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View Poll Results: What is your Insulin:Carbohydrate Ratio? | |
1 : 1-5
|    | 4 | 16.67% | |
1 : 6-10
|    | 10 | 41.67% | |
1 : 11-15
|    | 6 | 25.00% | |
1 : 16+
|    | 4 | 16.67% |
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12-16-2004, 07:10 PM
|  | Banned
I am a: Type 1 | | Join Date: Jul 2004 Location: Auckland, New Zealand
Posts: 619
| | | What is your Carbohydrate ratio?
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 |
12-17-2004, 05:10 AM
|  | Senior Member
I am a: Parent | | Join Date: Aug 2004 Location: Palm Harbor,FL
Posts: 1,092
| | | 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.
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Nancy
Thomas (13) diagnosed Sept 24th, 2003, a week before his 10th birthday, pumping since Deecember 2003 - Animas 1250
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12-17-2004, 07:58 AM
| | Member
I am a: Type 1 | | Join Date: Apr 2004 Location: Lexington KY
Posts: 381
| | Quote: |
Originally Posted by 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. | 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 |
12-17-2004, 08:13 AM
|  | Super Moderator
I am a: Type 1 | | Join Date: Aug 2003 Location: Northern California
Posts: 6,420
| | | 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. |
12-17-2004, 08:49 AM
|  | Senior Member
I am a: Type 1 | | Join Date: Aug 2003 Location: SF Bay Area
Posts: 2,868
| | | Mine changes. 1:15 at breakfast and lunch, 1:8 for dinner.
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To err is human, to purr feline >^.^<
T1 since 1991, Cozmo Pump 11/05
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12-17-2004, 09:06 AM
|  | Senior Member
I am a: Type 1 | | Join Date: Sep 2003 Location: The city on the edge of forever.
Posts: 4,841
| | | Mine seems to change with each meal.
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(you)  |
12-17-2004, 09:09 AM
| | Junior Member | | Join Date: Nov 2004 Location: Seattle, WA
Posts: 94
| | | 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) |
12-17-2004, 09:11 AM
|  | Senior Member
I am a: Type 1 | | Join Date: Aug 2004 Location: Sacramento, CA
Posts: 1,213
| | | I am about 1:16 for breakfast and 1:20 for lunch & dinner.
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My wife keeps telling me I never listen to her.... or something like that! |
12-17-2004, 10:27 AM
| | Senior Member
I am a: Parent | | Join Date: Aug 2004 Location: Palm Harbor,FL
Posts: 1,092
| | | 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.
__________________
Nancy
Thomas (13) diagnosed Sept 24th, 2003, a week before his 10th birthday, pumping since Deecember 2003 - Animas 1250
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12-17-2004, 10:30 AM
| | Senior Member
I am a: Type 1 | | Join Date: Aug 2004 Location: Sacramento, CA
Posts: 1,213
| | What can I say, I guess I am just a sensative guy! 
__________________
My wife keeps telling me I never listen to her.... or something like that! |
12-17-2004, 10:56 AM
| | Junior Member | | Join Date: Nov 2004 Location: Seattle, WA
Posts: 94
| | | 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! |
12-17-2004, 11:52 AM
| | Banned
I am a: Type 1 | | Join Date: Jul 2004 Location: Auckland, New Zealand
Posts: 619
| | 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. Quote: |
Originally Posted by JasonSmithMT .... 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!  I recently switched from Humalog to Novorapid buit it didn't make a difference.
Mark
Last edited by MarkMunday : 12-17-2004 at 11:55 AM.
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12-17-2004, 12:47 PM
| | Member
I am a: Type 1 | | Join Date: Apr 2004 Location: Lexington KY
Posts: 381
| | Quote: |
Originally Posted by MarkMunday 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 |
12-17-2004, 01:13 PM
|  | Senior Member
I am a: Type 1.5 | | Join Date: Sep 2003 Location: Hogwarts, Hobbiton, the Galactic Milieu &Ks when I have to be here
Posts: 4,299
| | Quote: |
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." 
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Frodo to Samwise
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12-17-2004, 01:50 PM
| | Banned
I am a: Type 1 | | Join Date: Jul 2004 Location: Auckland, New Zealand
Posts: 619
| | Thanks for the feedback. Quote: |
Originally Posted by JasonSmithMT .... 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  |
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