Replies to This Discussion

Permalink Reply by Laura S. on December 4, 2011 at 9:20pm

This is an old one, and I dont have time to check it out right now but give it a look........
http://www.diabetesnet.com/diabetes_tools/tools_carb.php

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Permalink Reply by Gerri on December 4, 2011 at 9:36pm

Any chart is going to give general info. Doses are variable by individual & based on weight, level of activity, degree of insulin resistance, to name just a few. Most people have different insulin to carb ratios depending on time of day. Morning is typically the smallest ratio. Hormones, stress & illness change ratios.

Doctors usually begin patients on a ratio of 1 unit insulin for every 15 gr of carbs. This is just a starting point & doses are fine tuned from there. Everyone is different, so through logging & experimentation you'll find what works best for you. Ratios don't remain static.

Using Insulin by John Walsh is good book. Another is Think Like A Pancreas.

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Permalink Reply by gayler on December 4, 2011 at 9:48pm

Thanks guys! After 38 years I still have troubles. My doctor originaly started me on 10u novolog at each meal and 30u Lantis at bedtime. I have since changed to 15u at meals. I would like to find something that will tell me accurately how many carbs in my meals, and how much insulin to take! My blood sugars are very unstable meaning I might be at 100 one min and ten minutes later at 30. It also seems I can eat the same meal every day, have the same activity level, same stress level, same everything and have very diferent blood sugar levels!

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Permalink Reply by Laura S. on December 4, 2011 at 9:57pm

I have the same problems. Not easy.
I can drop over 100 points from one unit at times, food never hits the same way twice and so carb counting is pretty unreliable. It's a constant struggle. Hope you can find some answers!

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Permalink Reply by Gerri on December 4, 2011 at 10:10pm

Don't know what your doses are, but large doses don't absorb as predictably as smaller doses. That might account for some of the differing results. Of course, you have scar tissue that also effects absorption.

Protein also effects BG. It's not just carbs, though carbs have the biggest, most immediate effect. So, if you're eating a meal with high protein/fat, that will have a delayed BG effect. Some people use two boluses for high protein meals to catch the later spike.

Are you using a sliding scale with set doses?

There really is no chart or guide that can tell you how much insulin to take. It's trail & error. Usually, a lot of error:)

I don't trust nutritional labels for accurate carb info, though sometimes that's all we have to go on. There are on-line carb counters & you need to know weight of items for greatest accuracy. I use an Eat Smart scale & love it. It has 999 preprogrammed foods. It calculates carbs, protein, fat, sodium, etc. for cooked & raw food. Under Rescources at the top of every page, click on Member Discounts for a discount on Eat Smart.

My readings are improved since changing to Levemir. Lantus was unstable for me with lows hours later when Lantus peaked. Many people do best using two doses of Lantus. Levemir is used in two doses.

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Permalink Reply by gayler on December 4, 2011 at 11:39pm

I realy don't know what a sliding scale is. I just guess alot. I also have found that a high fat meal realy messes things up. An hour or two after a meal my blood sugar is good and another four hours and it's to the moon!

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Permalink Reply by Gerri on December 5, 2011 at 12:03am

Sliding scale is taking a set amount of insulin that's not based on carb:insulin ratios. If BG is between a particular range, take X amount of insulin.

Yep, fat really slows down digestion.

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Permalink Reply by Zoe on December 5, 2011 at 10:11am

Gerri is right, Gayler, that you need to accurately dose your insulin for the carbs you are eating. First you need to find a good guide to counting carbs so you make sure you know what you are eating. Then that 1:15 is a good starting point and from there it is trial and error. If you do that and end up high, then go down to say 1:13. If you end up low, then you know you need to go up to 1:17 say. To further complicate matters you may find different I:C ratios for the different meals work for your. Mine, for example are 1:6, 1:10 and 1:21 for the three meals. But if you do the trial and error you will eventually hone in on your numbers.

You are right, that high fat/high carb meals make you fine two hours and high later. For those you might want to learn how to do combo boluses (some now, some later).

For me, there are also some foods I've learned (by trial and error) I just can't accurately bolus for and for me those are cereal and rice so I just don't eat them..

I second the recommendation for Using Insulin by John Walsh. Good for general principles though the formulas are just ballpark to me. It's all about trial and error. I remember when I first started on insulin and Gerri explained all this to me. It seemed like a lot of work - and it is, but it will make a real difference in your management.

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Permalink Reply by jrtpup on December 5, 2011 at 11:43am

gayler, can we start from the beginning? How are you dosing now? What insulin are you using? MDI or pump? Roughly how many carbs per meal (if you know). With more info we can give you more guidelines.

Using Insulin, as Gerri mentioned, is a must-have. You can get it on Amazon and elsewhere -it's a paperback, not that expensive.

Glad you came here to ask!

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Permalink Reply by gayler on December 6, 2011 at 9:34pm

jrtpup, I take 15u novolog at each meal, 30u lantus at bed time.I'm hoping to get on a pump after the first of the year. I don't know how many carbs per meal. I realy need to learn as much as I can about carbs because I'm trying to get a pump.

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Permalink Reply by jrtpup on December 6, 2011 at 10:10pm

I agree gayler, I think your first task is to learn carb counting and start logging carbs and blood sugars. This will help you see how various foods effect your BS.

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