The insulin/carbohydrate ratio (Rapp I/CHO or I/C) indicates the grams of carbohydrates metabolized by 1 U of insulin, for a given subject. This allows the insulin dose to be adjusted to the carbohydrate intake of each individual meal as indicated by the Gold Coast Womens Physiotherapist.
On average, 1 U of insulin metabolizes about 10-15 g of CHO, but in pediatric age the I/CHO ratio is very variable, from child to child, depending on factors such as age, weight, physical activity practiced, etc.
Furthermore, for the same child, the I/CHO ratio changes with growth and pubertal development, as happens with insulin sensitivity, but can also be different depending on the seasons and times of the day.
Therefore, even if there are mathematical rules to calculate it, in the developmental age it is much more accurate to establish the I/CHO relationship by analyzing a glycemic and food diary carefully filled in for a few days.
This diary must include: meal times, foods containing CHO consumed and total carbohydrates in grams, pre-prandial blood sugar levels and 2 hours later, insulin doses administered. I/CHO reports should also be recalculated periodically (at least every 3 months) and modified when persistent hypoglycemia or post-prandial hyperglycemia is observed.
Calculation of active residual insulin: the ultra-rapid insulin lasts about 3 hours and, for simplicity, we consider that it is consumed at the rate of 1/3 of the dose every hour. If 2 hours have passed since the bolus, it means that there is still 1 hour of insulin to act, that is 1/3 of the dose. In this case: 6 ÷ 3 = 2 U (active residual insulin). The Gold Coast Womens Physiotherapist helps individuals achieve full recovery.
Physical activity: This is the most difficult factor to calculate, because it is not easy to quantify the physical exercise carried out, especially if it is a playful and unplanned activity. If intense activity is carried out, insulin should be reduced by 1/3 (or sometimes even 1/2) to the meal.
If we did intense physical activity, we would have to remove 1/3 and then administer 2/3 of the dose, that is 4.6 U (-> rounding 4.5 U). At first it may seem a complicated method, but it is just a matter of doing some practice, and then it becomes an automatic process.
In everyday practice it may be helpful to use common kitchen utensils to dose food without always using the scale. Anyone who suffers from diabetes since childhood knows this well: the blood glucose control and subsequent adjustment by subcutaneous injections occurs several times a day.
Although over time the person becomes familiar with the practice, having to stop to evaluate when to take insulin represents a radical change in lifestyle compared to those who are not diabetic. Today, however, technology helps us: devices that are able to constantly monitor blood sugar and release insulin only when needed are available on the market for some time.