What is your Carbohydrate ratio?

[MarkMunday]

I am trying to get an idea of how much pre-meal injected insulin is typically required to process the carbs in the meal. This is expressed as the Carbohydrate Ratio. And it depends on a number of factors - weight, body composition, level of fitness etc.

If, for example, 5 units of Humalog are injected before a meal containing 40 grams of carbohydrate, the Carbohydrate Ratio is 1:40/5 or 1:8. Calculate your carbohydrate ratio and vote in the poll.

Cheers,

Mark

[nantomsuethom]

I voted on 1:6-10 because Thomas' ratios are different for each meal. Breakfast is 1:5, lunch is 1:8, dinner is 1:9. we did the 2 hour post many times and those are the numbers we have come up with that work best.

[JasonSmithMT]

I am trying to get an idea of how much pre-meal injected insulin is typically required to process the carbs in the meal.

Although I tend to give my insulin infusion post-meal, my breakdown is currently: 1:15 for breakfast, 1:17 for lunch, and 1:16 for dinner.

A good starting point for insulin to carbohydrate ratio that is commonly used is the 500-rule. I:C = 500 / TDD (total daily dose of insulin).

Jason

[notme]

I hit the wong button so the poll is messed up thanks to me. I have a 1:6 ratio and sometimes 1:8 depending on the food and my exercise for the day. I hit the 1:5 accidently. Sorry guys, I tried to fix it, but you can't change a poll vote after you mess up.

[HeatherP]

Mine changes. 1:15 at breakfast and lunch, 1:8 for dinner.

[lgvincent]

Mine seems to change with each meal.

[bac4uw]

Mine changes as well... I'm usually about 1:15-17 at breakfast and dinner and 1:20 at lunch.

I often wonder how much insulin I would need if I went on a low-carb diet that some of you are on. If I ate 6-10 carbs per meal - I wonder if I'd need any Humulog at all! (an interesting proposition)

[koblenz]

I am about 1:16 for breakfast and 1:20 for lunch & dinner.

[nantomsuethom]

Wow, most of your carb ratios are fairly high.

Thomas' were like 1:7 breakfast, 1:15 lunch and dinner- 1:22 about 6 months ago, then his pediatrician gave him oral steroids for an asthma attack and then he went to the ratios in my earlier post.

[koblenz]

What can I say, I guess I am just a sensative guy! ;)

[bac4uw]

Nancy- Mine have only varied a little bit in the six years I've been diabetic. I started at 1:15 and moved to 1:20. Now with a little weight gained, I'm usually somewhere in between. I walk and run quite a bit... this might be another explanation for the higher ratios.

Wow, the poll is pretty much dead even between the categories!

[MarkMunday]

This is interesting. There seems to be quite a spread in the poll results. Which, I suppose, reflects the fact that we are all different. But my carbohydrate ratio still seems to be excessively high. I need to use a lot of insulin before meals.

.... A good starting point for insulin to carbohydrate ratio that is commonly used is the 500-rule. I:C = 500 / TDD (total daily dose of insulin) ...

My TDD is about 35 units - 9 units of Lantus and 26 of Novorapid. Based on the 500 Rule, my carbohydrate ratio should be 1:14. It is, in fact, about 1:3.

I weigh only 72 Kg and require only 9 units of basal insulin. So I don't think I am insulin resistant. But I need to inject 5 units of Novorapid before eating a single piece of bread! :confused: I recently switched from Humalog to Novorapid buit it didn't make a difference.

Mark

[JasonSmithMT]

My TDD is about 35 units - 9 units of Lantus and 26 of Novorapid. Based on the 500 Rule, my carbohydrate ratio should be 1:14. It is, in fact, about 1:3.


I'm curious, have you tested your basal dose lately by doing the skip a meal thing. For most people (and we all know how our bodies like to follow the textbooks), 40-50% of the TDD goes towards basal with 50-60% of the TDD for prandial (bolus) . If my math is correct 74% of your insulin is prandial and 26% is basal. Maybe some of your rapid acting insulin is going to supplement a under dose of basal insulin (Lantus). Just a thought as to why your ratio might be high in the absence of insulin resistance. As you say, everyone is different.

Jason

[rzrbks]

I'm curious, have you tested your basal dose lately by doing the skip a meal thing. For most people (and we all know how our bodies like to follow the textbooks), 40-50% of the TDD goes towards basal with 50-60% of the TDD for prandial (bolus) . If my math is correct 74% of your insulin is prandial and 26% is basal. Maybe some of your rapid acting insulin is going to supplement a under dose of basal insulin (Lantus). Just a thought as to why your ratio might be high in the absence of insulin resistance. As you say, everyone is different.

What Jason said.

That would be the first place I'd look.


But then we're all so different, I might just assume, "If it ain't broke, don't fix it." :whistling

[MarkMunday]

Thanks for the feedback.
.... Maybe some of your rapid acting insulin is going to supplement a under dose of basal insulin (Lantus)....
I think you are right there. When I get up at 6:00am, I inject the 9 units of Lantus and I inject 5-10 units Novorapid. I do this because the Lantus from the previous morning is wearing off and it takes a couple of hours for the shot I have just had, to get up to strength.

After having a shower and getting dressed, which takes about 45 minutes, I inject another 5 units of Novorapid before breakfast. Which normally includes about 15gm of carbohydrate. Doing this generally keeps the bsl below 10 (180). If it spikes up through this level, I have a **** of job getting it back down again. :(

Needing to inject all this insulin could also have something to do with the Dawn Phenomenon. I have always had to do this. When I was on morning/evening shots of NPH, I assumed it was because I needed to fill the gap between the two peaks. But I have had a similar experience with Lantus. And I have tried having the shot in the morning, the evening and splitting it between the two.

I have tested the basal rate and it is, if anything, slightly high. This enables me to have a snack between meals - either a small piece of fruit of a biscuit with coffee - without bolusing for it.

Cheers,

Mark

[Clint]

mine is always 1:10 not matter what meal it is.

[Brent44a]

I chose 11-15 because I use 1:15 for breakfast and lunch. At dinner or evening snacks I use 1:10.

[zookeeper671]

1:15 for breakfast and 1:20 for lunch and dinner in flamingoville.

[KrisinNM]

Mark, have you tried splitting your Lantus? When I was on MDI and using Ultralente (basically the same as Lantus) I took 1/2 in the am and 1/2 12 hours later. This made for a more even "ride". Also it might give you a little more ammuntion since your Lantus is wearing off in the morning when Dawn Phenomena (I hate it!) is wreaking its havoc.
Thanks for this post, it hadn't occured to me that I may need different ratios for different meals. I have always used 1:10 because it usually worked and the math was easy to do in my head.

[Dewey]

I usually use the 1:15 ratio and it works well. However, I sometimes deviate if eating something that can pack a punch on the sugars, or if I'm not satisfied with the amount the pump suggests...lol ;) I also use the combo and extended boluses for things like pizza, rice and such.

[Maria]

My carbohydrate ratio is 1:9 on the week-day. But on the week-end it is 1:8