Carb/Insulin ratio.....Help! pumping for 1 week

Hi,I’m new here,started on the Spirit pump last Monday and I’m struggling with my bolus! On MDI my carb/insulin ratio was 13g/1u…this is nowhere near covering my carbs at the moment,nor is 10/1.I thought this ratio was supposed to go up on the pump? My numbers are terrible at the moment,way too high and not coming down at all in the first three hours (or 4 sometimes)after eating.My insulin has changed from Novorapid to Apidra.Please advise…nervous breakdown brewing lol x

Hi Tracy,
I don’t know if this is going to apply to you or not. I use Humalog in my pump and when Novolog first came out I switched to see how it worked. My BG was awful, it would not come down no matter what I did. I called the doc and he said that not all people do well on different insulin’s, Novolog works just fine for many people just not for me.

That may not be it though. You might have air in the tubing, a bad absorbing site or something along that line. It can be frustrating at first but then it becomes like second nature. Try injecting your bolus with Apidra when you would bolus for food and see if it makes a difference. If not then you may want to consider using Novolog since you used that before. If it does help though you may have a site that is not absorbing well or air in the tubing.

There is alot of knowledge here so I know you will get help.
Be well and be loved

My first suggestion (what many of us suggest here) is to cuddle up with the book “Pumping Insulin” by John Walsh. It is an invaluable tool to helping you figure out the details.

I’m a pumper on Apidra for several years. My carb ratios vary throughout the day, being tighter in the morning (1:10) when insulin resistance is higher and widening to 1:13 and 1:15 as I continue through the day. Some people actually find that theirs is as low as 1:7.

What are your pre-meal blood sugars like, how far in advance of the meal do you bolus, and how many carbs are you taking in at the meals that keep your sugar high? Depending on your answers, the solution might be different. 60-80g of carb and bolusing after a meal when your pre-meal sugar is 160 is going to be disastrous whereas a meal with 40g of carb, a bolus 20 minutes before you eat, and a pre-meal sugar of 110 is going to produce a very different outcome.

If you’re more like the latter scenario, it could be that your basal rates are off. Eat a low-fat meal and then start a (fasting) basal check a few hours later. After you’re sure your food has left your system, check your blood sugar every hour or two for 5-6 hours without eating. If your blood sugar rises over 30 mg/dL in an hour, your basal rate may be too low.

I am still adjusting my basal rates,nights are best,0.5u most of the night increasing to 0.6 at 6am and 0.7 at 7am.I have a steady rise in the mornings so 0.7 til mid afternoon (haven’t fasted for early evening yet. Example of a mealtime…had two small wholemeal rolls with small amount of cheese and onion for lunch today,BS was 8.1 (147) so had 7units to cover 60g carb (using 1:8 ratio) 5 minutes before eating. 90 minutes later my BS was 16.8 (305) and one hour after that(I waited to see if it would come down any) it was 333! I took a correction bolus of 2.5 units and it’s now back in the normal range.
There’s no air in my tubing etc all is well on that front. I’m having this problem after every meal…low carb,low fat etc.
I know it’s only been a week but it’s driving me mad lol!!

Pumping Insulin is great,am reading it thoroughly! Trouble with the fasting,skipping a meal is fine but between the highs and corrections,it’s difficult to find a period of time that suits the fasting criteria (no bolus for 3 hrs/no carbs for 5) I can’t stay in a good range long enough to start!! and I’m back at work tomorrow, which will confuse things more :slight_smile: