If my doctor changes my insulin to carb ratio, does that mean that my sensitivity factor to insulin is getting worse?
well as far as i know (becasue i haven’t been told other wise,) one unit of insulin will reduce my glucose 100 points but when i started on my pump i needed one unit to cover 65 grams of carbs. now my Endo has me on 1 unit to cover 30 grams of carbs. so since that change does that still mean that 1 unit lowers my glucose 100 points still?
It might mean that your sensitivity has changed. Or it might mean that you were just getting the wrong amount of insulin for meals. How long have you been on the pump? Are you getting high after meals?
Wow, 1 unit lowers you 100 pts & only 1 unit covered 65 carbs!
Over time, insulin needs changes especially once the honeymoon phase is over.
My I:C ratio has increased, but my ISF has remained the same. Don’t know if others have experienced the same. Of course, the only way to know is to test.
i’ve been on the pump since March. i do get high BS after meals not bad, well what the BS is versus what my mini-med states what insulin i still have active in my system, which is pretty acurate.
When I first figured my ratios, I was 1:7 and 1:30. After a while, we determined just prior to going to the pump that my ratios were more like 1:9 and 1:40. It’s not that you are doing “worse” it’s just that your needs are changing. It’s not unusual to have differnt ratios at different times of the day. Are you using the new ratios? How are you doing 2 hours after a meal? Your I:C and insulin sensitivity are somewhat unrelated. One is coverage, the other is deduction. Not worse, just changing.
badamz, I don’t want to oversimplify but I think that you may need to go back to the basics to understand what may be going on with you.
Insulin Sensitivity is the number of mg that one unit of insulin will lower your glucose. (U.S. calc)
Carb ratio is the number of grams of carbohydrate covered by one unit of insulin.
These calculations will result in different numbers. Example: my sensitivity is 1u to 30 mg but my carb ratio is 1 unit for 10 grams of carbs or 1:10. So one unit will drop my BG 30 points. And if I eat 30 grams of carbs I will need 3 units of insulin.
To confuse things further, If I eat a dessert without a complex carb or protein with it, I need to just about double my carb ratio, that is, it will take a ratio of 1:5 depending on the ‘sweetness’ of the dessert. So maybe 5 units with a meal or 10 units with a dessert by itself. In my view, it is the sensitivity that indicates whether you are becoming a bit more resistant to insulin. You can call that “worse” or you can call it a not uncommon progression of diabetes.
My sensitivity used to be 1:50 so I have more insulin resistance the longer I have diabetes. but my complications have worsened only minimally, according to lab tests.
I hope this is not insulting to you but the different ways to express these ratios can be confusing. I have to stop and consider each time I am asked by the endo staff what are my ratios.
There are others here that can explain this better than I but just thought I would throw this in.
good info, but if i were to eat food with out a complex carb that will make my BS rise higher than if i were to eat the same thing with one and still have the same amount of carbs in the meal?
I don’t know because each person is different in their response to particular carbs. For example, for some, a banana does nothing to the BG but to many, it will raise it. Mine, for example. My endo wants me to have desserts only with a meal that contains protein. That is, he does not want me to leave the dessert till later. So protein, or even fat, will help to slow down the BG rise due to carbs. I think I misled with the complex carbs item, not intending to cause you to think a complex carb is equal to a protein re BG rise.
Re your question, it also depends on the specific complex carb. Sorry, but you will have to test your BG before and 1 to 2 hrs after eating various foods to determine how they affect you. Over time, you will learn how specific foods affect you, taking into account activity level also. Having diabetes causes you to become a researcher with your own responses as the subject matter, so to speak!
My I:C ratio changes by season a little, and a lot depending on how much I exercise. And I would never let a doctor set my ratio. I test it myself in a variety of conditions, and with various foods. Try testing it yourself!
Sensitivity has to do with your body and how sensitive it is to insulin. As I’ve gotten older my body has becomes more sensitive to insulin so I’ve had to set the rate higher. My insulin to carb is all together another area.
If you look carefully at the approach in books like using “Using Insulin” the Total Daily Dose (TDD) is proportional to weight, activity level and insulin resistance. The “Using Insulin” approach sets a daily dietary carb level and estimates your insulin to carb ratio and insulin sensitivity factor based on that. You can look at the “500 rule” to see how the insulin to carb ratio is related to the TDD and the “1800 rule” to see how the insulin sensitivity factor is affected.
So your insulin to carb ratio will in general go up if you gain weight, go down for more activity and go up with insulin resistance.
So your insulin sensitivity factor will in general go down if you gain weight, go up for more activity and go down with insulin resistance.
Personally, I believe this view is probably too simplified, but most people that gain weight or insulin resistance will probably see general opposing trends in these ratios.
ps. I just edited this post and I am so happy. I didn’t use “any” math.
Betty, do you really mean “more” sensitive to insulin? That would mean it takes less insulin to drop your BG, I think. Not questioning your situation, just trying to understand. My semantics could be wrong but I require more insulin as I get older (or perhaps it is because I have diabetes longer, rather than age). So I consider my body to be less sensitive to insulin.
And I can’t visualize what is meant by ‘set the rate higher’ but I am a visual rather than a word person.
No need to answer this! I am just muttering my own difficulties with understanding the language of what I call the technology or math of having diabetes. I understand my situation so I am OK not ‘getting’ some of the discussions on here about the ratios, etc. I have to spell it out for myself!
Nell, I’ll try to explain as I understand it. I can set sensitivity on my pump was set for 45 but now it’s set for 60 to help prevent constant lows I was having. Hope that helps. I too have had D a long time this is my 51st year and I am in my late 60s.
Wow! So you do need less insulin. That is good. That is a big jump, seems like. But I know we are all different. I think we can all set the sensitivity on the pump. Mine has only changed by 5 points in the last few years, going up or down as needed. but over many years, my TDD has risen. Of course, on high activity days, I need less. [re next bsc post].