Is there a way to figure out icr?

[hybriduno]

Hi, sorry it's me again ! lol just trying to figure out my son's insulin to carb ratio

I know it's probably to early to figure out, but the lack of information from our nurse is ridiculous,we are trying to get ahead as it's something to take our minds of his diagnosis as such.

We can carb count that's not an issue. The nurse seems to think it would take a month for us to figure out, but it really is simple math's.

Anyway at this early stage in his diagnosis we are told that they are happy with his blood sugars where they are, although he's not between 4-8 (nearer 15)

Now I have ranted on again ill leave you guys to give it to me straight lol


Thanks again

Hybriduno

 

[Pigeon]

There probably is a formula somewhere, but for me it was just a case of trial and error! For adults they tend to recommend starting on a ratio of 1U to 10g carbs, but I would imagine a child needs less - maybe 1U to 20g carbs? Then you check BG 2hrs after eating and if it's ok then your ratio is good, if not adjust your ratio.

Perhaps you could work out a starting value already from a meal your son has had where the insulin doses seemed about right. Eg. if he is on a fixed dose of 5U with lunch and BG was about the same afterwards as before then you can work out the ratio from this if you count how many carbs he ate.

Your team probably want to start cautiously and don't want to bring his levels down too quickly as that can cause lots of false hypo feelings. Good luck with it all!

 

[pgcity]

It can be tricky to work out ratios when you have just been diagnosed because you can still be producing your own insulin on a sporadic basis. If you write down what you eat and how much insulin you have used you can tell from your 2 hour and 4 hour readings how you have done.
Here s an example

Starting bg 6.0 eat 60g of carbs take whatever your fixed dose is say 5u. This makes your ratio 1u to 12g
After 2 hours bg is 15.4
After 4 hours bg is 10.0

This may show that you have not taken enough insulin so try 1:11g next time. When the starting number and the after 4/5 hour number are similar you will have your ratio. If the 2 hour number is more that 3/4 mmols of the start try taking the insulin before eating. Start with 10mins before and work backwards in 5min blocks but don't do this with high fat foods as they take longer to start digesting.

Keep writing everything down and we can help you search for patterns.

Don't be too frustrated if you can't see any patterns or if they keep changing.

 

[xxlou_lxx]

Is it just me that has a varied carb/insulin ratio depending on what im eating?

 

[everydayupsanddowns]

Is it just me that has a varied carb/insulin ratio depending on what im eating?

Nope! Thats quite common. Often people need more insulin in the morning, but what you will need will be unique to you 🙂

I think the '500 rule' (450/550/600) is often used to suggest an I:C starting point, though again, these are only a starting point.

For the 500 rule, divide 500 by your average TDD and you will get (approximately) the grams of carb that would be covered by 1 unit of insulin.

Once you have your startin point you need to test to see if it works, but to do this you need to have checked your basal dose first 🙂

 

[xxlou_lxx]

Sorry to be really stupid here but what do all ur abreviations mean im assumung that c is carb and i is insulin lol... Also wats the 500 rule? Would u believe ive been diabetic for 24 yrs haha 😱

 

[everydayupsanddowns]

Sorry, slipped into jargon!

TDD = total daily dose. All your meal doses, corrections and basal for an average day.

500 rule = 500 divided by your normal TDD (these are likely to Cary a bit day to day, so pick a sort of 'middle' one

500/TDD will give you a guide to grams of carb per unit

So if your TDD was 35u the 500 rule would suggest 14g of carb per 1u. Or to put it another way, 0.7u per 10g of carb.

The 450... 600... Rules work the same, but offer a different weighting. The 600 rule is 'safest', giving the smallest boluses

 

[xxlou_lxx]

Your tdd will that be all of the insulin regardless of kind. I take 6 6 6 and 29 depending.. I normally just take 2 per 10g but finding myself hypo an hour or so after it. Then if i reduce it i find myself high. Only reason im bothered after all this time is because im up the duff lol and would like an accurate starting point so i can avoid goin low and high. Its such a pain lol

 

[everydayupsanddowns]

Yes. All your 'usual' meal doses plus your basal. So in your case 47u

500/47 = 10.6g (approx) of carb is dealt with by 1u

So even rounding up, that would suggest that 2u per 10g might be too much. Of course the 500 is only a guide - but maybe 1.5u or 1.2u per 10g would prevent those hypos?

EDIT: thankfully Sue spotted my fat-fingered adding error.

 

[Pumper_Sue]

Yes. All your 'usual' meal doses plus your basal. So in your case 65u

6 + 6 +6 + 29 = 47 TDD or have I missed something?

 

[XandersMum]

hi

My son was diagnosed on 27.12.12 (he's 8). He is currently on 1u per 20g c for breakfast, 1u per 15g c for lunch and dinner (all Novorapid) with 4u of Lantus every evening. For us its constantly tweaking and adjusting the doses but is early days yet.

 

[everydayupsanddowns]

6 + 6 +6 + 29 = 47 TDD or have I missed something?

Oops! Nope. More haste, less speed. And fat fingers on a phone. Doh!

 

[trophywench]

And of course, as you are pregnant, very soon, normal rules won't apply anyway, because preg hormones wreak havoc with ratios and all the rest of it!

Good luck.

 

[xxlou_lxx]

Lol!! I think i can try 1.5 see how it goes. 1.2 prob harder as my pen goes up in 1s lol maybe i should get that pump they keep trying to give me! I dont fit the normal criteria as my hba1c is always good but they have unlimited funding! Seems like more hard work to me though!! Lol

Thanks for the help.. I kind of hijacked this thread lol

 

[everydayupsanddowns]

Thing is you hardly ever eat just 10g CHO. Even at 1.2, 50g would make whole units and most meals would prob end up as close to whole or half units

As a halfway a smart meter might help. Makes tricky ratios much easier, and does the rounding/correcting for you to aim to get you mid-range. But yes, a pump would be great (and they are SO easy to use) 🙂

 

[Pumper_Sue]

Lol!! I think i can try 1.5 see how it goes. 1.2 prob harder as my pen goes up in 1s lol maybe i should get that pump they keep trying to give me! I dont fit the normal criteria as my hba1c is always good but they have unlimited funding! Seems like more hard work to me though!! Lol

Thanks for the help.. I kind of hijacked this thread lol

Your ratio works out to 1/10.6, so that a lot easier to work out 🙂

 

[trophywench]

Hee hee, my ratio - since I've had the pump - went to 1u:11g at one period.

Consultant : Doesn't that make it terribly difficult to work out?

Jenny : Errrr, No ???????

C : It would me ......

J : (when she could speak after guffawing) Well for starters, I use this handy little gadget supplied with my pump, the smart meter with the bolus wizard? - and even if I didn't - I learned my 11 x table in about 1957 !