I've read that you should keep your basal/bolus ratios at about 50-50 maybe 40-60 either way.
My question is that I take 4 units of basal to about 10 units of bolus which is 28-72. Is that strange?
My fasting BG every morning is about 80-90 and my last A1C was 5.6 so I am doing something right.
I just don't know anyone that takes such little insulin.
Let me also add I am extremely extremely thin and my endo said that thin people are more sensitive to insulin. Maybe I am still honeymooning as well. Who knows.
Keep on doing what you are doing the BG is great. Yes you are honeymooning your insulin consumption is very low. I use 50 units of lantus and about 30 units of novo for a low carb diet.
You’re really comparing apples to oranges when you compare insulin doses of a type 1 to a type 2. Insulin resistance is the main characteristic of Type 2 (though they eventually develop insulin deficiency as well), so type 2’s need significantly more insulin. Type is a much more significant dosage determinant than weight. Even within types our insulin needs vary greatly so comparison of doses have very limited significance. As for the percentage of basal and bolus those are general guidelines not hard and fast rules. Just like 1:15 is a median I:C ratio, but some of us vary greatly in either direction. I agree with Anthony: whatever works, works. I’m learning more and more that is what’s important for each of us, I take about 13 basal and 9 bolus so I’m slanted in the other direction. The amount of carbs we eat definitely influences the balance as well. I believe John Walsh who mentions the 50/50 “rule” talks about higher consumption of carbs than many of us use.
Yeah I have about 115-130g of carbs a day with my ratio at about 1:12. People look at me like I am crazy when I say I use .15units an hour but it works very well. Plus being a very thin type 1 also is why. I am very sensitive to insulin. If I am at 200 (which happens maybe once a week) I can give .5 units and I’ll be down to 120.
You are new to diabetes, give it some time to flesh out. I suspect your ratio will change. Now is an opportunity for you to really work on exercise/diet to keep that ratio (yes, I know you are T1).
It is possible, though, that your basal is covering some of your bolus. The best way I know of to determine this is to fast for a day. Or, for 12 hr one day, then the opposite 12 hr another day. Do this with the monitoring of your MD or practitioner! But, with 0 bolus insulin, if your basal is correct and only covering basal, you will be in control all day, if it is covering for some bolus you will run low and find out that your basal is too high.
So, your basal is 40 u/day and your bolus is 10u/day? That does surprise me some, 40 u basal is not on the low side, whereas 10 u of bolus is.
OK, I’m confused 0.15 u/hr = 3.6 u basal/day compared to 10 u bolus/day - so I read your original backwards. Your bolus is 74% of your total. So, I would suggest that your bolus is covering for too low a basal. Don’t be confused by your morning #s being OK, as many need much less insulin at night. My daily u/hr run ~1 u/hg, but that drops to 0.5 u/hr from 10 pm to 3 am (I have dawn phenomenon).
The fasting (with supervision) will still be a way to flush this out. No food=no bolus -> find out if your basal is working.
Your sensitivity to insulin, Rich, might also have to do with the fact that you have only been diagnosed 6 months. It might very well increase somewhat with time.
yep sorry, I got his original post backwards, thinking he was ~25:75 (bolus:basal) when in fact he’s 75:25. the suggestion to fast still stands (with supervision/permission from his doc).
Ratios are hard, and people are very different. Also, yes, the new diabetes is certainly something to consider.
The idea, like TS has said, is to not require any food when you take basal alone, nor require extra insulin on top of it, and keep sugars 80-130 mg/dl, or around there. The fasting could definitely help to see problem spots, if there are any.
Why would he need permission from his doctor to do a basal test? I do them all the time and I can assure you, I would never ask my doctor permission to do it. The idea behind having your basal test correctly is to be able to skip meals if you want to.
I completely agree, I do one at least every year. But, the first time, in a new diabetic - I just think I am not qualified to suggest that and he needs his doctor, or MM educator person. I also have a CGM, without it, I’d test a whole lot while doing this, something like every other hour.
I have been Type 1 for 29 years now and counting…my basal/bolus ratio is 25/75…similar to yours…and I am on no honeymoon for sure! Doing regular basal checks will tell you if you are covering a lack of basal with bolus…I know I am not. I have been on the pump for nearly a year and my AICs are 6.5 and below…so the ratios are correct. My afternoon basal rate from 1 p.m. to 5 p.m… is 0.025…the lowest you can go on the Animas Ping.I am normal weight…just about right at 132 lbs and 5’6" tall. I am also not one of those low carb folks…I love to eat…300+ carbs per day. Don’t argue with success…it is what it is, as they say!
I’d stick with what works in this case as other said. And even if the majority of people are actually 50:50 there are always outliers that still have happy and healthy lives
Basal testing during the day can be good to see if your rate is the right one because you’re testing to see if your number remains relatively steady w/o food and bolus. It’s a good topic to discuss with your doctor because it’s a good tool to understand for the future especially if you want to have more input into your management
One thing I’ve always wondered was whether one’s eating habits (grazing vs. fixed meals) might also affect what ratio you aim for or end up getting… like if one grazes then having a higher basal than you would if you fasted all day might work out because by grazing you would be less likely to crash than if you ate meals more spaced apart…and at the same time because some of the basal is covering your food it lowers your bolus too…
On another note… eating a lower carb diet might also affect your basal:bolus ratio esp. if you don’t need much or any insulin to cover large amounts of protein…
oh ok… that makes me feel better knowing someone else has a wierd ratio like I do. I have never done a basal check, other than testing at 3am and being about the same at 7am when I get up near 85ish
I pretty much only bolus 3 times a day for meals. My snacks are very low carb items like nuts, yogurt, veggies. But my meals are about 35-45g of carbs.
Hey Rich. I went through the same thing as you and just now am I starting to increase my basal.
So I take about 5 units of basal per day and 15-25 units of bolus depending on the day. (TDD is 20-30 units but usually 22)
That’s just like you, and I thought I was weird, and my doctor thought it was weird too, hahaha. But, I think it is because of the honeymoon. I am a year and a month into diabetes so I am a little ahead of you…and just now I am having trouble with my numbers and think it is because it is time for my basal to change!
Hey Rich. I went through the same thing as you and just now am I starting to increase my basal.
So I take about 5 units of basal per day and 15-25 units of bolus depending on the day. (TDD is 20-30 units but usually 22)
That’s just like you, and I thought I was weird, and my doctor thought it was weird too, hahaha. But, I think it is because of the honeymoon. I am a year and a month into diabetes so I am a little ahead of you…and just now I am having trouble with my numbers and think it is because it is time for my basal to change!
