So if you have different I:C ratios throughout the day, different for each meal-- and you skip breakfast, does lunch (the first meal after many hours) become like breakfast as far as IC is concerned, or do your lunch IC ratios hold true?
In other words... which really matters with varying IC ratios for each meal; the time of day, or the amount of time since your last meal?
may seem trivial, but for someone like me, who requires twice as munch bolus in the morning as in the evening, and sometimes have to skip breakfast, it could add up.
Good question, Sam! For me it seems to be strictly tied to time of day, and since it is programmed in my pump that way it works out. I too have differences in ratio, breakfast is 1:6, lunch 1:10 and dinner 1:15. I rarely skip breakfast but occasionally I eat it so late that I skip lunch and have an early dinner when I bolus according to my dinner ratio.
I would think the only time there would be a problem with this is if you had significant DP where your BG just kept going up until you ate. But I think for those people skipping breakfast is not something they can afford to do very often.
Mine is also tied to time of day. If I skip breakfast I will often go high (but if I sleep in I'm fine), but if I tried to then use my breakfast ratio for lunch, I'd end up low. My ratios used to vary, being highest at breafkast, lowest at lunch, and in between at dinner. I think they probably should still vary - but at the moment I've put them all to the same level to try and get back to the basics and figure out how to get better control.
So what happens to people who, say, work rotating shifts? Does 6pm remain “dinner” time even though they may have just woken up? I’ve posted this question several times over the years and gotten very little feedback… It seems not too many shift workers here on TuD
My insulin sensitivity is tied to the clock. In the morning, till noon or so, I'm resistant to insulin and use a 1:4 I:C ratio. Afternoon snack and dinner I'm a bit more sensitive to insulin and use a 1:6 I:C ratio.
I used to work the afternoon shift, 3-11:30 p.m. and my insulin sensitivity is the same as now as a retired person sleeping at night and awake during the day.
If I delay my late breakfast past noon, I still use the morning I:C ratio of 1:4.
Sam, I think the answer to your working through the night question is something someone has to discover for themselves but I suspect that the sunlight/dark cues are so deeply embedded in our DNA that that is what provides the overwhelming metabolic cue for our circadian rhythm.
If I skip my usual late breakfast and fast until dinner time, I use my usual dinner I:C ratio and it seems to work.
