I’ve been trolling on this site for quite a while and I have to chuckle–Does ANYONE use the sliding scale our Docs gave us?
I did-for two days before I went rogue…
And…does your Doctor know?
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Well, that is indeed an interesting disconnect. I know from personal conversations and online forum discussions that a great number of HCPs think their patients use sliding scale. How many of the patients actually do is something else again. I wish I knew some actual numbers, but I’ve no idea how one would go about obtaining accurate ones.
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Thank you for replying, David!
I’m not looking for statistics per se - just wondering about other members on here. Thanks! 
I got that. Your comment just triggered my curiosity itch.
For the sake of full disclosure, I have never used that silly thing. Not even on Day 1.
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I had to use it the first 2 days. Just home from severe DKA; my brain couldn’t yet follow simplest instructions so my husband was managing.
My hospital uses a sliding scale. My doctor came to visit when they were about to inject me, so I asked him to tell them to count carbs. In the end, I counted the carbs and they gave me the amount I asked (thanks to my doctor, of course).
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when i was first diagnosed, there was no pump and the BG meters took forever and were gigantic. the only option i had at the time was the sliding scale. there wasn’t even fast acting insulin back then. nothing was as fancy and high-tech as it is today.
now, as i look back, i can’t believe i ever did that. my A1cs came down from 9% to 7% to 5.8% since i have been on the pump. and i was taught to carb count by using my hand as a “ruler/ carb scale.” (well, often i still use my hands; mostly when i am at a restaurant and there are no labels on the food being served.) thank god for science and technology; we are in a much more diabetic friendly era.
is this what you were referring to??
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Daisy: I love hearing about the past, too!
I remember my Grandmother keeping a steel syringe and supplies in a cigar box. Everytime I smell insulin it reminds me of her. Good memories! I don’t recall ever seeing any type of glucometer though. I was probably 4 or 5, so this would’ve been in the 1960’s.
Trudy, I’d bet they didn’t know how to count carbs, much less correlate them with insulin!
Were you able to do corrections if you wanted to between meals?
I use a sliding scale but I have started recently to give myself 3 units right before the meal. I can correct after the meal, but sometimes I don’t have to, because I eat carefully.
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Nope, I didn’t do much in the way of corrections. They did pretty well, though–they automatically tested first thing in the morning and before all meals. We ordered our own meals from the hospital cafeteria, so I was able to order low carb meals. If I felt low 24/7, I’d ask my nurse to test me, and if I was indeed low they brought me foods like Ensure or yogurt.
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I write-up a sliding scale for my 18 month old T1 son when someone is taking care of him. It makes it a bit easier for the caregiver who does not have significant knowledge of diabetes like most people here do.
When my parents (who raised me as a T1 in the 1980s) take care of my son, I put everything in the 1980s diabetes-care-speak and it works great - He needs 1 starch choices and here is a sliding scale… It means I don’t have to do any re-training 
My parents are amazed how easy it is to use insulin pens and how fast the blood glucose meters are these days. I am amazed how much they remember.
The last time I used a sliding scale was probably around 2000-ish when I switched over to carb counting and using ratios. I was a big shift from eating a pretty much fixed diet to having flexibility in meal plans.
I did the sliding scale thing for 20 years on R/N insulin and for the life of me I couldn’t remember how to do it if you put a gun to my head.
I did the sliding scale thing when I was caring for my late husband after he had a stroke and was no longer able to handle his diabetes control himself. That would have been 1999-2003. He was on nph & r. Actually, I had to ask the doctor for a sliding scale. Until then, he had my husband on a set dose only. Far cry from what we are doing now with different insulin and carb counting.
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I guess if one is caring for a diabetic the only choice is sliding scale, (b/c only WE know ourselves) but…sliding scale to me is just so ridiculously skewed. How can Doctors assume the ‘one size fits all’? It never works! When I took care of patients b4 I was diabetic, sliding scale only covered their highs just b4 eating - never took into account carbs in subsequent meal, therefore bs stayed statically high.
My Doc has no idea how/why my a1c is so low. He never asks what I’m doing and I don’t tell. Do any of you with good control tell your Docs how you’re ACTUALLY doing it?
(Btw - I don’t know a single Dr who even HEARD of carb counting! All they seem to know is SS - which will NEVER put/keep a DM pt in decent control)!
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When I met my endo for the first time and he put me on insulin, concluding that I was probably LADA before he got the antibody test results back, he gave me a starting dose for the basal and a starting insulin to carb ratio for the bolus. Then he was going to turn me back over to my PCP.
Unfortunately from my past year and a half with her treating me as a type 2, I had zero confidence in her ability to get my doses adjusted properly. So I got the book Using Insulin by John Walsh and adjusted them myself. When I went back to my PCP and told her what my ratios were, she didn’t seem to know what I was talking about. So it was a good thing I went ahead and adjusted doses myself. I think she thought the endo had taught me how to do it. But she had said before she sent me to the endo that she didn’t want to put me on insulin because she was afraid I’d try to adjust my doses myself. LOL We do what we have to do.
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Oh my gosh, Uff-da…do I know what you’re talking about!
My PCP sent me to endo appx 2 mo after dx. Endo criticised me for EVERYTHING I was doing - 5 small meals every 2.5 hrs --said I should be able to go 24 hrs without eating (Huh? Why?)
Using oj for lows - “no no no -that’s old school, you need to use glucose tabs”. (Um, no, when I get low I’m too nauseated to eat 1 piece of chalk, let alone 4-6 it would’ve taken). But thanks smarty pants!
“Your DM is out of control”. (WHAT!!! My 90 day avg was 85! Yes, I had some lows, but I was newly dx and just figuring it all out). [N why the hell haven’t you even checked my A1C for so many months when my very 1st one was DkA in hospital months ago]?
No, I didn’t say this to him. It was obvious he was so intimidated using computer that when I asked him a question his answer had NOTHING to do with my question. In fact, he was so glued to the computer that I’m sure he could never even pick me out in a lineup!
Btw, when he said this my last A1C was 11.0 w/bs 572. ICU but no memory for 5 days.
Thankfully my A1C’s are now 4.7, but that presents another round of problems. Jeezum. Just can’t win!
Type 1 LADA
My doctor never told me to do a sliding scale. It’s always been count the carbs, determine amount of insulin based on THAT count. Measure BG, determine amount of correction based on BG target. Add the two amounts and take the insulin anywhere from 5-20 minutes before eating. Watch BG do whatever it wants to do, anyway.
And, under my breath, cursing. An exhaustive emission of exclamatory explicatives!
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Everything I know about my T1 D care I taught myself with the help of books and helpful folks like those here on TuD. The only thing I got from the nurse practitioner who diagnosed me was a prescription for insulin and a referral to a diabetes education class. I took the class and it was worthless to me. It felt like it was primarily just a way for the clinic to get the money that insurance companies allot for such classes. It was almost exclusively about helping T2s change and manage their diet. Several times, the teacher said to me “Oh, it will be different for you because you’ll be taking insulin.”
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