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[IP] Re: Different carb ratios/bolusing after meals

One of the major reasons we pushed for a pump for Paul was that he would go 
sky high every morning between breakfast and lunch. No matter what we did or 
how many tests we did through the night to see if he was going low and then 
rebounding, we could night find the cause or the solution. Jacking up 
breakfast insulin would bring the mid-morning numbers down but would make him 
go low at lunchtime.

Now, on the pump, we use a different carb ratio for breakfast and it works 
MUCH better. For Paul, his breakfast carb ratio is 17:1 and all others are 

As far as bolusing after meals, we always bolus BEFORE meals. I found Paul 
seems  to go high if we wait until after eating. We are also lucky that, in 
over five years with diabetes, he has never been a picky eater. As far as his 
appetite being affected by sickness, I can count on one hand the amount of 
times this has happened to us. But is sure wasn't fun so I can sympathize.

And now I have to do a little bragging about my very responsible son.

We always send Paul's lunch to school with a paper inside indicating the 
contents, carb count on each item and total bolus. He goes to the nurse, gets 
his test and then boluses. This has worked great for us. Last week, I packed 
some fresh pineapple in his lunch. He said he took one bite and realized it 
tasted so bad that he couldn't eat it. So, he went back to the nurse's office 
and told her. She checked the carb count (still taped to the lunch box) and 
gave him food from his supply kit to cover the missed carbs!!!

Also, this week Paul went to the nurse after gym with a BS of 80. He told her 
that he would definitely need glucose tabs or something else from his box. 
But, based on the sliding scale we use, she sent him back to class, with him 
telling her, "I"ll definitely be back!" Within a half hour he had returned 
with a BS of 62!

I am so proud that such a young boy is so responsible.

Janice, proud mom of Paul, DX 20 months, now 7 and pumping since July 12
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