Hi Nancie, since you mentioned being at 41 kg (90lbs) of body weight, it sounds like you are taking a lot of bolus vs. basal insulin for your weight. You said you’re taking a 2/3 (66%) split of bolus to basal (i.e., 20 units bolus, 10 units basal, 30 total). That’s a strong tilt toward bolus insulin, and it sounds like you’re covering a lot of carbohydrates per day as well.
Gary Sheiner, CDE, from “Think Like a Pancreas” suggests in his book that a good ratio of bolus to basal should be about 50% bolus and 50% basal as a starting point, and that your total daily insulin needs should be .5 unit to 1 unit per KG of body weight, if you are moderately active, and a bit more if you are not. So that would mean a total daily dose of 20 units to 40 units for 40 KG body weight, with half of those units going to basal and half to bolus on average.
If most of the 20 units of bolus you are taking is to cover carbs you’re eating…and you take 1 unit to 15 grams of carbs…that would translate to eating about 300 grams of carbs per day. That’s a lot of carbs! While that may be a standard diet for most people, it’s also very hard to control your blood sugars on 300 grams of carbs, or even 250 grams for that matter. Dr. Bernstein would recommend a much lower amount of carbs, balanced with more protein, vegetables and healthy fat. I find that 30-50 carb grams a day give me much lower and smoother blood sugars. Others may do well with 100 grams a day, if they have less insulin resistance. But 200 to 300grams of carb is pretty rough on your system and makes blood sugars hard to manage.
You didn’t mention your A1C or average blood sugars, but if you’re running high blood sugars a lot of the time, that may be one reason you’re not gaining any weight. But there could also be other issues, like hyperthyroidism (too much thyroid hormone) or something else. So it’s critical for you to see a doctor who can help you figure this out.
Also, I would highly recommend reading “Think like a Pancreas” from Gary Sheiner, to get tips on insulin and carbs, as well as Dr. Bernstein’s “Diabetes Solution”.
Good luck and Best wishes!