[2sweet4now]

I feel like a complete idiot! I've been injecting insulin for 14 years, took all the classes when first diagnosed, never learned about "ratios". I'm asking because I've read a few postings for more recently diagnosed diabetic advising awareness of "ratios".

I do watch my carb intake, skip white bread/flour, etc., and make the healthiest choices possible. I'm at a pretty heathly weight for my height (although I'd love to be about 15 lbs. lighter! - imagine most would) Just have had horrible control or lack of for the last three years. I'm about to get on an insulin pump, regardless.

I know I'll be trained on the pump, but in the meantime could anyone explain?
I still need to know since it could be a month or more before I'm actually on the pump. I imagine I'll need to know for the pump as well.

I test several times daily, use 22 u 75/25 humalog am/pm (any more makes me crash badly during the day) and sliding scale for fast acting humalog, inject in the am, before meals, I even try to self medicate 2u per every 50 if I'm over on my blood sugar between meals (starting at 200 - 2u drops me to 150). Morning BS are outrageous, lunch, dinner, and bed are actually pretty good - just that am reading out of control!

Is the ratio thing better than a sliding scale?

I thought I was doing everything I was supposed to.

[JediSkipdogg]

My first question is do you eat the same thing every day? I highly doubt it. That is why you might have to inject more insulin for running high or low. Someone that accurately carb counts, shouldn't have to do that.

Carb counting is something you definitely will learn in pump training. Basically what they do is give you a rough number, it's your job to fine tune it. They will start you off on a number around 1:15. Everytime you eat, you need to look at the nutritional label on the box, figure out how many servings you are having, and then look at the total carbs and add them up. Restaurants have this info also, sometimes harder to get. Here would be a lunch from McDonalds for me...

Quarter Pounder with Cheese: 43 carbs
Large Fry: 70 carbs
Diet Coke: 0 carbs
-------------------
Total Carbs: 113 carbs

My carb ratio at lunch (and yes, you may have different ones for different meals) is 1:19. Therefore 113 /19 = 5.94 units of insulin to take when eating the above meal.

Over time you can guestimate food and if you eat the same thing frequently you can just memorize it and be set. If you have anymore questions, just ask. And the reason you weren't taught this 14 years ago is it didn't exist. I wasn't taught about it either until I started pumping 4 years ago.

[poodlebone]

Originally Posted by 2sweet4now

I feel like a complete idiot! I've been injecting insulin for 14 years, took all the classes when first diagnosed, never learned about "ratios". I'm asking because I've read a few postings for more recently diagnosed diabetic advising awareness of "ratios".

I do watch my carb intake, skip white bread/flour, etc., and make the healthiest choices possible. I'm at a pretty heathly weight for my height (although I'd love to be about 15 lbs. lighter! - imagine most would) Just have had horrible control or lack of for the last three years. I'm about to get on an insulin pump, regardless.

I know I'll be trained on the pump, but in the meantime could anyone explain?
I still need to know since it could be a month or more before I'm actually on the pump. I imagine I'll need to know for the pump as well.

I test several times daily, use 22 u 75/25 humalog am/pm (any more makes me crash badly during the day) and sliding scale for fast acting humalog, inject in the am, before meals, I even try to self medicate 2u per every 50 if I'm over on my blood sugar between meals (starting at 200 - 2u drops me to 150). Morning BS are outrageous, lunch, dinner, and bed are actually pretty good - just that am reading out of control!

Is the ratio thing better than a sliding scale?

I thought I was doing everything I was supposed to.

You will definitely need to know what insulin:carb ratios are when you get a pump. Basically it's the number of grams of carbs that 1 unit of insulin will cover. It's different for different people, and people can have different ratios throughout the day. Many people will have a different one in the morning/for breakfast. The higher the I:C ratio, the more insulin sensitive you are and the less insulin you'll use. If one person has a 1:10 ratio, each 10g of carbs they eat will require 1 unit of insulin. If someone has a 1:20 ratio, they'd be using half the amount of insulin of the first example.

You'll need to know how to count carbs when you get on a pump. Once you can do that, the pump will help you to take exactly the amount of insulin you need and you can fine tune it to 1/10th or even 1/20th of a unit, depending on the pump. So, if you only need 4.3 units for a meal - no problem. It would be hard to get .3 units measured correctly with a syringe and many people would probably just round it up or down, and end up taking too much or too little insulin for that meal.

You'll also probably have to start testing more than "several times a day". I think the absolute minimum recoomended for a pumper is 5 times a day but a lot of pumpers (myself included) test a lot more than that. It's important to test a lot especially in the beginning, so get your fingers ready!

You're also on a mixed insulin which is never good. The pump uses only a fast acting insulin like Humalog or Novolog and can be fine tunes to give you more or less background insulin (basal) when you need it.

With carb counting, knowing your insulin:carb ratios and other factors, pumping is much better than a slding scale. Your CDE or trainer will go through it all with you. Make sure you bring records/logs of your BG readings that also include carb counts & insulin doses. That will help your CDE to figure out your starting numbers. There are simple formulas they can use as a starting point, but the more info you go in with the eaiser it will be to get you set up.

[2sweet4now]

I feel much more educated now. This is a great forum! I pretty much always eat the same breakfast, I vary on everything else however. Apparently I don't know how to count carbs or at least accurately count carbs. Thank you for your help, I'm sure I'll have more questions in the future.