Sometimes I face difficulties when my patient does not bother at all whether he/she is hypo or hyper, it's just an ordinary number on that glucometer.
Sometimes I face difficulties when my patient does not stay calm, he/she worries about all.the.numbers. They freaked out on all.the.numbers.
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I was explaining to this very smart, diligent and humble, uncle R about ICR (Insulin Carb Ratio) and how do we set different ICR for different main meals in a pump.
ICR (in grams) is each unit of analogue insulin can cover how many grams of carbohydrates. Different people will have different sensitivity for different meal timing. Don't freak out, it is the art of the pancreas.
For example:
My breakfast is ~7am, lunch ~12pm, dinner ~6pm, occasionally supper after 10pm. So I can set in a pump:
12am - 6am: 8g/unit
6am - 11am: 10g/unit
11am - 5pm: 12g/unit (maybe you're pretty sensitive for lunch)
5pm - 10pm: 10g/unit
10pm - 12am: 8g/unit (maybe you're less sensitive for supper)
Then, R was like, "Wow there will be time when people do not know what to do if their insulin pump fails!"
Nahhh, insulin pump is created by human being, it gives convenience. It does not replace the need for us to think like a pancreas. Time, effort and experience are needed, through "try an error" and "guess-timate" for the best setting in a pump.
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| If you want to know how much insulin to inject, I will ask my pump Adapted from: danscartoons.com |
