I was wondering, how long will it take until my doc and I figure out the right “recipe” for getting the boluses to match the carb count. I have not had much of a discussion with my endo because he wants me to just deal with being diabetic (had a total pancreatectomy on May 1st). I can count carbs and would like to get my BGs under better control so I can stop chasing thorughout the day. How does one figure out units per carb?
Hi David,
It’s mostly by trial & error. Most endos start out with a ratio of 15 carbs per 1 unit of rapid acting insulin & take it from there. The best way, I believe, is to eat low carb meals to get a feel for how your BG reacts to doses. Eating high carbs meals & taking higher doses of insulin makes it very difficult to accurately calculate ratios. There’s no reason for your doctor to not start this immediately & you should insist that you want a ratio. Dealing with being diabetic is doing this:) Also no reason for you not to get your BG under control as quickly as you can. You’re right!
It’s also helpful, if boring, to eat the same thing for several days in a row, at the same time if possible, to get a better sense of where things stand. Space your meals 4 hours apart, so you’re not overlapping insulin.
Keep good records: time of day, your BG before meals, your carb count for meals, your bolus dose, BG two hours after meals, in addition to your readings first thing in the morning & before bed.
Just so you won’t get frustrated, most people have different ratios at different times of the day. For many, the morning is a time of needing more insulin, afternoon less & evening more.