i weigh 108 lbs and am 5'4" tall. slender and average size. but my girlfriend who is taller than i and heavier takes much LESS insulin. whats up with that? and how does anyone figure out how much novolog to tk, what Ur basal rts R and what Ur I:C ratios? am totally confused. anyone out there with any answers? i am on the MM Pump for 11 yrs and should most likely know all this stuff by now, but i dont. i make minor adjustments to my basal rates when i see a poor BS pattern, but other than that, i havent made many changes since i've been finished with menopause.(no more of those pesky hormonal fluctuations)
SOS.
I would recommend to read the book "Pumping Insulin: Everything You Need to Succeed on an Insulin Pump" by John Walsh and Ruth Roberts. Latest edition: June 2012
I'd say the answer is that it's sort of random.
Your insulin sensitivity doesn't necessarily have much to do with your height and weight. I gained considerable weight after my kidney transplant (I was eating much better) and my ratios didn't change nor did my basal. I also have a friend, much smaller than I am, who requires a lot more insulin. It is different for everyone.
Cora
thx Cora; this disease never ceases to amaze me. it is its own paradox. perhaps that is one of the reasons it is so challenging to control.
Basal rates, I:C ratios, sensitivity can be set by carefully running experiments that rely on precise eating and frequent testing. It has been discussed here at length previously. I would recommend searching previous discussions.
Differences in our insulin requirements are a mystery to me as well. Of course, diet plays a big role. Particularly carbohydrate intake. I'm sure differences in digestion, immune response, liver functions, and perhaps remaining beta cell function all play a role. I wish I knew more about it.
I have had diabetes for 50 years. From age 10-24 I took hundreds of unit every day. Then it was 30-40. (This was the old days before basal and bolus.) Now I take about 15 units of Humalog everyday. It just all depends.
Oh, and let's see...also the weather, stress, kids, etc. It makes no difference. We are all different and sometimes different a little bit daily.
To add ..today I can't get my numbers ,since well after breakfast, in the( my ) normal range did my usual morning walk ...all I had for lunch was cheese( bolussed 0.075 u ) because I was hungry ; did a set change and results still higher than I like ...the mysteries/challenges of living with d. ...
I am remodeling my kitchen and went to buy cabinets and countertops on Saturday (big choice, live with it forever, money, etc.) Woke up at 243 that morning (really a high reading for me,) and did not get that number down until six. Stress takes its toll again.
Like I said, even a change in the weather....
Dosage for T1s has a lot to do with insulin sensitivity - the more insulin sensitive you are, the less insulin you need to take. The other end of the spectrum is insulin resistance. Insulin resistance is a hallmark of T2 diabetes (most T2 diabetics produce insulin but are resistant to it, thus causing their BG to rise). HOWEVER, T1s can also develop insulin resistance.
It is true that, generally speaking, weighing more, having more body fat, or being less active will make you less sensitive and more insulin resistant. Fat is more resistant to insulin than muscle, so leaner people with more muscle mass will generally require less insulin. The ratio of fat:muscle also impacts the degree to which you're sensitive or resistant to insulin. And there are a myriad of other factors that impact how much insulin one needs. It's NOT just based on body weight (despite that fact that, for years, that's how many of us were prescribed insulin).
Regarding basal rates - when I started on the pump, I was started on a straight 0.35 u/H rate. From there, we did some testing in 6-hour chunks and then made adjustments. HOWEVER, going forward, I have to admit that I just watch trends and make little tweaks as I see necessary. The problem for me with basal testing is that it's artificial and does not actually replicate what you do in a day. MM's Carelink provides some EXCELLENT data (if you're uploading the data from your pump) that makes basal adjustments quite easy.