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Re: [IP] Basal:Bolus Ratio

>Questions from Newbie Mom!
>I've heard the "norm" is roughly a 50:50 (or 40:60) ratio between the
>total daily amounts of basal and bolus insulin.  Brian is more like
>20:80 - about 5 units basal to 20 units bolus - has anyone else
>experienced this?  Also- he seems to require about the same amount (or
>some days even more) that he used on MDI.  It seems most people have
>been able to cut their insulin requirements substantially.  Am I
>concerned unduly?  One last thing (for now :)  ) after 6 weeks of
>pumping - Brian's numbers were pretty good until we went on vacation.
>He had his worst numbers EVER on the trip (I know, this could be due to
>a lot of factors-but we couldn't make sense out of the 27's and 600's we
>were getting all over the place - and we've been on this diabetes train
>for a while) Now that we have returned, it's like starting all over
>again, his numbers are still out of whack, and we are adjusting basal
>rates like crazy!
>Thanks, Laurie, mom to Brian, age 4, dxd 12-98, pumping since 4/00 and
>Keith, age 7
Dear Laurie,

It isn't unusual for a teen (and probably a younger child) to have a 
ratio requiring a higher percentage of boluses.  Kids tend to eat 
higher quantities of food, especially carbs, and have growth 
hormones, etc. factoring into the equation.  My 13 y.o. son, Noah, 
requires more for boluses than for basals.  However, you might want 
to be sure Brian's basals are set correctly.  I found through time 
and experience that Noah's needed to be raised.  He would go high 
several hours after eating and require a bolus which would then make 
him crash.  Just a thought.  Everyone's systems are so uniquely 
different - it takes time.  Noah's been a pumper ten months and we 
are still fine tuning basals.  I think it is so exact that the 
slightest error can make a huge difference.  Frustrating to trouble 
shoot - but certainly worth it to achieve smooth, consistent control 
of blood sugars.  You might want to get the book, Pumping Insulin, to 
use as a reference.  It discusses the possible need for children to 
have a higher bolus/basal ratio.  Good luck and hang in there!


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