HOWTO measure Blood Sugar to Insulin ratio. by: Michael A. Robinton, Michael@bzs.org v1.04, Feb 6, 1998 This document describes a method to measure Blood Sugar to Insulin ratio by carefully measuring your body's response to a 1 unit bolus of insulin. ______________________________________________________________________ Table of Contents 1. Introduction 1.1 Blood Sugar to Insulin ratio DEFINED. 1.2 Disclaimer 1.3 Other Blood Sugar related HOWTO's 2. Measuring Blood Sugar to Insulin ratio. 2.1 Preparation before testing your BG/I ratio 2.2 Repeatability of the BG/I test 2.3 BG/I test procedure 3. Copyright Notice ______________________________________________________________________ 1. Introduction 1.1. Blood Sugar to Insulin ratio DEFINED. The BG/I ratio is the blood sugar point drop for each unit of insulin administered to bring down a high blood sugar reading. An accurate measure of Blood Sugar to Insulin ratio ( BG/I ) is necessary to maintain good overall control of blood sugar levels. An estimate of BG/I can be made using the 1500 rule or the 1800 rule (in the section on Treat Highs Differently) if you use Humalog. For some people, these estimates may result in large errors. This straight-forward procedure provides an easy and accurate check of Blood Sugar to Insulin ratio ( BG/I ). 1.2. Disclaimer The information and procedures contained in this document are provided in the hope that you may find them useful. No guarantee or warranty of accuracy is given, or suitability for use implied by making this information available. Use of the information and procedures is AT YOUR OWN RISK. You should consult with your physician and health care team when making changes to your insulin regimen. 1.3. Other Blood Sugar related HOWTO's o HOWTO profile your BASAL RATES Check and adjust your Basal Rates o HOWTO estimate new Basal Rates Graphically estimate your basal rates on-line. o HOWTO measure Blood Sugar to Carbohydrate ratio Check Blood Sugar to Carbo ratio. o HOWTO check your RATIOS Check that your Blood Sugar to Insulin, Carbo to Insulin, and Blood Sugar to Carbo ratios are correct. 2. Measuring Blood Sugar to Insulin ratio. 2.1. Preparation before testing your BG/I ratio Test your Blood Sugar to Insulin ratio on a day which follows a vanilla day. That is, the previous day should have no insulin reactions, unusual highs or lows, or out of the ordinary physical activity. Prior to and during the testing period, you should not participate in any activites which are out of the ordinary. Do the things you normally do every day. In order for this procedure to work correctly, blood sugar levels must remain stable and constant during the test period. 2.2. Repeatability of the BG/I test The Blood Sugar to Insulin ratio measurement should be repeated two or more times on different days to make sure the results are accurate and repeatable. Make changes to basal rates and boluses only after successfully repeating the test results. It can be expected that there will be some minor variation in readings from day to day. Repeatable test results indicate a true pattern which can then be used to maintain correct blood sugar levels. 2.3. BG/I test procedure Measure your BG/I ratio by checking your body's response to a bolus. If you are comfortable with a one unit bolus when at 150 then the following procedure will give you a good idea of the blood sugar drop caused by a unit of insulin. The one unit bolus is intended to move your blood sugar levels down by 60 to 75 points. Use a smaller or larger bolus to achieve this target range and calculate the BG/I ratio after completing the test period. CONSULT your health care advisors if you are uncertain about this procedure, do not proceed. 1. Fast for 4-5 hours prior to beginning the test. 2. With blood sugar near 150, bolus 1 unit of Humalog. You may adjust your blood sugar using glucose tablets, however wait at least 20 minutes after taking glucose and test your blood sugar again before adminstering the 1 unit bolus. 3. Wait 2 1/2 to 3 hours and check your blood sugar, record the difference from the original reading, this is the Insulin to Blood Sugar ratio. This test could be performed using Regular insulin, however, the wait period would be 4 1/2 to 5 hours rather than 2 - 3 with Humalog. 3. Copyright Notice Copyright (C) 1998, Michael A. Robinton and Insulin Pumpers Permission to use, copy, distribute this document for any purpose is hereby granted, provided that the author's / edi- tor's name and this notice appear in all copies and/or sup- porting documents; and that an unmodified version of this document is made freely available. This document is dis- tributed in the hope that it will be useful, but WITHOUT ANY WARRANTY, either expressed or implied. While every effort has been taken to ensure the accuracy of the information documented herein, the author / editor / maintainer assumes NO RESPONSIBILITY for any errors, or for any damages, direct or consequential, as a result of the use of the information documented herein.