Insulin ratios and times of day

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Amity Island

Amity Island

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

I missed my usual lunchtime slot today (1pm) so had a later lunch, which left me a bit unsure about how much insulin to take.

Could anybody tell me if they have worked out at what points in the day do their insulation ratios change?

I'm typically 1.4u to 10g in the morning and lunch, with 1unit to 10g for evening meals and after. However, I've never needed to work out at which time does this ratio change from between 1pm and 6pm.

Any ideas?

Thanks
 
I don't think there will be a set time that it changes, but it will likely be a gradual change and as everyone is individual I don't think anyone could advise you precisely on how your body will change through the day. If you eat low carb as I do, it becomes much less of an issue as you are not multiplying by a significant factor, so the error margin is small. Why not split the difference and go far 1.2u to 10 g
 
I’m afraid I can’t give you a definite answer as it’s so individual. Have you had a chat with your hospital team?
 
Bronco Billy said:
I’m afraid I can’t give you a definite answer as it’s so individual. Have you had a chat with your hospital team?
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Hi Bronco Bill, I've not yet asked this question at the hospital but I will certainly ask at my next appointment. I was thinking that there may be set patterns to insulin ratios/requirements. The only pattern I notice is ratios are always greater upon waking. It would be interesting though to hear from anyone who works nights to see how if they still have greater needs during the mornings even if they haven't been to sleep yet.
 
I can't tell you what time things change, or whether that time varies from person to person, but I can tell you that I inject the same ratio for my lunch whether I have my lunch at an (for me) astonishingly early 1pm or a more usual 2 or 3pm or an oops, I'm running late 4pm. The only thing I need to remember if I have lunch at 4pm is that when I inject for dinner at about 7.30pm I've still got insulin in my system, so I might well need a bit less then.

I can also tell you that I need a different ratio of insulin to carbs at 1am from the ratio I need at 7.30pm (I have a neurological condition which causes sleep reversal, so I'm awake late and often have a bedtime snack at 1 or 2am). But I don't know what happens to people who are awake all night, I'm afraid, as I'm heavily asleep during what most people would consider early morning.
 
As others have said I suspect it will be a more gradual change - And may even be different day to day!

Nothing with diabetes is very predictable it seems!
 
When I set my daughter's pump up I tried to make sure that the time bands cover the whole range when she might eat a meal. For example, the breakfast time zone goes from 5.30am until 11am, because it's unlikely that she would ever be eating breakfast outside those times. Lunch goes from 11 until 4.30 pm and then tea from 4.30 until 10 pm, I think 4.30 is about the earliest acceptable time that she would ever have an evening meal of any sort, and actually she's unlikely to be eating anything later than 7pm but I kept that band going later just in case, e.g. on holiday. We know that she needs different ratios at different mealtimes, this is just my best guess of when to change them, and like everything to do with diabetes, it doesn't work all the time!
 
I work nights, I'm on a pump and have a work profile as I require less throughout the night and into the mornings, my basal rates are set to reflect this. Also if I bolus between 3am and 7am I use my exercise profile (30% less) otherwise I have a hypo, usually when I've just dropped off!
 
Sally71 said:
When I set my daughter's pump up I tried to make sure that the time bands cover the whole range when she might eat a meal. For example, the breakfast time zone goes from 5.30am until 11am, because it's unlikely that she would ever be eating breakfast outside those times. Lunch goes from 11 until 4.30 pm and then tea from 4.30 until 10 pm, I think 4.30 is about the earliest acceptable time that she would ever have an evening meal of any sort, and actually she's unlikely to be eating anything later than 7pm but I kept that band going later just in case, e.g. on holiday. We know that she needs different ratios at different mealtimes, this is just my best guess of when to change them, and like everything to do with diabetes, it doesn't work all the time!
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Thanks for your reply Sally, very interesting.
 
Lucy Honeychurch said:
I work nights, I'm on a pump and have a work profile as I require less throughout the night and into the mornings, my basal rates are set to reflect this. Also if I bolus between 3am and 7am I use my exercise profile (30% less) otherwise I have a hypo, usually when I've just dropped off!
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Thanks Lucy.
 
everydayupsanddowns said:
As others have said I suspect it will be a more gradual change - And may even be different day to day!

Nothing with diabetes is very predictable it seems!
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Hi Mike, I'll be asking about this at my next appointment, to try and get some broad opinion on how other peoples ratios change throughout the day. I came to the same conclusion as you about it being a gradual change, but I was also considering there were other things like the circadian rhythm which causes a more specific time change.
https://www.nature.com/articles/s41574-018-0122-1
 
I work night shift, because I have to...however I'm not a morning person.
 
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Amity Island said:
but I was also considering there were other things like the circadian rhythm which causes a more specific time change.
https://www.nature.com/articles/s41574-018-0122-1
Click to expand...

I think asking about a general consensus (or even if there have been any decent-sized studies) would be a good thing.

Yes - agree about the circadian rhythm - though my experience of those is that mine tend to ebb and flow over the weeks / months and can’t really be relied upon to behave themselves either! 🙄
 
I did as Sally did and considered my ratios in terms of meals and this bands of time in which I might have a particular meal. I think you are right though, it must just slowly change. Hard to pin down along with everything else
 
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