I think using the “increasing/decreasing” terms confuses people. They may be thinking that they need to increase the ISF number when they really want to increase the insulin dose to get the desired effect.
This problem was often present in the DIY Loop community a few years back. I think Katie DiSimone settled on describing changing ISF to make it stronger (deliver more insulin) or weaker (deliver less insulin). She saw the trap that “increasing/decreasing” language contained.
The best way to avoid this confusion is to use “stronger/weaker” language and then add that stronger means using a smaller number and weaker means using a larger number. Then, and here’s where people get lazy and try to get away with using fewer words, always use an example.
I’ve pointed out the importance of clear language describing ISF before and irritated someone who clearly understood the mathematical concept yet didn’t understand the deficiency of their description. I later smiled when this member used very clear language when confronted with this situation again.
I’m no math genius but I do have a feeling for numbers. I have a hard time understanding that numbers are stumbling blocks for many people. We can’t take shortcuts with words when describing concepts like ISF. Not everyone is numerate.
The confusion comes from double negatives.
But there is a carb ratio and also a correction factor. For when I am not eating, to correct a high not from eating carbs.
For most it’s the same as carb ratio but for me it’s isn’t.
I agree we need to have terms that we can all agree on. Every pump has their own terminology as does every insulin manufacturer.
Yes, that’s what I meant. I have never had a peptide test. I try to eat a balance of foods. I dont eat much fruit because of the sugar content. I limit my fat and sugar content mostly.
I am confused when you say that for most people the carb ratio and the correction factor are about the same. I don’t think it is close for most people unless I am totally confused by what you are saying. My carb ratio is about 14 and my correction factor (which in my world is the same as ISF) is 55-60. My guess might be that people with a lot of insulin resistance might have carb ratios and correction factors that are close but I wouldn’t think that is the case for most T1’s who are sensitive to insulin. Am I missing the boat on what you are saying?
What I was suggesting is that it takes me one unit of insulin to metabolize 20 carbs. But that I need more insulin to bring down high blood glucose.
I think in my case that when my sugars are high, I become insulin resistant and then much less resistant when my sugar is low. So my correction factor is more aggressive than the carb ratio for food.
This is something I never thought about until I had a looping pump system that shows more data and I can see that things are different depending on the circumstances.
My daily total insulin is pretty close to what it was when I was first diagnosed. I looked back at my hand written logs and I averaged around 50 units after my cpeptide fell to zero.
And it’s about 55 units per day now. But if my sugars are running high it can be as much as 65 units. Yet my carb ratio remains the same.
20 years ago I was in exubera inhaled insulin study where they did a test for insulin resistance, back then my numbers were so low they called it undetectable. I would like to see those tests now to compare, but those tests are pretty much only used in research and not for therapeutic use.
I agree. The correction factor and carb ratio are two different things. The first means how much your sugar lowers per unit of insulin and the last is how many grams of food are required per unit of insulin to keep your sugar level when eating.
I do this as well. I don’t see it as phantom carbs. I guess I don’t really look at it as carbs at all (which is probably the WRONG way to go about it, lol). I look at my food (and exercise that came before, or after), and find out what is in that food that makes my blood sugar go up (or activity that may make it go down, or not go up as much as usual). I do have to have an understanding of the difference in actual carbs, protein, and fat, but we all do that when it comes to carbs in general. Before we eat carbs, we all make a calculation to the type of carbs, be it simple, complex, low GI, high GI. I just view my calculation of protein and fat the same way.
I read in the Pumping Insulin book that high protein can be as much at 50% more bolus than the carb count actually is, and fat can be 100% more (extended of course). These are rough estimates, but when eating high fat/protein, it slows the metabolism of everything down so much that if you just keep an eye on your readings (and DON’T GIVE IT ALL UPFRONT), you can usually stop anything bad, like an overdose or an underdose, by cancelling whatever is left on the extended bolus, or adding in a correction to help an underdose.
But, to Timothy’s point, if my doctor looked at my numbers, he would probably ask me why I’m eating so many carbs. So I’ll have to explain my logic to him (which again, very well may be bad logic). I’m ok with that data being off.
I am really not invested in how you manage your insulin and numbers.
I’m a bit of a data head. I like data to be accurate, so when I look back at a later date, I don’t have to remember how I altered it.
To me, it’s just as easy to make a correction bolus as doing a carb bolus.
Yes, it seems to work for me. When I eat an eggsalad sandwich I usually bolus for about 8-9 carbs around 145pm as my sugar starts to rise around 2pm. Same with supper. Around 73 8pm my sugars start to rise and I bolus for about 11carbs then. It usuallly works out pretty good.
No doubt! Also in the same realm of thought of doing an extended bolus after a fatty meal vs doing an increased temporary basal rate. They do the same thing, just depends on how you view it.
In automode you don’t have the option of doing a combo bolus or a temp basal as those functions are not available in automode. You have to bolus for " phantom" carbs which really aren’t because of the rise from protein. You just have to
get the timing
right. They say people on low carb diets that the rise from protein is more obvious.
