Every person responds differently to insulin.
The whole basal- bolus insulin when simplified boils down to injecting slow and rapid acting insulin to mimic the body’s normal insulin pattern throughout the day to gradually lower the HbA1C levels.
Your basal insulin is that amount that controls your sugar levels in-between meals and while you are sleeping- this is crucial and needs to be fine tuned to match your liver’s normal output of glucose. While your bolus insulin- is the fast acting insulin aimed to control the spikes in sugar levels post meals.
Your basal insulin levels are determined by-
- Body weight and composition,
- Physical activity,
- Insulin resistance; and
- Hormonal levels.
I have observed that clients tend to take the basal insulin levels very lightly- however they forget that long acting insulin gives your body that sustained glucose supply and going wrong with this dose tends to starve or overfeed your body cells- so don’t take any shortcuts with your basal levels- go through the basal testing and find what your body really needs. Post this you can fine tune the dose as per your physical activity and sugar levels.
For Bolus insulin, the insulin to carbohydrate ratio comes into picture- so how do we know what’s the right ratio?
For this you have the 500-rule (very useful for type 1 diabetics).
This is based on an assumption that on a daily basis, a total of 500 grams of carbohydrates are taken at various intervals, so this number is now divided by the total carbohydrates that your meal has.
For instance, lets say you are having a potato sandwich: 2 slices of bread + 1 tbsp butter + 1/2 potato + 1 tomato.
So now your total carbohydrates will be counted for the portion of bread and 1/2 a potato, which approximately comes up to 30 grams of carbohydrates.
Now your bolus insulin dose for the sandwich would be 2 units on the basis of the 500-rule given the total daily dose is 30 units, this needs further tweaking from person to person and time to time.
There are many more ways of estimating the insulin to carbohydrate ratio- the next most popular one being the weight sensitive dosage- which keeps your weight as the only variable to decide the insulin dose- what I feel this method majorly lacks is the understanding that the body is composed of both fat and muscle- and it is this composition in addition to your physical activity and hormones that should decide your dose not the scales alone.
So moving on to a more lighter topic- I am so sure you would like to now know which carbohydrates are diabetes friendly or wait- can carbohydrates really be diabetes friendly?
In the next thread I will try and talk about how carbohydrates can help you gradually raise your blood sugar levels and how to avoid the sudden spikes in blood sugars post eating a meal.