Hi All- I am just a pest with questions this week.
I’ve been trying to figure out my insulin sensitivity ratio and carb ratio because I am ALLLL messed up now that my resistance is going down. So the other night my BG was 177 before bed, I did 30 units of Humalog along with my Lantus and I woke up shaky at 71. My ISF used to be 1:1. So I had figured that the 30 units would bring me down to 140-ish. Boy was I wrong. Then yesterday, working on my old factors, I had a sugar of 191, so I did 60 units to get to I thought 130-ish, and I went down to 51. So obviously my ratio’s aren’t working anymore, and I am trying to figure out how to do the math to figure out what the new ones would be. Last night I was at 171, and I did 25 units of Humalog along with my Lantus and this morning my fasting was 101. So, with those numbers can anyone help me figure out what my new insulin sensitivity factor is? I still have no clue about my carb to insulin ratio, but I am not really doing insulin with meals, because I am eating MUCH better and basically just rely on the Metformin to help out at meal times, if I am high after I do insulin then. Any advice would be greatly appreciated. I have an appointment with my endo on the 28th, but I’ve been doing so good, I don’t really want to wait and have a bunch of high and lows in between.
Looks like your are at leat 1:3-4 based on these numbers. I am NO expert though.
Devon, from the numbers given that a 70 point drop. 70 points divided by 25 units equates to 2.8 point drop per unit or a ratio of 1 unit/ 2.8 points. (3 units is pretty close). So a 1:3 ratio worked last night . . .25 units dropped you approximately 75 points.
I love you people! Thank you so much!
There is a little variance from night to night though - one night you were close to 2.8 and the other 3.5, you get the idea - there is some variance.
Actually, the first thing you should do is probably make sure your basal is set right. If you don’t have the book “Using Insulin” by Walsh, you might want to get it. And I know you are saying you are bolusing insulin for meals, but you are likely “covering” your meals through a combination of your basal and corrective boluses. In the long-term, you will do much better getting your basal insulin “just right” and then bolusing on top of that. It is usually preferable to bolus for meals and then only need correction boluses occaisonally. Correction boluses tend to “chase” your blood sugar. You have been taking such large doses of insulin. You will do much better with getting much tigher blood sugar control and just the right amount of insulin. And your weight will thank you. I am sure other insulin users will have good advice as well.
Very good input.
So maybe my Lantus needs to be increased… Thank you again. I will get that book.
Actually, it may need to be decreased. Your basal should keep your fasting level steady at a normal blood sugar. If you wake up at 100 mg/dl, don’t eat, and see how your blood sugar reacts in the morning before lunch. If you are high before lunch, that would indicate your lantus is too low, if you are low before lunch, then the lantus is too high.
I agree with BSC. It doesn’t seem to make sense to not bolus for your meals and then end up doing large corrections. Imho I:C ratios are a lot more reliable than ISFs and its a lot safer to bolus before not after eating.Doing large corrections and then going to bed sounds very risky, especially when you are unsure of your ISF!
Figuring out your I:C ratio is a trial and error thing. I started with 1:15 and then, seeing how I did two hours after meals I changed it up or down. Each meal or time of day is different (mine are 1:7, 1:9 and 1:18).
Your bedtime highs could be from your dinner or from too low of a basal. What do you see two hours after your meal? If your meal is in target, say 130 and then you climb to 177 I would suspect your basal is too low. If your meal is spiking higher than it is the need to bolus. At any rate, bolusing first and then only correcting if you end up too high is the way to go.
Thank you!
It’s definitely my meals throwing things off. I don’t really have a plan for covering them. I am basically still guessing. The plan was to do a flat 25 units with each meal, but I worry about that because often my meals vary so much and I never really know what I’ll be eating. Most of the time I have VERY low carb for breakfast and lunch and then it goes to pot by dinner. I am also eating dinner about 2 hours before bed so my schedule is very screwie. Honestly, I’m kinda making excuses right now… I just need to sit down and plan out what I’ll have. The trend I see in my numbers on a daily basis is 100-120-150-170. They just creep up all day until bedtime, occassionally I’ll have a low in between, but I am getting lots of lows in the middle of the night and then coming back up by morning.
Yep, the set dose for each meal is a terrible idea!
I was overwhelmed by the idea of carb counting and I:C ratios at first, now it’s a piece of cake…well, not a piece of cake actually…lol
If you are eating two hours before bedtime, that explains it. You are going too high because you don’t bolus, then you are trying to correct and going to bed! Nope, nope. It will work much better when you bolus for the meal you are going to eat. You’ll see!
I tried a 1:3 ratio for both my ISF, and for my carbs and it seems to be working REALLY well. Not too low, not too high. I actually stayed between 101-134 all day, before and after meals and before bed. Thank you guys for your help!!!
This is really big for you. You earlier said you were going for months with high numbers, I won’t even say how high, you know. And you were taking like hundreds of units.
To stay that controlled all day, truly an achievement.
I know all the stuff everyone has thrown at you about basal testing and all these factors can seem overwhelming. But you really just need to look in the mirror and smile. You are really getting a handle on things and I am just happy for you.
Thank you. I’m so happy even if this was just one perfect day, it goes so far in making me feel in control that I just can’t describe it. Thank you all for your help.