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On a typical week, how much of your total amount of insulin is your basal insulin?
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Consistently over the years 15-16 %. Does anyone know what the bull’s eye target for this is? ¯\_(ツ)_/¯
Like I said in my comment, the standard line for decades was that it “should” be 50/50. I used to get that from various endos, without there ever being a good explanation. AFAICT they just decided that since it was something you could have a stat for, with the advent of basal/bolus MDI as well as pumps that can keep track, they oughta have a rule about it. So I basically ignored it. I figure if your time in range is good, these rule-of-thumb kinds of things are pretty meaningless.
My understanding is that the physiological ratio in non-diabetics is 50:50. Hence, the same target recommendation for diabetics. Interestingly, pre-mix insulins that T2Ds might use are not at that ratio.
I believe there are far too many individual variables to establish a “norm”. IMO, following a lower carb diet, as I do, results in my basal being from 60% to 70% of my total daily insulin. Have been a Type 1 since 1976. Last A1c was 5.9.
I used to disdain the old shibboleth about keeping it 50/50. I was on R/NPH MDI for 20 yrs, during which this question wasn’t even a thing. On Lantus/Novolog it started to be something my endo would yammer about but I was so indoctrinated in carb-avoidance by then that it was always more like 60/40 or 70/30. So I never really paid that much attention to it, but over recent years on the pump I must have become more sanguine about letting carbs into my diet because it actually does seem to be settling in naturally at 50/50. One caveat about that though is I have to bolus a LOT for my morning coffee, which I have with Splenda and light cream, so no carbs. Some of that is also Dawn Phenom. So I put down 50/50 but in reality it’s still more basal than bolus I think.
All I know is I feel better when I’m not jacking myself up with a large bolus. My basal levels may be higher but my blood glucose goes down slow over 2 hours after eating.
Years ago, my Endocrinologist talked about obtaining a 50/50 bolus/basal ratio. It has fluctuated over the years. But, I’ve always, or mostly, been around 30% basal/ 70% bolus. Currently, I am 32% basal and 68% bolus. I wonder if it is because I’ve always eaten high carb diets (fruits, vegetables, breads).
I would love to see the numbers behind the percentages…e.g., I take 24 units of basal insulin per day and between 10 and 20 units of bolus insulin
I take 26 units of basal and 2-3 units of bolus per day.
I just guessed.
The answer differs vastly depending on your diet. I’m on a very low carb diet—about 20 carbs/day—and average 75%-80% basal. After having read Gary Taubes’ latest book, “Rethinking Diabetes,” what I’ve learned is that the 50-50 ratio promoted by the ADA, et al., is based on a diet relatively high in carbs … as is most standard clinical advice … advice based on the assumption that diabetics will eat the relatively high-carb diet promulgated by the ADA.
F that. I’m on a mission to minimize carbs, HbA1C, insulin and other metabolic syndrome medications, and the sequelae caused by hyperglycemia and hyperinsulinimia. But aren’t we all?
Very good observation. I’ve eaten 20 grams of carbs/day in almost 15 years now and my basal (Lantus) is about 90% of the total amount of insulin.
When you start eating a low carb diet, the focus on basal doses become far more important than your bolus. It’s with the basal you control the bg when you exercise, when you are having a flu, very warm or cold weather etc.
The bolus insulin is in my opinion irrelevant when you are on low carb diets. It should provide support in handling the bg under a short time (1-2 hours) after your major meals and then “leave you alone” :-).
I normally take 26 units of basal and 2-3 units of bolus every day and have done so for years now. No carb counting to estimate how many bolus units to take at every meal, since it’s always the same. That makes life sooo simple.
My current number from Glooco is 33%. Before I went on an hybrid closed loop system (Omnipod 5 & Dexcom 6) it was closer to 40%.
I m on the Omnipod 5. I think their algorithm is stingy on basal. I picked 30%
I chose 40%, but my pump stated 34.6%.
I think historically the basal seemed to be set high, to correct meal dosing to the point the individual had to eat or risk going low: thus the antiquated 50/50. Using the CGM integrated systems with a pump, better nutrition labels, and ease dosing for meals we’re finding ratio for basal dosing a lot less: generally closer to 30% or lower with the variable basal dosing. My a1C in the 5% range, with a 27 to 30% basal, I find Medtronic decreases that basal dose as I bolus offering tighter numbers (66-67% in the 70-130).
I’m on MDI at about 60/40 Basal/Bolus. My dose is 11 units of Tresiba (basal) 1x per day, 8-9 units Humalog per day split between breakfast & dinner (based on carbs that will be consumed but my diet varies very little). I typically eat a very low carb lunch- green veggies or salad, so don’t need to bolus before lunch. I’m 90% in range on my CGM and A1C is typically around 6.3. Diagnosed T1D 51 years ago and going strong !