number and more numbers

Sopies Grandma
By Sopies Grandma Latest Reply 2015-02-26 14:04:18 -0600
Started 2015-02-24 15:50:52 -0600

I ask my doctor what my ICR and ISF numbers are and she told me I didn't need to worry about it, but I really want to know, does anyone know how to calculate those numbers?

17 replies

RebDee 2015-02-25 13:36:37 -0600 Report

Before I can calculate, I need to know what ICR and ISF stands for. That is one of my pet peeves about Diabetic Connect, there are always initials for things that I have not learned about yet.
Could we all try to write the initials and then in parenthesis write what the initials stand for so that we are all on the same page? Thanks my friends.

Type1Lou 2015-02-26 08:36:12 -0600 Report

She clarified for me in my earlier comment below: ICR = Insulin to Carb Ratio and ISF means Insulin Sensitivity Factor. Both are essential settings in an insulin pump, so now, I understand. I agree with clarifying our acronyms…not everyone is familiar with them, even some of us old-timers. These are not settings that should be calculated by an novice pumper. I don't understand why her doctor/medical/pump team isn't involved with this…it seems criminally negligent for them to leave her on her own (unless there's something I'm not understanding?)

RebDee 2015-02-26 10:12:42 -0600 Report

Thanks Lou for the information. I am not sure what they will do me. I was on the Medtronics MiniMed Insulin Pump for more than 7 years and never heard those terms. What am I missing? Why did I need to know?
Of course since bariatric surgery I am no longer on pump or pills.

Type1Lou 2015-02-26 14:04:18 -0600 Report

These are both settings that are programmed into insulin pumps (I'd never heard them referred to by their acronyms but they are both familiar concepts to me.) The ICR is programmed for your metabolism and may vary by time of day. (I have 3 separate ratios programmed into my pump) It helps determine how much insulin you need when you input the carbs for your bolus. The ISF takes into account what your BG is whenever you bolus and calculates any correction that may be needed to get you back on target (your BG target range is also programmed into your pump). So, when you were pumping, you were using these. By knowing what they are and how they work, I've become comfortable "tweaking" my pump programming and my endo is on board with me. Knowledge, in this case, is power!

Jibber Jabber
Jibber Jabber 2015-02-24 17:53:19 -0600 Report

I love it when doctors tell you don't have to worry about numbers…ummm if they are something I don't have to worry about..then why are you freaking testing me to find out my numbers…I mean they don't magically appear on our blood work…so the doctor must of ordered them checked… Another incident of Doctors with God Complexes..not wanting to confuse us poor little dumbies with information…

Sopies Grandma
Sopies Grandma 2015-02-24 19:11:05 -0600 Report

I need these numbers to put into my insulin pump. My doctor told me she would program my pump, but I need to be able to do this myself, unless she wants to come live with me.

GabbyPA 2015-02-24 19:20:36 -0600 Report

LOL, maybe you need to ask her if she wants to pay rent? Then she can pay you to be your doctor. That sounds good to me.

Seriously though, if it's part of working your pump, I don't understand why she would say something like that. They always complain that we are non compliant, but when we ask for help or more information to become more compliant they keep their secrets. Kind of stupid if you ask me.

Type1Lou 2015-02-24 17:46:12 -0600 Report

Ditto Gabby! I'm not familiar with either of those terms and when I google it, I get a pageful of acronyms that don't appear to be health or diabetes-related.
Sopies,,,please explain what ICR and ISF represent.

Sopies Grandma
Sopies Grandma 2015-02-24 19:14:28 -0600 Report

ICR means insulin to carb ratio.. ISF means, Insulin sensitivity factor. These numbers are important if you wear an insulin pump.

Type1Lou 2015-02-25 09:26:01 -0600 Report

OK…now I know what you were referring to. Doctors calculate ISF based on the total number of insulin units you use per day. Gary Scheiner, in his book "Think Like a Pancreas" has a chart both in mg/dl and in mmol listing the sensitivity factor ranges for different total daily insulin usage. For example, when I first began pumping, I was using 16 units per day so my insulin sensitivity factor was programmed at 120. I am now averaging closer to 18 units per day, so my insulin sensitivity factor has been changed to 100. The "sensitivity factor" is defined as how much 1 unit of insulin will lower blood sugar. A factor of 100 means that when I take 1 unit of insulin, I can expect it to lower my BG by 100 mg/dl. Scheiner also has a very good discussion of ICR. There is more than one way to calculate that: the 500 Rule or the weight method. Either needs to be fine-tuned to accommodate individual metabolism, diet and activity. I've found Scheiner's book to be my go-to manual when I have had questions about diabetes. I purchased it on-line and at the time, it cost me $15.95…well worth it IMO.

Sopies Grandma
Sopies Grandma 2015-02-25 16:01:44 -0600 Report

Thank you for the info, do you know how to calculate the numbers, What I'm told is that my insulin pump has to be programed for every hour, and each hour is different. I feel terribly lost in this. Until I figure this out I can't wear my pump. My doctor just won't tell me. It almost seemed to bother her that I ask. I found the website on this subject but they dont' tell you have to do the math, what sure what the next step is here, I called the customer service department of the pump and they said I need to take some kind of class …GEEEEEZZZZZ ( that was me screaming) I can't be the only person with this issue. Thank you all for your help. :)

Type1Lou 2015-02-25 17:39:14 -0600 Report

This should not be left up to you as programming incorrectly could cause severe consequences. What kind of doctor do you have? My endo did all of the initial programming for my pump as back then, I hadn't a clue. I'm leaving the house in 5 minutes but didn't want to wait until tomorrow morning to get back to you…feel free to private message me to discuss this further. Hugs,

Jibber Jabber
Jibber Jabber 2015-02-24 20:01:25 -0600 Report

oh well God forbid a doctor take 5 minutes out of their day to explain THAT to a patient…someone that is actually paying for his time…and no I don't dislike ALL doctors…just most of them..