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Insulin to Carb Ratio

I was diagnosed with Type 1 Diabetes about 3 years ago(age 14) now and up until about 6 months ago I had absolutely no problems with my diabetes.  About 6 months ago I became a little less careful with regular glucose tests and the times I have been testing have been getting worse and worse readings.  Tonight I felt no symptoms of a high but I tested before I went to sleep and came out at 600.  Gave a correction bolus, 30 minutes later 600, another correction bolus another 30 minutes another 600, another correction bolus after a site change(insulin pump) and a big correction bolus, still about 500.  Now about 30 units of insulin later my blood sugar has only improved by 150 mg/dml.  I have heard of insulin resistance due to lack of exercise but surely not this sudden and extreme.  Lastly(sorry for the long post)  I was wondering what the average insulin : carb ratio would be for someone of my age/weight/physical wellness.  I am now 17, about 190lbs. and I try to exercise as much as I can by running all my errands on foot and walking the golf courses regularly.  Thanks a TON for the help in advance :)

Nydox
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Avatar universal
Hello again,

I am so glad to hear your are doing well and feeling well and that you found a meal plan that works for you!
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Avatar universal
Thanks for all the tips I appreciate it!  I did a lot of research the night I posted and one thing that was HUGELY recomended for ALL possible symptoms was DIET DIET DIET!!!!  Since I read about this I have been eating 6 small meals a day rather then 3 big meals, consisting of 1 serving of carbs(15-25 carbs) and 1 serving of protein(a small fist full) and vegetables with at least 1-2 meals a day and I have ben feeling great and my blood sugars have been great! So hopefully this helps other people with future nausea problems, as I had terrible stomach aches for days and actually had to go to the emergency room because I couldn't stand the pain anymore, they couldn't think of any major cause of this but diet seemed to have fixed it :)   Thanks again!!
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Avatar universal
Hi, I'm also a volunteer, long-time diabetic (dx'd as a teen), and not a physician.

As you follow the good advice already given, also consider that when our BG is very high, we are *temporarily* more insulin resistant.  It takes longer to get from 600 to 550, than from 200 to 150.  It takes longer to get from 200-150 than from 125 to 75.

It's likely that your high was related, in part, to insulin not getting from the pump to your bloodsteam.  I use a rule of thumb like you did -- 2 "unexplained" highs means time to change it all out.  I would do a coupla things differently; after an hour with no change, I would take a shot of insulin instead of a bolus.  I could them "buy" some time to figure out any pump issues.  And while it'd be tough to not test after 30 minutes, I wouldn't make any adjustments (or take a shot) until at least an hour had passed -- due to the insulin resistance issue when we're so high.

At age 17, whether male or female, hormones play a significant role in your metabolism.  Depending on your height, your weight might be just right, or it might be heavy.  If you're overweight, that can contribute to resistance.  Over time, type 1's eventually stop producing any insulin at all and it's possible that your pancreas has finally pooped out completely where it may have been helping you out in small ways before now.

Keep testing, try to nurture yourself in ways that many teens don't ;-) and you'll likely begin to see steady improvements in how you feel and how you feel about yourself.

Good luck.
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Avatar universal
I just read the post from Scott's Mom and found a TON of useful information, which may make this post obsolete.  But if you have any suggestions other then what is on that post it would still be appreciated.  I would not be upset if there was no response to this post though since 99% of my questions were addressed in that post :)  Thanks!
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Avatar universal
Hello Nydox,

Thank you for posting.  I am a volunteer, not a medical professional, so my advice and input should NOT be taken in place of your endocrinologist's.  My advice is based on my experience in caring for my son, now 10 who was diagnosed at the age of 3.  My sis was dxd 2 years before my son.  She was 24 yrs. old and is now 33.

My son is also on the pump.  He started on it in August of 2004.  You did the right thing by changing your infusion set.  Sometimes I find (and so does my sis who also has type 1) that when there is a high BG it seems like it can take a while to knock it down.

My son and my sister both test 10 plus times a day since they have started on the pump.

As far as the insulin to carb ratio, I am honestly NOT SO SURE that it has to do with the age / weight of a person.  I believe that it is simply an individual thing based on trial and error.  (Ew!  I hate to say error)  

This is what my sister's diabetic nurse (who is her primary contact) tells he to do and this is what your doc might reccommend for you or you could try it.  (I do not see any harm in this at all.)  

For a few days or so, keep yourself on a strict meal plan as far as time is concerned.  Try to have breakfast, lunch and dinner around the same time for these few days.  When you give your breakfast bolus, give your self a 2 hour BG reminder and re-test after 2 hours and write that BG reading down.  

Make a note of the pre-meal BG readn and time, as well as the post - meal reading and time.  (post being done 2 hours after as I mentioned)(Do NOT have snacks in betwen your 3 meals, unless low)  DO the same 2 hour testing after lunch and dinner.  The 2 hour post-meal reading will be very helpful in aiding your doc in making adjustments to your insulin to carb ratio.

I cannot stress enough (I am not preaching and I know you already know this...I am simply re-affirming) how Important it is to test regularly when on the pump.  Even if you are skipping a meal, test anyway.  What if there was a clog?  

You know, my son does not always feel symptoms of high unless he has ketones and is nauseous.  When he is high the only thing that tips him off (besides testing) is that his eyes feel really tired, SO, he will test when he is feeling this way, but sometimes he is not high, he was just tired because maybe he did not get enough sleep the night before.

Please talk to your endocrinologist about this matter.  

Keep us posted.

SS
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