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How often do you make adjustments to your insulin-to-carb ratio?
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Almost never. With the power of the automatic delivery system it is just not needed anymore than when I see my doc and maybe not then
When my endocrinologist says I need to
In the past it was very seldom as I had things pretty well fine tuned, but I recently moved from Medtronic to Tandem and am still fine tuning the ratios to adjust for the switch from Aspart to Novolog. My control is still not as good as it was, controlIQ for me has not been all it was purported to be, but I will get there.
I only change it if either my Dr suggests it or I see where the current ratio is not working. Frequency varies.
I go see my diabetes educator next week. We may tweak it. I’ve lost ten pounds in the past year. Not trying, just not hungry. Chore to eat now……..
We adjust whenever we notice a trend that needs addressed.
Almost every meal — depends on the carbs
My insulin-to-carb ratio is static and hardly ever changes. I do take less insulin than indicated on days when I’m exerting myself and while eating less frequently (extra ordinary activity).
My brother was also a T1D. He designed a matrix for me based on my height, weight, time I’d day, and current blood sugar. My endocrinologist has a copy. I use still after 20 years.
As shocking as this is, I don’t actually count carbohydrates. When I look at food, I see it directly in terms of insulin units and bolus accordingly. My endo endorses my method since it keeps me 90-100% in range. Her NP hates it and makes me back-calculate to carbs, so I use a ratio of 1:10 to make the math easy.
Every set change.
Never have, have always used MDI and numbers have been very good. 1 to 15 carbs
Endo has me giving a unit for morning coffee and made a late morning adjustment to carb ratio. Morning rise in blood sugar is a nuisance.
I guess I make mental adjustments occasionally rather than change pump settings.
Provider initially set ratio when I started using device 7 months ago. I adjusted two weeks later and not since.
I don’t use fast acting insulin that often. When I do, it’s because I had a big meal that had lots of carbs, which is not often. I take Lantus once a day. After a normal low carb meal, I walk or work in the garden or work around around the house. It does the trick.
I put every few months. I am on a new pump/algorithm, therefore trying to find the sweet spot.
I’ll take a look at it seasonally. I seem to need less insulin:carb in the warmer months. I also don’t have much of an appetite during the warmer weather (don’t have much of an appetite ever, but in the summer, eating is even less pleasurable)
Only when my numbers reflect it is needed.
The food can drive I:C ratio, in no way can it be fixed for all carbs. I.e., protein, fat, glycemic load. The hard fixed carb ratio is only part of the dosing calculation. It also is different throughout the day, something they don’t tell us.
Usually changes based on season. I am more active in the ‘warmer’ months, so my boluses change a bit to accommodate additional activity.
i don’t generally. i think my provider has changed occasionally
Never, but that wasn’t an option.
Only when my usual treatment procedure isn’t getting the usual results. I haven’t made a change in probably 8 years.
When needed.
My Endo reviews all my charts at each visit 3-4 times a year. Se will make slight adjustments on my pump if she feels it necessary. So far…so good.
All my settings change with the seasons, I kid you not! My basal rates are first, then my ratios, ISF…
Other-whenever it is warranted.
Simply put, as my body needs change and I see a need.
Whenever I see a trend up or down only once in this last year. Went from 1/15 to 1/12
So did I. I use 1/15 for most of the day, but 1/12 for lunch.
Go us!
Sometimes I seem to need more insulin for same amount of carbs. Sometimes my basal needs to be adjusted for night time lows. I am comfortable changing doses as needed.
I try not to mess with my settings unless I see a trend. I usually do it with the help of my dr /endo
I don’t change carb ratios
When I see my Endo she generally has some suggestions which make sense and I find it helpful.
Sometimes having a numeric value for a thing creates a sense of precision that isn’t necessarily reflected in reality. For all the tweaking, how often do you actually “stick the landing” bolus-wise with no adjustments after the fact? And when it doesn’t come out right, was that the fault of your I:C settings, or was it because you didn’t get the portion size right or didn’t know the cook added a big dollop of corn syrup to the glaze or whatever? Of course you have to have SOME basis for doing this, and I’ve done all the testing for basal rates, I:C ratios, correction factors, adjusted for times of day. But at some level of refinement these adjustments just kinda get lost in the error bars. After decades doing this my actual practice comes down more to experience, experience, experience, intuition, and CGM than on my Bolus Wizard, which I usually only resort to if I’m confronted with something truly unusual (“All right, I’m gonna have some of that pecan pie dammit!”). The whole promise of AID pumping is that your static settings are never going to be perfect and what you really need is a system that can adjust in real time to what’s actually happening. My own experience is that AID isn’t really there yet. But as CGMs have become more accurate the Wizard settings have become less crucial in terms of how I actually manage on a practical, day-to-day basis.
I make adjustments a lot. I keep a close eye on trends. The newest one has been a drop before dinner and before lunch. I have not been eating much lately, I have lost my appetite. So if it keeps on the next day or two I will adjust it and raise it in the morning, because every single morning it is high. I have heard about 3 reasons why. The newest is fatty liver. I have cut fat from my diet and lost 30 pounds. So, 30 more pounds let’s hope the fatty liver is not the problem and I can have breakfast again.
I was told to not change this ratio.
Any adjustments to my insulin-to-carb ratio is done with my Joslin dr.
I chose 2-3 times / yr. I normally wouldn’t touch the settings unless I see a change in TIR and/or StdDev. My situation is filled with high stress and caregiving, so I don’t change Insulin-to-carb ratio very often unless I see my boluses are no longer effective.