Good afternoon all, let me begin by saying I suffer from the can’t remember s*** syndrome, have forgotten most of what I knew about diabetes and pumps.
With that being said I am working on testing my settings for I/c ratios. I am trying to determine my proper ratios taking into account my current basal rate.
I am performing in am, fasting with stable bg. Today I started with consuming 55 grams of carbs with no bolus to see the effect on my bg. That was to much eventually had to bolus, am planning on doing like 5 times then averaging the rise.
My problem is I am not sure how to interpret these results into usable information related to my I/c ratio. Am I going about this the wrong way?
Thanks
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@T1john, I think yes you are going about this in a little too rigorous of a way. While the idea of understanding how quickly your body responds to a specific uncovered carb ingestion is interesting, I think the bigger deal is having an underlying basal rate that results in a flat response when no carbs are eaten. Then when approaching your I/C ratio you do a little trial and error on a known meal. i.e. I eat eggs and one piece of toast. Since that meal is reproducible and the carbs are very consistent you should be able to dial up a dose based on your I/C. If that is too strong or not strong enough I would adjust your I/C. The reality of getting the I/C right is much more difficult of course because your activity level, the amount of fat in the meal etc etc. All contribute to less than ideal responses to the meal based on your I/C. My son looks at his I/C as a starting place, then dynamically adjusts his dosing based on the 5-6 variables that are present when he is eating the food. Even with all of this, the I/C is bit more of an art than the basal, where there are less variables present.
As a thought, when my son’s basal is dialed in, everything else gets much easier. When you are making up for a basal mismatch with your food calculations that is when everything gets more difficult and roller coaster ride begins.
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Thank you, for reference my basal is great, last night I was within about 10 points on my Dexcom g-6 from 1:00 am to about 9:00 this morning when I ate carbs. I know fat, etc is variable that’s why I do like 5 tests using different food sources. By doing test in morning I take out exercise variable and wait for feet on floor to stablelize before starting.
I am getting ready to start on new pump and am going to all my #’s disliked in before switching over so I start from a good point.
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To complicate it even more, you probably have a different I/C for meals at different times of the day. Matching insulin to digestion is a complicated sort of thing. Glad your basal’s are set up. Would love to hear more about what you learn as you set up the new system.
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That approach has the difficulty that when the BG is high, it creates insulin resistance. So it could give a different number than if you had a bolus and the food.
I like Chris’s idea of dosing for the meal based on your assumed insulin:carb ratio, and then if the BG stays too high 2 or 3 hours after the meal, adjust the insulin:carb to give a little more insulin next time. Similarly, if the BG goes too low, adjust the insulin:carb to give a little less insulin. After trying it a few times with small adjustments the result should be an insulin:carb ratio that works satisfactorily.
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Understood, let me add that I have been pump user for I guess 20 years know, and I am also trying to get a better understanding of how carbs affect my bg. I cannot easily pre bolus due to stomach issues with digestion, am trying to find any insights into how I can better control my diabetes. I have long list plans, I am just having a hard time wrapping my head around what I could gain from this insight.
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I too have slow digestion now due to some gastroparesis. I NEVER EVER prebolus. I do not put complete trust into what my I/C ratio is set at and I determine on my own how much insulin to take to cover meals. Therefore, I eat LOW CARB and some Keto to avoid taking large boluses. TIR is around 80 - 85% most of the time. Just using Basal IQ on my Tandem pump. I do a lot of trial and error.
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