My brother has an insulin pump. He was seeing a medical school Endocrinologist and she had set his correction factor to 1:50. IT WASN’T WORKING! I found a smart endocrinology nurse practioner who changed my brother’s correction factor to 1:36. It has helped him tremendously. My brother had to switch insurance companies for 2020 and the smart nurse practioner is not in his new network. My brother turns 65 in September, so I will be able to switch him to a Medicare supplement then. I can then take him back to the smart nurse practioner. In the meantime, I took him back to the medical school and requested a nurse practioner. Apparently, the “difficult” Endocrinologist has told the medical school nurse practioner to change my brother’s correction factor back to 1:50, even though 1:50 never worked for my brother. It’s a long story, but it’s all a power trip for the Endocrinologist. I don’t think every single diabetic has a 1:50 correction factor. They must give all of their patients a correction factor of 1:50. I don’t think of Diabetes as a “One Size Fits All Disease”. Please tell me your correction factor.
You are so very correct that one size doesn’t fit all. The amazing thing about diabetes is numbers I used 5 years ago are not close to the numbers I use now. It is a moving target and always changing.
I hope you can get back into a medical practice that realizes everyone is different. And I find it amazing how one little adjustment can make all the difference in ones management of their diabetes.
Now keep in mind, I am in a clinical trial for a new drug so my numbers is different. But with this new drug I have gone from 1:90 to 1:120.
And you will see everyone chiming in with numbers that vary from very high to very low. There is no correct number. It is what works for your brother in this moment.
Good luck to both you finding that magically medical team!
My factor is irrelevant to anyone else managing the disease. You are going down the wrong path by asking others for their parameters.
Agreed. Asking about everyone else’s isf is not going to solve the problem and has nothing to do with getting the correction factor dialed in.
@Looking_for_Answers If the previous isf setting was working much better, why didn’t you just change it back to 35?
Tell your brother to read and re-read John Walsh’s Pumping Insulin. That is my tip of the day.
I don’t need to read anything on the correction factor. I know how well the 1:36 correction factor works for my brother. My point is that they give a 1:50 correction factor for all of their patients. My point is that everyone is different, but they don’t understand that.
Did I suggest YOU read that book??? I suggested YOUR BROTHER read the book.
You’re correct that that an insulin correction factor (aka insulin sensitivity factor or ISF) is not the same for all people who take insulin. In fact, for most people the ISF changes during the day. Many of us are less insulin sensitive in the morning and more sensitive in the late afternoon.
I use 6 correction factors during the day ranging from 1:18 (early morning) to 1:40 (afternoon).
It’s helpful and convenient to be able to do your own (or for your brother) experiment to check and discover what is the best number for you. This is a great skill because diabetes is devious and can change your correction factor.
I think your assessment of the doctor you wrote about is spot on. One size does not fit all. I’d like to give him the benefit of the doubt and think that he’s using 1:50 as a starting point and then adjusting from there but I fear that that’s not the case.
Good luck and feel free to ask more questions.
Terry4, Thank you for your response.It was helpful. My brother has had Type 1 for about 40 years now. I think his correction factor has been 1:50 the entire 40 years. He began using an insulin pump four years ago and the medical school Endocrinologist set the correction factor at 1:50. I switched my brother to a different provider after two years on the pump. The new nurse practioner changed his correction factor to 1:36 and it has helped him tremendously. The more I think about it, I bet people who have been Type 1 for a longer time probably need a ratio that gives them more insulin in their bolus, (than people who are recently diagnosed).
Dave44, I am my brother’s caregiver & power of attorney. If my brother read alot, he would be the one on this website, gathering information to help his Diabetes. I am the one who got him on the insulin pump and I manage all of his healthcare. My brother doesn’t know how to order his pump supplies and insulin, load the cartridge, insert the cannula. change the settings, etc. He doesn’t know his doctors names or the prescriptions he takes. He doesn’t know any questions to ask his doctors and he can’t answer most of the questions his doctors ask.
Terry 4, How long have you been Type 1?
Well then. Maybe you should heed my suggestion to read the pumper’s “bible”. I’ve gotten countless thanks for a couple of decades across many sites, when mentioning that book. The same goes for anyone else who mentions Walsh’s book–readers will thank them for recommending that book. Reading the book instead of asking strangers what their parameters are would be the nice thing to do for your brother. I’m trying to HELP you and you want to argue about it. This is my last comment to you.
1:50 is a very common starting correction factor and then based on the patients results will be adjusted higher or lower. In addition depending on what the starting BS level is it could be lower. For example if you are correcting a 250 BS the correction factor could be much lower than correcting a BS of 150. So anyway like many things diabetes related the answer is…it depends.
I agree, each person is different. I set my own correction factor, and in some cases use different number based on various factors. If my bg is very high, I will use more insulin then pump calculation. Less if I will be exercising after correction.
I also use cgm, so if I see bg dropping too quickly, I’m ready to eat if needed.
I was diagnosed T1D 36 years ago.
Your brother is blessed with your devotion to his health. You are definitely an exception to most gluco-normals as your love for your brother focusses your attention on diabetes details that fly over the head of most.
The ratio for food is different than the correction or insulin sensitivity factor. The mealtime insulin ratio uses carbohydrates to size up a dose of insulin. This is called the insulin to carb ratio or I:C. My I:C ranges from 1:4 in the morning to 1:8 later in the day. This ratio is determined by personal experimentation and your brother’s I:C is probably different. The book Dave is referring to explains how these ratios work as well as how to experiment to discover the correct one for you.
One thing about diabetes, however, is that nothing is static. Things change and unless you notice and change with them you end up like that doctor and use the same ratio for a lifetime and suffer poor glucose control. Diabetes is a dynamic, not static disease.
You may also be interested in reading Think Like a Pancreas by Scheiner and Sugar Surfing by Ponder. In diabetes management, knowledge is power.
It is terrific that your brother has you to be his caregiver, advocate, and POA. I do wonder if someone with T1 and who is not capable of self-care is SAFE on a pump…?
That thought crossed my mind also, when the OP mentioned he is his bro’s caretaker.
How would this be different than children on pumps with parent caregivers?
Wow, sorry that ppl have jumped down your throat and got a bit hoity toity on this thread in some answers. You sound lik you, are an excellent advocate for your brother. My correction factor is 1:70. But, as sb else said, if im really high, i may throw in a bit more, knowing the high bg will make me insulin resistant.
Yeah, I was thinking the same thing. As long as the responsible party pays attention and can take effective timely corrective action, a caretaker can keep their loved one relatively safe using a pump. Diabetes is inherently risky and using a pump usually does not add and often reduces that risk. It may not be safe in every adult needing oversight and care situation but I’m sure that happens in some adult/child caretaker relationships, but they are exceptions.