Do you believe in Carb Ratios and follow them closely? Or do you believe in dosing for meals based on a general “feel” and experience?
I’ve been tripped up for the last few years on bolusing for lunch on work days (office job - sedentary despite a concerted effort to go do stairs and take walks throughout the day). Up until the last few years, it did not phase me in the least to take 11-14 units of insulin for a 60g carb lunch on a work day. It also didn’t phase me to take 4 units of insulin for a 16g carb drink for breakfast every day. But supposedly I was supposed to hover around a 1:10 ratio according to: everyone (endo, CDE, a consultant CDE, etc). 1:10 worked for me…for weekend lunches and for all dinners. Otherwise it was garbage.
So I would drink the same breakfast everyday, and eat the same work lunch everyday, b/c I had those figured out for dose and for timing. I did not think a 1:4 ratio for breakfast was particularly scaleable…i.e. I really would not want to try eating a 45g carb breakfast one day and see how 11 units with a 40 minute pre-bolus did for me. But in theory, that’s supposed to be the idea. And I wouldn’t want to try to scale up using a 1:5 or 1:6 ratio on work days for higher carb lunches for a similar reason.
Now I’m thinking more in terms of Oomph for dosing meals. How much Oomph does my insulin need in the next few hours for this type/size of meal? Theoretically, all boluses (given at once) are supposed to last the same amount of time…so they’d each just carry a different amount of oomph to them?
The reason I think about this stuff is that I know it bothers me to scale up my doses when my instinct tells me to…but the math (or rule of thumb) says I shouldn’t…and in the back of my mind I worry that when waiting through the pre-bolus on a larger bolus, what if it just kicks in and tanks me? i’m working on getting less concerned about that, and I don’t know when that crept into my mindset so hardcore, but it has hung on pretty strongly. I’m sure that happened enough times to me on Lantus when it was too strong for the time of day and then I’d take a meal bolus and then while pre-bolusing it would just let loose…and it hasn’t happened recently but it still seems plausible.