Good to all, this is my first comment in the forum, I hope to help!
The first, the concept of sensitivity factor.This means, 1 insulin unit, how much blood glucose will lower me without carbohydrates in between.It is a tool to make corrections, whether pre or postprandial.Eg if with 1 unit I lower 50 and I am 200;I will need 2 IU to be 100. To adjust insulin to carbohydrates we use another tool, the ins /ch ratio
Now a review of how to calculate it
1. Several of you recommend calculate the FS using the 1600 rule (it would be for fast human) and the 1800 (it would be for ultra -granted anologists, the usual ones in DM1).These rules (you total/1600 or you total/1800), are to make the initial calculation when we are blind and we have no data. but it will always be better to calculate it based on the experience .Eye, experience means having "objective data", "not in my subjective experience."
2.How to calculate it: I ask my patients for a minimum of 2 weeks of intensive control.This includes:
a) Very fine count of hydrates (Best usual meals than meals away from home or "extras") and record it!
b) glycemias pre and 2h post of all meals, even some extra (pre -sleep, nocturnal, etc.) and record it!
c) usual physical activity and schedules;That is, during these two weeks, we need calculations to work in our daily routine, therefore we have to obtain them during the daily routine.It is not a good time to monitor all this on vacation, parties, meals out, etc.
c) As always in diabetes, essay and error !Value the data and see if we have done well !!!
Eg.
PRE 180 GLUCEMY -& GT;Ins by carbohydrates + 1ui per fs -& GT;2hpost = 100 -& GT;Perfect, your FS is 1UI/80 glycemia
PRE 180 GLUCEMY -& GT;Ins by carbohydrates + 1ui per fs -& GT;2hpost = 140 -& GT;Your FS is 1UI/40
PRE 180 GLUCEMY -& GT;Ins by carbohydrates + 1ui per fs -& GT;2h post = 80 -& GT;Your FS is 1UI/100
From here, we must test fs higher or lower depending on the results.Remember that you can have a FS every hour of the day.(Typical for example that it is more weak if you are going to exercise later) and that it is stronger if you are going on the couch)
To take into account:
* We must follow patterns, since so many factors influence each meal, that we cannot guide ourselves only by one;"Minimum 2 weeks of habitual life"
* For the examples I have taken into account that carbohydrate insulin was well calculated!If it is poorly calculated or we do not know, the above does not help us.I remember that the INS by carbohydrates we adjust through the INS/CH ratio, this is how many insulin units I need for each ration.A trick that I love: if your pre -glycemia is optimal, and you put a certain amount of insulin using the INS/CH ratio, your post blood glucose will depend exclusively on the ratio and you can know if it was wrong or well, since you did not need correction.Of course, this is only true if you have told the rations of hydrates well.
*All this is advanced diabetology very difficult to explain in writing and requires help from a professional team.
All the best!!!!