ratio for snacks

11 posts, 4 contributors

Search the DAFNE Online Forums

 
ang31 DAFNE Graduate
NHS Greater Glasgow and Clyde
1 post

if your on 3-1 ratio should what ratio do you take for snacks or extra food in between

novorapidboi26 DAFNE Graduate
NHS Lanarkshire
1,819 posts

Welcome........

Depends I suppose.........

I am on a 3:1 for breakfast, and a 1.5 for lunch, so if it was in between it would be most likely a 2:1 ratio I would take, but again it all depends on how close to your previous/next meal you are..................

But say you were on 3:1 all day, then you would take your snacks at 3:1 also, you may need to consider active insulin on board though and possibly reduce the dose.............

Carolin
Sheffield Teaching Hospitals
83 posts

ang31 said:
if your on 3-1 ratio should what ratio do you take for snacks or extra food in between


Any carbohydrate (over 1 CP) eaten will need to be covered by QA and we suggest you use the ratio you use at the mealtime closest to the snack.

The thing to be cautious of (and to which Novorapidboi alludes) is overlapping doses, however this really only relates to correction doses. For that reason DAFNE Educators normally recommend NOT testing your BG when you snack, especially if it's within maybe 2-3hrs of your last dose of QA as it may lead you to making an inappropriate decision on your insulin and potentially take more corrective.

So essentially, just take your usual ratio for that time of day for snacks, but don't take corrective.

Correct only at mealtimes when you know all previous dose(s) of QA are out of your system and no longer affecting your BG.

Good luck,

Carolin

novorapidboi26 DAFNE Graduate
NHS Lanarkshire
1,819 posts

What do you mean it only relates to correction doses.....................?

would there still not be a 'stacking effect' if you continued to snack several times between meals purely with the QA for the carbs alone.........

I would consider what insulin is on board each time [with the help of my fancy meter... Wink ], but if I were to snack 2, 3, 4 separate times then I would expect my BGs to drop lower than expected, hence the reason I dont actually do this, and I expect for most people this doesn't happen often...

Carolin
Sheffield Teaching Hospitals
83 posts

Snacking can admittedly be a tricky concept to grasp sometimes. But your QA:CP ratio should just 'cover' CPs eaten (or drunk) so that your BG doesn't end up high.

Clearly ratios can differ from person to person and/or at different times of the day, but if you get your ratio(s) right it means that by the time both your food and the corresponding dose of QA have cleared your system your BG should be back to where it started before you had the CPs.

If you were to test your BG within a couple of hrs of having CPs/QA it's likely to be high as the QA hasn't finished working on the carbohydrate, so if you choose to have more CPs you should only have the QA to cover what you're having, no extra to correct the BG. That's what these fancy new bolus adviser meters take into consideration with this 'insulin on board' thing.

If you find that you get low BGs when you snack and inject QA, then (unless you're exercising) it could be either you're overestimating the CPs in the snack, or using the wrong ratio, or that your BI is a little too high (which as you know you can test out by doing carb-free meal(s))

Hope this clarifies it?

Carolin

novorapidboi26 DAFNE Graduate
NHS Lanarkshire
1,819 posts

OK, so in theory you could snack numerous times and as long as you have delivered the right QA, all should be well.........?

I kinda thought that the peaks of the QA could clash etc and thus cause a low.............

As I say, this is only a pretend situation and its unlikely folk are going to have several consecutive snacks to which they will match with QA.......

I just assumed the OP was aware that you dont correct between meals/insulin doses [4-5hours], as it is one of the rules were taught as DAFNE graduates....

Carolin
Sheffield Teaching Hospitals
83 posts

novorapidboi26 said:
OK, so in theory you could snack numerous times and as long as you have delivered the right QA, all should be well.........?


Yep. Spot on!

Down side of lots of snacks however is you never get a 'true' BG reading before meals which can sometimes make it difficult to work out if your ratios are right.

novorapidboi26 DAFNE Graduate
NHS Lanarkshire
1,819 posts

Well, unless you waited till all QA and CPs had diminished................ Wink

JayBee DAFNE Graduate
James Paget University Hospitals NHS Foundation Trust
587 posts

For clarification Carolin, when snacking for unplanned exercise, is it best to go on what you expect your BGs to be after the insulin has run out, which is determined by what you did at your last meal, rather than what you are at the time of expecting to do the exercise?

I ask because this is what I currently do on the odd ocassion that I do have to look at this sort of thing (I'm usually not a snacker so it's not often). It seems to be a logical way to think about it but confirmation would be great. Smile

Is it safe to also assume that the same applies even if you take on the extra CPs after the exercise?
Does the type of carbohydrate matter in the late CPs?
Should I consider taking fast CPs mainly in those situations if so?

Thanks in advance! Very Happy

Carolin
Sheffield Teaching Hospitals
83 posts

JWo said:
For clarification Carolin, when snacking for unplanned exercise, is it best to go on what you expect your BGs to be after the insulin has run out, which is determined by what you did at your last meal, rather than what you are at the time of expecting to do the exercise?

I ask because this is what I currently do on the odd ocassion that I do have to look at this sort of thing (I'm usually not a snacker so it's not often). It seems to be a logical way to think about it but confirmation would be great. Smile

Is it safe to also assume that the same applies even if you take on the extra CPs after the exercise?
Does the type of carbohydrate matter in the late CPs?
Should I consider taking fast CPs mainly in those situations if so?

Thanks in advance! Very Happy


OK, snacking for exercise is another matter Smile

I'd refer you back to your course handbook for this, but generally we recommend if you're doing exercise you need to start with a BG above 7mmol/l, therefore if you're below 7 you need to take on extra CPs. How much you need will depend on the intensity & duration of the exercise, so if it were something gentle/short-term, just 2 CPs should be enough; something more strenuous you might need 3 CPs. You'd be best to choose a fairly rapid carbohydrate as you'll need the fuel quickly for the exercise.

It's worth considering what insulin you have around too of course, i.e. your last dose of QA or your BI in case either of these is likely to still be having an effect on your BG, or indeed if not, whether you need as many CPs prior to the exercise and/or a small dose of QA to help your body to use the glucose.

Hope this hasn't confused you more JWo?