Carb / insulin ratios

[Jimmy2202]

Hello.
3 months in having type 1 diabetes and so at been winging the carbs to good effect.
I’m now going to start carb counting so that I’m more exact with insulin amounts.

I’ve done a bit of research and so far this morning my breakfast contained 93g carbs.
I would usually inject 4 units novarapid on a non working day. Making my ratio about 1:22

Is this the correct way of working it out?
There’s no chance I can have a ratio 1:10 which I reserved was a common ratio

 

[Robin]

Hello.
3 months in having type 1 diabetes and so at been winging the carbs to good effect.
I’m now going to start carb counting so that I’m more exact with insulin amounts.

I’ve done a bit of research and so far this morning my breakfast contained 93g carbs.
I would usually inject 4 units novarapid on a non working day. Making my ratio about 1:22

Is this the correct way of working it out?
There’s no chance I can have a ratio 1:10 which I reserved was a common ratio

The correct way of working it out is, whatever works for you! If you’ve observed your carb and insulin, and found what ratio brings you back to where you want to be four hours after your meal, then yes, you have arrived at the right ratio for that meal. (other meals may have different ratios, just keep on observing them to work them out)
You will find charts and formulae online, suggesting starting points, and based on body weight etc, I never found these useful at all, as I don’t seem to conform to the ‘average'.
You may be in your ‘honeymoon period' and still producing a bit of your own insulin, so your ratios may well be radically different from the '1:10 is a good starting point' mantra, but your own insulin may decrease over time, so the main thing to remember is, once you’ve worked out your ratios, they aren’t set in stone for evermore, and if you notice that they’re not working in the future, then give them an overhaul.

 

[Jimmy2202]

The correct way of working it out is, whatever works for you! If you’ve observed your carb and insulin, and found what ratio brings you back to where you want to be four hours after your meal, then yes, you have arrived at the right ratio for that meal. (other meals may have different ratios, just keep on observing them to work them out)
You will find charts and formulae online, suggesting starting points, and based on body weight etc, I never found these useful at all, as I don’t seem to conform to the ‘average'.
You may be in your ‘honeymoon period' and still producing a bit of your own insulin, so your ratios may well be radically different from the '1:10 is a good starting point' mantra, but your own insulin may decrease over time, so the main thing to remember is, once you’ve worked out your ratios, they aren’t set in stone for evermore, and if you notice that they’re not working in the future, then give them an overhaul.

Exactly what I wanted to hear! My next question was how long after eating should I test again to check given the time it take to digest and for insulin to have been at peak.
Thank you again to such a great reply

 

[helli]

@Jimmy2202 the thing with working out bolus dose is that you MUST have your basal dose correct first. Otherwise, you are using bolus (or carbs) to correct basal mistakes.
So first, you need to do a basal test. Hopefully, someone wI’ll pop up with instructions for a basal test. However, during the honeymoon period, your pancreas may pump out some insulin during your test to confuse things.

To answer your question about when to test the bolus dose, it is at least as long after injecting as the bolus “life”. for example, for NovoRapid, this is 4 or 5 hours.

 

[Robin]

@helli is right, basal is the key. There’s a link in the Newbies section, I think. Ooh, found it. It’s a bit long winded, but it’s thorough.

How To Successfully Test Your Basal Rate

Are you looking for basal rate information and testing instructions? Perfect! You're in the right place!

www.mysugr.com

 

[Jimmy2202]

Cool. I’ll look into that.
by basal I think your referring to long acting insulin? Which I take Levimere 18 units before bed.
that’s what I’ve been put on straight from the off.

 

[helli]

Cool. I’ll look into that.
by basal I think your referring to long acting insulin? Which I take Levimere 18 units before bed.
that’s what I’ve been put on straight from the off.

That is correct.
Your long acting insulin is a background insulin which aims to keep your levels stable in the absence of food, exercise, etc. This “mops up“ the glucose which your liver drips out all the time.
I remember basal as the “base“ insulin.

 

[Piglet]

As you have only been diagnosed as a type 1 for a few months you are most likely still in the honeymoon stage where you are still producing some insulin thus requiring only.a small amount of injected insulin. This usually last about 6-8 months but this will change over time as you slowly stop producing insulin and will require more insulin to be injected. This means your ratio will also change. I would continue to `wing it ' for a couple of months and then ask to be put on a Carbs for 1 course where you will be taught to count carbs properly and you will be given a ball park ratio to work from. this again will change with lifestyle. I started on 1:4.5 but when was stuck on crutches for a while increased it to 1:5. some people also find the ration is different for different meal times. Every day is a learning curve but don't be afraid to experiment and do what you feel is right for you you are the one living with it after all.

 

[leonS]

That is correct.
Your long acting insulin is a background insulin which aims to keep your levels stable in the absence of food, exercise, etc. This “mops up“ the glucose which your liver drips out all the time.
I remember basal as the “base“ insulin.

Actually the base insulin is needed to allow the glucose to enter cells which need it for fuel. Most cells need insulin for this. The liver provides the required glucose as stated.

Your "etc", rather cructally includes short acting insulin.

It is MOST important that the base insulin does not change the BG by very much ie keeps it stable as you state. I too call it base, only posh folk call it basal.

 

[everydayupsanddowns]

Good luck with the carb counting experimentation @Jimmy2202 - sounds like you are off to a cracking start 🙂

As an aside Levemir is commonly injected 2x a day, because it isn’t really designed to last the full 24 hours. (varies by individual but likely to be approx 16-20hrs duration). This has an advantage because it allows you to have a different level of basal insulin active for two different parts of the day (doses often 12ish hours apart, but not necessarily). So for example you might have less Levemir active overnight and more during the day.

You may not need to worry about splitting your basal during honeymoon, as your remaining beta cells might be able to smooth off the edges?

Also… when it comes to carb ratios, it can help to try different sizes of meals to see how scalable they are. One peculiarity can be that you might need extra insulin (so a different ratio) at higher carb loads. Sometimes this is approx ‘your weight in kilos as grams of carb’, but not always.

Basically, don’t get too cross, confused, or disheartened if unusually large (or small) meals don’t follow the rules. You may need to develop some rules if thumb for unusual meal sizes 🙂