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Permalink Reply by Zoe on January 18, 2013 at 9:28am

It is an outdated method of determining insulin dose, but saying "if your blood sugar is between this number and that number take this many units". Insulin to carb ratio has replaced that as the best way to dose for meals.

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Permalink Reply by Terry on January 18, 2013 at 10:28am

It is an old fashioned method to dose insulin. It's major disadvantage is that it reacts to high BGs instead of anticipating nutritional intake.

Anyone with just a little experience controlling BGs with insulin knows, it's much harder to bring a high BG down than it is to prevent it. And it takes more insulin to do the same amount of work.

I consider the sliding scale as a method to keep BGs high and thus minimize the incidence of hypoglycemia. This still appeals to some medical professionals, especially those that work in hospitals.

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Permalink Reply by Zoe on January 18, 2013 at 10:43am

Good explanation, Terry. Yep, it amazes me how people think we could use the same amount of insulin for a salad as for a plate of pasta. I kind of assumed the logic of carbs causing blood sugar spikes if not accompanied by sufficient insulin pretty basic and understood by the medical profession. But I've mentioned on here before having a friend who is an RN whose knowledge and experience I've always found superlative. I mentioned limiting carbs and she said, "I've heard of low carb for weight loss, but do you mean for Diabetes". Well....duh!

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Permalink Reply by HPNpilot on January 18, 2013 at 11:26am

I think it may also be a relic of a time when people thought patients were too dumb to estimate carbs , divide by an I:C ratio, calculate a corection dose with their Insulin Sensitivity Factor, add them and inject. Instead they give the patient a simple table.

And the control is suboptimal.

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Permalink Reply by Mishi on January 18, 2013 at 11:33am

In japan when i was DX at three and going into my late teen we used the slide scale before carbs counting really came in,In UK use a brilliant system called Daphne and my sister partner went on a course i think lasted a week and in compassed everything to learn about crab counting and insulin ratio.

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Permalink Reply by MegaMinxX on January 18, 2013 at 11:39am

I used sliding scale in early days of MDI. It assumes you are following a consistent diet of approximately equal meals of 'exchanges' ( bread/meat/fat) EVERY DAY. I didn't learn about counting carbs until I asked about starting an insulin pump.

Before MDI, taking only one/injection/day, we only counted exchanges for meals, and took the same dose (Lente) in the morning. Every 6 months I saw the doctor, and if my urine testing logs showed too many pluses, then he increased the dosage by a unit or 2.

Times have really changed !!

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