insulin to carb ratios different day to day

[daniel warren]

hi guys im just wondering if its normal for you insulin carb ratios to change from one day to the next because for the past few weeks i had keep adjusting my ratios because they seem to be different from one day to the next or one week to the next for example

my morning ratio was 1u for 25g of carbs which was working fine for about a week or so then i noticed that i my sugars were still quite high 2 hours after eating so i reduced it down to 1:20 which again worked for about a week or so and over the past 3 days iv had to alter it again because it doesnt seem to be correct

yesterday morning i was at 4.8 before breakfast i had 35g ( 2 pieces of seeded bread cheese on toast) and injected one unit on a ratio of 1:17 and 2 hours later i was at 11.3 so i gave a 0.5 correction and and checked again 2 hours later and was at 7.2 so im thinking my ratios are still to high so iv adjusted them to 1:15

this morning my sugars we 6.3 before breakfast had 35g ( 30g of cornflakes, 200ml of semi skimmed milk, a cup or tea with sweetner and milk used from the 200ml) injected 2.5 units. 2 hours later im at 10.7 so given a 0.5u correction

i just dont get how my insulin ratios can change so dramatically, it feels like im constantly having to adjust my ratios which my dsn said once you have your ratios correct they shouldnt change much but since iv been diagnosed 3 months ago theve changed multiple times, have any of you guys had this issue.

iv even used the 100 and 500 methods to work out my ratios and im getting results of 1:30 for insulin to carb ratio and 1:6 for sensitivity which can not be right


thanks guys

 

[Sprogladite]

I'd be inclined to wait 2 or 3 days before making any adjustments to ratios to wait and see if a pattern is present, and then I'd only adjust one meal ratio at a time. I wouldn't go on 2 hour post meal readings either as insulin can hang around in your system for longer than this. Are you pre bolusing, and if not have you tried injecting 15 or so minutes before you eat to see if this helps?
Have you done a fasting basal test to check your basal is correct?
Be careful of correcting outside of meal times as due to the long acting nature of insulin you are likely to be stacking insulin which can make you very susceptible to hypos. Official advice is that you should only correct with meals.
You could also be coming out of the honeymoon phase if you've been recently diagnosed so that's something else to consider 🙂

 

[daniel warren]

I'd be inclined to wait 2 or 3 days before making any adjustments to ratios to wait and see if a pattern is present, and then I'd only adjust one meal ratio at a time. I wouldn't go on 2 hour post meal readings either as insulin can hang around in your system for longer than this. Are you pre bolusing, and if not have you tried injecting 15 or so minutes before you eat to see if this helps?
Have you done a fasting basal test to check your basal is correct?
Be careful of correcting outside of meal times as due to the long acting nature of insulin you are likely to be stacking insulin which can make you very susceptible to hypos. Official advice is that you should only correct with meals.
You could also be coming out of the honeymoon phase if you've been recently diagnosed so that's something else to consider 🙂

hi sprogladite, thanks for replying and i have looked at my levels over the past week and its hard to determine a pattern because my reading for the last 5 days and the first 3 days i was within target range 2 hours after eating but the last 2 days iv been high and i just checked my sugars again to see if theyd come down after 3 hours and theyve risen so im assuming my morning ratio has changed, i havent done a fasting basel test but i dont find my sugars climb or drop to much during the night im on 8u of my long acting insulin i might have to do one though to make sure its correct and i have tried timing my injections but to the exstent of 15 mins prior to eating i will give this ago with my current ratio and see if timing is the reason but its just weird that 5 days ago my morning ratio was 1:20 and 2 hours after it was within range and now iv changed my ratios to 1:15 im going high even though im having the exact same meal for breakfast and theres no major change to my routine

 

[SB2015]

Hi Daniel

There are so many factors in the insulin dose needed at any one time: carb ratio, carb count, other foods in with carbs, what you have been diong before meal, current BG, what you are planning to do next, ...
So we are all stars for getting any dose spot on.

Like others I would not change a setting in a day to day basis. I would gather the results and then look at the end of a week and see if there are any obvious patterns.