basal. Lantus keeps my BG almost dead level through the night (until DP starts around 4 AM) with just 8 units a day. Part of that is no doubt due to my age, 75. A chart in Scheiner’s book shows people over age 60 as needing an average of 33% less basal than younger adults. Also, I weigh 130 pounds. Heavier people would more likely need more.
My endo started me on 8 units a day basal four years ago, but at the time I had to decrease that to six units, then gradually increase to eight over the next two years as I apparently lost more beta cells. But he also started me at a ratio of 1:20 for bolus, I think. And I had to immediately titrate that up to current ratios.
I’m not sure about other people’s ranges (I’m recently diagnosed type 1), but I bolus 1 unit of humalog per 20 grams of carbs, and I take 10 units of lantis at night. I’m guessing everyone is going to be different depending on their own insulin sensitivity. And how much (if any) insulin they are still producing. I’m still going through the honeymoon stage, so I’m still a little bit of my own insulin. I’m also quite lean (I’m 5’5 and 110lbs) , so that might also affect things?
As long as you sugars are in range, that’s what’s important, right? 
The insulin to carbohydrate ratio (I:C) varies across a wide range. Some highly inulin resistant type II’s might be as low as 1:2 or 1:1. I use 1:4 for breakfast and 1:6 for dinner. Babies might be 1:100 or 1:50. Many people use 1:10 or 1:15. Some people benefit from home-grown insulin production and their external insulin needs are very low.
Your doctor may be just starting you at 1:15 and may adjust that up or down as your blood glucose responds. Bottom line is everyone needs the insulin they need. You can take too much insulin and find yourself constantly eating extra to balance diving blood glucose, called “feeding your insulin.” It’s a quick way to gain a lot of weight.
Your 16 unit Tresiba dose doesn’t seem high or low to me. The more important question is, how well does it provide needed basal support. How is your control?
It’s a mistake to relate total daily insulin amounts to mean anything by itself. Do you have any residual insulin production? That can make a difference.
Hi. When i was dx’d T1 last year, i was put on a 1:12 ratio. My endo just tweaked the numbers to 1:10 & 1:9 for breakfast. 
During my first year or two after diagnosis I was really grateful for the pen that could do half unit doses of bolus. These days full units provide all the fine-tuning I need.
It turns out everyone s different, I don’t know why but they are. And they can be very different. So in the end, the best answer is that your ideal ratio is the one that works best. So what is best? It is the ratio that gives you just enough insulin to cover the carbs. That means (assuming your basal is perfectly set), the ratio that returns your blood sugar back to it’s starting point after 4-5 hours.
I actually find that ratios don’t work very well for me as I actually need different ratios for different times of the day/meals and for different foods. But as a course guide, some people find ratios can give them good results.
I use the 500/100 rule to calculate carbs ratio and my correction ratio.
Don’t worry about ranges. You start with a ratio usually based on your weight, age and fitness level. Then you adjust it based on your uniqueness. Then something in your body changes and it needs adjusting again. Both you and your diabeetus are uniquely weird.
can you elaborate on that rule? I’ve never heard of it.
My typical ratio is 1:20 of novorapid although I take 1:15 with breakfast. I use a pump and take about 22 units per day in total which covers about 200 G carb and basal doses. Some foods I seem to use a lot less insulin for such as pasta for some unknown reason pasta has very little impact on my blood sugar, while chocolate has a very nice predictable impact that seems to line up nicely with my novorapid and gives me good post prandial results. It’s all trial and error really and just when you think you have it sussed, it all changes again which is one of the more frustrating parts of diabetes I think.
The responses are very useful to me. Partly just curious in the range that others use. I wondered how my doctor came up with the ratio he set last November. I notice variances for me with amount of exercise and types of foods. I am fortunate to still be producing “home grown” insulin to some degree but it has depleted over the past 18 years since I became a diabetic with gestational diabetes.
My control is improving, not perfect, but some days lower 100s for fasting morning reading some days closer to 200. I see the endo again in April. Think a nighttime correction is what I need to do but sometimes just so sleepy I skip that. Will see how my A1C looks then. I am learning more on bolus amounts and factoring in exercise such as walking/yoga and needing less insulin bolus prior to exercise…
Happy Saturday to Everyone!
Calculate a daily use for a couple of days of all the insulin you use. I use 14 days. On my 640G in the menu -> History then first option(=Totals??) and then 14 days. That is my daily total.
Then I calculate my carbs ratio= 500/daily total
Then I calculate my correction ratio= 100/daily total
That I can insert in my pump as settings for carbs and correction ratio’s
I made a program that calculates all those ratio’s but I don’t know how to upload it here and if there is a use for it here.
It’s for Windows,Linux and Mac’s but I only know that the windows works but I don’t know if the mac and linux versions works for you.
As indicated above, the variation from individual to individual is wide. And the number by itself isn’t good or bad. This isn’t like a lab test where there is a reference range and you’re okay within it and in trouble outside it. Your ratios are just your ratios; they correspond to the complex system that is your own unique physiology. Aside from that they have no particular meaning.
Mine are as follows:
Regular
AM 1:8
PM 1:11
Apidra or Novolog
AM 1:12
PM 1:16
The one part of your story that bothers me just a tad is this:
I, too, would like to know how he/she arrived at those numbers. Were they plucked out of the air? Lifted from some one-size-fits-all chart in a textbook? I know of no way to determine them safely and accurately other than through empirical testing; If there’s another method, I would be very grateful to learn what it is.
David_dns, when I was first dx’d with Type 1, twenty+ years ago, my endo had me keep a logbook for a month. Then she calculated from my logbook that I needed a l:15 ratio. That ratio proved to be correct and has gradually changed to my current ratio of l:10. Both are easy math, which I appreciate!
The so-called 500-rule is extremely crude, starting with the assumption that the average person supposedly eats 500g of carb a day! (I think that’s insane and am not even a low-carb advocate.) So you can make your own conclusion how “accurate” its resulting calculations are. I don’t think any modern-day endo should use that even as a basic rule-of-thumb. Much better to start by weight range (which is probably how the OP ended up with the 1:15 ratio recommendation.)
You can read Gary Schneider’s explanation of both here: http://integrateddiabetes.com/Articles/insu/carb%20ratio%20article%20for%20mendosa.pdf.
Trudy, that’s in essence just what I was talking about. Your endo calculated your ratio using actual measurement data from you. I don’t know any other meaningful way to do it.
there are US numbers rule, 1500/1700
and EU number, 100 rule. It depends what scale you work in
the next step, insulin adjustment
I am newly diagnosed as type 1 in May 1016 at the age of 61 and my endo is using the 1:15 ratio. I was told to eat 30-45 grams of carbs per meal and take 3 units of novolog. It has been tough figuring this out on my own. This site has been very helpful.