Help with ratios

[Naty]

Hello forum, I am struggling with my ratios

I went on a DAFNE course in May last year which was my first experience of carb counting in terms of matching your bolus to the amount of carbs. Since then I've been working on a ratio of 1 unit of Novorapid to 10g at breakfast, and 0.75 of a unit to 10g at lunch and dinner. That seemed to work well for ages. I have 7 units of Lantus at bedtime, and take 2 Metformin with dinner too.

Over the last six months there have been a couple of occasions where I've started to use 0.5 of a unit to 10g.

Now, in the last six days, I've had four hypos

Do people find that the ratio changes depending on what kind of food you eat rather than just the amount of carbs?

Yesterday was a pretty low carb day for me - about 60g in total I would say - evening meal was just over 30g, I had 2 Novorapid, was 8.3 at eleven o'clock and woke up at 3.10 at 2.5

Any ideas would be welcome...

 

[khskel]

Ratios can vary over time and are not guaranteed to stay the same forever. Got to keep an eye on the pesky blighters.

 

[Sprogladite]

Over the last six months there have been a couple of occasions where I've started to use 0.5 of a unit to 10g.
Now, in the last six days, I've had four hypos

Hi @Naty 🙂 As Khskel says, ratios can change periodically and its something that will require continuous review. You've said on a couple of occasions you've started using 0.5 of a unit to 10g - did your hypos start before or after you made that change? Are your hypos at different times of day or are they happening at around the same time?

Have you done a fasting basal test to make sure it is your ratio that is the culprit and not the basal? 8.3 after evening meal followed by a crash at 3am sounds suspiciously like it might be the Lantus as the Novorapid should be done working by then - I personally found that I crashed every night without fail on Lantus, so something to consider 🙂

 

[Naty]

Thanks @Sprogladite - the recent hypos were when I wasn't using 0.5:10 - but last night no matter which of the two ratios I used I would still have had two units because of rounding.

One hypo was at tea-time and the other three were in the early hours of the morning. I've seen that other people have not got on with Lantus but I've always been OK with it - been on a single-figure dose of it for almost three years...

 

[Sprogladite]

Thanks @Sprogladite - the recent hypos were when I wasn't using 0.5:10 - but last night no matter which of the two ratios I used I would still have had two units because of rounding.

One hypo was at tea-time and the other three were in the early hours of the morning. I've seen that other people have not got on with Lantus but I've always been OK with it - been on a single-figure dose of it for almost three years...

Unfortunately due to the nature of the beast that diabetes is, something can change out of the blue and throw a spanner in the works (for example, I was on Levemir for more than 10 years before becoming allergic to it!) so I wouldn't rule out the Lantus based on historical okay-ness. Are you able to get hold of a freestyle Libre so you can see what is going on while you sleep? That could be especially useful 🙂

 

[Bruce Stephens]

Things change, as others have said. Specifically, you might find the change in temperature messes things up. (I find I need to drop night-time basal insulin a bit and watch for lows during the day when it's hot. But never mind, it'll be winter again soon enough.)

 

[Naty]

Are you able to get hold of a freestyle Libre so you can see what is going on while you sleep? That could be especially useful 🙂

I have one on (they have virtually bankrupted me ) and until... well, the recent past, I used to have a more or less straight line overnight.

Here's an anecdote. On Thursday I did a freelance job which I am booked for every couple of months. Tea was from the local Waitrose and was 68g of carbs - I applied the 0.75:10 ratio and had 5 units. After the job, one of the attendees handed round her home-made flapjack... 😛 I reached for my Novorapid, dialled up two units and... then there was none left! I had some flapjack but drove home feeling a bit angry with myself. Was 8.9 at 11.15 - and down to 2.3 at 1.25. That does bear out the basal theory doesn't it?