# Subject: [IP] couple questions--TEACH ME!!!

```#1  What is YMMV?
Your Mileage May Vary, as in everyone is a little different

#2 Ratio will be what amount of insulin it takes to accomodate so many
carbs, correct?

Exactly

#3 Basal rate is going to be the amount of insulin you get
"continuously" all day...Is this something
you can begin to figure out before the pump?

Can't really figure it out ahead of time.  When starting the pump, the basal
rates are "guestimated" by the endo or pump trainer, then you start
"customizing" them from there according to whether sugars are running high
or low without eating.  If you did only Ultralente, with Humalog to cover
all meals, the amount of Ultralente might give you a close estimate of what
basal insulin you needed.  But it's okay to not know this ahead of time.

#4  How difficult was it to figure out what foods effect you...

Start keeping a great food diary - foods eaten (and their quantity - a good
kitchen scale to be sure of amounts is very helpful).  Check sugars not only
before meals, but 2 hours or so afterward - and watch for patterns to
develop.  For Jenna, steak will raise her sugar consistently - as well the
usual culprits, pizza, Mexican.  Not too bad with pasta unless she has a
cream sauce on it (loves fettucini alfredo - too much fat!)  Candy requires
more insulin than we'd predict based on the number of carbs.

The 1500 rule helps to figure out a sliding scale for high sugars (1500
divided by total units of insulin used per day = the amount that 1 unit of
insulin will drop the sugar), but it's just an estimate - and has to be
individualized.  For my daughter, that number comes out 49, but 1 unit
really drops her about 100 points, usually.  To test this, next time his
sugar is above 200, give him an amount of Humalog that you think is
appropriate - then, recheck his sugar 2.5 hours later.  Figure out how much
his sugar dropped (First reading - second reading), then divide by the
amount of insulin given.  The result is the amount of drop per unit of
insulin.  This is complicated by long acting insulins starting to peak,
activity, and several other factors, but if you do this a number of times,
it should help you figure out how much 1 unit of insulin lowers his sugar.

#5 Would anyone be willing to tell me their basic diet for a six yr old boy?

Carb counting was designed to get away from the bad food/ good food way of
thinking.  It's just food, and the thing that matters most to bloos sugar
control is how many carbs are eaten.  Obviously, there are foods that are
more healthy for all of us than others - fruit and veggies, better than
Chips and Coke, for example.  We try really hard to get in the recommended
4-6 servings of fruit and veggies, but there are unfortunately a lot of days
that this isn't reality.  I try to be sure to get in at least 1 yellow or
orange fruit or veggie each day, because the antioxidants are so good for
all of us.  But the beauty of the pump is that he can eat just what every
other 6 year old boy should eat.

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