# carbs and insulin

This is my first post. I need some help trying to figure this out. I have been using my medtronic pump now for 2 weeks so still learning. My carb ratio number is 23 (still in the figuring i think) so if i eat say 60 grams of carbs and take 3 units of insulin, the way i think this should work is my blood sugars should never reach 200 in 2 hours if i start out at a blood sugar of 113. Or is there something i am missing?

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### Replies to This Discussion

Congrats on your pump, Bill.

We all have different post prandial (2 hours after meal) targets. Mine is 140, many people use 120; 200 is pretty high imho. A rise of 87 points would be too much.

I agree with Zoe...200 is too high. I aim for 160 or less at the 2-hour mark. But then, two weeks is a very short time on a pump to get it fine-tuned. You might want to change your insulin to carb ratio very slightly (like, say, to 18 (which would have made your bolus for 60g 3.3 units instead of just 3), and see if that works...give it several days before changing it again, and then make very small changes.

It took me about 6-8 weeks to get everything really fine-tuned when I first went on the pump, and recently, after joining a gym and working out several times a week, I had to change everything again.

Ruth

So, if your carb ratio is 23 carbs per unit of insulin and after 2 hours you should have 70% of your insulin used, then 3 x .7 = 2.1 units. 2.1 units should take care of 48.3 carbs. This means you have to figure how much 11.7 carbs will raise you, plus however much basal you need to keep your bg flat without eating.

11.7 carbs could raise me at least 87 points.

According to the book Think Like a Pancreas:

@ 1 hr, 30% of insulin is used (70% remains)
@ 1.5 hrs, 50% of insulin is used (50% remains)
@ 2 hrs, 70% of insulinn is used (30% remains)
@ 3 hrs, 90% if insulin is used (10% remains)

These are, of course, approximate, assuming you are using either novalog or humalog, and you are injecting less than or equal to 7 units at a time. (According to Dr Bernstein, injecting more than 7 units at a time can cause irregular the insulin to act inconsistently). That is the Richard K Bernstein from New York, author of the Diabetes Solution.

Bill, if you don't already have it Pumping Insulin is a fantastic guide to pumps. Wouldn't be without it. It's available from Amazon and elsewhere.

200 is too high at 2 hours, but as others have said go slowly. Do you have a CDE or trainer who can help guide you?

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