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e||ement

at what point do you make a change to your I:C?

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e||ement

normally, if i see a trend for three days (high or low) then i make a change to my I:C.

 

but, with all the craziness of pregnancy and hormones, etc., i'm doubting myself a little. why? because the past week or so my numbers have been completely erratic— lows and some highs with no discernible patterns and no discernible reason.

 

but i've been high after breakfast three days in a row now (a pattern, in my opinion), with 1 hr pp readings of 8 (144), 7.4 (133) and 9.7 (175)!!!! so i'm thinking of doing a 1:12 instead of a 1:14 ratio. before that, my 1 hr pps at breakfast were always in the 4s (70s/80s) and i coasted nicely into the pre-lunch reading.

 

any thoughts?

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sarahspins

I'd go ahead and change it.. you'll know if it was too aggressive if you start having lows, but based on your numbers I think you've got enough of a pattern to change at least breakfast.

 

Don't be shocked if you're changing it again in a couple of weeks though.. towards the end (well, in the 3rd trimester at least) 2 days is considered a pattern, and it's okay to get a bit more aggressive at staying on top of changes. :)

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Michael_lambert
insulin:carb ratio. the number of units of insulin you require per grams of carb.

 

Aww... Another slow question, How does one calculate that?

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e||ement
Aww... Another slow question, How does one calculate that?

 

basically...trial and error :)

 

start with a ratio, look for patterns and adjust until you get your pp readings in your target range.

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e||ement
insulin:carb ratio. the number of units of insulin you require per grams of carb.

 

i should have said the number of grams of carbs one unit of insulin will cover.

 

it's always 1:xgrams carbs

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fairyblood
Aww... Another slow question, How does one calculate that?

 

It is different for everyone. Most people start at 1:15 and move up or down from there. Sometimes MD's will give you a starting point based on your weight and other factors.

 

I would recommend reading "Think Like a Pancreas" by Gary Scheiner. I am not sure how useful some of the info is for T2's but it will give you a much clearer understanding about insulin and has a chart in it to give you a ballpark about what I:C ratio to start with.

 

A lot of people recommend "Using Insulin" by John Walsh but I haven't read it yet however I know the author is excellent.

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e||ement

i changed my breakfast I:C to 1:12 (from 1:14) and my 1 hr pp was still 9.0 (162).

 

what the...???

 

help!

 

this sucks.

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Subby
i changed my breakfast I:C to 1:12 (from 1:14) and my 1 hr pp was still 9.0 (162).

 

what the...???

 

help!

 

this sucks.

 

I'd be looking at safely increasing basal leading up to those hours. I know it seems that its just the the food exerting an upward force, but I've found that if the basal is not enough for a resistance period, things might seem ok until you put the food on top. In times of resistance I find the walls tend to rise to new insulin intake and whatever you put on from that point is likely to be deferred and/or ineffective. If you have more basal insulin present behind the lines at the time the walls are put up, boluses are also likely to be more effective as well (though you may still need to adjust - even a lot).

 

Along the lines of combating resistance, prebolusing would be another definite tactic, too.

 

You can also keep putting up your I:C until you start getting hypos or big dips later later, up to that point your body apparently needs the insulin. That of course is not a suggestion to just put it up until you go dangerously low, just a comment that unless you are going low, you may have more distance to travel to find the right dose (slowly and steadily, of course).

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e||ement

thanks subby. as always you have great insight!

 

i only do one basal shot...at night...but it might be time to take it up a unit, as it's most effective around breakie.

 

i am, right now, 3 hours after injecting, experiencing a hypo (2.7 or 48) so that new I:C is probably not going to work for me after all. looks like a basal/resistance problem.

 

i already prebolus or split bolus, depending on what i'm eating, so maybe i will have to reevaluate that.

 

it just sucks, having everything change on what seems like a day-to-day basis.

 

(ok. i'll stop whining now.) thanks for your input :)

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Subby

Ah, sorry, I was thinking you were on the pump, just a quirk in my brain. You are 100% right, of course it's hard to change basal just for a short period of time on shots. Upping your shot a little if you can get away with it sounds like an idea to try.

 

OK, with those lows, it points back to the problem being resistance holding up the initial action. How long are you prebolusing? Care to try earlier? (Being careful of course). Just to give some ideas, I wouldn't recommend it, but I used to prebolus around 40 minutes, even more than an hour, when I had massive holdup problems. Usually required tests to check if my action was kicking in or not. You gotta do...

 

It sounds very frustrating. Please know I'm making comments also in sympathy, not just to "fix" things. If something I say helps sets a solution off, hey, that's good, otherwise at least you know you're not the only one thinking about such innane and annoying things ;)

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e||ement

nope...wishing i WAS on the pump though and i will be going that route after this baby comes:)

 

i pre-bolus 20-30 minutes...i could probably comfortably kick it up to 40 minutes. i'll give it a try tomorrow, with my old I:C, and see how it goes. if that doesn't work, i'll bump my basal up. one thing at a time, right?

 

i know you are being supportive subby :) and i am grateful!

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Subby

Good stuff!! May the better results continue. Did you reduce your dosage back again somewhat? Watch for those hypos now...

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e||ement

no i went back to the 1:14.

i guess an extra 10-15 minutes can make all the difference!

i'll keep at it and see if the good results continue.

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Katrina Stovold

Yes, Id change too!! I wait a couple of days before I see a definate pattern then I go ahead and adjust! But, sure enough things change again and sometimes backwards!! I SAY THIS IS THE FRIGGIN HORMONES!! Definately, a few days readings of 9.0's 2 hours after bfast Id adjustie:increase my novo rapid by 2 units and see what happens......MY DOC SAID: best not to correct the highs but rather wait and see a good 2 days pattern then adjust accordingly, I really hate seeing 2 days worth of high readings though but realise that its all for the purpose of seeing a pattern in the sugars and changing the dose accordingly, better to be stable rather then baby bouncing up and down ie: high to low readings. xx

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