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    • 6 hours, 1 minute ago
      Anita Stokar likes your comment at
      Which of the following do you use or wear at least 25% of the time (e.g., 2+ days per week)? Select all that apply:
      I'm cheap and go for the off brands. Saves a lot of money and it does what I need. No I can't give myself insulin through my watch, but it does notify me when my blood sugar is out of range.
    • 6 hours, 3 minutes ago
      Anita Stokar likes your comment at
      Which of the following do you use or wear at least 25% of the time (e.g., 2+ days per week)? Select all that apply:
      Pump and CGM 99.9% of the time.
    • 11 hours, 16 minutes ago
      Karen Bowlby likes your comment at
      Have you ever looked for information or read about islet cell transplantation?
      There are several interesting trials going on now. VERTEX, and Elodon are two US trials, their is also a Swedish trial the uses gene editing to eliminate the need for immunosuppressive drugs.
    • 12 hours, 26 minutes ago
      John Barbuto likes your comment at
      Have you ever looked for information or read about islet cell transplantation?
      No one is interested in immune suppression drugs- most of us are coping by now. Most of us would also be willing to try paths that don’t require additional drugs, but we’re rejected because we’re coping.
    • 12 hours, 26 minutes ago
      John Barbuto likes your comment at
      Have you ever looked for information or read about islet cell transplantation?
      I agree totally. Antirejection protocol would be worse than just pumping insulin. I don't see any advantage
    • 12 hours, 26 minutes ago
      John Barbuto likes your comment at
      Have you ever looked for information or read about islet cell transplantation?
      Yes, and looked at participating in research, but not willing to take the anti rejection drugs.
    • 12 hours, 26 minutes ago
      John Barbuto likes your comment at
      Have you ever looked for information or read about islet cell transplantation?
      Of course I read everything about research about T1D
    • 13 hours, 15 minutes ago
      Kathy Hanavan likes your comment at
      Have you ever looked for information or read about islet cell transplantation?
      Of course I read everything about research about T1D
    • 13 hours, 28 minutes ago
      Eve Rabbiner likes your comment at
      Have you ever looked for information or read about islet cell transplantation?
      Of course I read everything about research about T1D
    • 13 hours, 33 minutes ago
      Steve Rumble likes your comment at
      Have you ever looked for information or read about islet cell transplantation?
      I agree totally. Antirejection protocol would be worse than just pumping insulin. I don't see any advantage
    • 13 hours, 49 minutes ago
      Daniel Bestvater likes your comment at
      Have you ever looked for information or read about islet cell transplantation?
      Yes, and looked at participating in research, but not willing to take the anti rejection drugs.
    • 14 hours ago
      TEH likes your comment at
      Have you ever looked for information or read about islet cell transplantation?
      Yes, and looked at participating in research, but not willing to take the anti rejection drugs.
    • 1 day, 7 hours ago
      Lawrence S. likes your comment at
      Which of the following do you use or wear at least 25% of the time (e.g., 2+ days per week)? Select all that apply:
      None.
    • 1 day, 7 hours ago
      Lawrence S. likes your comment at
      Which of the following do you use or wear at least 25% of the time (e.g., 2+ days per week)? Select all that apply:
      Other for the lacking answer of none of these. It took a while to get used to wearing my pump and CGM. I HATE the feeling of attachments to my skin and can't wear jewelry or watches.
    • 1 day, 7 hours ago
      Lawrence S. likes your comment at
      Which of the following do you use or wear at least 25% of the time (e.g., 2+ days per week)? Select all that apply:
      None of these. I'm not interested and have not even heard of some of them. The fewer gadgets the better.
    • 1 day, 7 hours ago
      Lawrence S. likes your comment at
      Which of the following do you use or wear at least 25% of the time (e.g., 2+ days per week)? Select all that apply:
      Pump and CGM 99.9% of the time.
    • 1 day, 7 hours ago
      Lawrence S. likes your comment at
      Which of the following do you use or wear at least 25% of the time (e.g., 2+ days per week)? Select all that apply:
      How about “None of the above”?
    • 1 day, 7 hours ago
      Lawrence S. likes your comment at
      Which of the following do you use or wear at least 25% of the time (e.g., 2+ days per week)? Select all that apply:
      None of these
    • 1 day, 12 hours ago
      Steve Rumble likes your comment at
      Which of the following do you use or wear at least 25% of the time (e.g., 2+ days per week)? Select all that apply:
      Pump and CGM 99.9% of the time.
    • 1 day, 12 hours ago
      lis be likes your comment at
      How easy is it for you to find research opportunities that feel relevant to you?
      No one wants me. I am eighty four years old.
    • 1 day, 12 hours ago
      lis be likes your comment at
      How easy is it for you to find research opportunities that feel relevant to you?
      I can find research studies that pertain to my medical problems but I do not always have the prerequisites needed for the study.
    • 1 day, 12 hours ago
      lis be likes your comment at
      How easy is it for you to find research opportunities that feel relevant to you?
      Aged out
    • 1 day, 12 hours ago
      lis be likes your comment at
      How easy is it for you to find research opportunities that feel relevant to you?
      My age limits me
    • 1 day, 12 hours ago
      lis be likes your comment at
      How easy is it for you to find research opportunities that feel relevant to you?
      Agreed, and there are plenty of issues aging with T1D.
    • 1 day, 12 hours ago
      lis be likes your comment at
      If you were offered a therapy that aimed to restore your body’s insulin production, how likely are you to consider it?
      Would you be interested if the immuno-suppression was the new tegoprubart which is being used in the new Eledon trials? That immunosuppression is targeted to the attack of the islet cells and does not affect the rest of the body. So far no side effects shown. The longest participant in this trial is 20 months insulin free. Currently the trial uses a infusion of the tegoprubart every three weeks, but the company is working on injections/ pill that could be used at home. Possible a once a week or once a month injection or pill that would keep you insulin free. I think that is one immunosuppression I would take if at the end of the trials if the results are very good.
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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 worked in the diabetes research field 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
      3 years ago Log in to Reply
    2. Kristen Clifford

      When my endocrinologist says I need to

      1
      3 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
      3 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
      3 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
      3 years ago Log in to Reply
    6. Elle Hamann

      We adjust whenever we notice a trend that needs addressed.

      3 years ago Log in to Reply
    7. Natalie Daley

      Almost every meal — depends on the carbs

      2
      3 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
      3 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
      3 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
      3 years ago Log in to Reply
    11. mbulzomi@optonline.net

      Every set change.

      3 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

      3 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.

      3 years ago Log in to Reply
    14. KCR

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

      4
      3 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.

      3 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.

      3 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.

      3 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)

      3 years ago Log in to Reply
    19. Vicki Andersen

      Only when my numbers reflect it is needed.

      3 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
      3 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.

      3 years ago Log in to Reply
    22. Joan McGinnis

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

      3 years ago Log in to Reply
    23. Karen DeVeaux

      Never, but that wasn’t an option.

      3 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
      3 years ago Log in to Reply
    25. kim bullock

      When needed.

      1
      3 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.

      3 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…

      3 years ago Log in to Reply
    28. Becky Hertz

      Other-whenever it is warranted.

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

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

      3 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

      3 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!

        3 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.

      3 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

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

      I don’t change carb ratios

      3 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.

      3 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
      3 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.

      3 years ago Log in to Reply
    37. PamK

      I was told to not change this ratio.

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

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

      3 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.

      3 years ago Log in to Reply

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

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