Is a really complex game. The basic reasoning is that for every X carbohydrates ingested, you need to inject Y insulin (according to a personal ratio).

However, everything is complicated by numerous factors and the technology you use.

Factors: how you feel, stress, exercise, what you ate in previous meals, your blood sugar level at the start of the meal, and the activities you’ll engage in after the meal (physical or mental).

There’s also the issue of how you administer insulin.

In Italy, up until 3-5 years ago, most of us were using the “multiple daily injections” method, which involved taking a dose of “long-acting” insulin (lasting 24 hours) as a “base” and using “rapid or ultra-rapid” insulin at meals. Clearly, this approach provides limited control and requires a VERY habitual lifestyle (you can’t skip a meal; the long-acting insulin keeps working regardless).

Now (at least here in Italy), we are all transitioning to or already using CGM systems, which are more or less intelligent systems that continuously administer insulin at a “medium” rate. Based on input from the patient regarding the predicted amount of carbohydrates (and fats) they will consume, the system calculates the best strategy for what is called the “meal bolus” (using strategies like multi-phase, direct, etc.) and at the same time, it maintains a continuous but adaptable level of injection to achieve a target blood sugar level (day and NIGHT!!)

In essence, it’s a very nerdy way of dying slowly (hopefully as slowly as possible).

È un mondo difficile E vita intensa Felicità a momenti E futuro incerto