I’m going to test my own IC ratios which I haven’t done before. Currently I’m 1:5 in the morning and for lunch and 1:6 for dinner. To test, I’ve read -30 from starting flood sugar means the IC is too strong and should be adjusted. Any advice on what to eat before it? Assuming I should do quicker acting things and not high fat or protein while I work to figure it out. I looked it up in the search bar and didn’t see a ton of advice on this so any advice is really appreciated!
hi @Tee25 I use a medium fast carb like a wheat flour cracker. no more than a little fat. I keep the test to under 30 grams carb. Test or watch CGM. Test before you should be starting in-range, NO eating for 4 hours before the test… Testing starts from when the food is in your mouth (and is count in hours after eating (post prandial)), every hour for 4-5 hours. You will see a rise a peak and a return to normal. the key thing is your blood sugar being within +/-50 mg/dl compared to your pre meal sugar, at the 4 hour mark. There is a secondary goal of being no more than 50 mg/dl higher than your pre meal at the 2 hour mark, but that doesn’t always work.
there is a more rigid protocol here https://www.diabetesnet.com/diabetes-tools/insulin-dose-guide/check-carb-factor-or-icr/
your basal needs to be good before you start.
your activity level needs to be “average”
you cannot be in automode if you pump.
Great! This is super helpful thanks so much.
Hi Taylor @Tee25 , the basics of what @Joe wrote are similar to my method, but my thoughts differ from what both you and Joe are thinking environmentally. I’ll put this another way - for me, I most often eat very similar foods everyday for breakfast ranging between 40 and 52 grams of carb, and my lunch when home is a sandwich, glass of milk and piece of fruit - carbs 65 to 70 depending on the fruit. I like my carb ratios to reflecting AND FIT my “real life” rather than book-learning. The pandemic eat-at-home situation has allowed me to really fine-tune my Profile settings.
My supper/dinner is another story with food types and quantities all over the board. The pandemic eat-at-home situation has allowed me to really fine-tune my Profile settings.
Because my three main meals are only +/- 4.5 hours apart, I like by BGL back at my pre-meal target of 110 mg/dl. Once again, fitting the “book goal” of within 50 after four hours, to my real-life of back ar pre-meal within 4.5 hours. Where I very strongly agree wit Joe is:
- your basal needs to be good before you start.
- your activity level needs to be “average”
- you cannot be in auto-mode on you pump.
Great advice from others so far, which I second. Please note I am not a doctor or medical professional and I have only my own limited experience (10 months) w/ T1D to offer.
I emphasize the need to not eat for at least 4 hours after each meal, five would be better. For example, I do not eat breakfast (just a personal choice; the icing on the cake is it make controlling blood sugar and dealing w/ insulin much less of a hassle e/day). I eat lunch starting at 12:30-1:30. I eat dinner at 6:30. I go to bed at 11:30. So there are at least five hours in between e/ meal, as well as before I go to bed after dinner. I do not snack whatsoever. This protocol is really what has allowed me to get my carb ratios down. I now do a 9 carb/unit Humalog ratio for both lunch and dinner. Your basal insulin needs to be right. That means that your Lantus (or whatever) isn’t bringing you signficantly down or up while fasting (significantly meaning more than 20 or so points - 10 would be better).
Splitting boluses adds a whole other complexity factor. For example, it sometimes seemed like I was taking too little insulin for a meal, but I eventually realized it was actually that I took too much insulin before the meal, and not enough for my second or third dose (so there wasn’t enough potency later on). Similarly, going too low in the short-term may not necessirialy mean you took too much insulin overall, but that you took too much for the first dose of your bolus. Again, just my experience. I split all my boluses into at least two doses, often three (in the case of high fat - such as a cupful of nuts w/ cashews + other carbs - or bread, for which I need actually a lower ratio than for all other food - weird). A typical timing for a 3-split bolus for me would be ~50% 15 minutes before eating, ~20% 1.5 hours after starting eating, and ~30% 2.5 hours after starting eating.
Anyway I guess the moral I offer is, keep in mind that what is affecting your numbers doesn’t only have to do with the overall amount of insulin you’re taking, but also when you’re taking it, how you’re splitting it up, and what you’re eating (and of course, what level of activity you’re doing).
Oh yeah, I don’t mean to be overhwhelming, but another factor to consider is glycemic load - i.e. not what the thing is that you’re eating, but how much of that thing. For ex., I can eat 1/4 cup of granola and need a 9 carb ratio, whereas 3/4 cups of granola would require around a 6.5-7 carb ratio. I keep a log of all of this stuff, I try to learn lessons from every meal, and then apply that going forward and try to do better next time. I don’t cater my diet to diabetes, I eat what I want (the disease is already stifling enough). Sometimes I base my insulin not just on my ratio, but on what worked (or didn’t) in the past, for that particular food-type. A bit of knowledge gained e/day doesn’t seem like a lot, and may even seem like regression at times, but over time it adds up to a a month’s-worth of knowledge, a year’s-worth, etc. “Rome wasn’t built in a day”, and all that.