carb ratio's

[russ621]

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Now I know everyone is different and different foods require a different ratio to others. But until recently I hadn't come across ratio my food to insulin (old time trained and liittle to do with diabetic communities) I'm trying to nail this down and started on a 10 - 1 ratio, sometimes this is fine if my bs is 7 (126 ) or above. However if its below that I need to increase the ratio up to 15 or 20 - 1. I had a bowl of porridge for breakfast in the week, my bs before it was 6.4 (115.2) an hour and a half later it was down to 3.8 (68.4) Carb value of porridge was 25.3, units of insulin taken 2.
What ratio's do you guys aim at in your normal day to day diets ? do you change the ration on your bs reading ?

Russell

[sparrow1]

Yes everyone is different. If I am eating a bowl of porridge (and I mean the large flake kind), or a slice of stone milled whole wheat bread, or kidney beans, veggies, etc.) I don't bolus at all as they are all low GI foods. However, for the occasional cookie, or piece of cake, or any high sugary foods, my ratio is 1:4 unless I am low to start with - then it's 1:7. For correction dosages I need 1 unit for every mmo/L. So if I am 11 I would correct by 5 units to get to 6. Whatever works :)

[Real4]

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What ratio's do you guys aim at in your normal day to day diets ? do you change the ration on your bs reading ?

Russell

The ratio stays the same, assuming it's correct (from what you say, your's isn't. Too much insulin).

What you do is add a {correction} factor for the amount of points you want to drop. For example, you test out at 200, and your goal is 90. You want to drop 110 points plus covering what you are going to eat. You'd use your correction ratio to figure how much insulin you need to correct.
If your ratio is 50, then you need 2 units of insulin PLUS the regular ratio for your food. This sounds complicated, but it becomes 2nd nation. Do you test and correct between meals now?

[xMenace]

I don't change my ratios based on readings. If I'm high I'll give a correction and a bolus for food. By changing ratios only you many not get enough correction or you may get too much.

I find my ratios by eating the same food and making small adjustments until it works. Then I test that ratio on smaller and larger portions of the same food. If it all works, I'm happy. If you have variances with portion sizes, then this points to a problem with basal rates. I suggest nailing your basals first.

[Gary_W]

I'll agree with the previous posters and make another suggestion too; are you sure your basal insulin is set correctly? If it isn't, it can mean that carb counting doesn't always make sense as you could well have the basal insulin dropping you too.

Once you've got your basal correct, you should then be able to find your rations and stick with them. It is not uncommon for your ratio to be higher at a particular time of day (e.g. many people have to give a little more insulin to cover carbs in the morning compared with later in the day but we're all different).

Other food for thought is this. When you give a bolus dose, you are trying to match the absorbtion profile of the insulin with the absorbtion profile of the food as closely as possible. You are doing this both in terms of the amount and also the speed. If you are using fast insulin and eating slow food, the insulin can get ahead of the food and you go hypo. Porridge is nice, slow release stuff. It may just be that your insulin is getting ahead of it. Try carb counting for the porridge, but perhaps add a small glass of orange juice (for which you'll also need insulin!). The orange juice will absorb quickly and raise your BG, holding off the hypo whilst the porridge gets in.

Good luck

Gary

[BlueSky]

... What ratio's do you guys aim at in your normal day to day diets ? do you change the ration on your bs reading ?

Russell
Russell,

I know exactly what you are talking about. I have the same problem as you do. The lower my BG is, the less insulin I need. And the difference is substantial. It makes calculating a carb ratio very difficult. Especially in the morning as the Dawn Phenomenon effect adds to the confusion. While I count carbs, I have reverted to "eyballing" a meal and guessing how much insulin I need, based on various factors but especially the current blood glucose level. I have found the best way to deal with this uncertainty in the morning is to simply avoid carbohydrate altogether at breakfast time.

[russ621]

Thank you everyone for all your helpful replies. I do have a sneeky suspicion my problems are basal related. Thank you Blue sky, nice to know I'm not the only one who has these problems, do you snack before bedtime? if so what do you have ? No carb breakfast, do you not have any bolus with that ? A Pattern I've noticed over the years, if I wake with a low bs, my sugars will stay low all day (fighting hypo's), if my morning bs is high, I spend the day correcting with insulin, is this normal ? I feel stupid for asking but how do I work out my correction ratio ??? From high back down to in range, at the moment its on a guess ration.

[xMenace]

A Pattern I've noticed over the years, if I wake with a low bs, my sugars will stay low all day (fighting hypo's), if my morning bs is high, I spend the day correcting with insulin, is this normal ?

I've found the same thing, but not always. I always attributed this to a stronger than normal DP increasing my insulin resistance. I have absolutely no quantitative evidence.


I feel stupid for asking but how do I work out my correction ratio ??? From high back down to in range, at the moment its on a guess ration.

2.8 mmol/l equals 10g of carbs equals 50 mg/dl

[BlueSky]

... do you snack before bedtime? if so what do you have ? ...
No, I don't snack before bed. At the moment, my Lantus keeps my blood sugar pretty flat over night.
... No carb breakfast, do you not have any bolus with that ?
I bolus 8 units of Regular as soon as I wake up. It is a lot of insulin, some of which covers the meal (typically eggs, cheese & mushrooms). Much of it also covers the DP, which I find lasts until 11am.
... if I wake with a low bs, my sugars will stay low all day (fighting hypo's), if my morning bs is high, I spend the day correcting with insulin, is this normal ? I feel stupid for asking but how do I work out my correction ratio ??? ...
That sounds very familiar :mad: . It is why it so important for the day to start off well. Blood glucose needs to be in the target range when waking up. And I find that eating virtually no carb for breakfast helps keep it there until lunch time. I also have to guess at corrections done in the morning. I find doing corrections after lunch a lot easier, probably because the DP is over. I am a lot more sensitive to insulin and covering carbs is a lot easier too.

You ask if this is normal. Most people don't seem to have this problem as intensely, but you are certainly not the only one. ;)

[1type2go]

Oh yeah,

I too know this well
although not correctly using a carb insulin ratio
If I wake to a good BG level I usually cut back my dose 1u and eat the same thing each day .......before Lantus (R&N) I too only ate eggs and 4 egg whites ,fried in non-stick but now that I think of it ,I'm needing a couple slices of whole grain toast to hold my over.

bluesky I was asking earlier about going back to R&N or thought about using some R (humalin) in my regime
is this what you are doing?

Donovan

[nono87]

Well i have had to change my ratios for different times of the day in the morning it 1:5 lunch is 1:9 and diner is 1:11 i cannot keep the same ratio through out the day because i tend to run high in the afternoon and low at night so i take a higher dose in the morning to overlap with my afternoon dose. for me counting carbs and using the ratios has improved my control so much

[Tracy38]

I'm in the same boat as you. Just started with a new endo at a place called Diabetes Centers of America. But they gave me a ration of 15g carbs to 1 unit and a BG adjustment factor of 1 unit to reduce BG by 50 mg. So far, that isn't even coming close. I don't know if it is changing to novolog or lantus or this new math, but I was in better control before this.

[nono87]

yea they start you off on 1:15 but then you need to give it at least a week or 2 then start adjusting the carb ratio as you go along.....

[1type2go]

WOW
just go back from lunch at Subway ...had a foot long BBQ chicken..... Pre meal BG 4.7 ,took 5u{1:10 ratio} humalog, an hour and half later, BG is 4.8 !!!
This meal used to require 10 units when BG pre test was up at
7
Tracy38,;I've just changed over to lantus and rapid four months ago and my user name could have been YO YO

but since finding this forum and all the info, wouldn't you agree you must cautiously but ultimately take your health into your own hands and ask the right questions to your Dr.,....and with heightened awareness and knowledge we can sucseed ,I , just two days ago was ready to change back to my old insulin :confused: and asked about it on the forum .


I do belive urder control (tight ) and only then can we belive
1:15

[MinimedPumper07]

Does anyone have it where you need different ratios for different days? Weekday dinners I am 11:1 because I have been at school and studying, and weekend dinners I am around 7:1 because I just sit infront of the tv....

carb ratio adjusting sucks :(

[someone]

Carb ratios vary from person to person and tend to change based on time of day. Personally, I use 10:1 all day.