Insulin to carb ratio

So, how many of you have to charge the ratio at bed time? I have noticed that if I have a snack at bed time my sugar is high in the morning. The larger the snack the higher my sugar. If I have no snack then I hold fairly steady through the night.I was at one unit for 15g carbs and changed to one/ twelve and didn't see much change, so last night I cange to one/ten. At ten thirty I was at 121 and had a thirty gram of carb snack. I took three units to cover this. At 6:45 this morning I was at 186. Dang, three units sounds like a lot!

I don't snack at bedtime, but if you are hungry perhaps you can have a lower carb snack.The problem with eating at bedtime is that you can't test and correct two hours later if you're high.

gayler - Do you have any idea where your BGs are while you sleep? If your BG goes low (<70 for more than 15 minutes or so, my experience) then your body may over-respond with a liver sugar release combined with a counter-regulatory hormone release. Then your BG will bounce to the high side.

If you don’t know, it may benefit you to set an alarm to wake up to test. Of course, another way to monitor this is with a CGM. That’s one explanation for your mysterious high waking BGs, I’m sure there are others. Please report back when you figure it out!

When I,ve tested overnight I don't go low. I like it a little hight overnight because lows at night scare me. I try for 120 or so at night and if I don't snack it stays pretty steady.

I don't snack at bedtime unless I am under 90. Then, I just have about 6oz of milk. It has protein and under 12 carbs. It will keep my BS in my normal range for the next morning. I don't take any insulin for the snack.

Pretzels - which I crave - do that to me. I've switched to celery sticks with ranch dressing and morning BS are great

Unless I'm below 100, I don't generally have anything with that many carbs before bedtime. Also, the issue may not be with your fast-acting insulin but rather your basal insulin.

Are you on a pump or MDI? I did find that my I:C ratios changed throughout the day when on MDI (I was doing 1:10 in the AM, 1:14 in the middle of the day and 1:12 in the evening). However, on my pump, I am able to do a straight 1:15 ratio now throughout the day. I think the difference (for me) was that my basal rates are better tuned to my body's needs with the pump.

I actually have 5 different carb ratios set for my son depending on the time of day. So it wouldn't surprise me if you need different ratios in the evening.

Could you share with us what your 30g snack was????

Ok, but don't be too hard on me for eating an unhealthy snack. It was two ounces of Pringles potato chips.

What's important is whether you can maintain your blood sugar with that snack, and it doesn't sound like you can, so it's a choice you have to make.

I could not eat the Pringles or any other potato chips. When they make chips, and also dry cereal they grind the product into a powder and make a slurry that can be pumped through the machines. This operation breaks down the carbohydrates which are linked together in chains. And this in turn increases the glycemic index which is already off the charts for potatoes, and corn.

Thanks guys! I don't think it's the glycemic index tho. If I eat them at lunch time I don't have a problem.

The really good thing about Pringles (besides the taste) is they are very specific about the carb content in each chip. So instead of 30 grams or 2 ounces, try having 1 ounce and see if it satisfies the craving. For me the endo has said try to be at least 100 at bedtime. Don't think anyone is going to be hard on you for your unhealthy snack ultimately your are the only one you have to answer to, none of us. There are some fairly "healthy" chip options in fact there are some really good sweet potato chips they seem to have a lower glycemic index than the regular potato chips. Just a thought.

I don't change my insulin to carb ratio unless I see a pattern of high or low readings over four to six days at a time. I try to keep on a low carb diet and don't snack late at night. If I snack at all, I bolus for it and stay awake for the two hour check. I then correct and feel as if I can sleep at that point. Snacking at night drives up my blood sugar.

Agreed Brian, I also don't changed the I:C ratio unless something is amiss. And then I check with the CDE to get her take on it before I change anything. If I had to wait 2 hours to go to bed just because I had a snack, I would never have a snack.

Same here; I change my I:C ratios once in a blue moon (unlike my basals which I tweak periodically). I keep paper logs and each page is 3 weeks. At the end of the page I look at my numbers to see if there are enough out of range numbers to warrant a change. It's been awhile since I had one. I don't check with anyone if I want to make a change though.

I don't generally snack at all but bedtime would be the last time I would do so - I like to have a good idea of what my blood sugars are going to do while I'm asleep.

You stated “if I have no snack then I hold fairly steady throughout the night”. Then I have to ask why you would eat a pre-bedtime snack then?

Since my I:C ratio is only a few months old, I find it useful to get some advice from the CDE who gave me the ratio in the first place. I'm not confident enough yet to make changes on my own. I don't snack much either, but bedtime would not be my choice either.

my guess is he wanted one