How do you work out 'your' sums yourself instead of a bolus adviser doing the work?

[mum2westiesGill]

So as a lot of you know I use a bolus advisor - I've been using one since 2013 when I went on the X-pert insulin for type 1 diabetics course and we were all introduced to the accu-chek expert meter "like a pump but not a pump". I need to start using my head again sometimes (when not pushed for time) and start working out some of the sums myself so please would you lovely people show me how you work out 'your' personal sums for carbs, insulin dose etc?

 

[Lucyr]

You don’t need to do it in your head just because that’s how someone else prefers to do it. We each need to find what works for us.

For yourself, I’d suggest you stick to the app to avoid confusing yourself. If you start doing some insulin doses without using it, then it won’t know how much insulin you have on board to calculate corrections, and you’ll probably struggle to keep track of which doses the app does or doesn’t know about.

 

[SB2015]

I agree with @Lucyr it seems sensible to stick with what you have been doing. It can be very confusing if you switch between systems. Everyone manages their condition in different ways. You are in regular contact with your DSN and if you stick with one system it will be easier for them to help you to develop confidence in making your own changes, bit by bit.

 

[eggyg]

I stand up with the insulin pen, lid off, grasped in my right hand. Close my eyes, mumble some numbers ( according to Mr Eggy) and inject! I’m not joking. But as I mostly eat the same things over and over again, I know their carb contents by heart. If it’s morning, I know I need a 1:7.5 ratio, lunch 1.10 and tea time, 1.20. It doesn’t always work, but I generally end up between 6.5 and 7.5 before bed. Under 7 I’ll have a ginger nut, 9 grms of carbs. That usually does the trick. I suppose it helps that I’m quite good at basic maths. Just glad equations aren’t involved.
Just do what is best for you. If it ain’t broke don’t fix it.

 

[Robin]

I tend to be a bit on the Intuition approach these days, but only after some intensive years of writing everything down and calculating the carbs in all the dishes I normally make. Last night we had fish and chips, and it was a huge portion. There was no way I could accurately calculate the carbs in it, and I knew I wouldn’t eat it all . So I used the rule of thumb method, ie, this is a mix of carb, fat and protein, what would I bolus for a similar meal at home, if I ate til I was comfortably full? Then I bolused 5 units, ate til I’d had enough, stopped, and binned the rest, and it all worked out. (I hate food waste, if we go back to that fish and chip shop again I’ll know to buy one portion between two of us).
This approach works for me at the moment, but if I found my BGs drifting, I’d go back to basics for a while and write everything down again.

 

[Sally71]

Very very basically...
A carb ratio of 1:10 is nice and easy, if you eat 40g carbs you need 4 units, if you eat 35 carbs you need 3.5 units, if you eat 51 carbs you need 5.1 units but with a pen will have to round it down.
A correction of 1:2 is also easy, if you are 12 and you want to be 6 then that’s a difference of 6 so 3 units, add it on to the carbs.
BUT the numbers won’t always be that easy, and then you have to consider:
How long since you last ate? Don’t correct again too soon, within 4 hours
Are you about to do any exercise? You’ll probably need less insulin, but there’s no magic calculation to tell you how much to reduce the bolus by, people have worked that out for themselves by trial and error.

I only know how the bolus calculator works because I made a point of finding out just in case the pump failed and I had to do everything manually. It never failed though and we just let it get on with it, it works most of the time. I haven’t a clue how my daughter’s new pump does the calculations, only that it’s different - but if you’re on a pump you’re expected to just trust the bolus adviser, you can override it but why bother if it works?

The above is basically what the bolus calculator does anyway, plus it has some extra stuff in to calculate how much insulin is still active in your body, I’ve no idea how to do that. So you might as well just let the calculator do it. It works most of the time, human brains aren’t perfect either!

 

[JJay]

Gill, if it ain't broke, don't fix it. It's what you're comfortable and confident with that matters.

 

[rebrascora]

I agree with the others. Stick with your bolus calculator as it is working well for you and you do not have the confidence at the moment to do anything different and if you tried, it would almost certainly knock your confidence even more. You are doing great at the moment so just keep doing what you are doing.

My insulin usage is extremely intuitive and flexible and often involves a correction between meals to cover protein release or if my basal isn't holding me steady or a few carbs to top up my levels if I am dropping low. Libre allows me to do this because I scan 30+ times a day and end up with good results. A bolus calculator would be an absolute nightmare for me to use.

Horses for courses as they say! Bolus calculator works for you Gill. Libre and educated guesswork works for me.

 

[Bruce Stephens]

I agree with the others. Stick with your bolus calculator as it is working well for you and you do not have the confidence at the moment to do anything different and if you tried, it would almost certainly knock your confidence even more.

I do think it's important (as with any use of calculators, really) to use some common sense. If it says you need 30 units where you're expecting something more like 5, then you should certainly be checking to see what went wrong rather than blindly injecting 30 units.

So make sure you have an idea of what kind of answers are sensible, but so long as you're doing that then sure, let the machine do the tedious calculations. It's what they're good at.

 

[mum2westiesGill]

I do think it's important (as with any use of calculators, really) to use some common sense. If it says you need 30 units where you're expecting something more like 5, then you should certainly be checking to see what went wrong rather than blindly injecting 30 units.

So make sure you have an idea of what kind of answers are sensible, but so long as you're doing that then sure, let the machine do the tedious calculations. It's what they're good at.

That would be a definite if it said I need 30u and I expected a lot less!

 

[nonethewiser]

Couldn't begin to explain as can be complicated, just know from experience what bolus dose is needed for certain meals, some upfront some split, most from memory without looking anything up

 

[everydayupsanddowns]

I think one of the main benefits of using a bolus calculator is not having to keep the maths easy.

Mine are all 1:10 at the moment, but it’s usual for me to have 1:11 or 1:12 somewhere or other, which isn’t something I could quickly do in my head (so I’d be more likely to go 1:10 to 1:15, or worse still 1:20 - which is DOUBLING doses!)

Bolus calculators all the way for me.

 

[leonS]

There is a world of difference between not doing and not being able to do something. When it has just broken is not the time the time to find out that you can not do it any other way.

The explanation above gives the basis of the calculation needed as a fall back, and as a pen will not allow fractions to be used, near enough is good enough.

Always check that the answer is sensible - if an identical, or nearly so, meal yesterday required 10 units., then it should not require 30 units today!

 

[Leadinglights]

There is a world of difference between not doing and not being able to do something. When it has just broken is not the time the time to find out that you can not do it any other way.

The explanation above gives the basis of the calculation needed as a fall back, and as a pen will not allow fractions to be used, near enough is good enough.

Always check that the answer is sensible - if an identical, or nearly so, meal yesterday required 10 units., then it should not require 30 units today!

Always check that the answer is sensible is always what I used to tell students as they would use a calculator and the answer was in no way correct as they had put the wrong numbers in usually when trying to use the log or power function.