Changes in bolus insulin to carb ratios

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Amity Island

Amity Island

Well-Known Member
Relationship to Diabetes
Type 1
Hi Everyone,

My bolus insulin ratios have really been changing the past month or so. I usually have 1.5 units to 10g carbs breakfast, 1.5 units to 10g carbs lunch and 1u to 10g evening onwards.
This week my mornings have increased to 2units to 10g breakfast, 1.5 lunch and 1.5 evening.

Can anyone enlighten me to how often do ratios change, when and why?

Thanks
 
Have you checked your basal? I find more often than not it's the basal rather than the bolus that is the problem.
 
Every few months, but exacerbated by changes in weather temperature.
 
Like @Pumper_Sue I often find that tweaking my basal so that it is up to date usually gets my bolus doses and corrections working well again.

Having said that, if my basal has been notching up (or down!) successively over several weeks/months then I’ll have to tweak ratios too.

but it would have taken a while to make the change you suggest as I would see a noticeable effect changing by 10% so 1u:10g to 1.1u:10g or whatever.

Change seems more or less constant for me. It would be a very rare month where I didn’t make at least 2 tweaks or adjustments. Sometimes it’s just the ebb and flow of the year, other times it’s temperature or level of activity, or stress. I have stopped worrying about the causes now, or trying to predict - I just try to roll with it if a couple of days consecutive readings seem to be drifting in the same direction. 🙄
 
Pumper_Sue said:
Have you checked your basal? I find more often than not it's the basal rather than the bolus that is the problem.
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Hi Sue,
Yes checked basal, perfect. This is the reason I ask about how much boluses change and how often. The libre shows everything, there's no escaping it! Lol.
I've attached this mornings basal test. Over night was exactly the same.
 

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Its a tricky one to answer simply because we are all different and no one thing fits.

Mine change fairly often depending on being ill, stressed, which bit of the year I'm in and there could be a 101 other reasons it may change.

The only predictable thing about T1 is its unpredictability.
 
Schrodinger said:
Its a tricky one to answer simply because we are all different and no one thing fits.

Mine change fairly often depending on being ill, stressed, which bit of the year I'm in and there could be a 101 other reasons it may change.

The only predictable thing about T1 is its unpredictability.
Click to expand...

Hi Schrodinger,
What I'd really like to know is by how much can ratios change? Mine went from 1.5 to 2 in the mornings.
 
everydayupsanddowns said:
Like @Pumper_Sue I often find that tweaking my basal so that it is up to date usually gets my bolus doses and corrections working well again.

Having said that, if my basal has been notching up (or down!) successively over several weeks/months then I’ll have to tweak ratios too.

but it would have taken a while to make the change you suggest as I would see a noticeable effect changing by 10% so 1u:10g to 1.1u:10g or whatever.

Change seems more or less constant for me. It would be a very rare month where I didn’t make at least 2 tweaks or adjustments. Sometimes it’s just the ebb and flow of the year, other times it’s temperature or level of activity, or stress. I have stopped worrying about the causes now, or trying to predict - I just try to roll with it if a couple of days consecutive readings seem to be drifting in the same direction. 🙄
Click to expand...
Hi Mike,

Thanks for your reply. I know what you mean about just going with it, not much else you can do if you want to keep in range. I was really just wondering by how much boluses can change. My basal never seems to change, just my boluses. I wouldn't want to increase my basal as that wouldn't help.
 
Hi Amity
My bolus has gone 1:17g 3.5 months ago now to needing none until the evening meal and that is now 1:40g. However, as Mike has mentioned my Basal
has also reduced from 8.5 to 4.5 units.
Before about 6 months ago I had been stable with my ratios for about 12 months.
Oh the joy of the big D🙄
 
Amity Island said:
Hi Sue,
Yes checked basal, perfect. This is the reason I ask about how much boluses change and how often. The libre shows everything, there's no escaping it! Lol.
I've attached this mornings basal test. Over night was exactly the same.
Click to expand...
I can't really see what it's showing except a steady gradual increase as the morning has gone on with no reading after about 11AM.
If you are on a pump then to me personally a 7 before a meal is totally unacceptable on a regular bases. Obviously if MDI then it's harder to sort 🙂. You need to get your fingers imitating a watering can and do some serious basal testing and do a few minor changes to your basal. There's a good basal test explanation in the pump section.
Even a small change in a basal section ie. 0.025/hr can make all the difference in the world. My ratio's have changed about twice in over 12 years of pumping. Basal though is a different matter 🙂
 
Looks to me like you were hypo at 3am - that can't be described as perfect in my book!
 
Amity Island said:
Hi Schrodinger,
What I'd really like to know is by how much can ratios change? Mine went from 1.5 to 2 in the mornings.
Click to expand...

Arh! Slight misunderstanding 🙂 mine can change anything from 1 - 3 units but I don't keep that close an eye on it.
 
trophywench said:
Looks to me like you were hypo at 3am - that can't be described as perfect in my book!
Click to expand...
Jenny,
I take it that you've not seen a freestyle libre before?
The graph shows my basal test reading from 3am until 11am (when I took the picture) about 8hrs of readings. Stays around 5.5mmol all night and there is a small rise from waking at 7am up until 11am to 7mmol.
My consultant is very happy with my hba1c of 48 and my libre day to day readings and so am I.
 
Amity Island said:
I was really just wondering by how much boluses can change.
Click to expand...

I feel your frustration! Mostly when I am changing ratios I find 10% or rarely 20% ‘notches’ up or down are a reasonable tweak to make. So I’d generally make a 10% change and see how that went for a few days and then try another 10%. But sometimes diabetes throws the rule book out of the window (eg illness) and bigger changes are called for.

Hope you get it sorted soon.
 
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