MDI user Basal/Bolus ratio

I am only 2.5 years into this and over my honeymoon. My current basal is 16u Lantus split 10am/10pm and since I eat low carb I usually only use 4 to 7 units of Humalog per day. Every book I read says basal/ bolus should not exceed 60/40%. What is the danger of my 75/25%? Does anyone have any info on this? I see my Endo in Feb. Thanks, Robin

I have seen my endo (actually the NP) in the last 2 weeks, and she told me the old guidelines are just that - guidelines. Especially with your low carb intake, you have to do what works for you. If your basil(s) keep your readings fairly flat while not eating, you shouldn’t have to worry. Mine are that way, but always remember YMMV. No two of us are alike. Multiple tests are needed to get the best results.
Good Luck - Dick

I think they mean pumpers. I’ve been in this club since aug./08 at 52. I am also MDI and here’s what works for me. I do 30u Lantus in the morning, now as far as diet that’s different. I watch what I eat because now I have to inject, so food has to be worth the effort.LOL I eat whatever, just do things like side salad not fries at fast food, etc… When I eat I use a ratio, carbs. to novolog, which for me is 2u for every 15 carbs. What this has done is my last a1c was 6.8 and everybody is very happy with that, I think I can get lower. My post meal numbers were high ie:196 at 2 hrs, then 110 in 4 hrs. if I used more Novolog I go low which we all know is no fun at all. So now I inject about 30-45 mins. before eating and the numbers look a lot better, ie:140 at 2 hrs with the same food as the 196. I feel everybody needs to find what works best for them. When I was first dx’ed they had me on a diet like a type 2, I just think they didn’t know much about type 1. I have lost weight the good way LOL and got LDL from 180 to 80
OH, also pumpers only use just fast acting insulin so their basal/bolus have different rules(?) Hope this helped!!

Dick and Keith, Thank you for your replies, I agree if it works for me I don’t want to change a thing until it stops working. Robin

Your basal rate is that high because is has covered the basal needs. The additional shots of humalog were needed to reduce the after meal spikes. The rest has been covered by your own residual insulin production.

Now with your ending honeymoon this will change and you will need more insulin to cover your carbs. This transition phase is not very easy to handle. You will know best what works for you because the meter will guide your way. If you can achieve good numbers then this is fine. You will see that you will end up with a ratio that is significantly different from 75/25 (basal to humalog). My current ratio for example is 28/72 (basal to novolog).

The biggest concern about the basal rate is that it must cover your basal needs but at the same time it should not bring you down. There is a fine balance here that needs to be found. Physical activity for instances will lower your BG but this should happen in a way that can be controlled with additional carbs as a preparation. So the basal rate is the key for good control but it is also important for your quality of life.

Robin,

I’m on MDIs & my ratio isn’t 60/40. Whatever works best for you is fine.

Granted I have a really strong honeymoon, I’m not taking any bolus at all and only 6 units of a basal at night. Anyone else have a similar regiment during their honeymoon.

I was diagnosed Type1 Dec 15th

Yes that was me for only 6 months though , enjoy it while you can. Robin