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    • 57 minutes ago
      KarenM6 likes your comment at
      Do you live with diabetes-related neuropathy?
      same here. I was able to get a neurologist to diagnose it as that.
    • 58 minutes ago
      KarenM6 likes your comment at
      Do you live with diabetes-related neuropathy?
      I have developed this very weird numbness and pain in my left outer thigh which I attribute to neuropathy, although there has been no official diagnosis. Of course, like every good diabetic, I did my own research and found that it is called meralgia paresthetica. It only comes on intermittently and rarely interferes with daily functions. Rest remedies it. Having lived with T1D for 56 years so far, I consider myself to be pretty lucky...so far.
    • 1 hour ago
      KarenM6 likes your comment at
      Do you live with diabetes-related neuropathy?
      I feel the same way. I'm never sure who to believe or how to get a valid assessment.
    • 1 hour ago
      KarenM6 likes your comment at
      Do you live with diabetes-related neuropathy?
      I’ve been T1D for 60 years. There have been slight indications of neuropathy for a number of years. However it is not severe. Whenever I go to orthopedics, I try to stop at endocrinology first and get an accurate assessment of my current neuropathy. Whenever a non-endocrinologist doctor reads I’m T1D every problem I’m having is caused by T1D. Then the root, non-diabetic, issue is never addressed.
    • 3 hours, 42 minutes ago
      Lawrence S. likes your comment at
      Do you live with diabetes-related neuropathy?
      Gastroparesis
    • 3 hours, 43 minutes ago
      Lawrence S. likes your comment at
      Do you live with diabetes-related neuropathy?
      In late summer of 2017 I lost all feeling in both lower extremities to my hips and both upper extremities to my shoulders. It was not all diabetic related though. Lowered the drug in my chemo regimen but didn't reverse by next treatment, so that drug was stopped. Slowly I regained feeling in my arms and legs; left with no sensation in hands & feet up to ankles & wrist. I'm thankful that my oncologist realized that it wasn't just a diabetic thing.
    • 6 hours, 33 minutes ago
      Sandra Rosborough likes your comment at
      Do you live with diabetes-related neuropathy?
      I’ve been T1D for 60 years. There have been slight indications of neuropathy for a number of years. However it is not severe. Whenever I go to orthopedics, I try to stop at endocrinology first and get an accurate assessment of my current neuropathy. Whenever a non-endocrinologist doctor reads I’m T1D every problem I’m having is caused by T1D. Then the root, non-diabetic, issue is never addressed.
    • 7 hours, 21 minutes ago
      KSannie likes your comment at
      Do you live with diabetes-related neuropathy?
      I’ve been T1D for 60 years. There have been slight indications of neuropathy for a number of years. However it is not severe. Whenever I go to orthopedics, I try to stop at endocrinology first and get an accurate assessment of my current neuropathy. Whenever a non-endocrinologist doctor reads I’m T1D every problem I’m having is caused by T1D. Then the root, non-diabetic, issue is never addressed.
    • 10 hours, 28 minutes ago
      Lee Tincher likes your comment at
      Do you live with diabetes-related neuropathy?
      My feet were killing me when I started taking insulin. Saw on another website that alpha lipoic acid (ALA) was good for neuropathy. Once I started taking it, the pain was gone within a week! Still using it 20 years later, still pain free
    • 10 hours, 29 minutes ago
      Lee Tincher likes your comment at
      Do you live with diabetes-related neuropathy?
      I’ve been T1D for 60 years. There have been slight indications of neuropathy for a number of years. However it is not severe. Whenever I go to orthopedics, I try to stop at endocrinology first and get an accurate assessment of my current neuropathy. Whenever a non-endocrinologist doctor reads I’m T1D every problem I’m having is caused by T1D. Then the root, non-diabetic, issue is never addressed.
    • 10 hours, 48 minutes ago
      magoo likes your comment at
      Do you live with diabetes-related neuropathy?
      I’ve been T1D for 60 years. There have been slight indications of neuropathy for a number of years. However it is not severe. Whenever I go to orthopedics, I try to stop at endocrinology first and get an accurate assessment of my current neuropathy. Whenever a non-endocrinologist doctor reads I’m T1D every problem I’m having is caused by T1D. Then the root, non-diabetic, issue is never addressed.
    • 10 hours, 48 minutes ago
      Mike S likes your comment at
      Do you live with diabetes-related neuropathy?
      I’ve been T1D for 60 years. There have been slight indications of neuropathy for a number of years. However it is not severe. Whenever I go to orthopedics, I try to stop at endocrinology first and get an accurate assessment of my current neuropathy. Whenever a non-endocrinologist doctor reads I’m T1D every problem I’m having is caused by T1D. Then the root, non-diabetic, issue is never addressed.
    • 11 hours, 1 minute ago
      Dennis Dacey likes your comment at
      Do you live with diabetes-related neuropathy?
      I’ve been T1D for 60 years. There have been slight indications of neuropathy for a number of years. However it is not severe. Whenever I go to orthopedics, I try to stop at endocrinology first and get an accurate assessment of my current neuropathy. Whenever a non-endocrinologist doctor reads I’m T1D every problem I’m having is caused by T1D. Then the root, non-diabetic, issue is never addressed.
    • 23 hours, 59 minutes ago
      ConnieT1D62 likes your comment at
      What types of exercise do you participate in regularly? Select all that apply.
      I spend a bit of time in my garden, yardwork , the animal shelter. Days I'm not with the Shelter my herd gets walked.
    • 1 day ago
      ConnieT1D62 likes your comment at
      What types of exercise do you participate in regularly? Select all that apply.
      Good old WALKING!
    • 1 day, 5 hours ago
      Lawrence S. likes your comment at
      What types of exercise do you participate in regularly? Select all that apply.
      avid cyclist for many years now ........... OK ..... add in resident year around maintenance yard work
    • 1 day, 5 hours ago
      Lawrence S. likes your comment at
      What types of exercise do you participate in regularly? Select all that apply.
      Walking and hiking.
    • 1 day, 8 hours ago
      Steven Gill likes your comment at
      What types of exercise do you participate in regularly? Select all that apply.
      Try pausing insulin on your pump if you are below 150mg/dl.
    • 1 day, 10 hours ago
      Daniel Bestvater likes your comment at
      What types of exercise do you participate in regularly? Select all that apply.
      Really struggle with bouncing blood sugars and so I don’t exercise. I know this is a bad thing but really end up with so much bouncing hard to figure it out.
    • 1 day, 10 hours ago
      Dennis Dacey likes your comment at
      What types of exercise do you participate in regularly? Select all that apply.
      Good old WALKING!
    • 1 day, 10 hours ago
      KCR likes your comment at
      What types of exercise do you participate in regularly? Select all that apply.
      Good old WALKING!
    • 1 day, 10 hours ago
      KCR likes your comment at
      What types of exercise do you participate in regularly? Select all that apply.
      Really struggle with bouncing blood sugars and so I don’t exercise. I know this is a bad thing but really end up with so much bouncing hard to figure it out.
    • 1 day, 10 hours ago
      TEH likes your comment at
      What types of exercise do you participate in regularly? Select all that apply.
      Really struggle with bouncing blood sugars and so I don’t exercise. I know this is a bad thing but really end up with so much bouncing hard to figure it out.
    • 2 days, 7 hours ago
      Bonnie Lundblom likes your comment at
      What event(s) prompt you to calibrate your CGM? Select all that apply.
      I always do 3 successive finger sticks about 1 day after applying a new G7 sensor. I'm amazed at how much variability there is among sensors. Some are spot on, and remain so during the entire 10 days, while the worst I saw was off 100 mg/dl at the start (reading half of the actual level) (I demanded -- and got -- a replacement for that outlier, since I did't want to have to trust it for days and go through piles of strips just to see if it was as bad as it seemed). I generally also do another batch of 3 tests several days later, just to check. I care about accuracy. I've found that it is essential to do multiple sequential finger sticks to get an accurate number from strips, since they too are far more variable than I am comfortable with. If the variability in strips is too great, I do 4 tests rather than 3, and throw out one, averaging the rest. I love my CGM, but it doesn't completely replace strips.
    • 3 days, 10 hours ago
      Lawrence S. likes your comment at
      Have you ever been on a ketogenic or “keto” diet (low carbohydrate, high protein)? Please share more in the comments.
      I’ve been a T1D for about 50 years. After about 10 years I moved towards a more whole food diet with only small amounts of meat. I seem to consume 100-150 grams of carbs per day and try not to eat more than 30-40 grams at a time.
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    How often do you make adjustments to your insulin-to-carb ratio?

    Home > LC Polls > How often do you make adjustments to your insulin-to-carb ratio?
    Previous

    On a scale of 1-5 how informed is your T1D health care team about the latest T1D technology and medications? (1 = not at all informed, 5 = very informed)

    Next

    If you use both an insulin pump and CGM, do you currently use any of the following automated insulin delivery (also known as “predictive low glucose suspend” or “hybrid closed loop”) algorithms to help keep your glucose in-range?

    Sarah Howard

    Sarah Howard has dedicated her career to supporting the T1D community ever since she was diagnosed with T1D while in college in May 2013. Since then, she has worked for various diabetes organizations, focusing on research, advocacy, and community-building efforts for people with T1D and their loved ones. Sarah is currently the Senior Marketing Manager at T1D Exchange.

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    40 Comments

    1. rick phillips

      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

      2
      2 years ago Log in to Reply
    2. Kristen Clifford

      When my endocrinologist says I need to

      1
      2 years ago Log in to Reply
    3. Derek West

      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.

      1
      2 years ago Log in to Reply
    4. Mary Boudousquie

      I only change it if either my Dr suggests it or I see where the current ratio is not working. Frequency varies.

      4
      2 years ago Log in to Reply
    5. Joan Fray

      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……..

      1
      2 years ago Log in to Reply
    6. Elle Hamann

      We adjust whenever we notice a trend that needs addressed.

      2 years ago Log in to Reply
    7. Natalie Daley

      Almost every meal — depends on the carbs

      2
      2 years ago Log in to Reply
    8. eherban1

      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).

      2
      2 years ago Log in to Reply
    9. Natalie Daley

      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.

      1
      2 years ago Log in to Reply
    10. Marty

      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.

      6
      2 years ago Log in to Reply
    11. mbulzomi@optonline.net

      Every set change.

      2 years ago Log in to Reply
    12. Gary Rind

      Never have, have always used MDI and numbers have been very good. 1 to 15 carbs

      2 years ago Log in to Reply
    13. Patricia Kilwein

      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.

      2 years ago Log in to Reply
    14. KCR

      I guess I make mental adjustments occasionally rather than change pump settings.

      4
      2 years ago Log in to Reply
    15. Bruce Schnitzler

      Provider initially set ratio when I started using device 7 months ago. I adjusted two weeks later and not since.

      2 years ago Log in to Reply
    16. Milly Bassett

      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.

      2 years ago Log in to Reply
    17. Carol Meares

      I put every few months. I am on a new pump/algorithm, therefore trying to find the sweet spot.

      2 years ago Log in to Reply
    18. Trina Blake

      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)

      2 years ago Log in to Reply
    19. Vicki Andersen

      Only when my numbers reflect it is needed.

      2 years ago Log in to Reply
    20. Stephen Woodward

      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.

      3
      2 years ago Log in to Reply
    21. Chris Albright

      Usually changes based on season. I am more active in the ‘warmer’ months, so my boluses change a bit to accommodate additional activity.

      2 years ago Log in to Reply
    22. Joan McGinnis

      i don’t generally. i think my provider has changed occasionally

      2 years ago Log in to Reply
    23. Karen DeVeaux

      Never, but that wasn’t an option.

      2 years ago Log in to Reply
    24. Brian Vodehnal

      Only when my usual treatment procedure isn’t getting the usual results. I haven’t made a change in probably 8 years.

      1
      2 years ago Log in to Reply
    25. kim bullock

      When needed.

      1
      2 years ago Log in to Reply
    26. Carole Ludwig

      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.

      2 years ago Log in to Reply
    27. Cristina Jorge Schwarz

      All my settings change with the seasons, I kid you not! My basal rates are first, then my ratios, ISF…

      2 years ago Log in to Reply
    28. Becky Hertz

      Other-whenever it is warranted.

      1
      2 years ago Log in to Reply
    29. Dennis Dacey

      Simply put, as my body needs change and I see a need.

      2 years ago Log in to Reply
    30. Sherrie Johnson

      Whenever I see a trend up or down only once in this last year. Went from 1/15 to 1/12

      2 years ago Log in to Reply
      1. Teri Morris

        So did I. I use 1/15 for most of the day, but 1/12 for lunch.
        Go us!

        2 years ago Log in to Reply
    31. Jane Cerullo

      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.

      2 years ago Log in to Reply
    32. terrih57@msn.com

      I try not to mess with my settings unless I see a trend. I usually do it with the help of my dr /endo

      2 years ago Log in to Reply
    33. Karen Mielish-Clausell

      I don’t change carb ratios

      2 years ago Log in to Reply
    34. Teri Morris

      When I see my Endo she generally has some suggestions which make sense and I find it helpful.

      2 years ago Log in to Reply
    35. William Bennett

      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.

      1
      2 years ago Log in to Reply
    36. Jen Farley

      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.

      2 years ago Log in to Reply
    37. PamK

      I was told to not change this ratio.

      2 years ago Log in to Reply
    38. Mary Ann Sayers

      Any adjustments to my insulin-to-carb ratio is done with my Joslin dr.

      2 years ago Log in to Reply
    39. T1D4LongTime

      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.

      2 years ago Log in to Reply

    How often do you make adjustments to your insulin-to-carb ratio? Cancel reply

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