Can someone please remind me...

how to work out if your ratios and BI are correct? My DAFNE course was several years ago and I can't remember and am in a right pickle trying to correct highs and lows (mostly highs).

Thanks

Well the first step is to work on your BI as this is the key to the rest of it. You don't say if you are on a single dose or split dose, the principle is the same for both however the way to check is slightly different. The theory is if you don't eat and just use BI your BG should stay roughly the same. So of you inject before bed and test then don't eat again until morning your BI should be pretty much the same. If you are on a split dose and inject BI in the morning and skip lunch again your BI should be roughly the same before dinner. Of course its not always as simple as this but that is the basic principle.
If your BI is right and stable then your QA should only be needed to work on the food you eat. Therefore you should be able to inject the QA to match your CP's, if this doesn't have the effect expected then you increase the ratio of QA to CP's. However you need to base this decision on more than one meal, it needs to be done over a period of days to remove one-offs. Also remember that ratio's may vary at different times of day e.g a lot of people need a higher ratio in the morning to the mid-day or dinner ratio.
Hope that all makes sense, it is in the online handbook somewhere, I probably should know having just converted it to the online version

Thanks Marke. I am on a single dose of Lantus which I take before bed.

Hi Lizzie,
I would check your BI is right first (as Marke). Best way to check that is by having a carb free meal which will allow you to see how your BI is working (or not as the case may be). Once you have your BI right then next look at your QA ratios.

Good luck
Anele.

Hi

Thanks for all the advice so far. I am trying to work out BI but am not having much luck. I am currently on 28u Lantus before bed. But my blood sugars are still highish (12 or 13 or so) in the morning. I don't want to increase it too much, I used to be fine on 24u and I don't understand what has changed. I still eat pretty much the same stuff and have not made any other significant changes I can think of.

Please remember that most BIs will take 2 or 3 days to show any impact for changed dose. So slowly does it.

Regards

Garry

Lizzie said:
Hi

Thanks for all the advice so far. I am trying to work out BI but am not having much luck. I am currently on 28u Lantus before bed. But my blood sugars are still highish (12 or 13 or so) in the morning. I don't want to increase it too much, I used to be fine on 24u and I don't understand what has changed. I still eat pretty much the same stuff and have not made any other significant changes I can think of.

Injection sites are a good point. I always use my tummy and I know I should rotate. But I am very clumsy and find it impossible to inject anywhere else. I think you are supposed to use the outer side of your thigh but that is really painful for me for some reason. I tried a few times on the inner side but I found out you aren't supposed to inject there so I stopped.

My diabetes nurses seem nice people but cannot help me. They are obsessed with obesity and every time I visit them or the doctor they push metformin, statins or stomach stapling on me. I would rather deal with the root issues behind my disordered eating and generally poor diabetes care than amputate my stomach or take a drug to mask the problem but that sort of help is not accessible to me. My blood sugars are getting steadily worse recently so maybe next time they might take notice, probably not, and my next appointment isn't til 2012 anyway.

That is why I have approached people here.

if you were fine on the lower amount, it may be that you are going hypo during the night and the high reading in the morning is a back lash from that as your liver kicks in to fix it if you are not recognising it. I would try doing a BG at 3am and then again perhaps about 5am in the morning. Its a good way of checking what your lantis is doing over night although I know it is a pest. To find a pattern you might have to do that for 3 nights. Also try and take your lantis at the same time each night as your bedtime can change by more than 30 mins each time and that could be enough to put things out of sorts.

Hi. PaulineO and I have just been on the course. The doctor explained that if you are a bit over weight your body can develop a resistance to insulin in the same way a type two would.

I wouldn't dismiss it out of hand. It could be just what you need, particularly if you continue to struggle to control your bg.