Did you know that your carbohydrate sensitivity changes all day? That’s true and this can have a major impact on your diabetes management.
If you have insulin-dependent diabetes like me, you probably have some system of estimating the number of insulin units needed for a bolus for your diet.
Perhaps counting carbohydrates, using doses based on total calories, using slide scales, or simply estimating the amount of insulin you need based on experience.
But I often find people lack a very important part of the puzzle. This means that your calculations should consider how sensitive you are to carbohydrates during the day.
As Gary Scheiner explains in his book, like Thinks aa bancreas (I have posted an excerpt related to a post managing the Dawn phenomenon using basal insulin), our basal insulin needs differed throughout the day, and carbohydrate sensitivity also changed incredibly.
How can I know this? Well, I need more insulin to cover the amount of carbohydrates given in the morning than I do exactly the same type and amount of carbohydrates at night.
Why it’s important to know your different carbohydrate sensitivity
First and foremost, if you want to manage your diabetes as closely as possible, it is extremely important to nail the various sensibilities. If you don’t know what’s going on all day, you end up with a lot of things.
From a general health and fitness perspective, if this is not optimal, you risk getting on a roller coaster of hypoglycemia and hyperglycemia all day long. This can be very tiring, but it can also be very frustrating to not understand why you are constantly running high or low.
Let’s say you exercise in the afternoon and use the same formula you use in the morning to calculate your pre-workout dose. If you’re like me and you have a high need for insulin in the morning, you’ll probably be overdose. And we all know what that means. You need to skip workouts or eat extra carbs you don’t plan or want.
How to find your different carbohydrate sensitivities and track them
Remember how to use a blood glucose tracker to learn how to reduce the risk of hypoglycemia during aerobic exercise in my post about food and insulin about workouts? The same principle applies to finding different carbohydrate sensitivities.
I recommend tracking your blood sugar for about a week and keeping everything as constant as possible (food, exercise, sleep, everyday life, etc.). Then test it to find carbohydrate sensitivity at different times during the day.
The way to do this is to measure your blood sugar levels before eating and writing down what you eat. Then, take another measurement after 90 minutes. Dosage is appropriate if blood glucose levels are consistently within range 90 minutes after meals. If not, you will need to make changes.
These changes can be made in collaboration with the healthcare team, but you will need to bring your data. Otherwise they won’t know what changes they will make.
I am self-controlled. This means making changes to diabetes management yourself and making changes every day if necessary. I check in to Endo regularly, but being self-controlled has significantly improved my quality of life and diabetes management, especially considering how much my workouts affect my insulin needs.
How to track and adjust carbohydrate sensitivity
If you are using an insulin pump, you will see that when you go to Settings, the pump actually allows you to set up to six different carbohydrates and correction factors. You may not be using them today, but there is a reason why pump manufacturers put that option there.
If you are undergoing pen therapy, just like me, you need to track it all in your head (lol! You need more brain capacity than I have) or use some kind of calculator. In the past, I used the RapidCalc app to track everything. Below is a screenshot of the current settings.
update: The RapidCalc app is now available only on the EU App Store for iPhone, but you can change the settings to the US after downloading. How do you see it in this video?
It’s set up like a pump, so just enter all the information and calculate the recommended dose based on time and active insulin, just like a pump.
As you can see, I currently don’t use all six settings and only have three different ratios. The most insulin is required between 11pm and 10am.
10 g/unit means that 1 unit of insulin is required for 10 g of carbohydrates during that period, but in the evening only 1 unit of insulin is required for 16 g of carbohydrates.
If you already manage basic blood glucose control, we recommend honing your diabetes management skills by finding different day ratios. Knowing what’s going on only makes life easier, and ultimately you’ll have less time to worry about hypoglycemia or hyperglycemia.
Suggested next post: No carbohydrates, low or moderate carbohydrates – which is the best diabetic diet?
